First Report - Parliamentary and Health Service Ombudsman Scrutiny 2020–21

The Committee notes the actions taken by the Parliamentary and Health Service Ombudsman to ensure continuing services to the public in difficult and unprecedented circumstances throughout the pandemic. However, the Committee notes the substantial backlog which has developed as a result. Whilst action is being taken to reduce this, we remain concerned at the impact of delays upon those using the services of the PHSO. The Committee was also concerned to learn that changes to case-handling of level 1 and level 2 health cases have not been as clearly communicated to the public or Members of Parliament as they could have been.

The PHSO should more clearly notify visitors to its website which cases are not being considered under this new policy and further update the Committee on the review outlined to the Committee during the oral evidence session. The PHSO should also update the Committee on any prioritisation actions it is taking to ensure that the most severe cases are considered with all due haste.

The PHSO should also consider developing and reporting against timeliness targets for each grade of “severity of injustice” to better monitor the impact of the backlog on higher category cases in Levels 3 to 6.

The Committee notes that the PHSO has again struggled to reverse the trend of weaker feedback scores on some elements of its Service Charter performance areas. The Committee however also notes the need to clarify the wording of its Service Charter questions by providing additional context to PHSO users so that they can better understand what the relevant scores mean in terms of service delivery.

The PHSO should set out how it plans to take to address the three-long term, low performing scores relating to how evidence is gathered, how decisions are reached and how decisions are made in a timely final decision.

The PHSO have improved the data output about their own performance in recent years, which the Committee applauds. Nevertheless, the Committee is of the view that even more open and transparent access to feedback data will enable external stakeholders to give an accurate judgement on the work of the PHSO. One of the ways of doing that is to compare feedback from complainants who were happy with the outcome of their case, and those who were not.

The Committee recommends that the PHSO learns from and implements best practice at the Local Government and Social Care Ombudsman by publishing feedback scores about its service, split between those complainants who were happy with the result of their case and those who were not. This will allow for a better understanding of the service levels provided by the PHSO and provide a more accurate metric by which its service delivery can be assessed. (Paragraph 35) Parliamentary and Health Service Ombudsman Scrutiny 2020–21 27 Staff management

Good staff retention ensures high standards and shows an engaged and happy workforce. Therefore, the Committee believes that it is in the PHSO’s benefit, and the benefit of the people it serves to improve staff engagement and aim for high staff retention. We welcome the PHSO’s commitment to engage more fully with its staff and will be monitoring these scores in future staff surveys to assess progress.

The Committee welcomes the career development pathways and accreditation scheme put in place within the organisation, but also encourages the PHSO to look at possible new development opportunities within the organisation to encourage staff retention and to ensure there is minimal loss to institutional knowledge.

The Committee notes the progress that has been made to date in implementing the Donaldson Review and look forward to further updates on the implementation of the Review, including an update on the progress of the pilots into systematic investigations.

Prior to the next scrutiny session, the PHSO should update the Committee on progress against the implementation of the Donaldson Review, outlining how many areas remain outstanding and its proposed steps and timeline to address them. In this update, the PHSO should outline what actions it has taken to embed lessons on complex casehandling to its wider casework, including other technical casework areas.

The Committee welcomes the progress of the PHSO’s commitment to a diverse workforce. We are pleased by the pledge of continuous improvement in this area and look forward to hearing about further progress in the coming years. (Paragraph 52) Value for money

The considerably different operating environment brought on by the Covid-19 pandemic has forced the PHSO to critically evaluate how it delivers its services. The Committee are pleased the PHSO is conducting a pilot to evaluate the implications of new working practices. The Committee will continue to monitor developments as the PHSO considers its future operating model to ensure it secures value for money from the resources it uses. Proper regard should be given to staff welfare concerns with home working which should not be an assumption in any new working model.

The Committee notes the Parliamentary and Health Service Ombudsman’s commitment to undertaking a peer review and its engagement with the HM Treasury value for money framework. Whilst the Committee recognises the PHSO’s open engagement on measuring its value for money, it remains unclear when its next peer review will be.

The Committee reiterates its previous call to undertake a peer review, and recommends that the PHSO do so as soon as possible and on a more regular basis to ensure continued value for money. (Paragraph 61) 28 Parliamentary and Health Service Ombudsman Scrutiny 2020–21

The Committee reiterates its call for the Government to introduce legislation to reform the PHSO and start consulting with relevant stakeholders and the public, on a cross-party basis, to ensure the Bill be brought forward as soon as possible. It is now six years since the publication of the Draft Public Service Ombudsman Bill and we are still no further forward. This situation is as unacceptable as it is untenable in the long term. A Private Member’s Bill might also be considered as a vehicle for reform.

The Government has to take the issue of Ombudsman reform seriously and provide legislative action. We urge the Government to set out a legislative timetable before the end of this year, and seek to deliver the necessary reforms before the end of this Parliament.

The PHSO has outlined to the Committee evaluative criteria for the 2021–22 period and explained the delays to the launch of their new strategy. The Committee will continue to monitor the PHSO’s delivery against its 2022–25 corporate strategy. (Paragraph 74) Impact on other organisations

The Committee notes the strong progress the PHSO has made in delivering against this objective and informing discussions in the international Ombudsman community. The Committee looks forward to hearing of further progress in this area.

The Committee welcomes the PHSO’s actions in developing a complaints standard for the NHS and government bodies. The Committee looks forward to seeing further updates on the progress of pilots. (Paragraph 81) Parliamentary and Health Service Ombudsman Scrutiny 2020–21 29 Priorities for scrutiny As in our previous report, this annex sets out priorities for our scrutiny of the PHSO. Table 9: Areas of Scrutiny Area of scrutiny Example expected evidence Areas of particular interest PHSO casework Complainant and organisation The PHSO’s commissioning performance feedback recorded against the PHSO’s and use of clinical advice. Service Charter commitments. KPIs 8,11 and 13. Internal casework assurance scores. The impact of Covid-19 on Written evidence from complainants. demand for the PHSO and timeliness of investigations. The time taken to complete cases Staff Staff survey scores. Staff views on the quality of management and training they have received. training Improvements in service charter scores (such as commitment 11 on explaining decisions and recommendations.) Value for Money The Comptroller and Auditor General The composition of the next signed off the PHSO’s annual report peer review panel. and accounts with an unqualified opinion. Evidence of seeking, learning from and contributing to best practice from the international Ombudsman community. Periodic value for money studies. Impact on other Evidence that recommendations have The impact and organisations been followed up. effectiveness of the PHSO’s Complaints Standards Evidence of effective engagement Framework. with organisations like the Care Quality Commission or Select The PHSO’s relationships Committees of the House to maximise and outreach with Select impact. Committees. Implementation by organisations of The routine publication the PHSO’s upcoming Complaints of PHSO casework Standards Framework. and recommendation compliance 30 Parliamentary and Health Service Ombudsman Scrutiny 2020–21