Tribunal decisions

The decision

IN THE UPPER TRIBUNAL
IMMIGRATION AND ASYLUM CHAMBER Case No: UI-2026-003458
First-tier Tribunal No: PA/70940/2024

THE IMMIGRATION ACTS

Decision & Reasons Issued:

30th September 2026

Before

DEPUTY UPPER TRIBUNAL JUDGE HUGHES

Between

ANA ABDIU
Appellant
and

SECRETARY OF STATE FOR THE HOME DEPARTMENT
Respondent

Representation:
For the Appellant: Ms Vidal, Counsel.
For the Respondent: Mr Simpson, a Senior Home Office Presenting Officer.

Heard at Field House on 3 September 2026

DECISION AND REASONS
Relevant background
1. The Appellant appeals with permission a decision of a Judge of the First-tier Tribunal (‘The Judge’), promulgated following a hearing at Taylor House on 13 April 2026, in which the Judge refused her protection and Human Rights appeal.
2. The Appellant is a citizen of Albania. The basis of her claim is that she faces persecution on return at the hands of moneylenders from whom her father had borrowed money in order to pay for medical treatment for her in Italy. The debt remains unpaid, and for that reason she would be targeted on return by those moneylenders, and she would be at risk of forced prostitution or organ harvesting. There was insufficiency of state protection and internal relocation was not a reasonable option. It was not argued that the Refugee Convention was engaged, but Humanitarian Protection was sought. The same features engaged Article 3 and presented very significant obstacles to the Appellant’s integration to Albania. Otherwise, Article 8 was said to be engaged on the basis of her private life in the United Kingdom and Article 3 was also said to be engaged on grounds of health and suicide risk.
3. The Respondent’s decision dated 4 September 2024 accepted the Appellant’s identity and nationality, but nothing else about her claim. Her account was said to be inconsistent and lacking in detail. The Respondent rejected the contention that the Appellant was at risk on return, and found that in any event sufficient protection would be available to her from the Albanian authorities, and that internal relocation was a reasonable option. Appropriate medical treatment was available in Albania to address the Appellant’s health issues, and in the light of the overall findings, integration back into Albania was achievable. There was nothing exceptional that rendered the Appellant’s return to Albania a breach of her Article 8 rights.
The FTT decision
4. The Judge’s findings are set out from [13] of the decision under challenge. He found the appellant’s core account on the claimed debt to be “vague, inconsistent in places and lacking in sufficient detail” [16], that the claim was not made out even to the lower standard [16] and that even if her claim were to be accepted, there was sufficiency of protection in Albania, and there was no credible evidence that the moneylenders would have sufficient power or influence to locate the Appellant if she relocated to another part of Albania [17]. As to the other elements of the claim, the Judge found:
18. The appellant also claims that she would be at risk on return due to vulnerability based on her age and medical conditions. The appellant is now an adult but was a child when she made her protection claim. The appellant has stated that in May 2025 she had an operation on her back and neck for her scoliosis, and after an extensive period of recovery is now back at college and taking her GCSEs which she missed last year due to the operation. She also claims to be suffering from Neurofibromatosis type 1 (NF1), epilepsy, PTSD and anxiety and depression for which takes medication.
19. The appellant may have been bullied at school due to medical conditions, but that does not amount to serious harm for the purposes of HP. The appellant has now had the surgery she required for the scoliosis and the medical evidence indicates that she recovered reasonably well from that surgery. The relevant CPIN shows that medical treatment generally is available in Albania, including for mental health and other health issues, and the appellant has not provided medical evidence of any current treatment she is receiving or any likely future treatment she may require for NF1 if the appellant were returned to Albania. The appellant is now nearly 20 years old - her father and mother are still living in Albania, and she is still in contact with them and could return to live with them.
20. For those reasons I do not accept that the appellant would be at risk of persecution or serious harm on return to Albania due to a risk from a criminal gang, nor would she be at risk from her medical conditions, or for any other reason. She does not therefore qualify for a grant of HP.
Appeal on Article 8 Grounds
21. The appellant has been in the UK only since December 2022. She has spent the majority of her life in Albania, including her early childhood and formative years. She speaks Albanian and is familiar with the culture there. I have found above that the appellant’s mother and father are still in Albania and she could return to live with them, and that there would be medical treatment available for her there. She has continued her education in the UK. I conclude that there would be no very significant obstacles to her reintegration into Albania, and she would reasonably be able to reintegrate culturally, socially and economically. As such, Paragraph PL 5.2(b) is not satisfied.
