Croydon Health Services NHS Trust

3. Mrs J complains about the discharge plan her sister-in-law, Mrs H, received from the Trust, following her A&E attendance in January 2024 after she fell and broke her arm. Specifically, she says the Trust:

• discharged Mrs H without a package of care in place to support her with managing her stoma bag, despite the family raising concerns that she lived alone

• failed to involve relatives in Mrs H’s discharge planning and confirm that she had a relative to stay with

• failed to address her request for reimbursement for the private care in a timely manner when she raised this complaint following Mrs H’s discharge.

4. Mrs J says because the Trust did not provide a care package, Mrs H had to pay for a private care package. This consisted in carers attending twice a day for three months. She says this caused Mrs H to exhaust her savings putting her in a difficult position financially to meet this unexpected expense. The financial impact to Mrs H for the care package was £500 a fortnight, totalling £3,000.

5. Mrs J says Mrs H required 24-hour care due to being extremely incapacitated from her broken arm. She explained Mrs H’s additional care needs put significant strain on the family and became increasingly difficult to impossible to manage long term.

6. Mrs J says she has been frustrated by the Trust’s delay in responding and resolving the complaint.

7. Mrs J seeks financial remedy for Mrs H for the cost of the private care.

8. On 15 January 2024 Mrs H attended A&E with arm and facial injuries following a fall at home. Whilst in the emergency department (ED), the Trust conducted X-ray scans on Mrs H which showed a fracture in her upper arm.

9. Three orthopaedic consultants decided Mrs H should not undergo surgery to repair her arm. Instead, they gave her a humeral brace (a device which is used to restrict movement and stabilise the arm) with a cuff and collar support. The plan was to review her at the fracture clinic after one week.

10. Mrs H’s children expressed concerns to the ED staff about discharging her, as she lives alone. Specifically, they were worried about her ability to manage her stoma bag and cope with her frailty while recovering from a broken arm. The family asked the Trust to arrange a care package, but staff informed them that they could not provide this.

11. A doctor spoke to Mrs H about her children’s concerns when she was alone. A doctor advised Mrs H she could either be admitted as an in-patient or stay with someone until her follow up appointment. The doctor considered Mrs H to have the capacity to make this decision. Mrs H said she would stay with her sister. The Trust discharged Mrs H following satisfactory X-rays.

12. Mrs J says Trust staff failed to complete a comprehensive discharge assessment for Mrs H. As a result, the Trust discharged her from hospital without an appropriate package of care, to help her recover in the community. Mrs J explains Mrs H needed nursing care at home. She lived alone, was frail, had a stoma bag and a broken arm and was unable to care for herself. She feels overall, her discharge was not safe.

13. Mrs J explains Mrs H had to pay for private carers to assist her at home for three months. This led to a financial loss of £3000. She feels Mrs H was entitled to funded NHS care at home. She feels Mrs H would have had access to this care, had the Trust safely discharged her and considered her personal circumstances correctly.

14. On 17 January 2024 Mrs J complained to the Trust about Mrs H’s discharge plan. The Trust provided a final response to her complaint in February 2025.

15. Mrs J brought her complaint to our office in March 2025.

Poor discharge assessment

18. The law says we cannot investigate a complaint where a person has (or had) the option to take legal action, unless we consider this is (or was) unreasonable in the circumstances. We have discussed this with Mrs J to understand Mrs H’s circumstances and the outcomes she wants. We do not consider whether legal action would succeed but whether it would be a reasonable option to look in to.

19. Our first step was to determine whether Mrs H could potentially pursue her complaint, with Mrs J’s support, via a legal process.

20. Under the Care Act 2014, NHS hospitals must carry out a discharge assessment, to determine what support a patient will need at home, particularly if they have complex needs (like Mrs H’s stoma bag). Failure to do so properly, can potentially amount to clinical negligence.

21. The NHS guidelines on 'care after illness or hospital discharge (reablement)' (2022) explains NHS funded intermediate care (short -term nursing care to help patients recover at home) can be free up to six weeks. The guidelines explain it is the responsibility of the discharge coordinator at the hospital, to help the patient and assess what package of care they are entitled to.

22. Finally, the NHS guidelines on ‘social care and support continuing healthcare’ (2023) explains some NHS patients are entitled to funded NHS care ‘in a variety of settings outside hospital, such as in your own home or in a care home’. A patient may be entitled to a package of care ‘if they have needs arising from disability, accident or illness that cannot be met by existing universal or specialist services alone’.

