Recommendation 2

HM Government · verbatim extract Accepted in Part

Since April 2021, we have focussed PHSO’s resources on the more serious health complaints, in line with an approach already widely used across the Ombudsman sector. In practice, we have continued to examine all complaints brought to PHSO, and tried to quickly resolve those we are able to. If we are not able to resolve complaints quickly, and the claimed injustice is more limited and does not have an impact on wider learning or systemic issues, we do not consider the complaint further. This applies only to complaints about the NHS. In autumn 2021, we reviewed this approach and decided to continue with it for a further 12 months. This strategy has been successful in helping to reduce the queue from over 3,200 unallocated complaints in April 2021 to around 2,400 in June 2022; this is despite the number of incoming complaints rising by 24% compared to before the pandemic. In autumn 2022, we will undertake a final review considering 18 months of data and ensure that we have sufficient evidence to make a robust decision about our long-term approach. We welcome the Committee’s feedback on how we can communicate more clearly with members of the public through the PHSO website about our approach to handling less serious cases. We will review not only the relevant content on our website to make it more prominent and easier to understand, but also look at wider changes to users’ experience of the website to improve people’s understanding and experience of PHSO’s service. This will involve updating several areas of the website to ensure changes are consistent throughout and will be completed by September 2022. To ensure we offer a fair and equitable service, PHSO investigates complaints that come to us in the order that they are received. As a rule, we do not prioritise cases based on 2 Parliamentary and Health Service Ombudsman Scrutiny 2020–21: PHSO and Government responses their level of severity. We will however prioritise cases in exceptional circumstances. These include cases where there is an ongoing safety or safeguarding issue, or where the complainant has a terminal illness, is experiencing an ongoing impact to their health because of the subject matter of the complaint, or is in severe financial hardship (and the complaint is about a financial loss). In addition, where there are particular reasons for prioritisation, for example related to the complainant’s wellbeing, cases are carefully managed and monitored. We have clear policies in place for escalating and reporting issues, such as when a complainant may be at risk of self- harm. More complex cases are directed to specialist senior casework teams who have additional training that enables them to investigate complex cases effectively. These cases may take longer to close, as they often require consideration of additional evidence or specialist clinical or legal advice.