Findings – AJM Healthcare
A summary of our findings
22. There are four parts to Miss L’s complaint, spanning May 2019 to August 2020. She has complained about how long AJM took to deliver a wheelchair, this not meeting her needs and the length of time AJM took to collect it. Miss L has also complained about AJM’s communication. We have found failings in all aspects of her complaint.
23. We have also found significant failings in AJM’s record keeping, which is a fundamental part of providing a good service. This had a detrimental impact on the service AJM provided for Miss L.
24. This is a summary of what we found AJM got wrong on the basis of the evidence we have seen. We outline our findings in full afterwards.
25. The contract AJM holds with the ICB says it should have delivered a powered wheelchair which met Miss L’s holistic needs within six weeks of when it had her prescription. AJM had the prescription on 16 April 2019. It should have delivered her new powered wheelchair by 28 May 2019. It did not do this.
26. AJM did deliver a wheelchair to Miss L on 6 August 2019, ten weeks outside the recommended timeframe in its contract, and 12 weeks after it said it would. But this wheelchair was not suitable for Miss L because it was not in line with her prescription. It did not meet her holistic needs.
27. Miss L told AJM the wheelchair did not meet her needs on the day it delivered it. In line with the timescales recommended in the contract, it should have collected it within five working days. It did so on 24 March 2020, over seven and a half months later. AJM could not make any adaptations until it had the wheelchair back.
28. AJM said it was in a position to deliver a wheelchair in July 2020. There is no record of this. Miss L lost faith in its service and looked at alternative options in August 2020. This was almost one year and two months beyond the contracted timeframe.
29. Throughout this process, we have found AJM did not adequately communicate with Miss L and the ICB to keep her updated on its work. The evidence indicates some of its updates were inaccurate.
30. AJM’s record keeping was very limited. This has had a significant impact on our ability to understand what it was doing throughout. AJM’s contract with the ICB required it to keep clear and accurate records and it did not.
A detailed explanation of our findings
31. AJM took on responsibility for the NHS wheelchair service in Miss L’s local area on 1 April 2019. At this point, she was already in the process of getting a new powered wheelchair. The previous provider had already assessed Miss L’s needs and produced a prescription.
32. We can see AJM had some difficulties accessing Miss L’s assessment and prescription from the previous provider. Based on the information in the records, it is unclear when AJM did receive a copy of Miss L’s prescription, but we can see it had it by 16 April 2019 at the latest. We are not critical of AJM for the delay in having a completed prescription. We appreciate its contract with the ICB was in its infancy and AJM undoubtedly had a significant amount of work to do before it could start on its inherited and new referrals.
33. To help us understand what should have happened from 16 April 2019 onwards, we have looked at AJM’s contract with the ICB. This outlines what NHS funded services AJM should provide for the people living in the ICB’s jurisdiction. Importantly for this complaint, it outlines the timescales for AJM to provide these services. It sets out a complete service should be provided within 18 weeks. To meet this target, it recommends these timescales from the prescription being produced to delivery:
• locally held stock – within three weeks • orders from manufacturers – within six weeks • made to measure (bespoke seating) – six to 12 weeks.
34. We know AJM ordered Miss L’s wheelchair to be made by an external wheelchair manufacturer. We cannot see her chair needed any bespoke features, beyond what was available on the standard order form. The evidence shows her chair fell within ‘orders from manufacturers’, and AJM should have delivered it within six weeks of when it had the prescription, by 28 May 2019.
35. AJM did not deliver a wheelchair within this timeframe. The wheelchair it delivered on 6 August 2019 was five and a half weeks late, and it was not in line with the prescription. Miss L lost faith in AJM and explored the alternative options available to her in August 2020, over 15 months after it got a prescription. We have looked at the events during this substantial period of time to get a better understanding of how this happened.
36. Miss L has told us she contacted her local MP in April 2019 for support with her wheelchair provision, and the MP’s office contacted AJM on 15 April 2019. She was concerned as her understanding was the previous provider had completed the majority of the work needed to organise her new independent voucher, and this did not appear to continue when AJM took responsibility.
