R Rosalind Copson v Dorset Healthcare University NHS Foundation Trust NHS Dorset (Interested Party)
| Jurisdiction | England & Wales |
| Judge | H.H. Judge Keyser |
| Judgment Date | 28 March 2013 |
| Neutral Citation | [2013] EWHC 732 (Admin) |
| Court | Queen's Bench Division (Administrative Court) |
| Date | 28 March 2013 |
| Docket Number | Claim No: CO/9472/2012 |
[2013] EWHC 732 (Admin)
IN THE HIGH COURT OF JUSTICE
QUEEN'S BENCH DIVISION
ADMINISTRATIVE COURT
Cardiff Civil Justice Centre
2 Park Street, Cardiff, CF10 1ET
His Honour Judge Keyser QC
sitting as a Judge of the High Court
Claim No: CO/9472/2012
and
Katherine Olley (instructed by Scott-Moncrieff & Associates LLP) for the Claimant
John De Bono (instructed by Weightmans LLP) for the Defendant
The Interested Party took no part in the proceedings
Hearing date: 15 March 2013
H.H. Judge Keyser Q.C.:
Introduction
This is a claim by the claimant, Rosalind Copson, for an order quashing the decision of the defendant, Dorset Healthcare University NHS Foundation Trust, on 14 June 2012 to implement its Mental Health Urgent Care Services Project for the reconfiguration of mental health services in the west of Dorset. The Project is a collaboration between the defendant and the interested party. The particulars of the relationship between the defendant and the interested party and the mysteries of NHS organisation and structure were not explained or explored in the hearing of the claim and accordingly I shall pass over them.
Permission to apply for judicial review of the defendant's decision was given by Burton J at a hearing on 16 January 2013. The order for permission was made by consent and on agreed terms that provided for the parties to meet with a view to attempting to reach substantive agreement. Later in this judgment I shall say something about what has happened since the order was made; for the moment it suffices to note that no agreement was reached.
The claim is put on two grounds. First, it is said that the defendant failed, before reaching its decision, to carry out an adequate consultation with users of its mental health services, chiefly in that it failed to provide to those users sufficient information to enable them to engage meaningfully with the proposals. Second, it is said that the defendant failed to comply with its duty under section 149 of the Equality Act 2010 to have due regard, in the exercise of its functions, to the need to advance equality of opportunity.
I have been much assisted by the written and oral submissions of Ms Olley for the claimant and Mr de Bono for the defendant. However, examination of the facts was not assisted by the absence of any evidence from the defendant or the interested party and of any detailed chronological analysis of events. In what follows I shall largely let the documents tell their own story. I regret that the importance of releasing this judgment before Easter has not permitted the usual scrutiny of its text for grammatical and typographical errors.
The background
The claimant is a user of mental health facilities in Bridport, Dorset. The facilities that she uses include the in-patient facility at the Hughes Unit in Bridport. The defendant's proposed reconfiguration of mental health services in the area will involve the loss of that facility. The claimant is a member of the Hughes Unit Group Supporters, who are attempting to prevent that loss.
As a "relevant English body" for the purposes of chapter 2 of Part 12 of the National Health Service Act 2006 (the 2006 Act), the defendant is subject to a duty under section 242 of the 2006 Act:
"(1B) Each relevant English body must make arrangements, as respects health services for which it is responsible, which secure that users of those services, whether directly or through representatives, are involved (whether by being consulted or provided with information, or in other ways) in—
(a) the planning of the provision of those services,
(b) the development and consideration of proposals for changes in the way those services are provided, and
(c) decisions to be made by that body affecting the operation of those services.
(1C) Subsection (1B)(b) applies to a proposal only if implementation of the proposal would have an impact on—
(a) the manner in which the services are delivered to users of those services, or
(b) the range of health services available to those users.
(1D) Subsection (1B)(c) applies to a decision only if implementation of the decision (if made) would have an impact on—
(a) the manner in which the services are delivered to users of those services, or
(b) the range of health services available to those users.
(1E) The reference in each of subsections (1C)(a) and (1D)(a) to the delivery of services is to their delivery at the point when they are received by users.
(1F) For the purposes of subsections (1B) to (1E) … a person is a "user" of any health services if the person is someone to whom those services are being or may be provided."
It is also common ground that the defendant's proposals amount to a "change in service provision" and give rise to a duty on the part of the defendant, pursuant to section 244 of the 2006 Act, to consult formally with Dorset County Council's Scrutiny Committee in relation to the proposed changes.
