Nhs Pension Scheme · CAS-37266-F1D9

CAS-37266-F1D9

Ombudsman’s Determination Applicant Mr R

Scheme NHS Pension Scheme (the Scheme)

Respondent NHS Business Services Authority (NHS BSA)

Outcome

Complaint summary Mr R’s complaint concerns NHS BSA’s procedures. Specifically, NHS BSA has set “rules” that put members applying for ill health pension under financial pressure to accept Actuarially Reduced Early Retirement (ARER).

Background information, including submissions from the parties The sequence of events is not in dispute, so I have only set out the salient points. I acknowledge there were other exchanges of information between all the parties.

The relevant regulations are the National Health Service Pension Scheme Regulations 1995 (SI1995/300) (as amended) (the 1995 Regulations).

Regulation E2A, sets out the conditions that a member must satisfy to be entitled to an ill health pension on early retirement. Regulation E5, sets out the conditions for early retirement pension with actuarial reduction.

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• The views expressed by the OH Assist doctors were “not inconsistent” with the medical evidence available at the time. However, the final stage of the appeal process was completed in November 2017. Mr R’s employment did not cease until March 2018. “It is this later date at which he would be required to meet the tier 1 or 2 conditions”.

• Mr R had provided additional evidence that indicated that he was now under the care of a psychiatrist and management of his condition had moved on. It would be appropriate for NHS BSA to ask OH Assist to review his eligibility for benefits under regulation E2A as at March 2018.

• Regulation T1: “Claims for benefits” of the 1995 Regulations, requires Mr R to make a written claim for benefits “in such form as the Secretary of State may from time to time require”. So, it may be the case that NHS BSA will require him to complete another application for ill health retirement (AW33E) form.

Adjudicator’s Opinion Mr R’s complaint was considered by one of our Adjudicators who concluded that no further action was required by NHS BSA. The Adjudicator’s findings are summarised below:-

• Mr R had restated that his application for ill health retirement was mismanaged by NHS BSA. The Adjudicator explained that the new separate complaint concerning

2 CAS-37266-F1D9 NHS BSA’s procedures had been accepted for investigation and her Opinion only addresses this complaint.

• The Adjudicator noted that Mr R was previously given the opportunity to proceed on the basis recommended by the First Adjudicator and submit a new AW33E.

• However, Mr R effectively asked for his retirement benefits to be calculated under Regulation E5 and the parties agreed to proceed on this basis. In the Adjudicator’s view, there would have been sufficient information on NHS BSA’s website that would have alerted Mr R to the implications of claiming an ARER.

• The Adjudicator highlighted that NHS BSA cannot pay an ill health pension unless the relevant conditions are satisfied. While she sympathised with Mr R’s position, she was not of the view that NHS BSA’s conduct in this case amounted to maladministration.

Mr R did not accept the Adjudicator’s Opinion and the complaint was passed to me to consider. Mr R provided his further comments which do not change the outcome. He said that:-

• Initially, he did not want to get involved in the investigation because he knew it would affect his mental health.

• The views the Adjudicator expressed in the Opinion were expected. It is ironic that the very reason he accepted a reduced pension was the time it would take for an appeal to be reviewed. If he had waited for the outcome of the review, he would have been without an income and would probably have lost his home.

• He is still of the view that NHS BSA “hold staff to ransom.” However, as long as it does this in the “correct way” TPO will support NHS BSA.

I note the additional points raised by Mr R but I agree with the Adjudicator’s Opinion.

Ombudsman’s decision

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Anthony Arter

Pensions Ombudsman 3 January 2023

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