37. We understand AJM instructed a senior member of its management team to manage Miss L’s wheelchair provision and they contacted her on 14 May 2019 with a view to resolving the matter.
38. Miss L has given us some more information about this conversation with AJM. She expected AJM would be arranging another independent voucher for her. This is what she had always had, and it is clear from our telephone conversation it is a process she is very comfortable with and understands very well.
39. She has told us AJM persuaded her to change her funding option to a partnership voucher, and it would supply her powered wheelchair. We understand AJM explained this would be a better option for Miss L. She has told us it said she could have a higher specification product as AJM could negotiate a better price with its manufacturers. She would pay for wheelchair lights as an optional extra.
40. Miss L has told us the manager said AJM would supply an appropriate wheelchair within the next four weeks. There is no record of this agreement, or the discussion about the voucher options, in Miss L’s electronic patient record (EPR). AJM has told us it does not provide timescales for delivery, as they are difficult to estimate until an order has been placed. But Miss L has provided an email the manager sent her confirming the four-week timescale. The comments AJM have sent us say they discussed the partnership voucher in telephone calls.
41. AJM’s advice to Miss L to accept a partnership voucher is not in the scope of this investigation. But we know this was the outcome of their discussions about how she would get her new wheelchair, and that it would provide this within four weeks. Our Principles of Good Administration set out how public bodies, should act. AJM was commissioned by a public body – the ICB – to provide a service on its behalf. Part 2 says:
‘Public bodies should do what they say they are going to do. If they make a commitment to do something, they should keep to it, or explain why they cannot.’
42. We have found AJM did not act in line with our Principles when it did not provide a wheelchair within four weeks, as it had promised when it persuaded her to change her funding option.
43. There is a significant gap in the EPR at this point. It confirmed AJM held the prescription on 16 April 2019. The next entry is a retrospective note added on 6 November 2019, almost seven months later. We have used a combination of different sources to determine what happened and what should have happened.
44. Part 3 of our Principles outlines how to be open and accountable. It says:
‘Public bodies should create and maintain reliable and usable records as evidence of their activities. They should manage records in line with recognised standards to ensure that they can be retrieved and that they are kept for as long as there is a statutory duty or business need.’
45. We have also looked to AJM’s contract with the ICB here. It states ‘the provider must maintain accurate and up to date records on assessment, provision, re-assessment, discharges, repairs and maintenance, collection and decontamination and decommissioned wheelchairs’.
46. AJM did not act in line with our Principles or with its contract here. Its telephone call with Miss L on 14 May 2019 was significant. It outlined what service it could provide, had a very important discussion about her funding options, and confirmed when she could expect to get her wheelchair. AJM should have recorded this, along with the relevant follow up work.
47. There is nothing in the EPR to show us what happened here. We requested further information from the ICB, which included a timeline of events that AJM created. We are aware this timeline was created retrospectively. The source of the details in the timeline is unclear. We asked AJM if it could provide any further records. It has not been able to share anything with us that we do not already have. In the absence of any records made at the time, we are using the timeline to inform our thinking.
48. The timeline says AJM was delayed in ordering the wheelchair agreed on 14 May 2019 due to discussions with Motability. Motability is an independent organisation responsible for the finance, administration and maintenance of vehicles leased using the mobility element of certain benefits. The timeline says AJM did not order the wheelchair until 4 July 2019. It is unclear why it would have had to discuss this with Motability and why these discussions would have resulted in this delay. The timeline says AJM’s manager had discussions over a period of five weeks, focusing on Miss L’s Motability scheme renewal, the weight of the wheelchair and whether it was compatible with a new vehicle.
49. AJM has not provided any further information about its discussions with Motability. They are not recorded in Miss L’s EPR. Miss L was concerned Motability had released personal information to AJM unnecessarily and without her permission. Motability investigated this for Miss L and she has shared its response with us. The response is clear it had no record of any discussions with AJM in relation to Miss L’s wheelchair provision or Motability scheme renewal.
