CDE, R (on the application of) v NHS North East London Integrated Care Board & Anor

At the permission stage, a judicial review claim must be arguable with a realistic prospect of success. Statutory duties to arrange health, palliative and respite services do not, without more, require a detailed written operational plan or a named operational lead coordinating every interface. The question is whether the responsible bodies have assessed, planned and made available care that meets the person’s reasonable needs, with lawful reassessment when circumstances materially change and effective cooperation where duties overlap. A package that is being delivered or is available, supported by adequate information and contingency arrangements, can satisfy those duties. Articles 2 and 8 of the ECHR and the PSED do not create separate sustainable grounds where they add nothing to the pleaded public-law grounds. Accordingly, the renewed permission application was refused.

The claimant, a 15-year-old child with complex medical needs, sought judicial review of a joint response dated 3 February 2026 concerning his health and social care after the closure of Richard House hospice. He alleged that the integrated care board and local authority had failed to secure a finalised, child-specific and operationally deliverable pathway for respite, palliative care, urgent escalation and post-discharge support. Permission was refused on paper on 15 June 2026, and the claimant renewed the application after further evidence and continuing care reviews. The central issue was whether the statutory duties required the detailed written plan and operational lead sought, and whether the arrangements actually available had been lawfully assessed, coordinated and made deliverable.

Disposition. The renewed application for permission to seek judicial review was refused. The court found no arguable case that either defendant had breached its legal obligations.

1. Permission threshold. The relevant test was whether the claim was arguable with a realistic prospect of success, applying Sharma v Browne Antoine [2006] UKPC 57.
2. Statutory framework. Under sections 2 and 3 of the National Health Service Act 2006, the integrated care board was responsible for commissioning NHS services necessary to meet the reasonable requirements of those for whom it was responsible, including appropriate palliative and nursing services. The court summarised this as a duty to meet reasonable health needs. The local authority’s framework included Part III and Schedule 2 of the Children Act 1989, the Breaks for Carers of Disabled Children Regulations 2011 and section 11 of the Children’s Act 2004. The 2011 Regulations required, so far as practicable, a sufficient range of services to assist carers to continue caring or care more effectively, with regard to carers’ needs. The court referred to the helpful summary and discussion in R (MM) v London Borough of Hounslow [2015] EWHC 3731 (Admin).
3. Form of provision. Neither defendant had a legal obligation to provide the detailed written child-specific operational plan sought, or to identify an operational lead coordinating every interface between health, social care, palliative care, hospital provision, urgent escalation and post-discharge support.
4. Application to the evidence. The evidence showed an assessed and planned NHS package that was being delivered or was available, a responsive social-care plan, cooperation between the defendants, and provision through Haven House, Demelza and home care. The package met the identified provision of 18 social-care-funded nights and 20 health-funded nights. Reassessment was occurring in response to material changes, and there was no arguable case that care had been withdrawn, converted or substituted without lawful reassessment and a reasoned decision. Family hardship, private ambulance transfers, the absence of respite after the hospice closure and delayed replacement arrangements did not establish an arguable breach.
5. Other grounds and orders. Articles 2 and 8 of the ECHR and the PSED added no separate sustainable ground. The earlier £5,000 costs order in favour of the First Defendant was revoked; the Second Defendant sought no costs. The anonymity order was varied as requested, with no order as to the costs of that application.

This was a first-instance renewal hearing. Permission had previously been refused on paper on 15 June 2026. The renewed application was heard on 23 July 2026 and permission was again refused.