CDE v NHS North East London ICB: High Court refuses judicial review over disabled child's care plan

The High Court has refused permission for judicial review brought on behalf of a severely disabled and life-limited teenager, finding no arguable case that either the local NHS integrated care board or a London borough had breached their legal duties to secure his care.

In CDE, R (on the application of) v NHS North East London Integrated Care Board & Anor [2026] EWHC 2109 (Admin), Deputy High Court Judge Nigel Cooper KC dismissed a renewed application for permission following an earlier paper refusal by DHCJ Vikram Sachdeva KC on 15 June 2026.

The claimant, referred to as CDE and acting through his mother and litigation friend EDC, is fifteen, non-verbal, severely sight-impaired and medically fragile, with Lowe syndrome. He challenged a joint decision of NHS North East London Integrated Care Board and the London Borough of Tower Hamlets dated 3 February 2026, which set out the future provision intended for his health and social care needs following the closure of Richard House children's hospice in December 2025. For approximately nine years, Richard House had provided specialist respite care forming part of CDE's crisis safety net.

CDE argued that the defendants had failed to produce a finalised, child-specific and operationally deliverable care pathway, and advanced grounds of illegality, irrationality and procedural unfairness, alongside reliance on Articles 2 and 8 of the European Convention on Human Rights and the public sector equality duty.

Applying the permission stage test from Sharma v Browne Antoine [2006] UKPC 57, of whether a claim is arguable with a realistic prospect of success, DHCJ Cooper agreed with the earlier refusal on each ground. He held that neither defendant was under a legal obligation to produce the detailed operational plan sought. An adequate respite arrangement was already in place, comprising overnight care at Haven House hospice and home-based care available on request, alongside an Advance Care Plan addressing palliative provision.

The judgement noted developments since the paper refusal, including a meeting with Haven House on 20 July 2026 that had narrowed the live issues, with no exclusive choice of hospice provider now required. Remaining questions concerned the practical delivery of respite nights, clinical responsibility arrangements, and contingency planning should CDE's condition deteriorate or his mother be unable to provide care.

DHCJ Cooper found that the care package, involving Haven House, Demelza and home provision, met CDE's assessed needs for eighteen social care funded nights and twenty health funded nights, and that ongoing reassessment was taking place where circumstances changed. He accepted evidence of the family's difficulties, including privately funded ambulance transfers and the absence of respite since Richard House closed, but concluded this did not establish an arguable breach of statutory duty by either defendant.

The court also revoked an earlier costs order requiring CDE to pay the first defendant's costs, after counsel confirmed those costs were no longer sought, and the second defendant did not pursue its costs. Separately, the court varied an existing anonymity order to permit EDC to discuss the proceedings confidentially with specified categories of individual, a variation neither defendant opposed.