By Amanda Hill, 11th May 2026
The protected party (P) is a woman with diagnoses of mild learning disability, “emotionally unstable personality disorder”, functional neurological disorder, dissociative disorder and elective mutism (she communicates using Makaton).
She’s been in hospital since April 2025. In September 2025 she had surgery and was soon afterwards declared medically fit for discharge. By the time of the hearing I’m describing here (on 11 February 2026), that’s five months ago.[1] She is currently receiving nutrition by an NG tube. According to the approved order of 20th November 2025, “all parties agree that a coherent plan is required for [P’s] nutritional needs prior to discharge from hospital” – subsequently referred to an “eating and drinking plan”.
So, there’ s a deceptively simple solution to enable P to leave hospital – the development of an eating and drinking plan – but a complex web of responsibilities for making that happen, involving multiple public bodies, multiple teams, and multiple people. And a search for a specialist to produce the plan had proved fruitless at the time of the hearing.
This is the fourth hearing I’ve observed in this case (COP 13630253), before Senior Judge Hilder at the Royal Courts of Justice. The earlier hearings I observed were on 25th July 2024, 3rd September 2025 and 20th November 2025 and I blogged about the September hearing ( Should surgery be delayed while the legal framework relating to capacity is established?) There have been other hearings I haven’t observed, including one on 16 December 2025 and possibly one on 16th April this year.
It’s a complex case and I’ll try to keep it as simple as possible. Rather than go into detail about what happened at the hearing I observed, I will outline the key problems it highlighted, what is getting in the way of solving these problems, and what the judge can do about it.
One thing is clear: it’s P, the person at the centre of this case, who is the one who is bearing the brunt of the lack of progress.
The parties
In addition to P and her two siblings, there are four statutory bodies as parties to these proceedings, two as applicants and two others as respondents.
- The applicants are Suffolk County Council (SCC) represented by Ulele Burnham and NHS Suffolk and North East Essex ICB represented by Sarah Vince (who also represented the 3rd respondent)
- The 1st and 2nd respondents (represented pro bono by Anna Bicarregui) are P’s siblings.
- The 3rd respondent is Essex Partnership University NHS Foundation Trust (EPUT) (also represented by Sarah Vince)
- P is the 4th respondent represented via her litigation friend the Official Solicitor by Victoria Butler-Cole KC
- The 5th respondent (joined as a party from November 2025) is Hertfordshire Partnership NHS Foundation Trust, represented by Stuart Marchant.
Who is responsible for producing an eating and drinking plan?
The ICB has overall responsibility for meeting P’s medical needs in the community. On 20 November 2025 the court ordered the ICB to produce an eating and drinking plan by 1 December 2025. Nearly 3 months later, there is still no plan.
The two siblings are “saddened, angered and frustrated that despite the court’s best efforts in the last order there is no plan to get P out of hospital”. Their view is that “no one person/organisation is taking ownership” of the plan and that the public bodies are not working together collaboratively: each of them seems instead to be “more focused on setting out the limits of its responsibility”.
An additional complication is that EPUT and HPFT have differing responsibilities for P’s care and mental health treatment. EPUT are responsible for P’s psychological therapy. HFPT are responsible for primary care coordination, including specialist learning disability services, a role they took on a day after the hearing, following a six-week transition.
Senior Judge Hilder is trying her utmost to move things along. But, as P’s siblings say, “It is apparent that court orders are not currently being followed“.
The ICB and LA were directed to file an interim care plan including how P’s nutrition and hydration needs would be met on a return home by a deadline of 29 July 2025. They didn’t. Then another deadline was set for the ICB to produce the eating and drinking plan by 1 December 2025. Again, it’s not been produced.
The OS wants explanations for the lack of progress. They’ve gone as far as “seeking a direction that Chief Executives or other senior officers from the relevant statutory bodies attend this hearing to explain themselves“. But no Chief Executives attended the hearing on 11 February 2026.[2]
The OS is also seeking a direction that the ICB and EPUT pay P’s costs from 1 December 2025 “on the basis of the repeated failure to comply with court orders, and the failure to put in place the provision needed by [P] to return home”.