22. The appellant also claims that to require her to return to Albania would be a breach of her Article 8 private life rights, including her physical and moral integrity. I have considered her medical conditions under her protection claim and under the private life rules, and I have concluded that there would be no risk of serious harm for those reasons on return, and nor are there any very significant obstacles to reintegration for those reasons I have stated above. There are no additional circumstances which would render a refusal to be overawed disproportionate.
Appeal on Article 3 Medical Grounds
23. The appellant also claims to return her to Albania would be a breach of her Article 3 rights on medical grounds. For those reasons given above, the appellant circumstances for very short indeed of that threshold established in AM (Zimbabwe) [2020] UKSC 17. I conclude that it would not be a breach of Article 3 to return the appellant to Albania.
24. The appellant claims that she has considered suicide if returned, but there is no medical evidence before me with regard to the appellant’s genuine level of risk to herself. As established in J v SSHD [2005] EWCA Civ 629, where a claimant says that they have considered suicide, measures can be put in place at the points of informing of the decision, the physical removal and the reception in the country of return in order to minimise any risk of self-harm.
25. The appeal is therefore also dismissed on human rights grounds.
5. In a somewhat discursive application for permission to appeal the Judge’s decision, dated 30 April 2026, the Appellant alleges the Judge had erred in law in the following respects:
(i) The Judge’s consideration of the Appellant’s medical claim was materially flawed;
(ii) The Judge’s failed to consider relevant medical evidence that appropriate treatment was not available in Albania; and
(iii) For the same reasons, the Judge’s conclusion in the Article 8 proportionality assessment was flawed; exceptional circumstances existed, and the Appellant’s return to Albania would lead to unjustifiably harsh consequences.
6. Permission to appeal was granted by Judge Degirmenci of the First-tier Tribunal on 25 June 2026, with the observations “In my Judgement it is arguable that the Judge failed to come to clear findings on the appellant’s medical conditions and that the Judge failed to take into consideration relevant medical evidence in assessing the appellant’s claim. For these reasons I conclude that it is arguable that there are material errors of law in the decision. I grant permission to appeal on all grounds.”
7. A Rule 24 response was filed on behalf of the Respondent on 16 July 2026. The Respondent’s position was that there had never been an issue as to the nature and extent of the Appellant’s physical and mental ill health, and the findings reflected the medical and country evidence. The Article 8 findings were similarly adequate and sustainable.
The error of law hearing, discussion and reasons for decision
8. In the hearing Ms Vidal relied upon the grounds of appeal, and submitted that the flawed analysis of the medical evidence went to both the heart of the Appellant’s Article 3 health claim and a proper assessment of whether the Appellant faced very significant obstacles to integration on return to Albania.
9. Mr Simpson, in short, submitted that whilst the Judge’s findings in relation to the Appellant’s medical claim were very briefly stated they were adequate. Furthermore, any error was not material to the Article 3 claim as on any assessment of the medical evidence the Appellant would not have discharged the burden of establishing that the AM (Art 3; health cases) Zimbabwe [2022] UKUT 00131 (IAC) threshold was met. As to Article 8, it was argued that there was nothing in the appellant’s case over and above that advanced for the Article 3 claim, and that the Judge’s findings were sufficient.
10. I mean no disrespect to either advocate by not selling out their submissions in full, but I will refer to them where relevant, if necessary, in my reasoning. I have considered them carefully. At the conclusion of the hearing, I indicated that I would reserve my decision, which I now give together with my reasons.
11. The jurisdiction of the Upper Tribunal on an appeal from the First-tier Tribunal lies only in relation to an error of law, not a disagreement of fact. The following are possible categories of error of law, as summarised in R (Iran) & Ors v SSHD [2005] EWCA Civ 982 at [9]:
“i) Making perverse or irrational findings on a matter or matters that were material to the outcome ("material matters");
ii) Failing to give reasons or any adequate reasons for findings on material matters;
iii) Failing to take into account and/or resolve conflicts of fact or opinion on material matters;
iv) Giving weight to immaterial matters;
v) Making a material misdirection of law on any material matter;
vi) Committing or permitting a procedural or other irregularity capable of making a material difference to the outcome or the fairness of the proceedings;