50. We are not taking a view on whether or not AJM’s manager did have this discussion with Motability. The key point here, from the evidence we have seen so far, is AJM’s lack of communication with Miss L and the lack of accurate, timely record keeping. It is a core principle of AJM’s contract with the ICB that it should deliver ‘a person centred service that works in partnership with service users and their carers and makes the service user/carer voice central to any design, innovation and service change.'
51. AJM did not act in line with this part of its contract of the guidance on record keeping we set out earlier. Regardless of the reasons for the delay, it should have put Miss L at the centre of the process by keeping her updated. It should have also kept a detailed record of any reasons for the delay. It did not.
52. We acknowledge circumstances can change that can result in justifiable delays. But AJM did not have its discussion with Miss L and confirm what it could provide until 14 May 2019, two weeks before it should have delivered a powered wheelchair in line with the terms of its contract. There were then further, unclear delays which resulted in it not ordering the wheelchair until 4 July 2019.
53. Part 1 of our Principles are about getting things right. It says:
‘In some cases a novel approach will bring a better result or service, and public bodies should be alert to this possibility. When they decide to depart from their own guidance, recognised quality standards or established good practice, they should record why.’
54. AJM was clearly departing from recognised standards and the terms of its contract. In line with our Principles we would have expected it to document a clear, detailed rationale in the EPR explaining the reasons for the delay and an open and transparent line of communication with Miss L. It did not do this.
55. AJM delivered a wheelchair to Miss L on 6 August 2019, ten weeks longer than the timeframe set out in its NHS contract and 12 weeks after it said it would provide the chair. She immediately made it aware the wheelchair did not meet her holistic needs. It was not in line with her prescription. It had the wrong backrest, footplate, arm rests, neck support, wheels and joystick. We do not know why the specifications were wrong because AJM did not document anything in the EPR. It has been unable to confirm the specifications of the delivered wheelchair during our discussions. We do not know if it placed the order incorrectly, or if its supplier sent something different from what it had ordered. Either way, AJM was responsible for supplying a wheelchair in line with Miss L’s prescription. It should have checked what its supplier had provided was right before sending it to her and it did not do this.
56. Miss L’s concerns were recorded on the delivery note. AJM only documented the delivery in Miss L’s EPR retrospectively on 6 November 2019, along with confirmation some parts of the wheelchair were not correct. Miss L has told us she had discussions with AJM between 6 August and 6 November 2019 via her advocate.
57. AJM’s retrospective timeline contains a final entry which states ‘September – parts and prices sorted for items needed and request for rectification’. It details the work required to make the wheelchair appropriate for Miss L’s needs, as set out in her prescription. The retrospective timeline ends at this point.
58. Miss L raised a complaint about AJM with the ICB in October 2019. This prompted the ICB to contact AJM to gather further information about what it was doing to resolve this issue for her. The ICB’s correspondence has provided a key piece of evidence for us in establishing what happened from October onwards, in the absence of records from AJM. We have used this correspondence to inform our findings from this point onwards.
59. AJM’s retrospective timeline is clear it identified all the necessary parts in September. It was aware of the urgency of this case, and how long Miss L had been waiting for a piece of NHS funded equipment she was entirely reliant on. At this point, we would expect to have seen AJM acting in line with its contract with the ICB by putting Miss L at the centre of its service. We think it should have done this by ordering the required parts promptly in September. We cannot see it did this.
60. It is unclear when AJM did order the parts based on the information in its emails to the ICB. It has not sent us any evidence of when it placed any orders. We can see in an email AJM sent to Miss L on 30 December 2019 it asked: ‘How are things with the chair?’ It is unclear why it would ask this when it knew her chair was not fit for purpose and she had been waiting for almost five months at this point for adaptations. AJM offered no update on when it would make these.
61. We can appreciate how frustrating it was for Miss L to receive this email. In response to this, the ICB asked AJM not to contact her directly, and to send further communication via the ICB.
