Facts: the PCT assessed PE’s needs as not being primarily healthcare needs, so that she was ineligible for NHS continuing healthcare. St Helens, the local authority on whom the social care costs then fell, sought a judicial review. Beatson J refused permission to apply for judicial review and St Helens appealed.

Judgment: the Court of Appeal (May and Scott Baker LJJ, Sir Peter Gibson) dismissed the appeal, holding that the critical statutory was that imposed on the Secretary of State for Health, under sections 1–3 of NHSA 2006; it was that legislation that was the dominant legislation in the sense that decisions under it were determinative of whether a person had a ‘primary healthcare need’, the local authority’s function being residual. Accordingly it was for the NHS to determine whether a person was entitled to NHS continuing healthcare and, if a local authority challenged that decision, the usual judicial review principles would apply and there would not be a merits based review by the court, even though the consequence of the NHS decision was that the local authority had to shoulder a burden it considered to be ultra vires its powers.