Recommendations & Conclusions
16 items
1
Conclusion
Sixth Report - Parliamentary and Health…
Accepted
The Committee considers the objectives of the Parliamentary and Health Service Ombudsman (PHSO) Strategy for 2022–25 to be appropriate to achieve the aims of “becoming an even more modern and vibrant Ombudsman service”. This includes promoting greater awareness of the PHSO’s services, providing a high quality, empathetic and timely service, …
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The Committee considers the objectives of the Parliamentary and Health Service Ombudsman (PHSO) Strategy for 2022–25 to be appropriate to achieve the aims of “becoming an even more modern and vibrant Ombudsman service”. This includes promoting greater awareness of the PHSO’s services, providing a high quality, empathetic and timely service, and continuously improving the organisation. We welcome the reference to international benchmarks in the Strategy for the first time, the emphasis on data, and the organisation’s plans to gather direct feedback from service users and members the public. However, while it is included in the 2022–23 Business Plan, the absence of any reference to how the organisation will cope with the ongoing impacts of Covid-19 and high levels of cases brought to the PHSO is regrettable. The ambition to promote awareness and accessibility of the PHSO’s role and service is positive and welcome, but the Strategy does not set out how the organisation would cope with potentially increased service demand.
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Government response AI summary
The PHSO is absorbing an increase in demand for its service, and its plans for implementing the 2022-25 Corporate Strategy will drive efficiencies, enhance service, and ensure a user-focused approach by increasing efficiency, introducing new mechanisms, and identifying systemic cases.
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3
Conclusion
Sixth Report - Parliamentary and Health…
Accepted
The Committee recognises that the PHSO has made significant efforts to cope with the huge pressures placed on its services as a result of the Covid-19 pandemic. We note that the backlog of cases has been reduced significantly and welcome the ambition to completely clear the queue of unallocated cases …
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The Committee recognises that the PHSO has made significant efforts to cope with the huge pressures placed on its services as a result of the Covid-19 pandemic. We note that the backlog of cases has been reduced significantly and welcome the ambition to completely clear the queue of unallocated cases by the end of the 2022–23 business year. Equally, we are encouraged by the ambitions of the casework improvement programme and implementing the end-to-end review of casework processes to drive efficiencies and improve service quality. However, whilst we cannot generalise from individuals’ experiences with the PHSO’s service, there were a number of pieces of written evidence received by the Committee during this inquiry highlighting that perceived poor handling of cases remains a significant concern from service users. This includes details of lengthy investigations, poor communication by complaint handlers, sudden change of caseworker mid-investigation, loss of records, and issues with the complexity of the complaints process. The changes resulting from the end-to-end review of casework process, including changes to complaint forms, while positive, are relatively minor compared to the scale of these perceived issues. (Paragraph 33) Parliamentary and Health Service Ombudsman Scrutiny 2021–22 35
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Government response AI summary
The PHSO has already made improvements to aspects of the casework process, including the casework management IT system, forms, letters and templates, learning resources for caseworkers, and revised training and guidance. They are evaluating a test of call recording and transcription of casework discussions, and …
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6
Recommendation
Sixth Report - Parliamentary and Health…
Accepted
We are concerned by the number of Level 1 and 2 cases that are not being considered by the PHSO due to the approach of prioritising health complaints using the severity of injustice scale. We recommend that the PHSO sets out in its response to this Report the evidence base …
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We are concerned by the number of Level 1 and 2 cases that are not being considered by the PHSO due to the approach of prioritising health complaints using the severity of injustice scale. We recommend that the PHSO sets out in its response to this Report the evidence base for continuing with this approach for another business year and provides detail on how this decision compares to other ombudsman institutions, both domestically and internationally. Furthermore, we request that an explanation of the criteria being used to make a final decision on the future approach at the end of the business year is provided to the Committee.