The ICB disputes this, saying that: “The ICB have only ever held a commissioning role in [P’s] care. The ICB cannot create care plans nor force compliance with trusts outside of its commissioning area”.
The outcome at the end of the hearing of 11 February 2026
At the start of the hearing, Senior Judge Hilder said that it was very difficult to understand who is responsible for the eating and drinking plan. Key sticking points were the identification of a suitable specialist to draw up the plan and funding of that specialist. P’s needs are complex and identifying a person with exactly the right skills has not been easy. A named person identified had that very day declined to take on the work. The OS legal team had already been searching and had come up with another named person, who HPFT were going to meet with directly after the hearing. If that person was not suitable, the Deputy Director of Nursing for the ICB agreed to take responsibility for a new search. The OS legal team and SCC offered to pass on the results of their searches in order not to duplicate effort. HPFT would make the final decision.
In terms of funding, it was hoped funding would be agreed at an ICB panel meeting of 26th February 2026, or if not at the next one on 26th March 2026. The Deputy Director of Nursing told the court that would be the last panel meeting for the ICB as it was closing on 31st March 2026.
With regards to the costs issue, a solicitor from the OS legal team is going to provide a breakdown of costs to the relevant parties, and all appropriate parties will make written submissions to the court, that the judge has made time in her diary in late February to consider. It was agreed that P’s siblings should not bear any of the costs even though they are parties.
At the end of the two hour fully remote hearing SJ Hilder stated “Let’s get this sorted please, it’s been going on long enough”.
Provided a specialist with the appropriate skills to develop the eating and drinking plan can be identified, and that they agree to take on the work, funding will be agreed at either a panel meeting on 26th February or 26th March 2026. And then work on the eating and drinking plan should begin.
The Approved Order
As I often do, after the hearing I asked for a copy of the approved order so that I can check the details. I received it on 20 February 2026, the day it was issued.
The update from the hearing was that the role of care coordinator was now to be due on 17 February. A dietician identified by the Official Solicitor was considered to have the appropriate skills and the order noted by way of a recital that “following the hearing but before this order was perfected, HPFT confirmed that it would ask the ICB to commission (the dietician) to prepare an eating and drinking plan for [P]”.
The ICB was ordered to place the funding application before the panel of 26th February 2026, and to inform the parties of the panel’s decision by 4pm on 4 March 2026. If funding is agreed, the first version of the eating and drinking plan is (finally!) to be circulated to all parties by 25th March 2026.
Closing reflection
I was surprised how difficult it seemed to be to locate a specialist to develop the eating and drinking plan and that (apparently) there isn’t a database or directory. I very much hope by the time of the next hearing to learn that P has left, or is about to leave, hospital: by that time, she would have been in hospital for around a year.
Amanda Hill is a PhD student at the School of Journalism, Media and Culture at Cardiff University. Her research focuses on the Court of Protection, exploring family experiences, media representations and social media activism. She is a core team member of OJCOP. She is also a daughter of a P in a Court of Protection case and has been a Litigant in Person. She is mainly on LinkedIn (here), but also sometimes on X (@AmandaAPHill) and Bluesky (@AmandaAPHill.bsky.social).
[1] I asked for all the parties’ position statements for this hearing, to enable me to understand it better in accordance with the open justice principle. SJ Hilder directed disclose of the Official Solicitor’s position statement for the Official Solicitor, and all the other parties agreed to send me theirs without needing a direction (including P’s siblings). I had received all the anonymised PSs by the end of the day of the hearing on 11th February 2026. I am very grateful to all the parties: the PSs have been very useful in enabling me to follow and report on this complex case and I have drawn on them in writing this blog.
[2] The Deputy Director of Nursing for the ICB attended, as did the Interim Associate Director for EPUT, the Head of Operations and Partnerships for Mental Health at SCC, the Managing Director for Learning Disabilities and Forensic Services at HPUT and the Head of Legislation and Compliance at HPUT.
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