Tribunal decisions

The decision

IN THE UPPER TRIBUNAL
IMMIGRATION AND ASYLUM CHAMBER Case No: UI-2025-003611
First-tier Tribunal No: HU/50362/2024
LH/01537/2025

THE IMMIGRATION ACTS

Decision & Reasons Issued:
On 27th April 2026

Before

UPPER TRIBUNAL JUDGE PINDER

Between

I Z
(ANONYMITY ORDER MADE
Appellant
and

THE SECRETARY OF STATE FOR THE HOME DEPARTMENT
Respondent

Representation:

For the Appellant: Ms Zumba, the Sponsor, not represented legally.
For the Respondent: Ms R Arif, Senior Presenting Officer.

Heard at Birmingham Civil Justice Centre on 10 February 2026

Order Regarding Anonymity

Pursuant to rule 14 of the Tribunal Procedure (Upper Tribunal) Rules 2008, the Appellant is granted anonymity.

No-one shall publish or reveal any information, including the name or address of the Appellant, likely to lead members of the public to identify the Appellant. Failure to comply with this order could amount to a contempt of court.

DECISION AND REASONS
Introduction
1. This is the re-making of the decision in IZ’ appeal. This follows the earlier decision of Upper Tribunal Judge Rastogi and Deputy Upper Tribunal Judge Burns (‘the panel’) to set aside the decision of the First-tier Tribunal (‘the FtT’) dismissing the Appellant’s appeal on human rights grounds because this contained material error(s) of law. The panel’s decision (‘the error of law decision’) was promulgated on 2nd January 2026.
2. Following a transfer order, I heard the re-making appeal on 10th February 2026.
3. I have maintained the anonymity order in respect of the Appellant. I consider that on the specific facts of this appeal, the maintenance of the integrity of the United Kingdom’s immigration system and the Appellant being a vulnerable person as a result of her mental health, are such that an anonymity order is a justified derogation from the principle of open justice.
4. As was recorded in the error of law decision, the decision of the FtT involved the making of material errors of law and the decision was set aside. The panel determined at paras 38-39 of their decision that the only issues to be decided when the decision is remade are whether the Appellant meets para ADR 5.1 of the Immigration Rules and whether the refusal of her application would give rise to unjustifiably harsh consequences under Article 8 ECHR. The panel also preserved the findings made by the FtT at [20] of that decision, which are as follows:
i) At the date of the FtT hearing the Appellant was well looked after by her carer,
ii) There was no indication that the carer relationship was not going well or that it was to end at any time in the near future and,
iii) There is likely to be other people who will undertake care of the Appellant in the future if needed.
5. The Respondent’s decision refusing the Appellant’s entry clearance and human rights application is dated 4th January 2024.
Factual and procedural history
6. The Appellant is a national of Tanzania who applied, on 22nd October 2023, for entry clearance to join her sister, the Sponsor, in the UK. The Appellant suffers from mental-ill health and applied for entry clearance under the provisions contained in Appendix Adult Dependent Relative (‘Appendix ADR’) to the Immigration Rules. That application was refused on 4th January 2024 by the Respondent and the Appellant appealed against the decision.
7. The Respondent refused the Appellant’s application on the basis that she was not satisfied that the Appellant met the requirements of paras ADR.5.1-5.2 of Appendix ADR. The Appellant’s subsequent appeal to the FtT was dismissed by decision promulgated on 3rd July 2025. That decision was subsequently set aside by the Upper Tribunal, as summarised at para 4 above.
The hearing
8. The Appellant’s sister, the Sponsor in the application, Ms Zumba, attended the hearing on the Appellant’s behalf and acted as the Appellant’s representative.
9. A number of updating medical letters concerning the Appellant had been filed with the Upper Tribunal by the Sponsor but not served on the Respondent. It appeared that this was a result of the Sponsor’s misunderstanding that e-filing with the Upper Tribunal’s online portal did not also amount to service on the Respondent. Copies of this updating evidence were provided to Ms Arif, who was also given time to consider the contents. Upon doing so, Ms Arif confirmed that she did not object to the evidence being admitted and did not require any further time to prepare. Ms Arif confirmed that she was ready to proceed with the appeal hearing and I duly admitted the Appellant’s further evidence.
10. Following the short discussion summarised above, the parties also agreed that the issues for me to determine are as follows:
(a) Whether the Appellant meets the requirement of para ADR 5.1, namely that the Appellant must as a result of age, illness or disability require long term personal care to perform everyday tasks;