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Government response AI summary
The PHSO states they consider all complaints, but for less serious NHS complaints, they will consider whether they can resolve the complaint promptly and if not, they will not take those complaints further. They also state that a proportional approach to deciding which cases to …
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11
Recommendation
Sixth Report - Parliamentary and Health…
Accepted
The PHSO should update the Committee on the outcomes of the review of how the PHSO obtains feedback from service users, including the Service Charter, and what changes will be put in place as a result. The Committee understands that the PHSO is awaiting data from an independent research agency …
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The PHSO should update the Committee on the outcomes of the review of how the PHSO obtains feedback from service users, including the Service Charter, and what changes will be put in place as a result. The Committee understands that the PHSO is awaiting data from an independent research agency to determine whether survey data can be split by those cases upheld and not upheld; we would urge this work to be prioritised, and expect an update on both these areas of work in its response to this Report. (Paragraph 41) Staff management and training
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Government response AI summary
The government has redesigned the complainant satisfaction survey based on recommendations from an independent research agency, tested it with users, and will roll it out in May 2023. They will publish the data coming from the new survey later in the year, disaggregated by case …
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14
Conclusion
Sixth Report - Parliamentary and Health…
Accepted
The Committee welcomed in its PHSO Scrutiny 2020–21 Report the positive steps that the PHSO has taken to improve the use of clinical advice in investigations. It is encouraging to see that this work has not lost momentum, with 23 of 25 of the recommendations from the “Donaldson Review” now …
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The Committee welcomed in its PHSO Scrutiny 2020–21 Report the positive steps that the PHSO has taken to improve the use of clinical advice in investigations. It is encouraging to see that this work has not lost momentum, with 23 of 25 of the recommendations from the “Donaldson Review” now implemented, and the development of a Clinical Advice Quality Framework underway.
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Government response AI summary
The government states that they have completed implementation of all recommendations made by the Donaldson Review into PHSO’s approach to clinical advice and have a framework for assuring the quality of clinical advice.
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15
Recommendation
Sixth Report - Parliamentary and Health…
Accepted
The PHSO should clarify how the Clinical Advice Quality Framework will improve trust and confidence in the quality and standards of the PHSO’s casework, what changes Parliamentary and Health Service Ombudsman Scrutiny 2021–22 37 have been made to date, and how success will be measured. Furthermore, whilst we acknowledge the …
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The PHSO should clarify how the Clinical Advice Quality Framework will improve trust and confidence in the quality and standards of the PHSO’s casework, what changes Parliamentary and Health Service Ombudsman Scrutiny 2021–22 37 have been made to date, and how success will be measured. Furthermore, whilst we acknowledge the challenges associated with the outstanding recommendations from the Donaldson Review, the PHSO should reach a decision as soon as possible on whether to take forward naming clinical advisers in decision reports and sharing provisional reports with advisers, given the review was published four years ago.
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Government response AI summary
The PHSO has completed implementation of all recommendations from the Donaldson Review. Provisional views are shared with clinical advisors. They will not take forward naming clinical advisers due to concerns about safety and security, and the risk of giving disproportionate weight to their evidence.
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21
Conclusion
Sixth Report - Parliamentary and Health…
Accepted
In the Committee’s PHSO Annual Scrutiny Report 2020–21, we called for a Peer Review of the PHSO to be undertaken as soon as possible. We are pleased that this took place in 2022 and reported before our annual scrutiny session. The Committee welcomes that the PHSO was the first body …
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In the Committee’s PHSO Annual Scrutiny Report 2020–21, we called for a Peer Review of the PHSO to be undertaken as soon as possible. We are pleased that this took place in 2022 and reported before our annual scrutiny session. The Committee welcomes that the PHSO was the first body to undergo a review by an accredited Panel, and in line with our previous recommendation, the Panel included a member with auditor experience. The Committee notes the positive results of the Peer Review, as well as areas identified for improvement. Although the Peer Review Panel 38 Parliamentary and Health Service Ombudsman Scrutiny 2021–22 did not provide any in-depth value-for-money analysis of the PHSO’s service, it has helpfully identified areas where the organisation is performing well and where it could improve in the future. We therefore support and encourage the continued use of periodic peer reviews to assess the effectiveness of the PHSO.
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Government response AI summary
The government is committed to embedding the peer review recommendations, taking action on coaching/training, communication, publishing cases, anonymisation, and reducing queues in 2023-24, and progressing outstanding actions through the 2022-23 Corporate Strategy by 2025, including digital updates and IT system integration with the NHS.
