Recommendations & Conclusions
13 items
1
Conclusion
Third Report - Parliamentary and Health…
Accepted
We have heard praise of the PHSO’s handling of casework, but we have also received evidence of concerns with some aspects of its service provision. The PHSO told us that it would reflect on the concerns about the service it provided to people with disabilities while outlining the measures it …
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We have heard praise of the PHSO’s handling of casework, but we have also received evidence of concerns with some aspects of its service provision. The PHSO told us that it would reflect on the concerns about the service it provided to people with disabilities while outlining the measures it takes to meet the needs of complainants. In its response to this report, the PHSO should outline to us the steps it proposes to take to address the concerns we have heard in our written evidence, in particular in relation to service provision to people with disabilities and the elderly.
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Government response AI summary
The PHSO committed to implementing disability awareness training for all staff in 2024-25, reviewing its house style and language guide for accessibility improvements, and leveraging its DDaT strategy to better understand and tailor services for disabled and elderly complainants.
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2
Conclusion
Third Report - Parliamentary and Health…
Deferred
We welcome the fact that the PHSO has worked hard to reduce the backlog of cases created by the COVID-19 pandemic and met its target for making initial decisions about cases within seven days. However, we remain concerned by the fact that the PHSO has missed its targets on deciding …
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We welcome the fact that the PHSO has worked hard to reduce the backlog of cases created by the COVID-19 pandemic and met its target for making initial decisions about cases within seven days. However, we remain concerned by the fact that the PHSO has missed its targets on deciding cases subject to further consideration. The PHSO attributed this to the lag effect of closing cases that had been in the queue for a long time and expect that the time taken to complete further consideration will drop dramatically once the backlog has been cleared. In order to clarify how far the work being undertaken to clear the backlog of cases is the main cause of the length of time taken to resolve cases subject to further consideration, the PHSO should find a way to present the information on the time involved in case resolution by giving separate figures for those cases which are part of the COVID-19 backlog and those others which have been received since the end of the pandemic.
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Government response AI summary
The PHSO reported that it returned to normal operating levels by March 2024 and is close to meeting its KPI targets for case closure times, providing overall performance metrics. However, it did not commit to presenting separate figures for COVID-19 backlog cases versus new cases …
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3
Conclusion
Third Report - Parliamentary and Health…
Accepted
We do not accept the Ombudsman’s argument that we would have been critical of the PHSO for setting lower, yet more realistic, targets for case resolution. The setting of unrealistic targets leads to them being missed, and draws unwarranted criticism where realistic targets would not do so. Rather, we are …
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We do not accept the Ombudsman’s argument that we would have been critical of the PHSO for setting lower, yet more realistic, targets for case resolution. The setting of unrealistic targets leads to them being missed, and draws unwarranted criticism where realistic targets would not do so. Rather, we are of the view that targets should be simultaneously ambitious and realistic, to allow the public and us to assess the performance of the organisation more clearly. In its response to this report, the PHSO should provide details of the methodology it uses for deciding its targets for how quickly it should resolve cases subject to further consideration, and outline any steps it will take to review that methodology to arrive at more realistic targets to be used in the future.
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Government response AI summary
The government states its current case resolution targets are based on best practice and are achievable, citing pre-pandemic performance. It indicates it will only reflect on KPIs and consider a review in the event of another significant impact on productivity.
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4
Conclusion
Third Report - Parliamentary and Health…
Accepted
We welcome the increase in the number of cases resolved by mediation and PHSO’s ambition to widen the range of cases resolved by mediation in 2023/24. The PHSO stressed that the cultural attitudes of stakeholders, notably in the NHS, were a barrier to increasing the number of cases resolved through …
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We welcome the increase in the number of cases resolved by mediation and PHSO’s ambition to widen the range of cases resolved by mediation in 2023/24. The PHSO stressed that the cultural attitudes of stakeholders, notably in the NHS, were a barrier to increasing the number of cases resolved through mediation. The PHSO should outline how it is working with stakeholders to place a stronger emphasis on mediation in the Complaint Standards for the NHS and for Government. The PHSO should also write to us before our next annual inquiry into the PHSO, setting out whether it has matched its ambition for 2023/24 to maintain the number of cases resolved by mediation and to appropriately widen the types of cases resolved to include more complex cases and cases beyond those focused on healthcare. It should also set out what its medium- and long-term aims are for mediation and the measures it is intending to take to achieve those aims. (Paragraph 23) 28 Parliamentary and Health Service Ombudsman Scrutiny 2022–23
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Government response AI summary
The government confirms it maintained the number of cases resolved by mediation and widened the types of cases in 2023-24. It commits to providing a further update on mediation prior to the Committee's next inquiry.