(b) In respect of para ADR 5.2., the parties agreed that the panel had preserved the FtT’s finding, which was that, at the time of the FtT hearing and on the evidence before it, the Appellant did not meet that provision. Para ADR 5.2 states as follows:

“Where the application is for entry clearance, the applicant, or if the applicant is applying as a parent or grandparent, the applicant’s partner, must be unable to obtain the required level of care in the country where they are living, even with the financial help of the sponsor because either:
(a) the care is not available and there is no person in that country who can reasonably provide it: or
(b) the care is not affordable.”

The parties agreed that I am to determine whether that remains the case on the evidence before me or whether I would be justified to depart from that finding.

(c) Subject to my determination of the issue at (b) above, whether the Appellant can demonstrate unjustifiably harsh consequences under Article 8 ECHR.
11. I heard oral evidence from Ms Zumba, who adopted as her evidence her previous witness statement and all other written materials that she had authored. She was then duly cross-examined by Ms Arif on behalf of the Respondent. I also asked one or two questions by way of clarification and there were no questions arising, or anything further, from either party thereafter.
12. I then heard legal submissions from both parties, after which I confirmed that I would be reserving my decision.
The evidence
13. I had before me the consolidated bundle (‘TB’) prepared by the Upper Tribunal and served on the parties in advance of the error of law hearing on 7th November 2025, consisting of 129 pages.
14. In advance of the re-making hearing on 10th February 2026 and in reply to the directions set out in the error of law decision, the Sponsor filed two additional medical letters. The first was dated 15th January 2026 and concerned the Appellant’s current carer, whom I will refer to as ‘the carer’. The second letter was dated 27th January 2026 and concerned the Appellant. The Respondent did not seek to rely on any further evidence.
15. I have given careful consideration to all of the written materials and evidence admitted into these proceedings and to the Sponsor’s oral evidence as well as to the parties’ oral submissions. I do not summarise the contents of the evidence and submissions separately but refer to these, where necessary and relevant, in my analysis below.
Findings of fact and Conclusions
16. I first consider, as I am required to, the Appellant’s ability to meet the requirements of the Immigration Rules. As I have summarised above, it is first necessary to consider whether the Appellant can meet the provisions of paras ADR 5.1.-5.2 with no preserved findings of fact in respect of para ADR 5.1.
Paragraph ADR 5.1. of the Appendix ADR to the Immigration Rules
17. The Appellant has been diagnosed with schizophrenia (TB 104) and a chronic depressive condition (letter of 27th January 2026). The medical letters submitted in support of the Appellant’s appeal confirm that she is a patient at the Regional Referral Hospital in its Mental Health Department since June 2022. The doctor’s letter of 10th August 2023 states the following in summary:
• The Appellant presented with a variety of mental health symptoms including difficulty coping with daily life environment, sleeping disturbances, loss of interest in activities, decreased energy level and feelings of worthlessness;
• The Appellant has been given anti-psychotic and anti-depressant medication and psychological counselling;
• The Appellant went missing on 18th July 2023 and was found in Dar es Salaam almost a week later;
• During the assessment, the Appellant appeared to have difficulty concentrating, expressed feelings of hopelessness about her future, thoughts of self-harm/ suicide.
18. The doctors’ letter dated 30th June 2025 provides a summary of recent consultations and/or visits with the Appellant and states the following in summary:
• On 9th January 2025, the Appellant appeared alert but withdrawn with inappropriate grooming and hygiene; she maintained limited eye contact. Her mood appeared flat. Her insight into her mental health condition was absent with the patient showing reluctance to engage in current treatment and to a deal with prescribed medication. The Appellant reported limited interactions with family and friends and described a sense of isolation and mistrust. The doctors’ key concerns on that date included social isolation, limited insight, ongoing emotional distress;
• On 3rd April 2025, the Appellant presented with ongoing symptoms including disturbances in mood, behaviour, cognition and/or perception. The Appellant also reported that she was triggered by the thoughts of her past illness and hallucinations and worried about experiencing these. She admitted anxiousness and low self-esteem/lack of confidence to perform duties, she cannot work and perform personal hygiene;
• On 27th June 2025, the doctors confirmed that despite on-going treatment (which included injections) and regular clinical reviews, the Appellant remained psychiatrically unstable. Further, that she presented with persistent symptoms affecting her ability to function independently on a day-to-day basis. She struggled with marked lack of concentration, memory issues, difficulty with coping with routine daily activities without supervision or support. Social isolation continued to be a problem.
