The well-respected Patients' Association is recommending that patients do not make the effort to appeal to the Health Service Ombudsman. In an alarming report , citing many shocking cases the association finds that the Ombudsman failed to establish the facts of the cases cited, didn't take the views and information provided by the complainant relatives into proper account and failed to take proper clinical and medical advice.
The Patients' Association found:
- 1. The jurisdiction of the PHSO is unclear, leaving ill-defined boundaries between the organisation and other public funded bodies such as the CQC.
- 2. The PHSO hides its failings behind legislation.
- 3. Individual cases take far too long to be assigned to an investigator and subsequently, the investigations are far too lengthy.
- 4. The current process relies heavily on families providing the burden of evidence. If evidence is not presented by the families, the PHSO does not look further to find it.
- 5. There are too many gaps involving clinical decisions that the PHSO refuse to investigate, therefore families fall into a bureaucratic no man’s land, for example, cases under the Mental Health Act or where there is a case of Do Not Attempt Resuscitation (DNAR).
- 6. The right people, with the right skills, are not always assigned to cases and as a consequence, this can negatively impact on the outcome of an investigation.
- 7. Investigations are not diligent , robust or thorough.
- 8. The PHSO investigators fail to appropriately consult medical and clinical advisors who might be available to them.
- 9. Complainants are refused the chance to meet with the person investigating their case, in order to explain their concerns, agree the remit and terms of reference of the investigation, timelines and communication pathways.
- 10. The PHSO fails to acknowledge that many relatives have intimate knowledge of the care received by their loved ones and detailed facts relating to their particular case.
- 11. The PHSO also declines requests from families for additional crucial information and evidence to be submitted, once a written complaint has been made and an investigation has begun – they frequently ignore evidence from families and carers.
- 12. Linked to this, there is little evidence that PHSO investigation conclusions are entirely evidence based. Crucial mistakes in investigations result in flawed decisions and recommendations.
- 13. As a consequence, the PHSO continually make errors of judgement and mistakes, which ultimately leads to re-investigations, which then result in a dditional cost to the public purse and considerable further distress to the families.
- 14. The PHSO compound their errors by frequently re-assigning the same investigators to re-investigations. As a consequence, mistakes made the first time round remain unchallenged and are even, on some occasions, repeated. The investigators are in effect re-investigating themselves.
- 15. If and when the PHSO appeal process agrees to a re-investigation and despite their possession of the papers from the initial investigation, the families are expected to submit all the relevant papers all over again and are only afforded two weeks in which to do so.
- 16. The PHSO requires families to keep the outcomes of draft reports confidential under dubious application of the law, effectively gagging the families concerned.
- 17. Families are not consulted prior to finalisation of reports and as a consequence, have no influence or say regarding the final recommendations.
- 18. Even when recommendations are made, there is little evidence that they are followed up, reviewed or the Trusts held to account for failing to implement any recommendations.
- 19. Throughout the whole PHSO process, families are left distressed, exhausted and distraught by the failings of the body to carry out their public function in an efficient, effective and caring manner.
- 20. In real terms, the total cost to society and families of the PHSO far exceeds the £40 million funding the body receives.
- 21. The PHSO appears to be both unaccountable and untouchable.
The Public Accounts Committee of the House of Commons is currently looking into the work of the Health Service Ombudsman. Concerned members of the public may write to their MPs to stress the importance of taking the Patients' Association evidence most seriously.