62. The ICB discussed this case with AJM on 2 January 2020. AJM said the various parts were due for delivery between 8 and 23 January. On 28 January, AJM told the ICB it expected to have all the necessary parts in stock by 10 February.
63. On 11 February, the ICB asked AJM for an update. It received no response, so chased AJM again on 13 February. AJM responded on the same day. It could not confirm it had received the parts.
64. AJM emailed the ICB on 24 February. It said it had an update on the parts for Miss L’s wheelchair and it would send a more detailed update by the end of the day. It did not do so, and the ICB chased AJM again on 27 February. AJM sent the promised update on 28 February. It confirmed it had yet to receive all the parts.
65. We can see that on the 13 March, AJM again told the ICB it had yet to receive the necessary parts.
66. On 24 March, AJM collected the wheelchair it had delivered to Miss L seven months and 18 days earlier. In line with its contract, it should have collected this within five working days of when she told AJM it was wrong, which was the day it delivered it, 6 August 2019. AJM has explained it could not collect the wheelchair sooner than it did as Miss L needed an advocate with her during the visit. We cannot see any evidence that AJM tried to arrange a suitable time when this would be possible, and that there were problems with this that might justify such a significant delay. There is nothing recorded in the EPR.
67. None of AJM’s actions show us it put Miss L at the centre of its service throughout the process of ordering the parts. There is a significant failing in the quality of AJM’s record keeping. It did not follow our Principles or its obligations under its contract with the ICB.
68. There is no clear record of when it ordered the parts, when it expected to have them, or what action it took to mitigate any delays. The evidence we have seen so far indicates they were due on 23 January 2020 at the latest. There was a significant delay in AJM receiving the parts. There is no reliable record of when it ordered or received them, only that it fitted them at some point between 13 and 31 March 2020. There is not a single entry in Miss L’s EPR about provision of the equipment until 31 March when it states ‘Single folks (sic) ordered, and panels are in for re-spray. All other parts fitted.’ AJM has told us it wanted to confirm with a representative of the supplier that they were ordering the right parts, but that person was on leave. AJM has not explained which period this relates to, and we cannot see it explains a delay of months.
69. We have considered if the updates AJM was providing to Miss L or via the ICB were accurate. The evidence we have seen leads us to question what it claimed it was doing. Across the multiple emails described above, AJM confirmed it had ordered parts and gave estimated delivery dates. But other evidence indicates it may not have ordered them when it said it had. We have set out our findings on this next.
70. On 30 December 2019, AJM emailed Miss L to ask how things were with her wheelchair. This does not demonstrate that it was doing anything about the adaptations at this stage. AJM sent an email to Miss L’s advocate on 7 July 2020 giving specific information about the outstanding adaptations. It states AJM had ordered the required joystick and agreed to make adaptations to the footplate. But there is an indication all the parts were ordered following the telephone call with the ICB in January 2020, and the EPR records ‘all (parts) on order’ in March 2020.
71. There are no further entries in the EPR about AJM receiving and fitting parts. We have found AJM’s communication was not person-centred as it should have been. At least some of it was inaccurate.
72. The ICB recorded in its complaint response it met virtually with AJM on 24 July 2020 and recorded all the required adaptations to the wheelchair had been completed. But Miss L was not well that day. She tells us she had seen photographs of the wheelchair and knew it was too wide for her home. Due to the length of time she had waited, Miss L felt she had no choice other than to stop engaging with AJM and explore alternative wheelchair provision options. She had lost faith in AJM. Without any clear records from AJM, and given the conflicting evidence on this it is impossible for us to know when Miss L’s powered wheelchair was ready for her, if at all.
73. We acknowledge that from March 2020, many NHS services were severely impacted by the COVID-19 pandemic. AJM has not told us Miss L’s wheelchair provision was affected by any restrictions the Government put in place. In fact, it was from March 2020 when AJM appear to have made the most progress.
