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Challenging NHS Treatment, Medication and Funding Decisions
Decisions about healthcare, treatment, medication and NHS funding can have a significant impact on a person’s health, wellbeing and quality of life.
Where a treatment or medication is refused, funding is declined, or a health body has failed to properly consider relevant evidence, it can be difficult to know what can be challenged and how quickly action needs to be taken.
At Watkins Solicitors, our Public Law and Human Rights team advises individuals, families and representatives on challenges to NHS and health body decisions.
This may include urgent advice where a decision has immediate consequences, as well as support with pre-action correspondence, negotiations with the relevant public body, and judicial review proceedings where appropriate.
We provide clear, careful and practical advice to help you understand your position, your options and the steps that may be available.
To speak to our team, please call 0117 939 0350 or email info@watkinssolicitors.co.uk.
Support where treatment, medication or care arrangements have immediate consequences.
Careful review of decision letters, policies, clinical evidence and individual circumstances.
Advice on negotiation, pre-action correspondence and judicial review where appropriate.
An explanation of available funding options before any steps are taken.
We can advise on public law challenges involving decisions made by NHS organisations and other health bodies.
The key question is whether the decision may have been made unlawfully, unfairly, irrationally, or without proper consideration of the relevant evidence.
We can help you understand whether there may be grounds to challenge the decision.
A refusal to provide treatment can be extremely distressing, particularly where the treatment is important to a person’s health, independence, quality of life or long-term care.
A challenge may be possible if the health body has:
Early advice can help identify whether the decision can be challenged and what evidence may be needed.
Some cases involve a refusal to provide or fund medication.
This may include medication that is not routinely available through the NHS, medication requested because other options have not worked, or medication recommended by a treating clinician.
Where medication is refused, it is important to understand why.
The decision may have been based on national guidance, local policy, clinical criteria, funding rules or an assessment of the individual circumstances.
A legal challenge may be possible if the decision was not made properly, if relevant evidence was ignored, or if the health body failed to apply its own policy.
An Individual Funding Request, often called an IFR, is a request for NHS funding for treatment or medication that is not routinely available.
These decisions can be complex and can involve detailed medical evidence and clinical judgment.
It may be possible to challenge an IFR decision where there are concerns about the way the request was considered.
This may include concerns that:
We can advise on whether an IFR decision may be open to challenge and whether urgent steps may be needed.
Some challenges involve wider NHS funding decisions, including decisions about whether a person is eligible for funding, whether a particular service will be provided, or whether funding previously granted should continue.
These decisions may affect treatment, medication, care arrangements, support services or access to specialist provision.
A challenge may be appropriate where a decision appears to have been made without proper consideration of the evidence, without clear reasons, or in a way that does not follow the relevant legal duties, guidance or policy.
We can help review the decision and advise on whether there is a public law basis to challenge it.
NHS bodies often use eligibility criteria to decide whether treatment, medication or funding should be provided.
Eligibility criteria must be applied lawfully and fairly.
A challenge may be possible where:
These cases often require careful analysis of the policy, the evidence and the decision-making process.
Many healthcare decisions are made by applying NHS policies.
Policies can be important, but they must be lawful and applied properly.
A public body should not usually apply a policy so rigidly that it fails to consider the individual facts of a case.
A challenge may be possible where an NHS body has:
We can advise on whether the policy and the way it has been applied may be open to challenge.
A common issue in public law challenges is whether the decision-maker properly considered the evidence.
In NHS treatment, medication and funding cases, relevant evidence may include:
If important evidence has been ignored, misunderstood or not properly addressed, this may support a challenge.
This may be because treatment is time-sensitive, a person’s health is deteriorating, medication is needed quickly, care arrangements are at risk, or a refusal has immediate consequences.
Where a decision is urgent, it may be necessary to act quickly. This may include urgent correspondence with the relevant NHS body or, in appropriate cases, seeking urgent or interim relief through the court.
We can advise on whether urgent action may be available and what steps should be taken.
Judicial review is the legal process used to challenge certain decisions made by public bodies.
In healthcare cases, judicial review may be used where an NHS organisation or health body has made a decision unlawfully, unfairly, irrationally or through an improper process.
The purpose of a judicial review is not to ask the court to make the decision for the public body, but to consider whether the decision was made lawfully and properly.
If a challenge succeeds, the court may require the public body to reconsider the decision, follow the correct process or make a fresh decision in accordance with the law.
In some cases, issues can be resolved through early advice, pre-action correspondence or negotiation without the need to issue court proceedings.
Judicial review is not always the first or only route.
Depending on the circumstances, there may be other ways to challenge or question a healthcare decision.
This may include:
We can advise on the most appropriate route and whether a formal legal challenge may be needed.
Healthcare decisions often overlap with wider health and social care issues.
For example, a decision about treatment, medication or funding may affect someone’s care needs, placement, discharge planning, mental health support, community care or ability to remain safely at home.
Where a person has care and support needs, it will be particularly important to consider whether their individual circumstances, family life, dignity and wellbeing have been properly taken into account.
These cases may involve NHS bodies, local authorities, care providers, advocates, family members and other professionals.
We can help identify which organisations are involved and whether the issue is best approached as a public law challenge, complaint, safeguarding issue, claim for damages or another route.
We have particular experience advising in matters involving people with care and support needs.
This may include autistic people, people with learning disabilities, people with physical disabilities, people with communication needs, people detained under the Mental Health Act, people subject to deprivation of liberty safeguards, and people receiving care in residential settings, supported living arrangements or their own home.
Where a healthcare decision affects a disabled person or someone with complex needs, it may be particularly important to consider whether their individual circumstances, communication needs, family life, dignity and wellbeing have been properly taken into account.
The evidence needed will depend on the decision being challenged.
You do not need to have all documents before asking for advice. We can help identify what may be needed and whether further information should be requested.
Our aim is to help you understand whether the decision can be challenged and what steps may be available.
We consider the decision, policy, reasons and available evidence.
We assess urgency and whether a complaint, review, negotiation or legal challenge is appropriate.
Where appropriate, we prepare correspondence and engage with the relevant public body.
If necessary, we advise on judicial review, permission and urgent or interim relief.
Funding will depend on the type of case, the circumstances and the legal route involved.
Funding options may include Legal Aid, legal expenses insurance, private funding or other funding arrangements depending on the matter.
We will discuss funding at the outset so you understand your options before any steps are taken.
It is important to seek advice as soon as possible if you are concerned about an NHS or health body decision.
Public law challenges can be subject to strict time limits, and delay may affect the options available.
Early advice can help identify the correct route and protect your position.
Watkins Solicitors are a multi-award-winning law firm with more than 55 staff across offices in Bristol, Bath and Hereford.
Founded in 1998, the firm has built a strong reputation for providing clear, practical and client-focused advice across areas including Family Law, Education Law, Conveyancing, Public Law, Legal Aid, Wills, Powers of Attorney, Probate and Estate Administration.
Our Public Law and Human Rights team advises individuals, families and professionals across England in complex and often urgent cases involving public bodies, NHS organisations, health bodies, local authorities and other decision-makers.
We understand that decisions about treatment, medication and funding can feel overwhelming, particularly where health, care or quality of life is affected.
Our approach is to provide clear, careful and practical advice so you understand your options and can take the next step with confidence.
If you would like advice about challenging an NHS treatment, medication or funding decision, please contact our friendly team.
We advise clients across England and Wales, with offices in Bristol, Bath and Hereford.
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