GVH, R (on the application of) v Leicester, Leicestershire and Rutland Integrated Care Board

This is the judgment on an application for permission for judicial review which I heard on Friday 24 April 2026. At the end of the hearing there was no time available for a decision to be given and so I reserved my judgment.

The Claimant is aged 17 and is very significantly disabled. He has quadriplegic cerebral palsy with global developmental delay. The Claimant requires assistance with all aspects of daily living. Acting by his litigation friend and mother, the Claimant has applied for permission for judicial review of the Defendant’s decision of 10 September 2025 to reduce the funding for a care package that he receives from 56 hours a week to 32 hours a week (“the funding decision”). That decision was made by the Defendant’s High Risk and Complex Care Panel for Children and Young People’s Continuing Care (“the Panel”). The funding decision followed a series of meetings and assessments starting on 10 June 2025 with the “Assessment and Decision Support Tool” process.

The application for permission was first considered by me on the papers on 31 March 2026 when I adjourned the case to an oral hearing and gave case management directions leading to the hearing which took place last week.

At the hearing the Claimant was represented by Ms Bethan Harris of counsel, and the Defendant was represented by Mr Parkhill of counsel. Both parties submitted helpful skeleton arguments in advance of today’s hearing which were supplemented by oral submissions. I am grateful to both counsel for their assistance.

Leicester City Council, who provide social care for the Claimant, has been named as an Interested Party but it was not represented at the hearing, and it had not filed an Acknowledgment of Service.

When I adjourned this case for consideration at an oral hearing, I indicated that the court would be assisted by argument on the Defendant’s contention that permission should be refused on the ground that the Claimant has not used an effective alternative remedy, arguing that judicial review is a remedy of last resort. I will start with that point.

The Claimant argues that the complaints process would not be an “equivalently efficacious remedy”. The Claimant submits that the Defendant’s track record shows that a complaints process would “likely to be protracted”. The Claimant points to the delay in the letter summarising the needs to be supported under the reduced care package which was not sent until 5 December 2025, nearly 3 months after the impugned decision was made. The Claimant also points to the fact that the Defendant had still to respond to a request for the funding decision to be reconsidered on the basis of a report from Dr Patel, a respiratory consultant. The Claimant argues that the complaints procedure would mean that the Claimant would not have an adjudication on the legal merits and access to a clear remedy of a quashing order. The Claimant also relied upon the fact that any complaint would be adjudicated upon by the Defendant and therefore there would be an absence of independence. It was argued that a judicial review would bring about a swifter resolution.

The Defendant argues that permission should be refused because there is an adequate alternative remedy by which the Claimant can pursue his challenge to the funding decision. The remedy is the Defendant’s complaints process which is a process governed by the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 (“the Regulations”).

The complaints policy provides, inter alia: where possible, the Defendant will endeavour to provide the complainant with a full response within 25 working days and, where that is not possible (for example because of the complexity of the issues raised by the complaint), the complainant will be advised (para 77); the Corporate Governance Team may take expert advice to determine if there could be clinical risks which will require an immediate response outside the complaints process (para 72); and any potential / actual risks to patient safety or safeguarding issues identified as a result of complaints investigations will be escalated to the Chief Nursing Officer and / or the safeguarding team (para. 74). The Regulations are largely the same as those regulations considered by McCombe J R (F & Ors) v Wirral Borough Council[2009] EWHC 1626 (Admin). In that case McCombe J had concluded the complaints system under those regulations provided an effective alternative remedy. The Defendant argues that the Claimant has not shown why litigation is “really unavoidable”, as required by Lord Woolf MR’s judgment in Cowl & Ors v Plymouth City Council[2001] EWCA Civ 1935 at [27]. The Defendant argued that the Claimant’s reliance on the case of R (KM) v Cambridgeshire CC [2012] UKSC [2012] PTSR 1189 was misplaced as there the court had not considered the issue at all as to whether there was an adequate alternative remedy.

The Defendant relies on the fact that there is no dispute between the parties as to the applicable law. The grounds are concerned only with the application of the facts. The Defendant also points to the fact that the National Framework for Children and Young People’s Continuing Care (which is directly relevant to the Claimant’s Grounds Three and Five) itself refers to disputes being resolved through internal complaints procedures.

Courts have long emphasised that the judicial review procedure is a “remedy of last resort, to ensure that the rule of law is respected where no other procedure is suitable to achieve that objective”: R (Glencore Energy UK Ltd) v HMRC [2017] 4 WLR 213 at [55]. In R (Watch Tower Bible & Tract Society of Britain) v Charity Commission [2016] EWCA Civ 154 [2016] 1 WLR 2625 Lord Dyson MR explained at [19] that “[i]f other means of redress are ‘conveniently and effectively’ available to a party, they ought ordinarily to be used before resort to judicial review. … It is only in a most exceptional case that a court will entertain an application for judicial review if other means of redress are conveniently and effectively available”.

