The Local Government and Social Care Ombudsman has raised concerns about the support provided to Hounslow children with special educational needs who are schooled out of borough after two complaints were upheld in quick succession.

In one case, a primary school girl with autism and complex special educational needs, whose Education, Health and Care (EHC) Plan said she needed speech and language and occupational therapies, received neither for two full school terms.

Throughout the family’s complaint, the council never made it clear that it had a legal duty to ensure the girl gets the therapy she needed in her current school. The family thought she could only get therapy provision if she moved to a school within the council’s area.

The lack of information and advice from the council led the family to decide that moving their daughter was the only way she could receive the therapy she needed. The move led to the girl, who had been happy and settled at her original school, showing behaviours that her family had never seen before.

Having realised that moving their daughter to a different school was a mistake, the family appealed. By that point, her original, out-of-borough school place had been given to another child. In the end, the girl will be returning to her first school from September 2026.

The Ombudsman has also found the same gap in provision in another recent complaint about Hounslow council. The law is clear: if a child's support plan says they need therapy, the council must make sure they get it, no matter which school they attend. Hounslow council has not been meeting this basic legal responsibility.

Amerdeep Clarke, Local Government and Social Care Ombudsman, said:

"This case is a stark reminder of what can go wrong when a council loses sight of its responsibilities to children educated outside its boundaries. A child with complex special educational needs missed vital therapy provision for two whole terms, not because it could not be arranged, but because the council did not have the right systems in place to make it happen.

"I want every council in the country to look at this case and ask whether they are confident they have proper oversight of the children in their area who are educated in out-of-area placements. Are the right arrangements in place? Do staff understand the council's legal duties? Are there systems to check that provision is actually being delivered?

"Children with SEND are amongst the most vulnerable in our communities, and the impact of getting this wrong, on their development, their wellbeing, and their families, can be profound and long-lasting. Effective scrutiny and oversight of local SEND services is not a bureaucratic exercise; it is how councils make sure every child gets the education they are entitled to."

The Local Government and Social Care Ombudsman remedies injustice and shares learning from investigations to help improve public, and adult social care, services. In this case the council should apologise to the family and pay them £1,700.

Article date: 14 May 2026

People who have concerns about how councils manage social housing can now complain to an independent Ombudsman, even if they are not a tenant, under changes brought into force today under the Renters' Rights Act.

Until today, the Local Government and Social Care Ombudsman (LGSCO) could not look at complaints about housing management from people who were not tenants, and neither could The Housing Ombudsman, which investigates complaints from tenants. This meant people had nowhere to turn if things had gone wrong.

Changes to the Local Government Act 1974, which come into effect on 1 May 2026, extend the jurisdiction of the Local Government and Social Care Ombudsman (LGSCO) to cover complaints about local authority social housing management from people who are not tenants.

The Housing Ombudsman will continue to handle complaints from tenants about their social landlord, including where that landlord is a local council.

Amerdeep Clarke, Local Government and Social Care Ombudsman, said:

"This is a significant and long-overdue change. Until now, people who had genuine concerns about how their council was managing social housing - but who were not tenants themselves - had nowhere to turn once they had exhausted the council's own complaints process.

“These amendments close that gap and ensure that we can provide the independent scrutiny and redress that the public deserves. I would encourage all local authority complaint managers to familiarise themselves with the new arrangements and the signposting tool we have developed."

NHS commissioned services should operate fairly, transparently and with clear clinical rationale, the Parliamentary and Health Service Ombudsman (PHSO) has said following an investigation which found that an NHS body denied women, but not men, NHS funding for sterilisation.  

This aspect of commissioned services falling short of what we expect them to be was brought to light when Leah Spasova complained to the Ombudsman after her request for sterilisation was rejected by Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (ICB). 

At the time, the ICB did not routinely fund female sterilisation and cited the risk of regret as a reason for refusing women the procedure. Its policy for male sterilisation routinely funded vasectomy for eligible men and did not use regret as a reason for rejection. 

The Ombudsman concluded that the ICB’s approach was unfair, inconsistent, and based on subjective reasoning. 

The Ombudsman found that women were not given the same opportunity as men to make an informed decision about sterilisation. The ICB failed to explain why it chose not to follow clinical guidance. The guidance is not mandatory but says sterilisation should be available for women and that counselling – not blanket exclusion – should address the risk of regret.  

The investigation also identified inconsistent use of cost-effectiveness arguments. Male sterilisation was recommended for funding without updated cost data, while female sterilisation was rejected due to a lack of recent evidence, despite older studies showing it can be more cost effective over time. 

The Ombudsman found the ICB did not balance this evidence appropriately when devising their sterilisation policy. 

In 2024, an advisory committee was given responsibility for making policy recommendations for six ICBs across the South East region, including Buckinghamshire, Oxfordshire and Berkshire West. Four of those six ICBs already funded female sterilisation.  

Following Leah’s complaint, the advisory committee reviewed the female sterilisation policy recommendation and recognised the equality issues created by funding male but not female sterilisation. It recommended that female sterilisation should be funded. Regret or the availability of more cost-effective alternative contraception is no longer used as grounds for refusal.  

Paula Sussex CBE, Parliamentary and Health Service Ombudsman, said,  

The issue highlighted in Leah’s case about the commissioning and managing of services by ICBs is not an isolated one. We are concerned that there may be similar wider problems affecting multiple areas of healthcare, and we have concerns that the system is not consistently meeting people’s needs and is letting patients down.  

 

 

"Our data has highlighted that there are often unclear explanations of treatment or diagnosis within in the NHS, confusing pathways, a lack of updates while patients wait for care, and poorly communicated changes to provision.   

 

 

"This case shows the power of the patient voice. Leah complained about her experience and the ICB is now reviewing its sterilisation policy. This could benefit and empower many more women to make informed decisions about their health.” 

The Ombudsman also found failings in how the ICB handled Leah’s complaint. This included unclear response times and inadequate engagement with her concerns and instead focused on reiterating its sterilisation policy to her. 

The Ombudsman recommended the ICB writes to Leah to acknowledge its failings, apologise and explain how its review will take place and what it has done, or will do, to improve its commissioning and complaint handling processes. The ICB has agreed to comply. 

Leah, a psychologist, from Oxfordshire said,

I have been enquiring about sterilisation for 10 years and was just passed back and forth between services. Then the ICB turned down my request for funding. One of the most important lessons from my case is the systemic problems and the lengthy process that patients must go through to challenge NHS decisions. 

 

“Before approaching the Ombudsman, I conducted my own research and found that the policy in place at the time appeared inconsistent with key principles of NHS care, did not respect the NHS Constitution, and did not align with NICE guidance around contraceptive choice. It did not follow the widely recognised principle that clinicians provide advice, but patients ultimately make decisions about their own bodies.  

 

“These concerns about autonomy and fairness prompted me to seek further accountability. Rejecting my application for sterilisation on the basis of regret means they were taking on liability for my feelings. The ICB says sterilisation is funded under exceptional circumstances, but nowhere do they list what those criteria are so it is impossible to know if you will be accepted or not. Someone else is making decisions about your body based on criteria you can’t even see.  

 

“Policies like this are damaging for women’s healthcare and women’s access to health services - it’s absolutely discriminatory. There is continuing widespread inequality in how permanent contraception is accessed with concerns about fairness and respect for women’s bodily autonomy remain unresolved. The key lesson from my case is how commissioning policies can create unequal barriers and why people should fight for their rights through transparency and accountability.” 

Read the investigation report.