WND, R (on the application of) v NHS West and North London Integrated Care Board

Facts

The claimant, WND, is a 13 year old boy with complex medical disabilities arising from a rare genetic disorder diagnosed in 2018, with symptoms including seizures, fluctuating muscle tone, learning disability, and communication and mobility disabilities. He is at high risk of sudden unexpected death in epilepsy, the risk being greatest at night. He is cared for at home by his parents, who provide night-time care themselves. The defendant Integrated Care Board has commissioned continuing care for him since 25 June 2015, and since 2023 has provided 126 hours of support per week delivered at a 2:1 ratio across 63 hours, rather than 24/7 care. Following an updated assessment, the Decision Support Tool recommended that he was not eligible for continuing care, but the defendant's panel did not adopt that recommendation: on 24 September 2025 it found him eligible, on 7 December 2025 it maintained the existing package, and on 28 January 2026 it determined the staffing allocation, deciding that the 63 hours at a 2:1 ratio should be delivered by a registered nurse and a healthcare assistant. The claimant, by his litigation friend WSA, brought judicial review of the decision of 28 January 2026, no longer pursuing a mandatory order for 24 hour care but seeking to quash that decision as irrational. The London Borough of Haringey attended as interested party but took no part.