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5
Recommendation
Third Report - Parliamentary and Health…
Deferred
The potential barriers presented by training and culture among NHS staff to increasing mediation cannot be overcome solely by the PHSO. Other stakeholders, including the Government, have a role to play in promoting mediation. The Government should outline how it is working with NHS England and other relevant stakeholders to …
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The potential barriers presented by training and culture among NHS staff to increasing mediation cannot be overcome solely by the PHSO. Other stakeholders, including the Government, have a role to play in promoting mediation. The Government should outline how it is working with NHS England and other relevant stakeholders to promote a culture and training that is supportive of mediation among NHS staff and those working in government departments.
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Government response AI summary
The government's response did not address the recommendation about promoting a culture and training supportive of mediation. Instead, it discussed the PHSO's 'severity of injustice' approach to case management and its ongoing testing of a new 'public value model' for triage.
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6
Recommendation
Third Report - Parliamentary and Health…
Deferred
We reiterate the concerns we expressed in our 2021–22 report about the PHSO’s continuation of the ‘severity of injustice’ approach to case management which means certain cases are very unlikely to be resolved and are not subject to detailed investigation. This was introduced as a temporary measure during the pandemic. …
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We reiterate the concerns we expressed in our 2021–22 report about the PHSO’s continuation of the ‘severity of injustice’ approach to case management which means certain cases are very unlikely to be resolved and are not subject to detailed investigation. This was introduced as a temporary measure during the pandemic. The PHSO have stated it intends to review its future approach when the backlog of cases caused by the COVID-19 pandemic has been dealt with, with this likely to take place towards the end of the 2023/24 financial year. We reiterate the recommendation from our 2021–22 report that the PHSO should set out publicly the criteria it will use during the review to determine its future approach.
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Government response AI summary
The government's response did not address the recommendation to set out publicly the criteria for reviewing its 'severity of injustice' approach to case management. Instead, it detailed improvements to Service Charter scores, queue reduction, staff training, and complainant surveys.
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7
Recommendation
Third Report - Parliamentary and Health…
Deferred
We welcome the PHSO’s actions following our previous recommendation, resulting in reforms to how it conducts its Service Charter survey and differentiating the data depending on the outcome of a complaint’s case. However, we remain concerned that these changes do not address the underlying problems revealed by missing the targets …
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We welcome the PHSO’s actions following our previous recommendation, resulting in reforms to how it conducts its Service Charter survey and differentiating the data depending on the outcome of a complaint’s case. However, we remain concerned that these changes do not address the underlying problems revealed by missing the targets for the three KPIs, and by the persistently low scores related to gathering information, explaining decisions, and making and communicating the final decision to complainants in a timely fashion. The PHSO should set out in its response to this report the steps it is taking to drive continual improvement in its scores in these key areas. (Paragraph 36) Staff management and training
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Government response AI summary
The government's response did not address steps to improve KPI scores related to information gathering and decision making. Instead, it focused on staff turnover figures and the review of its hybrid working policy, scheduled for summer 2024.
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8
Conclusion
Third Report - Parliamentary and Health…
Deferred
We note the welcome increase in the PHSO’s number of staff, especially its new caseworkers. Likewise, we welcome the fact that it has retained specialist workers and has increased the amount of training it delivers to staff. This increase in training means it is even more important for the PHSO …
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We note the welcome increase in the PHSO’s number of staff, especially its new caseworkers. Likewise, we welcome the fact that it has retained specialist workers and has increased the amount of training it delivers to staff. This increase in training means it is even more important for the PHSO to retain staff, given the additional investment now being made in them. The Ombudsman and Chief Executive suggested current levels of staff turnover could be the result of a lack of opportunity for career development and the PHSO’s different policy on hybrid working compared to other ombudsmen. We welcome the PHSO’s intention to review its hybrid working policy next year. The PHSO should separately assess whether there are further steps it can and should take to reduce staff turnover, including how far its hybrid working policy is leading to higher turnover than other ombudsmen. The PHSO should look to complete its reviews of hybrid working and the factors causing staff turnover by the summer of 2024, and share its findings with us ahead of our next scrutiny session for the 2023/24 period. (Paragraph 44) Value for Money
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Government response AI summary
The government's response did not address staff turnover or hybrid working policies. Instead, it outlined the PHSO's five-year Digital, Data and Technology strategy, its ambition to be a leading digital ombudsman, and a commitment to report back on financial savings from this strategy.
