Tribunal decisions

The decision

IN THE UPPER TRIBUNAL
IMMIGRATION AND ASYLUM CHAMBER Case No: UI-2026-000936
First-tier Tribunal No: HU/01518/2024

THE IMMIGRATION ACTS

Decision & Reasons Issued:

19th June 2026

Before

DEPUTY UPPER TRIBUNAL JUDGE ATHWAL

Between

CHHAYA SHREEPAD LELE
Appellant
and

SECRETARY OF STATE FOR THE HOME DEPARTMENT
Respondent

Representation:
For the Appellant: Ms Sood of Counsel, Direct Access
For the Respondent: Ms Arif, Senior Home Office Presenting Officer

Heard at Birmingham Civil Justice Centre on 5 June 2026

DECISION AND REASONS
1. The Appellant appeals the decision of the First-tier Tribunal (“the FtT”). On 1 August 2025, the FtT dismissed the appellant’s human rights appeal, made under s.82(1)(b) of the Nationality, Immigration and Asylum Act 2002 (“2002 Act”).
Background
2. The application for leave to remain was advanced on private life and family life grounds pursuant to Article 8, it being contended on behalf of the appellant that there would be very significant obstacles to her integration in India.
3. The appellant is said to suffer from a number of medical conditions. These include Parkinson’s disease, depression, osteoarthritis, hypotension, frailty, and associated mobility difficulties with an increased risk of falls. Consequently, she is dependent upon her daughter Dr Priti Kulkarni, and her son Mr Praful Lele to provide her with physical, emotional, and psychological support.
The Decision of the First-tier Tribunal
4. The Judge found that the appellant suffers from multiple health conditions and would face challenges on return to India. The Judge accepted that care facilities are available in India, albeit not of an equivalent standard to those available in the United Kingdom. Whilst recognising that the appellant would encounter obstacles to integration, he concluded that those obstacles did not meet the threshold of being “very significant.” He further found that Article 8 family life was engaged but that the appellant’s removal would be proportionate. In reaching that conclusion, the Judge determined that the public interest in the maintenance of effective immigration control outweighed the appellant’s circumstances.
Issues on appeal to the Upper Tribunal
5. The appellant sought permission to appeal against the decision of the FtT on a number of grounds. In summary, it was contended that the FtT;
a. Failed adequately to identify and define the nature and extent of the appellant’s emotional needs and dependencies, as set out in the care diaries, witness statements, and expert evidence.
b. Failed properly to consider the expert reports of Dr Junaid, Dr Arora, and Ms Davison, and failed to assess the appellant’s emotional and physical dependency upon her children.
c. Failed to consider the cumulative effect of the evidence when assessing whether there would be very significant obstacles to the appellant’s integration in India.
d. Failed to apply Mibanga [2005] EWCA Civ 367.
e. Failed to address the viability of alternative immigration routes, including under the Adult Dependent Relative provisions.
6. Permission to appeal was granted on application to the FtT. It was observed that, whilst certain matters identified in the preliminary section of the grounds were considered to lack merit, it was nevertheless arguable that the FtT had erred in law in the following respects;
a. Ground 1-The FtT failed to adequately consider:
(i) the full extent of medical & social reports of Dr Junaid, Dr Arora, Ms Davison;
(ii) the evidence of the appellant’s children.
b. Ground 2- In view of that evidence the FtT failed to provide adequate reasons for:
(i) why the appellant, who is elderly and suffers from a number of health conditions, and whose physical and emotional dependencies were said to be significant, could live alone in India.
(ii) why care available in India was adequate.

