Source · Select Committees · Public Administration and Constitutional Affairs Committee
Sixth Report - Parliamentary and Health Service Ombudsman Scrutiny 2021–22
Public Administration and Constitutional Affairs Committee
HC 745
Published 31 March 2023
Recommendations
6
Accepted
Para 36
We are concerned by the number of Level 1 and 2 cases that are not...
Recommendation
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 …
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Government Response 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 progress to investigation is common among the Ombudsman community.
11
Accepted
The PHSO should update the Committee on the outcomes of the review of how the...
Recommendation
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 …
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Government Response 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 outcome as well as the stage the complaint was concluded.
15
Accepted
Para 55
The PHSO should clarify how the Clinical Advice Quality Framework will improve trust and confidence...
Recommendation
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 …
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Government Response 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.
23
Accepted
Para 78
It is unsatisfactory that data provided to this Committee has been subsequently revised.
Recommendation
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 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.
32
Accepted
Para 100
We recommend that the PHSO increases its engagement with departmental Select Committees to encourage them...
Recommendation
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 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.
34
Accepted
Para 102
Ahead of the next annual scrutiny hearing, the PHSO should provide an update to the...
Recommendation
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 …
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Government Response 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.
35
Accepted
We also welcome the PHSO’s efforts to engage with MPs and their staff on the...
Recommendation
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 …
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Government Response 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 inquiry.
Conclusions (9)
1
Conclusion
Accepted
Para 15
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, …
Government Response 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.
3
Conclusion
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 …
Government Response 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 will plan for wider digital and technological improvements.
14
Conclusion
Accepted
Para 54
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 …
Government Response 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.
21
Conclusion
Accepted
Para 76
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 …
Government Response 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.
22
Conclusion
Accepted
Para 77
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 …
Government Response 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.
24
Conclusion
Accepted
Para 79
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 …
Government Response 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.
25
Conclusion
Accepted
Para 80
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 …
Government Response 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 Teams.
28
Conclusion
Accepted
Para 96
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 …
Government Response 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.
30
Conclusion
Accepted
Para 98
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 …
Government Response 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.