Our grateful thanks to Daniel Grütters of One Pump Court Chambers for this note of a Section 204 appeal of a review decision that it was reasonable for appellant to continue to occupy her accommodation, so she was not homeless. The key issue is the always current question of how far the council decision maker and the review officer can prefer the advice of medics (Now Medical, inevitably) who have not met or interviewed the applicant (or as also here, rely GP records) where there is expert consultant evidence.
Dervishi v Royal Borough of Kensington and Chelsea. County Court at Central London. 10 July 2025. (Unreported elsewhere. Copy of Judgment here)
The Court held that it was perverse to prefer the absence of a complaint to a GP, or the answers given in two short questionnaires, to the opinion of a qualified expert.
The Appellant survived the Grenfell Tower fire of 14 June 2017. She lost friends in the fire. She also lost the home she shared with her family. The family were rehoused following the fire, but in time, the Appellant – who was 23 at the time of the fire – left the family home. The family relationship had deteriorated as a result of the fire.
The Appellant spent a number of weeks street homeless and applied for assistance from the Respondent. As a result of the Respondent’s intervention, Ms Dervishi obtained an assured shorthold tenancy of a property in SW5; a terrace house which has been converted into eight flats.
On 11 October 2020, the Appellant made a fresh homelessness application. It was said that the accommodation was not reasonable for her to continue to occupy and that she was thus homeless. On 18 October 2022, the Respondent determined that she was neither homeless nor threatened with homelessness. The Appellant sought a review of that decision. The review process took exactly two years to conclude.
The Appellant obtained two reports from Dr Paul Wallang, a consultant forensic psychiatrist, following two ninety minute assessments. Dr Wallang concluded that the Appellant suffered with clear and severe PTSD symptoms since the Grenfell fire. He further advised that:
‘… It is vitally important that those suffering with PTSD have a safe and supportive environment, free from triggers which would damage an already fragile mental state. Ms Dervishi’s current accommodation is inimical to her recovery due to it chaotic and triggering nature. Ms Dervishi requires a calm environment, without other residents who create noise, smoke, threaten her and generally worsen her PTSD symptoms.’
However, following advice from two psychiatrists at NowMedical, the review officer preferred to rely on the medical records obtained from the Appellant’s GP. Those records did not include any mental health diagnosis of PTSSD, anxiety and depression but did include two short questionnaires, completed by the Appellant, which suggested mild (not severe) anxiety and moderate (not severe) depression. In turn, the review officer rejected that the Appellant’s accommodation was unreasonable to continue to occupy, such that she was homeless.
The Appellant appealed and argued that the only way the review officer could reasonably decide that the overall medical evidence did not support the conclusion she was homeless would be to completely reject Dr. Wallang’s expert opinion. However, the officer did not explain why Dr. Wallang’s diagnosis might be wrong. Instead, the officer relied on two short self-assessment questionnaires, which only asked sixteen questions about the previous two weeks. It was argued that it made no sense to prefer these limited questionnaires over a thorough psychiatric evaluation, especially without giving any reason for dismissing the expert’s findings.
The Respondent responded that there was a stark contrast between the position in the medical records and the report of Dr Wallang. They highlighted the approach for a “sick note” from work on 30 January 2024 and the questionnaires completed before seeing the medical practitioner that day which suggested mild anxiety and moderate depression. Her GP agreed that she was able to return to work on 9 April 2024. That was said to be entirely supportive of the review officer’s conclusion.
HHJ Holmes noted that it was the absence of a more detailed complaint, or of a complaint of symptoms similar to those set out by Dr Wallang, to her GP that concerned the review officer. However, there was no assessment which came to a contrary conclusion to Dr Wallang. The review officer noted the absence of referral or treatment by secondary mental health professionals. That was right, but the Judge found it difficult to see how that absence of a referral was sufficient to outweigh the opinion of a consultant psychiatrist who had seen the applicant (twice).
The Judge further noted that it was also noticeable that the review officer did not specifically say that he did not accept the opinion of Dr Wallang. The review officer (and the medical advisor) did not set out any deficiencies in Dr Wallang’s analysis. Indeed, the most that the medical advisor was able to say was that the first report was ‘rather brief’. The Judge further accept the Appellant’s submission that the review officer did not consider whether it was the PTSD itself which was stopping her from seeking assistance from her GP or from wanting to engage in talking therapies.
The Judge concluded that the medical records were not a sufficient basis upon which Dr Wallang’s opinion, given in two reports, could be discounted in the way that it was in the review decision. There was no analysis of the report to justify any decision not to accept it, and nor could there be on the evidence. The central reasoning of the review decision was fundamentally flawed. Just as a review officer needs to exercise care before preferring the opinion of a medical advisor who is not as well qualified and has not examined the applicant, he must be just as careful to discount expert evidence in preference for what is contained in medical records, particularly in circumstances where those records are primarily being relied upon for what they do not say rather than the scant detail that they do contain. It was perverse to prefer either the absence of a complaint to a GP, or the answers given in two short questionnaires, to the opinion of a qualified expert.
Moreover, he held that had any doubts about the reports, or concerns about the disparity between the reports and the records, the review officer had several options open to him. He could have asked questions of Dr Wallang. He could have agreed to Dr Wallang speaking with the authorities’ medical advisor (as was suggested in Shala v Birmingham). He could have had the Appellant examined by the authorities’ medical examiner or a different psychiatrist. Those steps would have been an appropriate way of dealing with any concerns that the review officer may have had. Discounting the opinion of the medical expert without taking one or more of those steps was not a course which was open to him.
The appeal was allowed and the decision quashed.