23. Mrs J claims Trust staff did not complete Mrs H’s discharge assessment to an appropriate standard and her discharge was not safe. She claims this left Mrs H having to pay for privately funded care. It is possible to say Mrs H may have incorrectly paid privately for care, due to potential failings in her NHS discharge assessment. She could potentially recover this cost via a clinical negligence claim.

24. Additionally, Mrs H could potentially pursue a legal claim on the grounds of ‘negligence misstatement’. This is when an organisation gives ‘false, incorrect or misleading information’ in a ‘careless’ way, which leads to financial loss for the complainant.

25. In this case, Mrs J is claiming Trust staff incorrectly told Mrs H and her family, she was not entitled to any NHS funded care on leaving hospital. A legal claim may find this ‘incorrect’ or ‘misleading’ information caused her direct financial loss.

26. On this basis, we are satisfied Mrs H could potentially pursue her complaint via a legal process with support from her family.

27. We next considered if there are any barriers preventing Mrs H from exploring whether she can take legal action. During our telephone call with Mrs J on 23 July 2025, she did not disclose any barriers which would stop Mrs H, with the support of her family, from exploring a legal process. She did, however, explain Mrs H and the family would not be able to afford the expense involved in pursuing a legal claim.

28. We appreciate the costs involved in pursuing legal claims. We explained to Mrs J the option of no win no fee solicitors. She explained that she had already spoken with a relative, who is a solicitor, about her complaint. She says the relative told her she would not have legal case.

29. In this case, Mrs J confirmed her relative has not formally agreed to consider a legal claim for Mrs H. We know they have had a conversation about Mrs H’s care, but we have no evidence to show a solicitor has officially considered the details of her complaint. We currently consider this reason is not robust enough, to set aside our legal remedy test. We would need to see evidence Mrs H has formally explored the no win no fee route, with support of her family, and what the outcome was, before we can say a legal route has been exhausted.

30. Mrs J’s complaint is about the Trust’s discharge plan of her sister-in-law, Mrs H’s, care in January 2024. Therefore, it is within the three-year time limit for Mrs H to explore legal action, with the support of her family.

31. In our view, Mrs H appears to potentially have a cause of action to take this case to court and Mrs J has not identified any additional barriers to pursuing legal action. Therefore, we consider it reasonable and proportionate that she seeks legal advice, with the support of her family.

32. We understand Mrs J is also unhappy about the complaints process. She claims the Trust took too long to write to her, to address her complaint and decide not to refund the costs of Mrs H’s treatment. We have carefully thought about whether we need to consider this part of her complaint separately. We recognise this does not in itself have a legal cause of action as it is an administrative issue.

33. When we spoke to Mrs J, she told us the only reason she wants us to look at her complaint is to get the costs reimbursed for Mrs H’s private care. There does not appear to be any other outcomes she wants to put the complaint handling aspect of her complaint right.

34. As Mrs H can potentially achieve this outcome via a legal claim, it does not appear reasonable to consider this part of the complaint separately. There is no other achievable outcome Mrs J wants relating to complaint handling, so it is not appropriate to take this forward for investigation.

35. If Mrs H is unable to secure legal representation, with the support of her family, Mrs J can come back to us, and we can further consider her complaint. We will need to see evidence Mrs J has contacted two or more legal firms and what the outcome was.

36. We would ask Mrs J to come back to us promptly if she is unable to proceed with legal action or if there are outstanding outcomes. This is because we are unable to investigate complaints brought to us 12 months after someone has become aware of the problem. We can put this time limit to one side if we think there is a good reason to do so and would consider any legal advice or action sought.

37. We thank Mrs J for bringing her complaint to us. We were sorry to hear of Mrs H’s experience with the Trust and the impact that this has had on her and her family. We hope we have provided reassurance as to the next steps Mrs H should take with the support of her family. We wish her the very best for her future health and recovery.

1. We have carefully considered Mrs J’s complaint about Croydon Health Services NHS Trust (the Trust). We are very sorry to hear Mrs J is unhappy with the Trust’s decision to discharge her sister-in-law, Mrs H, without a home care plan in place after she broke her arm. She explained this meant Mrs H had to pay for private carers for several weeks at a considerable cost. We recognise this must have been a distressing and difficult time for Mrs H and her family.

2. We have decided not to take further action at this time. This is because we consider it is reasonable for Mrs J to help Mrs H explore taking legal action on the issues she brought to us. We explain the reasons for this below.