19. The updating letter from the Appellant’s doctor dated 27th January 2026 included the following information in summary:
• The Appellant experienced significant impairment in her ability to function independently. In the doctor’s clinical opinion, she requires ongoing assistance to complete essential day-to-day activities, including - but not limited to - washing and bathing, cooking and food preparation, feeding and dressing and maintaining personal hygiene;
• After discussion with fellow doctors, it was agreed that the Appellant should be prescribed Aripiprazole as part of her treatment regimen but this drug is not currently available in Tanzania.
20. The Respondent has not disputed the Appellant’s diagnosis and she took issue instead, both in the initial refusal decision and in her review, with the evidence concerning whether or not the Appellant requires long-term care because she cannot perform everyday tasks and whether the current care arrangements for the Appellant can continue.
21. The medical evidence, summarised above, was also accompanied by the Sponsor’s own evidence, both in writing and orally. I found the Sponsor to be impressive as a witness. She was candid in her evidence and did not seek to exaggerate her evidence in any way. She has written and spoken clearly of her understanding of her sister’s condition and of her sister’s needs. She also gave her evidence clearly as to the difficulties that she has experienced in being able to support her sister. I also consider that the Sponsor’s own evidence is strengthened by the fact that she is a qualified nurse, who has also experienced mental ill-health of her own in the past. It was clear to me that the Sponsor has both a professional and personal understanding of and a detailed insight into her own past difficulties and those of her sister’s as well. This is contrast to the Appellant’s doctors who report that she has poor or limited insight, if any, into her condition.
22. In light of the above, which includes the medical evidence and the Sponsor’s own evidence, I am satisfied that the Appellant suffers from schizophrenia and depression.
23. Ms Arif submitted that the medical evidence did not demonstrate that the Appellant as a result of her illness was struggling to look after herself to the extent that she requires a carer. Ms Arif asked me to place little weight on the medical letter of 27th January 2026 since this did not provide the details of how the doctor had formed their conclusions and did not cross-refer to the earlier letter of 30th June 2025. With regards to the letter of 30th June 2025, Ms Arif submitted that this showed three instances whereby the Appellant had been assessed by her medical team and nothing further. Ms Arif also reiterated the point made in the Respondent’s review that the letters had been obtained close to the appeal hearings each time.
24. I have considered the Respondent’s submissions very carefully but I do not consider that these form valid reasons for attaching little, or less, weight to the medical evidence submitted. Firstly, the fact that these have been obtained close to the appeal hearings is not in itself a valid reason to do so. I have firmly in mind that the Appellant has not been legally represented throughout and most recently, both parties were given permission to rely on updating evidence in preparation for the re-making appeal hearing. That direction asked that the parties file and serve their respective updating evidence no later than 14 days before the date of the next hearing. The Appellant can therefore hardly be criticised for obtaining updating evidence two weeks prior to the hearing.
25. I also consider that it is necessary to read the three medical letters together. The two most recent letters have been co-/authored by the same doctors. They are letters from treating physicians and the authors have not been instructed to write their reports as independent experts. As noted above, the Appellant has not been legally represented and I also bear in mind that the use of the English language is likely to differ in Tanzania.
26. The Sponsor in her evidence also explained that she is of the view that the medical professionals do not at times understand her sister, the Appellant. She stated that the Appellant becomes aggressive and shouts and that she is not dressed appropriately or speaking appropriately. The Sponsor stated that that is in part why she is so concerned. This is also corroborated in the treating doctors’ assessments and opinions.
27. It is clear from the medical letters that the Appellant has several times been reported as not having dressed appropriately and as having inappropriate hygiene. The doctors have also confirmed that she is unable to undertake essential day-to-day activities of the type listed at para 19 above. The medical team, which has been responsible for the Appellant’s condition and treatment, has been involved with the Appellant for a considerable period of time, namely since June 2022 and is, in my judgment best placed to comment on such things. I do not consider that the Respondent has been able to successfully challenge this written, specialist evidence and I attach considerable weight to this.
