Leah Spasova complained to the ombudsman after her request for sterilisation was rejected by Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (ICB), now part of NHS Thames Valley ICB.

Paula Sussex, Parliamentary and Health Service Ombudsman, said: ‘This case shows the power of the patient voice. Leah complained about her experience and the ICB is now reviewing its sterilisation policy. This could benefit and empower many more women to make informed decisions about their health.'

The investigation found the ICB did not routinely fund female sterilisation and cited the risk of regret as a reason for refusing women the procedure. Its policy for male sterilisation routinely funded vasectomy for eligible men and did not use regret as a reason for rejection. 

The ombudsman concluded that the ICB's approach was ‘unfair, inconsistent, and based on subjective reasoning'.

The ombudsman recommended the ICB write to Spasova to acknowledge its failings, apologise and explain how its review will take place and what it has done, or will do, to improve its commissioning and complaint handling processes. The ICB has agreed to comply. 

Spasova, a psychologist, from Oxfordshire said: ‘Policies like this are damaging for women's healthcare and women's access to health services - it's absolutely discriminatory. There is continuing widespread inequality in how permanent contraception is accessed with concerns about fairness and respect for women's bodily autonomy remain unresolved. The key lesson from my case is how commissioning policies can create unequal barriers and why people should fight for their rights through transparency and accountability.'

A NHS Thames Valley spokesperson said: ‘NHS Thames Valley accepts the findings of the Parliamentary and Health Service Ombudsman regarding historical decision making in this case. Since that time, NHS Thames Valley has introduced a new policy to ensure that patients who meet the criteria are able to access female sterilisation. As a new ICB, we are also redesigning our complaints function to ensure concerns about local services are responded to more effectively and in a timely way.'