The Hearing
7. The parties confirmed that the documents relied upon were contained within the Upper Tribunal composite bundle and the Supplementary Error of Law Permission Bundle dated 27 May 2026.
8. Ms Sood clarified that she did not pursue the points advanced in the “preliminary” section of the grounds seeking permission to appeal. She further confirmed that the argument that the Judge had failed to address the viability of alternative immigration routes, including those under the Adult Dependent Relative provisions, was not relied upon.
9. I heard submissions from Ms Sood and Ms Arif. I reserved my decision
Discussion
Ground 1
10. I remind myself of the principles of judicial restraint to be exercised when considering whether the FtT made a material error of law set out in Ullah v Secretary of State for the Home Department [2024] EWCA Civ 201 at [26] and Volpi & Anor v Volpi [2022] EWCA Civ 464 at [2-4]. Of particular relevance to this appeal are the principles that the UT should be slow to infer that the FtT did not take into account a relevant point not expressly mentioned by the FtT Ullah [26 (ii)] and the UT should not assume that the FtT misdirected itself just because every step of its reasoning is not set out Ullah [26 (iii)].
Consideration of the medical and social evidence
11. The reports in issue were prepared by medical professionals instructed on behalf of the appellant. Dr Junaid, a consultant psychiatrist, prepared a psychiatric report dated 17 January 2023. Ms Davison, a senior nursing and social care professional, prepared two social care reports dated 13 October 2022 and 20 September 2024. Dr Arora, a consultant physician and geriatrician, prepared two reports dated 30 September 2024 and 5 July 2025.
12. It was established that Ms Davison and Dr Junaid prepared their reports prior to the appellant receiving a diagnosis of Parkinson’s disease, which was made on 5 July 2024. Thereafter, Ms Davison provided a supplementary report, and Dr Arora produced two reports.
13. In her first report, Ms Davison set out the appellant’s personal and medical history, her current physical and emotional difficulties, and her physical and mental health. She addressed the appellant’s dependence on care and overall wellbeing, identifying in particular issues with mobility arising from osteoarthritis, dizziness, and periods of low mood, together with the daily care and support provided by the appellant’s children.
14. Dr Junaid repeated the appellant’s personal and medical history but, unlike Ms Davison, undertook a mental state examination and diagnosed mild cognitive impairment, mild depressive symptoms, and minimal anxiety. He considered Ms Davison’s social care report together with the appellant’s wider medical records. His overall impression was that the appellant had experienced a depressive episode of moderate severity, now in remission albeit with residual symptoms, and that her improvement was attributable to the time spent with, and support received from, her children. He further noted that the appellant is physically frail, at risk of falls, and does not meet the diagnostic criteria for dementia. Dr Junaid addressed the appellant’s capacity to participate in immigration proceedings and recorded her views regarding living in India and the importance of family support in the United Kingdom. He concluded that the removal of that support, in the context of her depression, frailty, and mild cognitive impairment, would increase the risk of morbidity and disability, and that her conditions would make it extremely difficult for her to adapt to a new routine or environment. He expressly agreed with, and set out in full, the conclusions of Ms Davison.
15. Ms Davison provided a supplementary social care report approximately two years after her first report, in which she was instructed to address the appellant’s current care and dependency needs and the potential risks to her welfare and life in the event of return to India. In that report, Ms Davison set out afresh the appellant’s medical conditions and further took into account the subsequent diagnosis of Parkinson’s disease and the impact of that condition upon the appellant’s health and her resulting care requirements.
16. Dr Arora recorded that he had been provided with, and considered, the reports of Dr Junaid and Ms Davison’s supplementary report, together with the appellant’s care diary, memory board, neurologist’s reports, general practitioner records, and correspondence from a physiotherapist in India. He extracted from those materials the relevant clinical issues and diagnoses and used the same sources to set out the appellant’s background. He further recorded in detail his discussion with the appellant concerning her life and the support available to her in India and in the United Kingdom. Dr Arora conducted a mental state examination and a mental capacity assessment and reviewed the appellant’s medication. He concluded that the appellant’s emotional and physical health would be likely to deteriorate were she to return to India to live alone, due to the combined effect of her medical conditions, her vulnerability, frailty, and advancing age, none of which were likely to be reversible. Conversely, he considered that her circumstances would be improved by the provision of emotional support and day-to-day care from her family as she progresses into the later stages of her life. He expressly agreed with the conclusions of Dr Junaid and Ms Davison, stating that living alone at this stage of her life, in the context of her co-morbidities and fragile mental and physical health, would more likely than not be further detrimental, probably irreversibly, whereas family support and an encouraging environment would be of clear benefit.