28. I also accept the Sponsor’s evidence that she has arranged for the Appellant to live with someone else, so that she can be cared for and benefit from support on a daily basis. The Sponsor confirmed the funds that she sends regularly in order to fund this and this was not disputed by the Respondent. Prior to the Appellant’s current carer, the Sponsor had organised for others to care and support the Appellant but the Sponsor gave evidence, which I accept, that these arrangements did not last long. In addition, the Sponsor confirmed that she rings her sister/her sister’s carer on a daily basis and during these calls, she checks whether the Appellant has taken her medication and other such tasks.
29. For the reasons above, I am satisfied that the Appellant, as a result of her illness requires long term personal care to perform everyday tasks, in accordance with para ADR.5.1.
Paragraph ADR 5.2. of the Appendix ADR to the Immigration Rules
30. I next turn to consider whether or not the Appellant has demonstrated that she is unable to obtain the required level of care in Tanzania, where she is living, even with the financial help of her sister, the Sponsor, because either the care is not available and there is no person in that country who can reasonably provide it, or the care is not affordable.
31. Neither the Appellant nor the Sponsor have pursued an argument that the care that the Appellant requires is unaffordable. The case presented on behalf of the Appellant turns on the first premise therefore, namely whether the care that she requires is available and if so, that this cannot be reasonably provided to her in Tanzania.
32. As I have already summarised above, the finding at first instance in this respect was preserved. The Sponsor has asked that I re-visit this however as she has presented evidence that firstly, it is no longer reasonable to expect the Appellant’s carer to look after the Appellant and there is no one else who can reasonably be expected to care for the Appellant instead. Secondly, the Sponsor also argued on behalf of the Appellant that the Appellant could benefit from medication, which is not available to her in Tanzania but would be in the UK.
33. With regards to the first reason given by the Sponsor, the Sponsor obtained a letter from the carer’s own doctor, which is dated 15th January 2026. This confirms that the carer is 72 years old and has been followed at the regional hospital since 2024. The carer has been diagnosed with hypertensive heart disease and osteoarthritis. The Sponsor argues that it is not reasonable to expect the carer to continue to look after the Appellant and that it is also clear from the medical letters concerning the Appellant that the carer has not been managing either. For instance, the Appellant remains in a fragile state, unkempt and socially isolated.
34. The Sponsor also gave evidence that she is worried about the carer. She confirmed that she very much appreciated her help but she is aware that the carer is managing her own health and advancing age. The Sponsor stated that the carer had recently complained about her knees to her and that walking had become a problem for her. The Sponsor confirmed that she felt that she was placing pressure on the carer and that this was not sustainable or reasonable, particularly consider her sister’s own age of 39 years.
35. The evidence concerning the carer’s own age and health was not evidence that was before the FtT. It is evidence that has now been obtained considering the passage of time since the Appellant first applied to the Respondent and the carer’s advancing age. Ms Arif submitted that the medical treatment that the Appellant has been receiving in Tanzania remains available to her as is the case with the care and support provided to her by her existing carer. Ms Arif submitted that this does not demonstrate that the Appellant meets the requirements of para ADR.5.2.
36. I do not consider however that the Respondent has successfully disputed the medical evidence pertaining to the Appellant’s carer. At the time of the FtT appeal, the Judge found that the current care arrangements could continue. However, there is evidence before me that this is not the case. Furthermore, it is also evident from the Appellant’s medical letters and the Sponsor’s evidence, which I accept, that the level of care that the Appellant requires is not being met by the Appellant’s current carer as summarised above.
37. I consider in parallel, but also in the alternative, that the Appellant and Sponsor have demonstrated that an aspect of the Appellant’s care is not available in Tanzania. This is because the medication Aripiprazole is not available in Tanzania, as per the Appellant’s doctors’ most recent letter. As I have summarised above at para 19, the doctors confirmed having taken the view, after consultation with other medical professionals, that the Appellant would benefit from this medication.