vii) Making a mistake as to a material fact which could be established by objective and uncontentious evidence, where the appellant and/or his advisers were not responsible for the mistake, and where unfairness resulted from the fact that a mistake was made.”
12. As a general matter, I remind myself that appropriate judicial restraint should be exercised before interfering with the decision of the First-tier Tribunal. A person challenging a decision must have regard to the guidance provided by the Court of Appeal in in Volpi v Volpi [2022] EWCA Civ 462 at [2], Ullah v Secretary of State for the Home Department [2024] EWCA Civ 201 at [26], and Hamilton v Barrow and Others [2024] EWCA Civ 888 at [30-31], which I have.
13. When analysing a decision of the First-tier Tribunal, is important to read it sensibly and holistically, and to guard against the danger of simply substituting one view for the legitimate view of another. Perfection is not being sought, there is no obligation to provide the best possible reasons (or indeed reasons for reasons), and an irrationality challenge imposes an elevated threshold.
The three Grounds of Appeal
14. There is a significant overlap in the three grounds of appeal. Ms Vidal set out her stall at the outset of the hearing, submitting that at the hub of the Appellant’s case. was her medical condition, and that the Judge's conclusion that “medical treatment generally is available in Albania, including for mental health and other health issues”, whilst referencing an unspecified “relevant CPIN” failed to engage whatsoever with one key pieces of evidence. That was the unchallenged evidence of Dr Silvana Kau, Paediatric Neurologist, dated 19 May 2023, concerning the combination of medical conditions faced by the Appellant, and that the Appellant needed continuous dynamic follow-up by a multidisciplinary group (paediatric neurologist, neurosurgeon, physiotherapist) specialised in the given diagnosis. She needs to be treated with new medicines and surgical interventions that are not currently available in Albania.” That evidence was supported by the, again unchallenged, evidence that the Appellant had needed to travel to Italy in 2022 to receive the necessary treatment.
15. Mr Simpson sought to persuade me that the Judge’s findings on the availability of appropriate medical treatment in Albania were adequate, but I am in no doubt that cannot be right. I cannot tell whether the Judge was specifically directed to the evidence of Dr Kau during the First-tier hearing, it certainly was not highlighted in Ms Vidal’s Appeal Skeleton Argument dated 19 February 2025. However, it clearly was evidence that was before the Judge, and I am satisfied that it was evidence which went to the heart of the Appellant’s case on the medical element(s) of the appeal. It follows that I find the Judge’s consideration of the Appellant’s medical claim was inadequate and flawed.
16. Whilst Ms Vidal prayed in aid the further medical evidence of Dr Uzma Sajid, dated 8 August 2024, and acknowledging that it sets out the significant mental health challenges faced by the Appellant, I do not consider that the absence of the Judge dealing specifically with this evidence gives rise to legitimate cause for criticism.
17. By the same token, I find little force in the further submission advanced by Ms Vidal, namely that the Judge failed to make specific findings as to the various medical conditions which affected the Appellant. I accept the submission of Mr Simpson in this regard; first, the Respondent had never taken any issue with the existence of the Appellant’s conditions, but rather had focussed upon the availability and accessibility of appropriate treatment in Albania. Second, it is implicit from the Judge’s recitation of the conditions at [18], albeit partially couched in terms of “she also claims to be suffering from…”, that there was in fact no dispute as to the nature and extent of the Appellant’s medical conditions.
18. Where do these findings take me? I must next consider whether the flawed consideration of the Appellant’s medical claim was in fact a material error of law. Ms Vidal submitted that the errors materially infected the consideration of the Article 3 health claim, the proper consideration of whether the Appellant would face very significant obstacles to integration (PL.8.1. of Appendix Private Life), and the consideration of the Article 8 claim outside the Immigration Rules. I have already set out Mr Simpson’s position.
19. As to the Article 3 health claim, the legal framework is clear following AM (Article 3, health cases) Zimbabwe [2022] UKUT 131 (IAC). It was for the Appellant to establish that they are a seriously ill person and adduce evidence capable of demonstrating that substantial grounds have been shown for believing that as a seriously ill person they would face a real risk, on account of the absence of appropriate treatment or the lack of access to such treatment, of being exposed to a serious, rapid and irreversible decline in their state of health resulting in intense suffering, or to a significant reduction in life expectancy.