In cases where there is an alternative administrative procedure such as a complaints procedure, particularly one created by statute (such as is the case here), the courts will require the claimant to use that procedure before resorting to judicial review (R. (Cowl) v Plymouth City Council [2002] 1W.L.R. 803 at [10]–[14]; R. v Barking and Dagenham LBC Ex p. Lloyd [2001] L.G.R. 421; R. (Carnell) v Regents Park College and Conference of Colleges Appeal Tribunal [2008] E.L.R. 268; R. (Zahid) v University of Manchester [2017] EWHC 188 (Admin); [2018] P.T.S.R. 1728 at [68].

In my judgment the complaints procedure provides an effective mechanism which would provide redress conveniently and effectively. I do not accept the Claimant’s argument that the delay in providing the summary of the impugned decision or the failure to respond to the request for reconsideration of the decision following Dr Patel’s report indicates that the complaints procedure would be protracted and lack efficacy. As the Defendant explained at the hearing, the delay in providing the summary was caused by staff absences and the fact that ordinarily such summaries are not produced. Whilst the absence of a response to the request for reconsideration is regrettable (not least in circumstances where, as Lord Woolf made clear in Cowl, there is a duty on lawyers acting on both sides to avoid litigation) it does not in and of itself indicate that the complaints procedure would be ineffective. Moreover, litigation can sometimes unhelpfully hinder effective dialogue between a patient and those caring for the patient.

In my judgment the complaints procedure could offer more effective redress than a quashing order. The circumstances here are similar to those in in R (S) v Hampshire County Council [2009] EWHC 2537 (Admin), in which the claimant was a severely disabled child. He sought to challenge the adequacy of the care delivered to him. Walker J held that the existence of the complaints procedure, which was an adequate alternative remedy was, itself, sufficient reason to refuse permission. At [59] Walker J observed:

As Ms Harris rightly submits, the existence of an alternative remedy does not go to jurisdiction but is a matter of discretion. However, I am not persuaded that this is one of the exceptional cases where, despite the existence of an effective alternative remedy, my discretion should be exercised to grant permission. I would therefore refuse permission on that basis.

Notwithstanding the foregoing, I have also considered whether or not the Grounds of challenge are arguable.

The Claimant advances five Grounds, albeit recognising that Grounds Three and Four significantly overlap. The Grounds are:

I am not persuaded that any of these Grounds are arguable and have a realistic prospect of success that merit full investigation at a substantive hearing.

Ground One as pleaded is misconceived as it is not sustainable by reference to the records. The minutes for the September Panel meeting (when the decision under challenge was taken) record Ms Mulhall stating “The information has been received from KS. It is agreed that is eligible for high in eating and drinking, communication and mobility. But does not support high in breathing. • This is because of looking at the care records in the last 6 months which had no clinical indication for suctioning.” It is therefore clear that the Panel did not only consider records over a 10-day period. The panel considered the position reflected in the records over (i) a 6-month period, and (ii) the additional 10 day period.

In oral submissions, Ms Harris glossed this ground as a complaint that the panel did not look carefully enough at the evidence. However, that is not the pleaded Ground and there has been no application to amend. In any event, as Mr Parkhill argued in his oral submissions, even as glossed this complaint could not realistically be challenged as being Wednesbury unreasonable.

Ground Two does not meet the threshold for permission. Although the Claimant is correct that the nighttime records referred to catheter suctioning on four occasions those were ones where the Claimant’s mother had undertaken the suctioning. The records did not explain why the catheter suction was thought to be necessary. As to the second aspect of this Ground, only 2 of the staff actually deployed to care for the Claimant were trained in catheter suctioning although more of the care agency’s staff may have been trained. Critically, Ms Bailey, the Chair of the Panel that made the decision under challenge, has said that the observation that only a small number of staff had training in catheter suctioning was not central the decision. As Hallett LJ made clear in R (Plantagenet Alliance Ltd) v Secretary of State and Others [2014] EWHC 1662 (Admin) at [139]: “…the Tameside information must be of such importance for centrality that its absence renders the decision irrational.”

I can take Grounds Three and Four together (consistent with the way in which it was argued at the hearing). Ms Harris argued that the essence of these Grounds was the failure to make a holistic assessment and “to consider how different but inter-related needs across more than one domain can complicate the child’s overall care needs and result in sufficient complexity, intensity or risk to demonstrate continuing care needs. The Panel failed without good reason to follow the approach required under the Framework and take account of the material matter of the evidence about night-time risk”.

This challenge does not have reasonable prospects of success. Taken as whole, the funding decision does show a holistic assessment. There was an appreciation of the complexity of the Claimant’s condition and there was consideration of nighttime positioning. An assessment was made that nighttime manual handling was not an unmet health need. That cannot realistically be characterised as Wednesbury unreasonable for the reasons set out at paragraphs 53-55 of the Defendant’s Summary Grounds.