74. We have found significant failing sin how AJM managed Miss L’s powered wheelchair provision. There was a delay of at least ten weeks in it providing any wheelchair. That initial wheelchair was not right. It took far too long to collect the wheelchair and made adaptations to it. It did not have an adapted wheelchair ready for almost 16 months after it had her prescription and over 14 months after it should have supplied an appropriate wheelchair. it documented very little information about what was happening at any point. Its communication with Miss L and the ICB about what it was doing was inadequate and, at least in part, inaccurate. We next look at the impact of what we have found AJM got wrong.
The impact of AJM’s failings
75. We think AJM’s failings have had a significant impact on Miss L.
Miss L’s account of the impact on her
76. She has kindly provided us with some of her own words, explaining how her experience with AJM has impacted her:
‘To be treated so badly by a large organisation was truly an awful experience and this resulted in unfairly and unnecessarily in the sustained de-railing of all aspects of my already challenging life causing a magnitude of consequences for me.
I feel truly worn down by the conduct of AJM and the ongoing residual consequences that I must now life with. This situation has truly changed the trajectory of my life in the worst possible way and at the worst time in my life.
I no longer have the resilience that I did previously, and the momentum I had built up to maintain and manage my health and disabilities, over 40 years, was brutally halted when AJM left me with without a powered wheelchair, a momentum I just can’t find again.’
77. Miss L has told us not having an appropriate, reliable wheelchair also had a detrimental impact on her physical health. It meant she did not have a safe way to attend some health appointments, which meant she was left in pain at times that she could have avoided. She has also told us about the financial impact as she had to source a wheelchair through the Motability scheme. She also had to sacrifice the wheelchair accessible car,adapted to her needs, which she had through that scheme.
Our view on the impact
78. Miss L tells us she has many health conditions (autonomic, cardiovascular, dermatological, endocrinal, gastroenterological, gynaecological, hepato-biliary, maxillo-facial, musculo-skeletal, neurodevelopmental, neurological, psychological, respiratory and sensory). Each of her conditions presents Miss L with challenges and they combine to create complex needs. Her wheelchair, alongside other NHS provisions and community services, is key to managing her needs.
79. We know Miss L was eligible for an NHS funded, powered wheelchair. We can see from her assessment completed by the previous provider in February 2019 that her mobility was limited by pain and fatigue. Her ability to move around inside her home depended on her pain and fatigue each day. It is clear she was entirely reliant on using a powered wheelchair.
80. While she was waiting for AJM to provide a wheelchair, Miss L did have access to her previous powered wheelchair. There is no record of the condition of this wheelchair in the EPR so we asked Miss L for some more information about it. She had been using it for five years at the point AJM got her prescription. She told us the manufacturer considered it as beyond economical repair and said it would be best broken down for its usable parts.
81. In terms of its day-to-day use, Miss L has told us its batteries were severely degraded and ran out very quickly, its motor was failing and caused the wheelchair to pull to one side. The seat had become very loose and had worn out of shape. It is clear the wheelchair was no longer suitable for Miss L’s needs.
82. We have found AJM’s failings meant Miss L did not have a reliable wheelchair which met her holistic needs from 28 May 2019 until August 2020. This is the point from when it should have provided a powered wheelchair to the point Miss L entirely lost faith and decided to access a wheelchair via a different route. It is a period of one year and two months.
83. We can see AJM’s failings had a significant, wide-ranging impact on Miss L. As we set out above, she found the experience extremely difficult. She faces many challenges in her life and her experience at the hands of AJM has made things even harder for her.
84. We appreciate why Miss L feels like this. She is entirely reliant on her wheelchair to be able to maintain her mobility and lead an independent lifestyle. AJM is the wheelchair provider in her area, and she depends on it to be able to provide this key service. It did not provide the service reliably and Miss L was forced into a long process of over one year and two months without any reassurance she would receive the equipment she needed.