17. In his supplementary report, Dr Arora set out in detail the accounts provided by the appellant and her children as to the appellant’s daily life, her relationship with her children, and her relationship with her grandchildren. He conducted a further medical examination and, in substance, reiterated the conclusions previously expressed in his earlier report.
18. I turn to the Judge’s summary of, and conclusions upon, this evidence. In the context of considering the appellant’s reasons for not giving evidence, and whether any adverse inference should be drawn, the Judge recorded Dr Arora’s medical assessment at [7];
“Dr Junaid had given the opinion that: “Due to her physical frailty, she would find it very difficult to give evidence at a formal hearing.” However, Dr Junaid is a psychiatrist and this opinion was based upon her physical frailty. Dr Arora did not offer a view about the Appellant’s ability to participate in the proceedings. However, the Appellant was assessed on various scales: on a visual frailty score, she would score moderate frailty; she scored 90/100 on a daily living score, losing out on mobility and ability to manage stairs; on a scale assessing instrumental activities of daily living, Dr Arora considered that she can function with some support; she scored 25/27 on a validated memory scale; she scored high on a mini COG assessment and no significant concerns were noted about memory or thinking; and she showed moderate depression and mild anxiety. Dr Arora offers the opinion that the Appellant would find it “very stressful to give evidence in court”. However, this does not indicate to me that the Appellant is incapable of participating in the proceedings.”
19. The Judge then proceeded to consider whether there were very significant obstacles to the appellant’s integration in India. He referred to the medical evidence he set out at [7]. At [15] to [17], he set out Dr Arora’s diagnosis and prognosis in accurate terms. It is apparent that he accepted Dr Arora’s medical opinion, and further to that, took into account Dr Arora’s views as to the availability of care in India, placing some weight upon them, as recorded at [15].
20. Ms Sood was invited to clarify the continuing relevance of the report of Dr Junaid and the first report of Ms Davison, given that both pre-dated the appellant’s diagnosis of Parkinson’s disease, which it was accepted had altered her condition physically, psychologically, and emotionally. In response, Ms Sood submitted that those reports remained material as they addressed the appellant’s circumstances at the time of her arrival in the United Kingdom, when she had recently been bereaved, was suffering from depression, and was dependent upon her children. It was contended that these reports established a baseline profile of the appellant’s disabilities which, it was argued, the Judge failed to analyse in any detail. It was further submitted that this failure resulted in the Judge not properly considering the totality of the factors said to give rise to a risk to the appellant on return to India
21. We considered in further detail the first social care report prepared by Ms Davison concerning the appellant’s emotional and physical needs, and the nature of the dependency, care, and support provided by her children. It is correct, as submitted by Ms Sood, that the Judge did not expressly refer to either of Ms Davison’s reports in his decision. However, the Judge did summarise the findings from Dr Junaid’s report, which itself included direct quotation from Ms Davison’s first report. In those circumstances, it is apparent that the Judge was aware of those aspects of Ms Davison’s evidence which were relied upon by Dr Junaid.
22. Ms Sood was accordingly invited to address whether there were aspects of Ms Davison’s first report which were relevant, but not encompassed within Dr Junaid’s report, and which might have materially affected the Judge’s findings. In response, Ms Sood submitted that, although Dr Junaid adopted Ms Davison’s conclusions, his report did not address the significance of the family care arrangements evidenced by the care diaries, memory boards, and discussions with the appellant’s children. It was argued that Ms Davison’s reports engaged specifically with the care provided by family members, which was not analysed in the same manner by Dr Junaid.
