The Ombudsman Process — And The NHS Doubled Down

How This Unfolded

This whole saga took years. It built over time, through a series of conversations, delays, and decisions that only made sense once I stepped back and looked at the full picture. Here’s what actually happened, step by step:

Timeline: Childfree by Choice Realisations, Investigating Female Sterilisation Process and The Application and Rejection of my Funding Request

• In My Early 20s
• I realised I didn’t want children and started asking about permanent contraception. Over the years that followed, I repeatedly tried to get information from both GPs and sexual health clinics, but I was consistently redirected or told I was too young. There was never a clear answer or pathway.
• October 2022
• I decided to ask again. I spoke to my GP about accessing female sterilisation through the NHS. He told me he didn’t know the process himself but said he would look into it and come back to me.
• Early 2023 (after several months)
• My GP came back to me with information — with a policy. This was the first time I became aware that female sterilisation had been defunded locally, despite being a nationally recognised and funded procedure.
• Spring / Summer 2023
• Following the guidance I was given, my GP submitted an Individual Funding Request (IFR) for the procedure. There were no clear criteria or expectations outlined — it was essentially a case of applying and waiting for a decision.
• Summer 2023
• My funding request was rejected. The response didn’t meaningfully engage with my situation, and when I asked for further clarification, I was referred back to the same policy - despite me pressing for clarity on  their decision making process that led to a rejection.
• 2 July 2023
• I submitted a formal complaint to the BOB ICB. In that complaint, I challenged the policy itself — its legality, its alignment with national guidelines, and the way it restricts access to a legitimate healthcare option.
• July – October 2023
• The complaints process became drawn out and difficult to navigate. I followed up multiple times, but responses were delayed and often did not address the substance of my concerns. The process exceeded its own stated timelines.
• October 2023
• After much pressing and many delays, I received a final response from the CEO of the local NHS Trust. The response largely reiterated the existing policy, reasurringly spoke about the rigorous process Policies are made through and confidently stated the Process has been followed. Yet it did not meaningfully engage with the legal, ethical, and clinical issues I had raised.
• November 2023
• After exhausting the internal complaints process, and with my concerns still unresolved, I escalated the case to the Parliamentary and Health Service Ombudsman. But my Complaint wasn't taken in immediately.

19 December 2023

• They came back to me saying that I need to have affirmative from the NHS that they have finalised my complaint before I can approach the Ombudsman. This took a few more months to get to. I needed to get the NHS to affirm they're done with their internal investigations into my complaint and I was gonna do it.
• 13 February 2024
• After a lot of emails and pestering, a small yet huge victory came through one day. A letter from the CEO of the BOB ICB NHS Trust -  Dr Nick Broughton FRCPsych came through.

With the NHS CEO's letter in hand, and even more confidence that he had shot himself in the foot with it - I approached the Ombudsman again and filed a Complaint with them.

February 2024 -  September 2024

What I hadn’t fully realised at that point is that escalating to the Ombudsman doesn’t automatically mean your case will be taken forward. Before anything else, they assess whether your complaint falls within their remit and whether it meets the threshold for investigation. In my case, there was a real possibility that it wouldn’t. One of the concerns raised was that I was a single complainant, and the Ombudsman typically prioritises cases that demonstrate wider systemic impact. That was difficult to hear, because from my perspective, the issue was already obviously systemic — it just wasn’t being recognised as such.

I made it very clear that this was not just about me. This policy affects every woman in the region who might want to make the same decision, and many of them will never even get to the point of questioning it. Most people don’t have the time to dig through policies, meeting notes, and guidelines. They don’t know where to look, or that they can challenge decisions like this in the first place. So what appears as a “single complaint” is often just the visible tip of something much bigger. It took several more months of back-and-forth, clarifications, and persistence before the Ombudsman accepted that this warranted investigation.

Eventually, they confirmed they would take the case forward and formally look into the NHS’s actions, but even getting to that point was a process in itself.

But before all the developments on that front, something even crazier happened...

The NHS Doubled Down, Despite Knowing the Ombudsman is Looking to Investigate Them

While the Ombudsman was still deciding whether my complaint was even worth investigating, the NHS didn’t pause, reflect, or reconsider anything. Quite the opposite. During that period of back-and-forth, where I was essentially trying to prove that this issue was bigger than just me, a new version of the policy was published in July 2024. It confirmed, in plain terms, that female sterilisation “is not normally funded,” again citing “levels of regret” and “more cost-effective methods of contraception” as justification. The language hadn’t meaningfully evolved, the reasoning hadn’t been strengthened, and none of the concerns I had raised — about legality, ethics, or alignment with national guidance — appeared to have been addressed. If anything, it felt like a quiet reinforcement of the same position, just formalised again.

What made this particularly difficult to process was the timing. While I was still navigating a long, exhausting process just to get my complaint recognised as valid, the system I was challenging was actively reaffirming itself. There was no indication of review, no acknowledgement of scrutiny, no sense that the issue had even been taken seriously enough to reconsider. It felt less like a process of accountability and more like an institution closing ranks. To see a policy that I had spent months dissecting and challenging simply restated, without engagement or reflection, made it very clear how resistant these systems can be to change — even when serious questions have been raised.

Timeline: The Ombudsman Process

At this point, my complaint had left the NHS system entirely. But what I didn’t expect was just how long the next stage would take.

Here’s how that unfolded:

• 15 November 2023
• I submitted my complaint to the Parliamentary and Health Service Ombudsman.
• February 2024
• The Ombudsman formally acknowledged my complaint and confirmed they would need to assess whether to take it forward.
• April 2024
• My case was allocated to a caseworker for initial review.
• September 2024
• Due to the complexity of the case, it was escalated and reassigned to a Senior Caseworker .
• 5 November 2024
• The Ombudsman formally opened a full investigation and requested evidence from the NHS.
• January 2025
• I received a formal notice that the investigation had already taken 12 months , with further delays due to the volume and complexity of evidence.
• Throughout 2024–2025
• The Ombudsman:
• requested multiple rounds of evidence
• reviewed internal NHS documents
• corresponded with both myself and the ICB
• issued provisional findings and allowed both sides to respond
• 16 December 2025
• The Ombudsman issued their Final Report and Decision .

This means the process from submission to final decision took over two years .

And importantly — during this time, the NHS continued to uphold and reinforce the policy , despite it being under investigation.