85. Miss L had told us she felt frustrated and distressed throughout this process. Her referral was transferred to AJM with the understanding she would be getting another independent voucher. She knew what chair she wanted to order, her view was AJM only needed to approve the cash value of the voucher. AJM did not do this. It recommended the partnership voucher route, telling her she would get better equipment. We understand why Miss L took this recommendation. She had no reason not to have faith in what AJM was telling her. But AJM got things wrong in so many ways, making multiple failings throughout the process without a suitable remedy. Miss L was left with the frustration of knowing she would very likely have had a wheelchair appropriate for her needs had she just continued down the independent voucher route she was so familiar with.
86. Miss L had a car which was funded by the mobility element of her benefits, through the Motability scheme. AJM’s actions meant she had to make a very difficult decision here. Miss L knew she could get a powered wheelchair leased through Motability, but she could not have a wheelchair and a car at the same time. She felt her only option was to end her Motability car lease, and lease a new powered wheelchair.
87. We acknowledge this was Miss L’s own choice. We understand why she made this decision, it was a direct result of AJM’s failings. AJM had let her down so badly that she had entirely lost faith in its ability to provide her with the service which was so integral to her maintaining her quality of life. She had the continued frustration of knowing things could have been different had she not agreed to the partnership voucher. There has been a lasting impact here too. Miss L’s agreement with Motability expired in December 2025. She has renewed it for at least another year because she was not confident in AJM’s ability to provide her with a wheelchair that fully meets her needs. We can see why Miss L made this decision. She has had no further reassurance about AJM’s service.
88. We have found we cannot link everything Miss L has told us entirely to what AJM got wrong. We acknowledge her old wheelchair was at the end of its lifespan and needed replacing.
89. Miss L has told us this meant she had to miss some of her health appointments. We have thought about whether we can say this is because of what AJM got wrong. We do not think we can. Miss L has not suggested to us she was entirely housebound. She did have use of her old powered wheelchair. It was uncomfortable and unreliable, but useable. We know she was able to attend some of her health appointments using it, with her Motability car providing for the majority of the distance to her local hospital.
90. This is an example of how AJM’s poor service made Miss L’s life far more difficult than it needed to be. What we have found to have gone wrong had a significant impact on Miss L’s day-to-day life generally, including her ability to attend important health appointments. She should have had a reliable wheelchair which she could confidently use to attend the appointments she needed to maintain her independence and quality of life. We have found AJM’s failure to provide the wheelchair when it should have impacted this and so many other similar aspects of her life.
91. We have looked at Miss L’s claim she has been financially disadvantaged as she had to fund her wheelchair through the Motability scheme, rather than it being NHS funded. We cannot say she has been financially disadvantaged. If Miss L had persevered with AJM and received an NHS funded wheelchair, the mobility element of her benefits would have continued to contribute to the car she had through the Motability scheme.
92. We do acknowledge Miss L would have preferred for this part of her benefit to have been used for a car, and not a wheelchair, and we do not want to understate this. If Miss L had not felt she needed to decide to use the mobility element of her benefit for a wheelchair instead of a car, we think she would have continued to have the use of a car, with the added independence that brought, for longer. Had she decided not to continue with Motability, she would at least have had the benefit of the mobility payments to help maintain her independence.
93. Miss L has told us she is unlikely to have been driving now because of the length of time since she last had a car, and because she does not feel she is now well enough. We cannot know how long Miss L’s health would have allowed her to continue driving if she had been able to retain her Motability car. But she was still driving at the time she decided to access her wheelchair via Motability. So it is more likely than not she could have continued at that time and for a portion of the next five years. This is another way in which AJM’s mistakes mean she lost the ability to maintain her independence as fully as she had been able to.
94. In summary, we have found there has been very clear and significant impact on Miss L here, across all aspects of her life. AJM left her without a reliable powered wheelchair for an extended period of time, having to rely on an old wheelchair which was unreliable. This substantially changed how Miss L manages her complex needs and maintains her independence. Had this not happened, it is unlikely she would have felt she had no other option but to sacrifice her car.