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22
Conclusion
Sixth Report - Parliamentary and Health…
Accepted
The Committee was disappointed to learn that some of the data provided by the PHSO to inform the Committee’s PHSO Scrutiny 2020–21 Report had been revised unjustifiably ahead of this year’s inquiry, preventing easy comparability between reports. For the Committee to accurately fulfil its responsibilities to assess the performance of …
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The Committee was disappointed to learn that some of the data provided by the PHSO to inform the Committee’s PHSO Scrutiny 2020–21 Report had been revised unjustifiably ahead of this year’s inquiry, preventing easy comparability between reports. For the Committee to accurately fulfil its responsibilities to assess the performance of the PHSO, it is vital that the PHSO collects and publishes accurate and consistent data going forward.
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Government response AI summary
The PHSO states that it conducts a thorough review of all performance data annually and that data provided to the Committee is quality assured to the highest standard, explaining the circumstances around the data revision.
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23
Recommendation
Sixth Report - Parliamentary and Health…
Accepted
It is unsatisfactory that data provided to this Committee has been subsequently revised. The PHSO should report back to the Committee on what steps it is taking to quality assure its data before it is published and used by the Committee.
Government response AI summary
The PHSO states that it conducts a thorough review of all performance data annually and that data provided to the Committee is quality assured to the highest standard, explaining the circumstances around the data revision.
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24
Conclusion
Sixth Report - Parliamentary and Health…
Accepted
The Committee notes the benefits that hybrid working has brought to the PHSO, notably the ability to increase its workforce by 20% without expanding its office footprint. However, the impact of hybrid working on organisational productivity, culture, and employee wellbeing should be continually monitored, and the requirement to be in …
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The Committee notes the benefits that hybrid working has brought to the PHSO, notably the ability to increase its workforce by 20% without expanding its office footprint. However, the impact of hybrid working on organisational productivity, culture, and employee wellbeing should be continually monitored, and the requirement to be in the office 40% of the time revised as necessary.
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Government response AI summary
The PHSO has robust performance management systems and continually seeks feedback on the impact of business changes on workforce productivity and wellbeing, including on hybrid working, through staff engagement mechanisms and the annual Staff Survey.
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25
Conclusion
Sixth Report - Parliamentary and Health…
Accepted
The PHSO should provide an update in its response to this Report regarding what tools and infrastructure have been upgraded to support hybrid working, as mentioned in the Business Plan for 2022–23. The Committee would also appreciate information on what the PHSO is doing to continually monitor the impact of …
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The PHSO should provide an update in its response to this Report regarding what tools and infrastructure have been upgraded to support hybrid working, as mentioned in the Business Plan for 2022–23. The Committee would also appreciate information on what the PHSO is doing to continually monitor the impact of the requirement to work in the office 40% of the time on organisational productivity, culture, and employee wellbeing.
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Government response AI summary
The PHSO states that following the decision to maintain hybrid working, they have made some updates to systems to maximize productivity, including integrated telephone and ICT systems, simplified login process and remote connectivity, enhanced office wireless networks and piloting the further capability offered by Microsoft …
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28
Conclusion
Sixth Report - Parliamentary and Health…
Accepted
The Committee welcomes the PHSO’s progress in developing the NHS and UK Central Government Complaint Standards, in close collaboration with partner organisations. We are encouraged by the number of organisations that have volunteered to adopt the Standards. We agree that the Complaint Standards initiative has the potential to significantly reduce …
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The Committee welcomes the PHSO’s progress in developing the NHS and UK Central Government Complaint Standards, in close collaboration with partner organisations. We are encouraged by the number of organisations that have volunteered to adopt the Standards. We agree that the Complaint Standards initiative has the potential to significantly reduce pressures on the PHSO’s services Parliamentary and Health Service Ombudsman Scrutiny 2021–22 39 by addressing more complaints on the frontline. We look forward to hearing from the PHSO on good practice, as well as areas for improvement as the Standards are adopted into the working practices of organisations.
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Government response AI summary
The government welcomes the Committee's support and will report on progress embedding the Complaint Standards in its first twelve months of operation, publishing feedback, best practice, training, support, and guidance early in 2024-25.
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30
Conclusion
Sixth Report - Parliamentary and Health…
Accepted
The PHSO’s ability to lay reports before Parliament regarding thematic failings and instances of non-compliance with its recommendations should be a powerful mechanism to bring cases to the attention of parliamentarians, and for the subjects of those reports to be properly and fully held to account. However, it seems that …
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The PHSO’s ability to lay reports before Parliament regarding thematic failings and instances of non-compliance with its recommendations should be a powerful mechanism to bring cases to the attention of parliamentarians, and for the subjects of those reports to be properly and fully held to account. However, it seems that this system is not working effectively if PHSO reports laid before Parliament are ignored by the addressees of such reports.
