Seventh report - Parliamentary and Health Service Ombudsman Scrutiny 2019–20

The information provided in the PHSO’s annual report on the outcome of enquiries and complaints should be made more transparent. The grouping of cases that “are not ready to be taken forward” and “should not be taken forward” should be ended. Presumably the former could still lead to investigations being conducted while the latter would not. The PHSO should also separately report on complaints partially and fully upheld.

In May 2020, the PHSO reported to the Committee that it had experienced an increase of 13 per cent in demand compared to the previous financial year. Due to the introduction of a new digital casework management system, comparisons between years were not possible. This means that the 13 per cent figure cannot be evidenced. The PHSO made no effort to proactively correct the record. If witnesses provide evidence to select committees which is later demonstrated not to be evidence, those witnesses should correct the record. This responsibility is especially applicable for bodies that are scrutinised by those select committees.

The Committee welcomes the PHSO’s efforts to set stretching target section scores for its Service Charter commitments, but continues to regard the relatively low scores against commitments 8, 11 and 13 as continuing priority areas for improvement and requests an update from the PHSO when data for the mid-year point is available.

The Committee appreciates that there is a risk that complainants could be overwhelmed with information if all the evidence the PHSO has collected is shared with them, but it remains the case that complainants need to be assured that all the evidence they have provided has been properly logged. We recommend as an initial step that the PHSO should at a minimum produce a schedule of evidence that they have collected and that this schedule is shared both with complainants and with the organisations being complained about. This would give both parties assurance at least that all the evidence they have provided has been properly logged. This may help improve scores against service charter commitment 8 on gathering all the necessary information.

The PHSO should report in its annual report and accounts the number of new enquiries and complaints that have been received in that financial year. This number is separate from the number of enquiries and complaints that the PHSO has “handled” in that same financial year.

The PHSO should provide a breakdown of how long health cases that are over one year old have been open for. This information should also be produced next to the general information the PHSO provides on the amount of time it has taken to close cases in that financial year. (Paragraph 24) Parliamentary and Health Service Ombudsman Scrutiny 2019–20 17

The PHSO should report regularly in its annual report the number of cases in the queue for allocation to a caseworker and the average amount of time it took for cases to be allocated to a caseworker. This will be particularly important to understand the impact covid-19 has had on PHSO services.

It is necessary for complaints to the PHSO to be time-limited, as there needs to be some level of certainty about when matters that could potentially be complained about can no longer be taken forward. However, the Committee’s view is that if an organisation cannot demonstrate that it has informed complainants in good time of their ability to refer a complaint to the PHSO, then this should be a material consideration in whether the Ombudsman decides to use his discretion to investigate the complaint despite being out-of-time under the legislation. The PHSO should report to the Committee annually about the number of cases that have been “timed out” and how often and why the Ombudsman’s discretion has been used.

The Committee recommends that the PHSO should publish a target for responding to correspondence, and should track its performance against that standard and report to the Committee each year. (Paragraph 31) Value for Money

The Committee believes that regular peer review studies will be an important source of assurance of the effectiveness of the PHSO’s processes and in turn, its value for money. The Committee recommends that peer review should include specific assurance on the quality of the PHSO’s casework. This should involve analysing a sample of the PHSO’s recent casework and comparison to the PHSO’s service charter commitments.

While peer review does require some degree of understanding of ombudsman services, fresh independent perspectives are valuable to avoid groupthink setting in. The Committee recommends that the next peer review should include in its panel an independent member, such as an auditor who has experience of looking at complaints handling organisations.

The Committee recommends that the value for money study should adopt the following broad structure in its report: For each area examined, the report should first set out what is expects to see of a modern ombudsman organisation, it should then explain what it did actually find and finally it should analyse how the PHSO’s performance compares against modern expectations.

The Committee reiterates its conclusion that legislative reform of the PHSO is required. The PHSO’s legislation is out of date compared to modern Ombudsman standards. While the Committee appreciates the pressing priorities facing the Government, including covid-19, reform of the PHSO should not be treated as a trifling matter and unworthy of parliamentary time. The PHSO represents the final stage in a complaints process. For many complainants, their complaints refer to matters of grave seriousness, such as the passing of a loved one, and it is essential they can have complete faith that there is an effective organisation at the end of the process. The outdated legislation undermines this important aim. (Paragraph 41) 18 Parliamentary and Health Service Ombudsman Scrutiny 2019–20 Impact on other organisations

Routinely publishing the PHSO’s casework online, including levels of compliance with the PHSO’s recommendations will help to demonstrate the impact of the PHSO on other organisations. For recommendations that are of a more long-term nature, such as forming and implementing an action plan, publishing casework online also helps interested parties to understand and follow-up on the recommendations. An example could be users of a particular NHS trust’s services. (Paragraph 46) Parliamentary and Health Service Ombudsman Scrutiny 2019–20 19