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9
Conclusion
Third Report - Parliamentary and Health…
Deferred
We welcome the PHSO’s digital ambition and believe that this is a sensible way to increase value for money. We request from the PHSO a further update on progress Parliamentary and Health Service Ombudsman Scrutiny 2022–23 29 towards achieving these aims, along with a detailed analysis of any financial savings …
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We welcome the PHSO’s digital ambition and believe that this is a sensible way to increase value for money. We request from the PHSO a further update on progress Parliamentary and Health Service Ombudsman Scrutiny 2022–23 29 towards achieving these aims, along with a detailed analysis of any financial savings expected to be made as a result, with both to be included in the PHSO’s next Annual Report and Accounts.
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Government response AI summary
The government's response did not address the request for an update on digital strategy progress or financial savings. Instead, it discussed the need for legislative reform for the PHSO and called on political parties to include such commitments in their manifestos.
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10
Recommendation
Third Report - Parliamentary and Health…
Deferred
We renew our call for legislative reform of the PHSO, the principle of which enjoys widespread support among stakeholders and the ombudsmen that would be directly affected. The PHSO have outlined to us some concrete examples of the operational issues that are being caused, and exacerbated over time, by the …
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We renew our call for legislative reform of the PHSO, the principle of which enjoys widespread support among stakeholders and the ombudsmen that would be directly affected. The PHSO have outlined to us some concrete examples of the operational issues that are being caused, and exacerbated over time, by the lack of reform. Reforms are long overdue, and we do not agree with the Government that this is not an urgent issue; rather it has been neglected too long and further delay is no longer tenable. The Government should reconsider its position on reforms and set out its plans, ahead of the general election. It should consult with a wide variety of stakeholders, including different ombudsmen, parliamentarians and PHSO service users. All political parties should include a commitment to reforming the legislation relating to the PHSO in their upcoming manifestos ahead of the next General Election, coupled with a commitment to introduce such legislation early in the next Parliament. (Paragraph 58) Impact on other organisations
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Government response AI summary
The government's response did not address legislative reform for the PHSO. Instead, it outlined lessons learned and best practices adopted from international collaborations, such as the Canadian 'Complaints Champions' model, 'roadshows' based on Dutch and Western Australian approaches, and a learning exchange on mediation with …
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11
Conclusion
Third Report - Parliamentary and Health…
Deferred
We welcome the PHSO’s continual collaboration with ombudsmen in other countries and across the UK, along with its collaboration with other organisations. In its response to this report the PHSO should outline the lessons it has learnt and best practices it has adopted because of its collaboration with other ombudsmen.
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We welcome the PHSO’s continual collaboration with ombudsmen in other countries and across the UK, along with its collaboration with other organisations. In its response to this report the PHSO should outline the lessons it has learnt and best practices it has adopted because of its collaboration with other ombudsmen.
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Government response AI summary
The government's response did not outline lessons learned from collaboration with other ombudsmen. Instead, it detailed the successful pilot and rollout of NHS Complaint Standards, the launch of UK Central Government Complaint Standards, and the provision of training to NHS and government staff, with bespoke …
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12
Recommendation
Third Report - Parliamentary and Health…
Accepted
We welcome the progress that has been made in developing and rolling out Complaint Standards for the UK Government and the NHS. These Standards have the potential to improve the quality of public services and the handling of complaints. Ensuring that staff know about and act on these Standards is …
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We welcome the progress that has been made in developing and rolling out Complaint Standards for the UK Government and the NHS. These Standards have the potential to improve the quality of public services and the handling of complaints. Ensuring that staff know about and act on these Standards is critical to achieving these goals. In its response to this report, the PHSO should set out both the proportion and number of all relevant NHS and UK Government staff who have been trained in its respective Complaint Standards, broken down by department where appropriate, and inform us of its targets for training over the 2023–24 financial year.
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Government response AI summary
The PHSO reports that over 1,248 NHS learners registered and over 720 people from 145 NHS organisations completed training courses by April 2024. It also states that bespoke training for government departments is being tested and expected to launch by June 2024.
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13
Recommendation
Third Report - Parliamentary and Health…
Accepted in Part
We reiterate the recommendation from our previous report that the Cabinet Office should strongly encourage Government departments and public bodies to sign up to the Government Complaint Standards. In its response to this report, the Government should outline how many departments and public bodies have now signed up to the …
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We reiterate the recommendation from our previous report that the Cabinet Office should strongly encourage Government departments and public bodies to sign up to the Government Complaint Standards. In its response to this report, the Government should outline how many departments and public bodies have now signed up to the PHSO Complaint Standards, and set out its plan and timetable to introduce these Standards across all departments and public bodies. (Paragraph 69) 30 Parliamentary and Health Service Ombudsman Scrutiny 2022–23
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Government response AI summary
The government agrees to strongly encourage departments to adopt the Complaint Standards, noting early adopters, but rejects mandating their use across all organisations due to their diversity, preferring a flexible approach.
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