23. In relation to Ms Davison’s supplementary report, it is noted that this was considered by Dr Arora, who drew upon it, together with Dr Junaid’s report, in identifying the appellant’s clinical issues, diagnoses, treatment, and the support provided by her family. Ms Sood was invited to identify any material contained within either Ms Davison’s supplementary report or Dr Junaid’s report which was not reflected in Dr Arora’s report, and which might have materially affected the Judge’s findings. In response, Ms Sood submitted that Ms Davison’s supplementary report addressed matters relating to the appellant’s mobility, including the way her family encouraged her to walk and assisted her with personal hygiene, which she contended were not sufficiently addressed in Dr Arora’s report. It was further submitted that, whilst the Judge accepted that the appellant’s subjective views were relevant, those views had been recorded by Ms Davison, and the Judge had failed properly to take them into account.
24. I have carefully considered whether the Judge failed to take into account any material information contained within the medical and social care reports. I am not satisfied that the Judge erred in that regard. As set out above, Dr Junaid had sight of, and considered, Ms Davison’s first report, and repeated the appellant’s personal and medical history and her dependency upon her family. His report reflects the material mental and physical health concerns identified by Ms Davison and expressly adopts her conclusions as to the likely impact upon the appellant were she to return to India without the support of her family. In those circumstances, I am satisfied that, in considering Dr Junaid’s report, the Judge thereby had regard to, and adequately considered, the relevant material contained within Ms Davison’s first report.
25. I turn to Dr Arora’s report. As set out above, he considered the reports of Dr Junaid and Ms Davison’s supplementary report, together with the appellant’s care diary, memory board, neurologist’s reports, and general practitioner records, and used those materials to identify the relevant clinical issues and diagnoses. He went on to record in detail his discussions with the appellant and her children concerning her health and the support available to her in India and in the United Kingdom and concluded by agreeing with the conclusions of both Dr Junaid and Ms Davison. Having considered the evidence in the round, I reject Ms Sood’s submission that Ms Davison was the sole source of the appellant’s subjective account. At [9] to [31] of his first report, Dr Arora recorded his discussion with the appellant and her son about the appellant’s health issues, the support required and what was available in India and the UK. In his supplementary report, at [10] to [26], he recorded further discussions with the appellant and both her children, noting and developing the appellant’s account of her health difficulties, the support provided by her family in the UK, and her reasons for asserting that she would be unable to care for herself in India.
26. Furthermore, as demonstrated at [22] the Judge took into consideration the appellant’s views and fears which he noted were, “reasonably clear from the evidence of both her children and Dr Arora in particular.”
27. I am therefore satisfied that, as demonstrated at [7] and [15] to [17], the Judge adequately considered Dr Arora’s reports and, in doing so, took into account the material elements of Dr Junaid’s and Ms Davison’s reports. Further, I am satisfied that Ms Davison’s first report and Dr Junaid’s report would not in any event have been material considering the appellant’s subsequent diagnosis of Parkinson’s disease. Given the changes to the appellant’s health and the level of support she now requires because of that condition, those earlier reports do not accurately reflect the appellant’s current health and care needs.
Consideration of the appellant’s children’s evidence
28. The appellant has not established that the Judge failed to adequately consider the evidence of the appellant’s children. At [18], the Judge recorded that Dr Arora’s evidence was broadly consistent with that of the appellant’s children and the earlier medical reports. He states;
“I accept the evidence of the Appellant’s children, who in my view were plainly giving an honest account, borne out of their love for their mother and their wish for what they consider to be the best for her. They have produced care diaries, which show the levels of care their mother requires. I have considered all of this evidence.”
29. At [20] and [21], the Judge further recorded the evidence provided by Mr Lele, thereby demonstrating that he did in fact take into account the evidence of the appellant’s children.
Ground 2- adequacy of the reasons provided
30. I start by noting the Practice Direction of the Senior President of Tribunals: Reasons for Decisions dated 4 June 2024 ) (“2024 PD”) which at [6] states;
“[5] Where reasons are given, they must always be adequate, clear, appropriately concise, and focused upon the principal controversial issues on which the outcome of the case has turned. To be adequate, the reasons for a judicial decision must explain to the parties why they have won and lost. The reasons must enable the reader to understand why the matter was decided as it was and what conclusions were reached on the main issues in dispute. They must always enable an appellate body to understand why the decision was reached, so that it is able to assess whether the decision involved the making of an error on a point of law. These fundamental principles apply to the tribunals as well as to the courts.
