2nd Report - Parliamentary and Health Service Ombudsman Scrutiny 2018–19

The government's response

What the committee recommended 16

1. 1
   The Committee welcomes the fact that the PHSO has met its target KPI scores against... Conclusion · paragraph 11
2. 2
   Notwithstanding the fact the PHSO has met its section average KPI scores, there are some... Conclusion · paragraph 12
3. 3
   There are clear advantages to PHSO investigations being conducted in an efficient fashion, such as... Conclusion · paragraph 18
4. 4
   The PHSO’s decision to pause NHS complaints as a result of Covid-19 was a reasonable... Conclusion · paragraph 20
5. 5
   As the PHSO’s report into Nic Hart’s case acknowledges, there were multiple failures in the... Conclusion · paragraph 23

See all 16 recommendations and conclusions

Sources

• 2nd Report - Parliamentary and Health Service Ombudsman Scrutiny 2018–19 ↗The committee's report, HC 117, parliament.uk
• Second Special Report - Parliamentary and Health Service Ombudsman Scrutiny 2018–19: Parliamentary and Health Service Ombudsman’s response to the Committee’s Second report ↗The government's response, 28 September 2020, parliament.uk

Recommendations and conclusions 16

1. 1
   The Committee welcomes the fact that the PHSO has met its target KPI scores against... Conclusion · paragraph 11 Conclusion (the committee's words)

   The Committee welcomes the fact that the PHSO has met its target KPI scores against each section in its Service Charter.
2. 2
   Notwithstanding the fact the PHSO has met its section average KPI scores, there are some... Conclusion · paragraph 12 Conclusion (the committee's words)

   Notwithstanding the fact the PHSO has met its section average KPI scores, there are some particularly disappointing scores relating to gathering information and explaining how it makes decisions and recommendations. There is also a significant gap between the scores from complainant feedback and the PHSO’s own internal assurance scores for these KPIs. It is essential that complainants feel the PHSO has gathered and used the evidence correctly if they are to have confidence in the outcome of the PHSO’s investigations, and these scores indicate serious dissatisfaction among a significant number of complainants. The Committee welcome the PHSO’s publication of the guidance on how caseworkers should use and weigh evidence. This should be a priority area for improvement for the PHSO who should report back to the Committee with the actions it is taking to improve these scores and the results of those actions. This report should also highlight any similarities between the types of cases that seem to consistently attract low scores. The PHSO should also review its internal assurance procedures to narrow the gap between complainant scores and the internal assurance scores.
3. 3
   There are clear advantages to PHSO investigations being conducted in an efficient fashion, such as... Conclusion · paragraph 18 Conclusion (the committee's words)

   There are clear advantages to PHSO investigations being conducted in an efficient fashion, such as recommendations being timelier, which can in turn help prevent similar scenarios from reoccurring. The Committee is pleased to hear that the PHSO has cleared its backlog and that the time taken for complaints to be resolved appears to have fallen in 2019–20. This is something the Committee will monitor for the next scrutiny session.
4. 4
   The PHSO’s decision to pause NHS complaints as a result of Covid-19 was a reasonable... Conclusion · paragraph 20 Conclusion (the committee's words)

   The PHSO’s decision to pause NHS complaints as a result of Covid-19 was a reasonable immediate reaction. However, this is not a long-term sustainable position, as there is a risk of a backlog of cases developing, which could leave complainants seeing longer periods of stress and uncertainty and may serve to distort the PHSO performance in terms of completed cases in a satisfactory amount of time. The PHSO should ensure that its reporting on the time taken to complete cases is not distorted and may need to compensate with extra information in its 2020–21 annual report, for example, by publishing further information on the time taken to complete NHS cases that do not include the time lost to Covid-19. This will present a clearer picture of the PHSO’s productivity.
5. 5
   As the PHSO’s report into Nic Hart’s case acknowledges, there were multiple failures in the... Conclusion · paragraph 23 Conclusion (the committee's words)

   As the PHSO’s report into Nic Hart’s case acknowledges, there were multiple failures in the PHSO’s handling of Nic Hart’s complaint and the Committee finds these failures extremely concerning. The report vividly demonstrates the scale of the serious problems that the PHSO was struggling with when Rob Behrens took up his post.
6. 6
   The Committee supports the improvements that the PHSO has implemented to prevent similar failures as... Conclusion · paragraph 25 Conclusion (the committee's words)

   The Committee supports the improvements that the PHSO has implemented to prevent similar failures as that encountered by Nic Hart. In particular, it will 22 Parliamentary and Health Service Ombudsman Scrutiny 2018–19 revisit the PHSO’s changes to how it commissions and uses clinical advice in future scrutiny sessions, as this is particularly important considering that NHS cases take up the majority of the PHSO’s caseload. The PHSO must learn the lessons from Mr Hart’s case and ensure that these mistakes are not repeated.
7. 7
   The changes to processes for commissioning and using clinical advice were clearly necessary. Conclusion · paragraph 29 Conclusion (the committee's words)