The consultation and decision-making process
For the purposes of this case, the narrative can begin in August 2011 with an Equality Analysis by the defendant in respect of what was then being called "Enhanced Recovery Services" for the West of Dorset. This recorded: "An integrated acute care recovery service is planned for all adults with functional mental health difficulties who require either an emergency or urgent response to safeguard them and/or others from the likelihood of significant harm." The document identified "equality target groups" (race, gender, disability etc), assessed the potential impact of the proposed development on each of those groups, and set out required actions or action plans. Section 4 of the Equality Analysis set out the steps that were to be taken to engage and involve "stakeholders" (service users, carers, the public etc) in the formulation of the proposed development.
By October 2011 Enhanced Recovery Services had been re-named "the Mental Health Urgent Care Services Project". A Task and Finish Group was set up, and the report to the first meeting of that Group on 14 October 2011 explained the aims and nature of the Project.
"The project aims to provide sustainable and accessible urgent care services within mental health for people in the west of Dorset …
Proposals would cover the three primary care localities of North Dorset, West Dorset, and Weymouth & Portland, for people aged 18 years and over. …
The project proposes
1. The clinical and operational integration of crisis resolution, home treatment and inpatient services.
2. The extension of locality-based services to include crisis accommodation and day treatment, based on the reinvestment of money released by reductions in the number of inpatient beds.
3. The updated of the environments within the retained inpatient services together with the replacement of the Linden Unit.
…
The proposed new services will be created by combining Crisis Response and Home Treatment (CRHT) teams with inpatient staff to provide alternatives to hospital admission within a unified team and management structure. The proposals also involve re-investment in an expanded range of local services designed to help people stay at home wherever it is safe for them to do so. …
The Mental Health Urgent Care Service will be structured about a hub and spoke model of service provision …. Services will be accessed through both the central hub and locality services on the basis of a single triage and assessment process ("no door is the wrong door")."
The hub and spoke model was illustrated in a diagram. The hub provided for inpatient admission and treatment units, emergency response within four hours, Mental Health Act assessments, admissions to designated places of safety and prison placements. From that hub radiated three spokes for, respectively, West Dorset Locality, Weymouth & Portland Locality, and North Dorset Locality. Each spoke provided for urgent assessments, treatment programmes, home treatment and "Crisis Accommodation".
The report continued:
"The proposed changes are based on a phased programme of bed closures and complementary investment in locality based services. This would involve the reduction in the number of functional inpatient beds from the current establishment of 58 to 38 beds which equates to a 35% reduction."
The existing 58 beds were listed: nine at Stewart Lodge, Sherborne; seven at Hughes Unit, Bridport; sixteen at Linden Ward, Weymouth; fourteen at Minterne Ward, Dorchester; twelve at Melstock Unit, Dorchester. The report explained that the proposed "bed reductions and reinvestment in locality services" would be based on the phased closure of the Hughes Unit ("7 beds for younger adults") and Stewart Lodge ("4 beds for older adults and 5 beds for younger adults"). The report set out a "phased programme plan"; Phase 1 provided for a formal consultation process in February/March 2012 and a final decision in March 2012. Phases 2 and 3 provided for implementation to commence in June 2012.
The minutes of the meeting of the Task and Finish Group on 14 October 2011 recorded the intention behind the phased implementation of the proposals:
"The Project would be managed carefully so that patients were not put at risk and a phased approach to implementation had been adopted to ensure this. The Project would be carried out in three phases to ensure that service improvement was aligned with bed reductions and the outcome of one phase would be reviewed before the next phase started."
The minutes of the meeting also show that the question of cost and funding was raised:
"A question was asked as to why funding had not been mentioned and that the public's perception of this would be that the...
To continue reading
Request your trial
-
R (on the application of MA and Others) v The Secretary of State for Work and Pensions Birmingham City Council (Interested Party) The Equality and Human Rights Commission Shelter and Another (Interveners)
...by the public authority is unreasonable or irrational"). HHJ Keyser QC, sitting as a deputy judge of the High Court in Copson [2013] EWHC Admin 732 was right to observe at paragraph 57(4) that "[t]he public sector equality duty is not a back door by which challenges to the merits of decisio......
-
R Anthony John Flatley v Hywel Dda University Local Health Board The Welsh Ministers (Interested Party)
...of His Honour Judge Keyser QC sitting as a judge of this court in R (Copson) v Dorset Healthcare University NHS Foundation Trust [2013] EWHC 732 (Admin), a case not dissimilar from this on its facts. That case too concerned healthcare services, and in that case too service user transport ar......