20. The medical evidence adduced by the Appellant was in theory capable of establishing that she was “a seriously ill person”, as no issue was taken with the qualifications, experience and diagnoses of the two treating doctors, or indeed the evidence of the Appellant herself as to nature and impact of her conditions.
21. However, the Appellant had not adduced evidence capable of discharging the burden of establishing a prima facie case to the lower standard that the absence of the necessary medical treatment in Albania would create the real risk of a serious, rapid and irreversible decline in their state of health resulting in intense suffering, or to a significant reduction in life expectancy. When pressed, Ms Vidal acknowledged that must be the case.
22. It follows that I am satisfied the Judge’s inadequate consideration of the Appellant’s medical claim did not give rise to a material error of law in the context of whether the Appellant’s expulsion would violate Article 3.
23. For the sake of completeness, I should record there was no criticism in the grounds or indeed before me of the Judge’s assessment of the Article 3 (suicide risk) element of the Appellant’s claim.
24. I turn then to Article 8.
25. The Judge clearly accepted that the Appellant had established a private life in the United Kingdom [22] and that Article 8(1) was engaged.
26. I acknowledge Mr Simpson’s submission that in health and suicide risk cases Article 8 is not to be regarded merely as Article 3 with a lower threshold. There must be some separate or additional factual element which brings the case within the relevant paradigm (see SL (St Lucia) v SSHD [2018] EWCA Civ 1894 and AA (Morocco) v SSHD [2025] EWCA Civ 144. However, Article 8(1) having been engaged, the Judge first considered whether the Appellant met the requirements of the relevant Immigration Rules, namely PL 5.1. I am satisfied that the Judge’s findings at [21], that would be no very significant obstacles to the Appellant’s integration into Albania, were infected by the conclusion that there would be medical treatment for her there. This was, as I have said, at the very heart of her claim. I am similarly satisfied that it cannot be said that the outcome of the consideration of whether very significant obstacles existed would necessarily have been the same if the Judge had properly considered the medical evidence as discussed above.
27. It follows that I find the flawed consideration of the Appellant’s medical claim gave rise to a material error of law, albeit limited to the Article 8 element of this appeal.
28. Accordingly, I set aside the First-tier Tribunal decision.
29. There having been no challenge to the Judge’s findings on the core of the protection claim, the findings of fact at [14] – [17] are preserved. Having found no material error of law in the Judge’s consideration of the Article 3 element of this appeal, the remitted appeal will be restricted to the Appellant’s Article 8 claim.
30. Applying AEB v SSHD [2022] EWCA Civ 1512 and Begum (Remaking or remittal) Bangladesh [2023] UKUT 00046 (IAC), I have considered whether to retain the matter for remaking in the Upper Tribunal, in line with the general principle set out in paragraph 7 of the Senior President’s Practice Statement. Having reached the conclusion that the both assessment of whether the Appellant would face very significant obstacles to integration and the Article 8 proportionality assessment was infected by the Judge’s error, I am satisfied that it would be appropriate to remit this matter to the First-tier Tribunal where the task of such specialist fact-finding is more appropriate.
Notice of Decision and Directions
31. The decision of the First-tier Tribunal is set aside for the reasons set out above with the findings set out in paragraph 24 above preserved.
32. The remaking of the decision in the appeal is remitted to the First-tier Tribunal at Taylor House; the hearing being restricted to the Appellant’s Article 8 claim.
33. Usually, directions are left to the FTT, but to assist with ensuring that the next hearing is effective at the FTT, I make the following preliminary directions to assist.
(i) By no later than 28 days after the promulgation of this decision the appellant must upload to the MyHMCTS online portal an up to date and consolidated bundle of evidence upon which reliance will be placed at the re-hearing of this appeal before the First-tier Tribunal.
(ii) By no later than 14 days following the upload of the appellant’s consolidated bundle of evidence the respondent must undertake a meaningful and pragmatic review of this appeal and upload the same to the MyHMCTS online portal.
(iii) The appeal will be relisted by the First-tier Tribunal as a priority face to face hearing on the first available date thereafter. An Albanian interpreter is required.
Anonymity
34. I remove the anonymity direction previously made as this case no longer concerns a claim for international protection and the interests of the Appellant do not outweigh a fundamental tenet of the justice system, namely the principle of justice being administered openly and in public.

Leighton Hughes
Deputy Judge of the Upper Tribunal
Immigration and Asylum Chamber
25 September 2026