[6] Providing adequate reasons does not usually require the First-tier Tribunal to identify all of the evidence relied upon in reaching its findings of fact, to elaborate at length its conclusions on any issue of law, or to express every step of its reasoning. The reasons provided for any decision should be proportionate, not only to the resources of the Tribunal, but to the significance and complexity of the issues that have to be decided. Reasons need refer only to the main issues and evidence in dispute, and explain how those issues essential to the Tribunal’s conclusion have been resolved.”
Why the appellant could live alone in India
31. I am satisfied that, when read as a whole, the Judge accepts that the appellant would not be able to live independently in India. The Judge’s assessment of the facts begins with an evaluation of the appellant’s health conditions and treatment. At [15] to [17] it is accepted that the appellant has a number of medical conditions requiring ongoing treatment and would face challenges on return to India. The Judge then sets out Dr Arora’s expert opinion as to the difficulties the appellant would encounter in living alone or in securing accredited and good quality care.
Why care available in India was adequate
32. Ms Sood submitted that the medical and expert evidence had been afforded scant regard. It was argued that the determination did not engage with the risks identified by the experts, nor explain how such risks might be mitigated in practical terms. Further, it was submitted that the Judge failed to explain why the reasoning of the experts, whether individually or collectively, as to the appellant’s risk on return and the absence of mitigating factors, was not accepted. In support of that submission, reliance was placed upon Mibanga [2005] EWCA Civ 367, [24], a case that addresses the issue of credibility and expert evidence, in support of her assertion.
33. As set out at [6] of the 2024 PD, a judge is not required to identify all the evidence relied upon in reaching findings of fact, nor to set out every step of the reasoning process. The reasons given for a decision must be proportionate to the resources of the Tribunal and to the significance and complexity of the issues to be determined. It is sufficient that the reasons address the principal issues and the evidence in dispute and explain how those matters essential to the conclusion have been resolved.
34. I carry forward my findings in respect of the Judge’s consideration of the medical and expert evidence. I do not accept the submission that such evidence was not adequately considered. On the contrary, the Judge did engage with that evidence and accepted the substantive conclusions reached by the experts.
35. Ms Sood clarified that it is the appellant’s case that, although care homes are available in India, the quality of care is poor, and neither the appellant nor her children wish for her to be placed in accommodation of that standard
36. At [21] the Judge found;
“I have considered CPIN: medical and healthcare provision, India, April 2023, as well as the evidence of Dr Arora. I note that there are a range of care homes available, as well as treatment for a variety of conditions. While I accept that the provision in care homes may not be at the same level as in the UK, I am satisfied nonetheless that care is available. The Appellant’s son indicated that his mother’s property is around 50km from the suburbs of Mumbai, which is not that significant a distance.”
37. I am satisfied that at [21] the Judge identified the appellant’s argument and provided adequate reasons for why that was not sufficient to meet the legal test. This finding accords with the well established legal framework governing Article 8 claims founded upon medical grounds. The Court of Appeal in AA (Morocco) v SSHD [2025] EWCA Civ 144 made clear that the rigorous principles applicable to the consideration of ill-health cases under Article 3 apply with equal force in the context of Article 8. Absent the exceptional circumstances identified in the authorities, there is no obligation under the ECHR upon the United Kingdom to provide medical treatment on the basis that such treatment is unavailable in the country to which an appellant is to be returned.
38. For these reasons I reject the argument that the Judge provided inadequate reasons for why the care available in India was adequate.
Conclusion
39. It follows that the appellant has failed to establish that the Judge’s decision is infected by an error on a point of law.
40. The appellant’s application under rule 15(2) of the Tribunal Procedure (Upper Tribunal) Rules 2008 to adduce updated medical evidence is therefore refused as there will not be a remaking hearing.
Notice of Decision
41. The decision of the First-tier Tribunal contains no material error of law and accordingly stands.

H.Athwal

Deputy Judge of the Upper Tribunal
Immigration and Asylum Chamber

11 June 2026