Taking Action against CCG for their refusal to fund required presciption
Once you (or your doctor) has sent a letter to your local Clinical Commissioning Group (CCG) asking if they will fund your required prescription and they they respond telling you they will not fund your prescription, you need to send a letter of complaint back to them. Before any action can be taken, it has to be seen that all internal avenues have been exhausted . Below is a template complaint letter which may assist youin making a complaint to the CCG . We would suggest that the complaintis also copied to their doctor. Remove what doesn’t apply to your case.
Please send a copy of your (or your doctor’s) original letter to the CCG and any responses received from them to Carol firstname.lastname@example.org
Insert your address
and telephone number
and email address
The Chief Executive
[Insert name and address of Clinical Commissioning Group]
Formal Complaint under CCGs Complaints Procedure
[Insert name of person, date of birth and address]
I am writing to lodge a formal complaint regarding the CCGs discharge of it sstatutory functions towards [insert name of person]. Ia m the [carer] [parent] [ family member] of [insert name of person] and am writing this letter on their behalf as [they have confirmed they are happy for me to write this letter on their behalf and they have signed at the end of this letter] or [the person lacks capacity under the Mental Capacity Act 2005 to make decisions regarding their health and welfare] or [they are a child].
Please ensure that a copy of this letter is passed immediately to the complaints department and that you acknowledge receipt of this letter by providing a copy of the CCGs complaints procedure along with how you intend to progress this complaint within 24 hours. [Insert name of person] his/her [age] and [insert any diagnosis or summary of disabilities]. He / she is currently under the care of [insert name of responsible clinician] at [insert name of hospital or other care facility at which clinician is based].
Details of the Complaint
Set out here in brief and clear terms:
a)what the complaint is about, such as:
the CCG has refused to fund medical care or treatment
your care / support has been reduced and you do not agree with the decision
there has been a change in your circumstances and your care is no longer sufficient
you are not being provided with the correct care which the CCG has agreed is needed.
b)What are the key dates?
c) What it is you want the CCG to do?
For example do you want an apology, a change in the care / increase in care / provision, analteration to practice, compensation, or change in health care personnel? It is important to be as specific as possible as to exactly what you want the CCG to do.
d) If you have any evidence from other people to support what you are asking the CCG to do then attach to your letter. This could include your GP, other medical professionals, social workers, current carers, school, and therapists.
Please confirm that you will take the steps which I have identified above within 7 days i.e. by [insert date], failing which I shall be taking legal advice.
I have written this letter using a guide that has been published by Headway. That guide was based upon legal advice
I look forward to hearing from you.
[insert name and sign]