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Government response AI summary
The PHSO maintains a program of regular engagement with Parliament and shares information about key themes in complaints with Select Committee clerks. In rare cases of non-compliance, the PHSO has statutory powers to bring a case to Parliament's attention.
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32
Recommendation
Sixth Report - Parliamentary and Health…
Accepted
We recommend that the PHSO increases its engagement with departmental Select Committees to encourage them to scrutinise PHSO reports laid before Parliament, particularly when those reports relate to findings against individual departments and public bodies under their remit.
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We recommend that the PHSO increases its engagement with departmental Select Committees to encourage them to scrutinise PHSO reports laid before Parliament, particularly when those reports relate to findings against individual departments and public bodies under their remit.
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Government response AI summary
The government states that PHSO maintains a programme of regular engagement with Parliament, including Select Committees, and shares information with Select Committee clerks about key themes or recurring issues identified in complaints.
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34
Recommendation
Sixth Report - Parliamentary and Health…
Accepted
Ahead of the next annual scrutiny hearing, the PHSO should provide an update to the Committee on progress with its outreach activities and any evidence of its impact on the diversity of complainants and types of complaints it receives. We would welcome clarification on whether complainant diversity data in the …
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Ahead of the next annual scrutiny hearing, the PHSO should provide an update to the Committee on progress with its outreach activities and any evidence of its impact on the diversity of complainants and types of complaints it receives. We would welcome clarification on whether complainant diversity data in the Annual Report and Accounts could be used to assess whether correlations exist between complainants’ backgrounds, the types of complaint they make, and their routes to complain.
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Government response AI summary
The PHSO will update the Committee on the progress of its Outreach programme ahead of the next scrutiny inquiry, focusing on building trust and engagement with communities that rarely complain, and will explore options for gathering additional information about complainants to understand barriers to complaining.
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35
Recommendation
Sixth Report - Parliamentary and Health…
Accepted
We also welcome the PHSO’s efforts to engage with MPs and their staff on the use of its services, but we believe that still more could be done in this space. The PHSO should increase its engagement with staff based in MPs’ constituency offices in particular to improve awareness of …
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We also welcome the PHSO’s efforts to engage with MPs and their staff on the use of its services, but we believe that still more could be done in this space. The PHSO should increase its engagement with staff based in MPs’ constituency offices in particular to improve awareness of its services amongst those who deal directly with referrals, including providing relevant training on mediation services. (Paragraph 103) 40 Parliamentary and Health Service Ombudsman Scrutiny 2021–22 7 Priorities for Scrutiny As in our previous reports, this section sets out the Committee’s priorities for scrutiny of the PHSO for the year 2021–22. Table 2: Areas of scrutiny Area of scrutiny Example of expected Areas of particular interest evidence PHSO Corporate Strategy Written evidence from the Organisational priorities, for 2022–25 PHSO and service users. and how these compare to previous years. PHSO Corporate Strategy Delivery of the Strategy, PHSO Business Plan assessed alongside the annual Business Plan and Peer Review Report Covid-19 recovery. PHSO casework Casework and staff data Impact of Covid-19 on performance in the Annual Report and service delivery and Accounts casework management. Service Charter scores Quantity, quality, and timeliness of investigations. Written evidence from service users and Implementation of the organisations casework improvement programme Peer Review Report Mediation capabilities Changes in Service Charter scores Staff management and Staff survey scores Numbers of staff and training turnover Written evidence from the PHSO Training opportunities available to staff Annual Report and Accounts, employee data Staff views on learning and including diversity development Diversity of the workforce Use of clinical advice Value for money PHSO Annual Report and Findings of the Peer Review Accounts Changes in budget and Peer Review Report spending Written evidence from Impact of hybrid working PHSO and service users Modernisation and reform Parliamentary and Healt
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Government response AI summary
The government acknowledges the PACAC's role in encouraging engagement and are piloting activities with MPs' offices, including bespoke training and constituency visits based on feedback from a recent event, and will report back to PACAC on the impact of this work during the next scrutiny …
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