Peter Szabo, R (on the application of) v NHS Southeast London Integrated Care Board (No 2)

At the judicial-review permission stage, an arguable claim with a realistic prospect may proceed where the court cannot be satisfied that it is highly likely the outcome would have been the same without the alleged public-law errors. An ombudsman or data-protection route does not necessarily answer a challenge to the lawfulness of a public body’s first-stage complaint decision: it may remain arguable that the complainant is entitled to a lawful initial decision before using a later safeguard. Whether those routes are adequate, and whether the alleged errors occurred, may be left for the substantive hearing.

The claimant had made six complaints to the defendant integrated care board about Cator Medical Practice (CMP), including its immediate removal of him from its patient list. Following earlier proceedings, the Board issued an outcome decision on 10 October 2025, attaching a response from CMP dated May 2025. The claimant brought this second judicial-review claim, challenging the Board’s investigation and outcome. The earlier proceedings are described in Szabo (No.1) [2025] EWHC 2235 (Admin).

Permission had been refused on the papers. After an oral hearing, the High Court reconsidered the application afresh. It considered whether the claim had viable grounds, including whether the Board had independently determined the complaints, fairly addressed the immediate removal and given the claimant a chance to respond to CMP’s account. The Board also relied on data-protection procedures and the Public Service Ombudsman as alternative remedies. The central question at this stage was whether those arguments defeated permission, not whether the challenged decision was ultimately lawful.

1. Permission granted. The claim crossed the threshold of arguability with a realistic prospect of success. The Board had not shown that it was highly likely the outcome would have been no different absent the alleged public-law errors. The court decided permission only; it made no final determination of the substantive grounds.

2. It was arguable that the Board had failed to investigate the facts and materials for itself, make its own findings, and determine which complaints were upheld. The substantive hearing would need to decide whether the outcome decision, read fairly as a whole and in context, did determine the complaints. The earlier judgment had emphasised the Board’s responsibility to obtain information from CMP and then determine the complaints itself.

3. It was also arguable that the investigation and outcome had not grappled with the issues raised by the claimant’s immediate removal from CMP’s list. These included the allegations said to justify removal, the claimed retaliatory motive, the stigma attached to immediate removal, and the possible gap in access to care. The reference to an “8 day removal grace period” did not resolve what the removal was or whether the Board had properly addressed the complaints. National Health Service (General Medical Services Contracts) Regulations 2015, reg.25, was identified as describing immediate removal on the ground of an act of violence; the court did not determine the legal effect of that provision in this case.

4. Under regs.13(7) and (8) of the Local Authority Social Services and National Health Service Complaints (England) Regulations 2009, it was arguable that the statutory discussion duty had not been discharged. The court considered it arguable that the email exchanges did not amount to the required dialogue. It was also arguable that fairness required the claimant to receive CMP’s May 2025 response and an opportunity to address it, given the Board’s apparent reliance on that response in reaching its own outcome.

5. The availability of the Data Protection Act 2018 procedures and the Public Service Ombudsman did not provide a decisive answer at the permission stage. It remained open to the Board to argue at the substantive hearing that either route was an adequate alternative remedy. It was at least arguable that the claimant was entitled to a lawful Stage 1 decision before being directed to the Stage 2 ombudsman. The court was sceptical about the medical-records ground, which appeared to concern a positive determination and might have an answer in the 2018 Act procedures. The question whether the Board had invoked the regulation 8 exclusion, among other remaining points, was left open.

6. No directions were made. The costs order imposed when permission was refused on the papers on 22 May 2026 was discharged.

Permission was refused on the papers on 22 May 2026. Following an oral hearing, the High Court reconsidered the application afresh and granted permission.