NHS Windsor And Maidenhead Clinical Commissioning Group v SP (Withdrawal of CANH) [2018] EWCOP 11 (20 April 2018)

In this case, Windsor, Ascot and Maidenhead CCG (The CCG) applied to the court for a personal welfare order in respect of SP for a declaration and order that it was not in the best interests of SP for CANH to be continued. Palliative care would be provided but it was expected that SP would die within 7-14 days.

On 03/10/14 at the age of 50, SP suffered a cardiac arrest and after being admitted to Wexham Park and subsequently Northwick Park Hospital, she never regained consciousness. SP was cared for in a nursing home from 23/03/15 and in April 2015 she was diagnosed as being in a permanent vegetative state (PVS). She had been in receipt of CANH since October 2014.

Family accounts of SP prior to her cardiac arrest pained a vivid picture of someone full of life with a sense of fun, who was warm and caring, dedicated to her children and had a love of the outdoors and children.  The family had reached the view that it was in SP’s best interests for CANH to now be withdrawn and the investable outcome of that decision was accepted.

Various reports obtained from experts over the years confirmed the permanent vegetative state of SP. In March 2015 a best interest meeting had taken place and it concluded that in her current situation, SP would not have wanted her life prolonged. However, no steps were taken at the time to withdraw CANH due to issues of guardianship of her children. Another meeting took place on 07/10/16 which involved discussions with the family and amongst professionals and the same conclusion was drawn, that it was in SP’s best interests to withdraw CANH, with provision for palliative care only. A palliative care plan was drawn up.

The CCG approached the Official Solicitor (OS) in October 2016 about making an application. The OS agreed to act for SP and investigations ensued. In February 2018 the OS and the family confirmed they were content to make the application to be made on paper. Proceedings were issued on 19/03/18 and the Court was invited to determine the application without a hearing.

Mr. Justice Williams considered various previous case law and subsequently accepted the evidence of the clinicians and the family. He concluded that CANH should be discontinued and replace by palliative care only, although this decision was made with inevitable regret but he was clear that this was in SP’s best interests. Mr. Justice Williams therefore made the Declarations and orders sought.

The full judgment can be read here.

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