Understanding the role of the PHSO

Guest post by Rob Behrens, Parliamentary and Health Service Ombudsman

Behrens: We are not in competition with legal colleagues

The Parliamentary and Health Service Ombudsman makes final decisions on unresolved complaints about the NHS in England and UK government bodies. We look into complaints where someone believes there has been injustice or hardship because an organisation has given a poor service and not put things right.

Around two-thirds of the complaints we receive are about the NHS and span the full range of services, including GPs, dentists, hospitals, mental health services, and commissioning and funding healthcare.

The majority of the parliamentary complaints we receive are from four central government departments and their public-facing agencies: the Department for Work and Pensions, the Ministry of Justice, the Home Office and HM Revenue & Customs.

Our service is particularly important for the most vulnerable in society whose voices might not otherwise be heard.

Making recommendations for change

Service failure quite often falls outside of the law, but it is important for individuals who complain to obtain justice, and to ensure the same mistakes do not happen to others. We do this by, for example, recommending changes to policies and procedures, and training for staff, to make sure public services improve.

The majority of people who complain want an apology and acknowledgement that mistakes were made. They also want the organisation at fault to make changes to avoid the same problem happening to someone else.

Holding the NHS and government bodies to account

We lay cases before Parliament to help them scrutinise public service providers who fail to comply with our recommendations and hold these organisations to account. This also ensures the systemic problems we uncover are addressed to improve public services and complaint handling.

An example of this is the tragic case of Matthew Leahy, who died after procedures were not followed at the North Essex Partnership University NHS Foundation Trust, which was caring for him. We published our investigation report in June 2019 which found a series of significant failings in his mental health care and treatment.

Following our recommendation, NHS Improvement established a review to identify any systemic issues and will share the learning across the NHS.

Another recent example is the two investigations into the Care Quality Commission’s (CQC) regulation of the fit and proper persons requirement (FPPR). These related to whistle-blowing incidents.

In the first case, published in December 2018, we found that the CQC lacked openness, accountability and had poor record-keeping in relation to the appointment of an NHS director who had been convicted of fraud.

The CQC accepted our recommendations and we called for reform of the FPPR system and for the recommendations from the Kark review to be swiftly implemented by government.

Growing demand for our service

Last year, we received over 100,000 enquiries and handled over 30,000 complaints. This was a 13% increase on the previous year.

Like other ombudsman services, demand for our service is growing, which highlights the importance of having an independent, impartial redress body for members of the public.

Using mediation and resolving cases earlier

We are increasingly focusing on using mediation and resolving cases earlier without the need for a full investigation. This means that complainants get the answers they need more quickly and the increased efficiency provides better value for money for the taxpayer.

Last year, we set up a new early consideration team to take on this work. This involves bringing the complainant and organisation complained about together, in person or virtually, and facilitating a conversation between the two parties. Both parties have reported high levels of satisfaction from the approach in our evaluations.

Working with the legal system

The ombudsman is part of the wider administrative justice system. We are not in competition with legal colleagues but present an alternative route to justice. Our service is free and in some cases we ask the organisation complained about to pay a financial remedy.

Our existence means the system offers flexibility for members of the public who have experienced poor service.

We are increasing our liaison with tribunals and courts to see where we can learn from each other and share good practice to make sure we are using the best techniques possible.

To find out more, get in touch with PHSO by contacting their liaison team at liaisonmanagers@ombudsman.org.uk

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