   The changes to processes for commissioning and using clinical advice were clearly necessary. The Committee recommends that the PHSO closely monitors and reports back on the effectiveness of the changes to clinical advice. A further follow-up review should be commissioned at the end of the two year implementation period, and again this should be overseen by an independent expert adviser.
8. 8
   The senior management of the PHSO has done a good job to create a sustained... Conclusion · paragraph 31 Conclusion (the committee's words)

   The senior management of the PHSO has done a good job to create a sustained and substantial improvement in the staff engagement score, particularly given the scale of change the organisation has recently undergone. The Committee will continue to follow the PHSO’s performance as part of the Civil Service People Survey and would encourage the organisation to build upon these scores to become a high performer in that survey.
9. 9
   The Learning and Development scores are disappointing considering the PHSO’s investment in training, particularly a... Conclusion · paragraph 35 Conclusion (the committee's words)

   The Learning and Development scores are disappointing considering the PHSO’s investment in training, particularly a positive response of just 52% to the statement “Learning and development activities I have completed in the past 12 months have helped to improve my performance”, which represents a reduction of 3% from the previous year. The Committee recommends that the PHSO carries out more analysis into these results, including consulting staff directly, to understand why these scores are low and what training staff feel is needed. The PHSO should report its findings to the Committee, alongside an action plan for improvement before the next survey.
10. 10
    The Committee welcomes the Ombudsman’s commitment to commission another value for money study during the... Conclusion · paragraph 38 Conclusion (the committee's words)

    The Committee welcomes the Ombudsman’s commitment to commission another value for money study during the remainder of his term and is pleased that the International Ombudsman Institute will validate the membership of future peer reviews. The value for money studies should provide assurance on the quality of the PHSO’s casework, by comparing it with best practice in the Ombudsman sector.
11. 11
    The Committee believes that the PHSO’s service charter provides robust data about the PHSO’s performance,... Conclusion · paragraph 40 Conclusion (the committee's words)

    The Committee believes that the PHSO’s service charter provides robust data about the PHSO’s performance, which helps to assess the organisation’s value for money and thereby supports the PHSO’s move to also collect feedback against the Service Charter from the organisation being complained about. The PHSO should also include casework assurance scores against the Service Charter in its Annual Report.
12. 12
    The PHSO successfully delivered cost reductions of 24% in a short amount of time. Conclusion · paragraph 43 Conclusion (the committee's words)

    The PHSO successfully delivered cost reductions of 24% in a short amount of time. There is, however, a need for a serious discussion about the level of funding the PHSO requires to sustainably deliver a good service and become an exemplary Ombudsman. Ombudsman services serve as a last point of appeal for complaints Parliamentary and Health Service Ombudsman Scrutiny 2018–19 23 from people who have suffered great distress or loss. It is essential that such services are properly resourced. The Committee would support an evidence-based bid for more funding if it could be demonstrated that this would improve service to complainants. The PHSO should prepare this evidence ahead of the now-postponed Spending Review and keep the Committee fully informed of its funding requirements and the implications of the eventual settlement.
13. 13
    The Committee repeats its predecessor Committee’s calls for modernising legislation, which is plainly necessary to... Recommendation · paragraph 51 Recommendation (the committee's words)

    The Committee repeats its predecessor Committee’s calls for modernising legislation, which is plainly necessary to improve the effectiveness and value for money of the Parliamentary and Health Service Ombudsman. The Government should start the legislative process anew with an updated draft Bill for consultation and pre-legislative scrutiny. As part of such legislative reform, the PHSO and the Local Government and Social Care Ombudsman should be replaced with a single Public Service Ombudsman.
14. 14
    While the Committee accepts there are some good reasons for removing the “MP filter” to... Conclusion · paragraph 52 Conclusion (the committee's words)

    While the Committee accepts there are some good reasons for removing the “MP filter” to bring complaints to the PHSO about government departments and agencies, Members of Parliament play a vital role in supporting their constituents’ complaints. Therefore, a role for MPs to support their constituents must remain in any substantive legislative reform.
15. 15
    As part of future scrutiny of the PHSO, the Committee will seek evidence that the... Recommendation · paragraph 55 Recommendation (the committee's words)

    As part of future scrutiny of the PHSO, the Committee will seek evidence that the PHSO has followed up on recommendations to ensure organisations are compliant with their recommendations. In cases in which it would not be appropriate for the PHSO to follow up on recommendations, the PHSO should ensure relevant bodies have been informed about their recommendations and the level of compliance with those recommendations. The PHSO should include compliance information in its Annual Reports and should set out the steps it has taken to maximise compliance with, and impact of, its reports. As part of this work, the PHSO should strengthen its relationships with Departmental Select Committees, especially at official level. Select Committees would benefit from learning about findings against Departments ahead of sessions with Permanent Secretaries on the annual reports and accounts.
16. 16
    There are obvious advantages to improving complaints handling by frontline bodies. Conclusion · paragraph 57 Conclusion (the committee's words)

    There are obvious advantages to improving complaints handling by frontline bodies. If people are satisfied with the way their complaint has been handled in the first instance, this means they will feel they have had a more efficient resolution to their complaint and they will be less likely to pursue a complaint with the PHSO. The Committee supports the PHSO’s work on the Complaints Standards Framework and will seek an update at the next scrutiny session on how that framework is received and how its effectiveness is being monitored.