95. The way AJM dealt with Miss L was extremely frustrating and distressing for her. She completely lost faith in its ability to help and this has continued to affect her decisions on how she arranges her wheelchair provision. AJM no longer has the contract to provide an NHS wheelchair service in her area. She has told us her experience with AJM has made her anxious about any NHS wheelchair provision in the future.
Findings – Cambridgeshire and Peterborough Integrated Care Board
96. Miss L has complained the ICB did not properly manage or investigate her complaint about AJM Healthcare. She says it did not explain what went wrong, or put right AJM’s mistakes. Miss L has told us she felt the ICB was not listening to her or taking her concerns seriously.
97. We have referred to the ‘NHS Complaint Standards’ and the ICB’s ‘Policy for the Management of Concerns and Complaints and responding to Feedback from Patients and the Public’, which was in force when the ICB managed Miss L’s complaint in 2019 and 2020.
98. The complaints policy sets out a limited role for the ICB in managing complaints about its commissioned service. The complainant has a choice to complain to the commissioned service directly, or complain to the ICB. If they choose to complain to the ICB, the policy is clear its role is to gain consent and forward the complaint on to the commissioned service for it to provide a response. They policy also allows the ICB to act as an intermediary between the commissioned service and the complainant to advise of the complaints process and the options available.
99. Miss L contacted the ICB about her concerns with AJM in October 2019. It acknowledged this and contacted AJM for further information about how it was managing her wheelchair provision.
100. The ICB identified AJM had been unable to provide Miss L’s wheelchair so it paused what it was doing towards getting her a formal complaint response to focus on facilitating her getting an appropriate piece of equipment. Miss L agreed with this approach. Her priority was to get a wheelchair that met her holistic needs, and she saw this as the best way of doing that.
101. From December 2019, the ICB’s emails show it started to work more closely with AJM to ensure it was properly adjusting the wheelchair Miss L had received in August 2019 so it was appropriate for her needs. It was trying to closely monitor what parts AJM needed to order, whether it had ordered them, and when it was due to receive them.
102. The ICB recognised where AJM made mistakes, and it suggested AJM looked at the NHS Complaint Standards and considered providing compensation for Miss L.
103. Once Miss L lost faith in AJM and disengaged from its service in August 2020, the ICB returned to working on ensuring Miss L got a formal response to the complaint. It sent this in April 2021.
104. We can see the ICB acted outside its own policy here. It did not ask AJM to provide the response directly. It formed a response based on the information AJM had provided throughout the previous ten months. We understand why it did this and we do not consider it a failing. it knew how upset Miss L was with AJM - this is why it had been acting as an intermediary. The ICB had Miss L’s individual circumstances in mind here, which our Principles of Good Administration say public bodies should do.
105. We cannot see the ICB made mistakes in how it managed or investigated Miss L’s complaint. It acted in line with its own policy on handling complaints about services it commissions. In some actions, such as its close oversight of AJM’s wheelchair procurement, it did more than what was required of it. It was trying to do as much as it could to help Miss L. We appreciate this raised her expectations of what the ICB could achieve.
106. We understand why Miss L has asked us to look at the formal response. She has complained it did not fully explain what went wrong, and does not put things right for her.
107. The complaint response does not account for the significant failings we outlined earlier in this report. We do not think we can say the ICB is responsible for the quality of the complaint response. As we have already said, the ICB’s policy only guides it to advise AJM of the complaints process and the options available to it. It formed the response based on information AJM provided, which is had no control over. We do not think we can be critical of the ICB for the content of the response. We understand the ICB has a role in managing the contract with AJM, however, this is not part of the scope of our investigation.
108. We find the ICB followed the relevant guidance in how it managed Miss L’s complaint. It has a very limited role as an investigator. It cannot give its own explanations about whether anything went wrong or put things right itself. We appreciate Miss L expected more oversight from the ICB, particularly because it did go beyond its responsibilities as set out in its own policy. When we weigh up the evidence, we have found no failings in the ICB’s involvement in Miss L’s complaint.