38. Alongside this, the Sponsor has also presented background evidence that confirms that this particular drug is widely used/preferred in high-income countries such as the UK, USA, EU countries and Japan for schizophrenia, bipolar disorder and as adjunct in depression. The Sponsor was also able to give evidence before me that it is medication that she has been prescribed for herself, which is why she has knowledge of this medication and was able to discuss the same with her sister’s, the Appellant’s, medical team. The Sponsor’s medical history and prescriptions are confirmed in her own medical records, which she has disclosed within these proceedings (TB 105). The Sponsor’s openness about this and willingness to disclose corroborative records within these proceedings has also reinforced my positive assessment of the Sponsor as a witness and my acceptance of her evidence.
39. Mr Arif submitted that whilst alternative medication might not be available to the Appellant in Tanzania, she continues to be followed and appropriate treatment prescribed to her. The fact that the Sponsor has put forward alternative suggestions for the Appellant’s medical treatment does not demonstrate that the care that the Appellant requires is not available and that therefore the relevant rule contained in para ADR.5.2 is met. This submission has considerable force but I also consider that the Sponsor’s evidence, which is corroborated in the Appellant’s medical letters, that the Appellant’s conditions of schizophrenia and depression are not currently being managed, has equal force.
40. The Appellant’s medical treatment has been changed and adjusted on several occasions as confirmed in the medical letters of 2025 and 2026. Those letters also confirm that, despite compliance with the pharmacological interventions, there has been limited clinical improvement. As I have addressed already, the doctors confirmed on 27th January 2026 that the Appellant should be prescribed Aripiprazole as part of her treatment regiment but this is not possible as the drug is currently not available in Tanzania.
41. For the reasons above, when considered cumulatively, I am satisfied that the Appellant has demonstrated before me that the care she requires is not reasonably available to her in Tanzania. This is as a result of the Appellant’s current aging carer, who has own her medical needs and who is not able to ensure that all of the Appellant’s essential needs are met. This is also combined with the Appellant’s conditions not being managed on her current treatment regimen. I am also satisfied that it is appropriate and justified to depart from the FtT’s finding in this respect – the evidence now relied upon was not before the FtT at first instance and has a resulted from the passage of time and the carer’s own progressing difficulties.
42. I also accept the Sponsor’s evidence that she would experience severe difficulties in securing an alternative carer, who would be able to reasonably provide the care that the Appellant requires. As I have briefly addressed above, the Sponsor has tried alternative arrangements, which were not sustainable and which resulted in the Appellant going missing for almost a week. Despite the relative stability of the Appellant’s current carer’s help, the Appellant’s conditions are still not being managed. I accept the Sponsor’s evidence that the Appellant requires close supervision and stimulation, which her current carer has not been able to provide her with, as per my findings above. This is also a situation, which will only keep on deteriorating as the carer gets older and more immobile. In contrast, I accept the Sponsor’s evidence that she has a close relationship with her sister, understands her needs and is able to provide her with the support that she requires.
43. As a result of the above, I am satisfied that the Appellant meets both sets of requirements contained in paras ADR.5.1-5.2 of Appendix ADR to the Immigration Rules.
44. Applying the statutory framework contained in s.117A-B of the 2002 Act, as required, whether or not the Appellant speaks English and would likely be self-sufficient financially thanks to the Sponsor’s support (s.117B(2)-(3), are neutral factors. The ‘limited weight’ factors contained in s.117B(4)-(5) have no application as the Appellant has not been residing in the UK. It is also the case that the maintenance of effective immigration controls is in the public interest (s.117B(1) and this is fulfilled as I have found the relevant Immigration Rules to be met by the Appellant.
45. It follows from the above that the Appellant’s human rights appeal falls to be allowed since the Article 8 ECHR requirements reflected in Appendix ADR to the Immigration Rules are met. For all of the reasons above, IZ’s appeal against the Secretary of State’s decision of 4th January 2024 is allowed on Article 8 ECHR grounds.
Notice of Decision
46. The decision of the FtT dated 3rd July 2025 did involve the making of material error(s) of law and has been set aside, pursuant to the decision of the panel dated 2nd January 2026.
47. I re-make the decision by allowing the Appellant’s IZ’ appeal against the Respondent Secretary of State’s decision of 4th January 2024 on Article 8 ECHR grounds.

Sarah Pinder

Judge of the Upper Tribunal
Immigration and Asylum Chamber

20.04.2026