PHSO Annual Scrutiny 2017/18: Towards a Modern and Effective Ombudsman Service Contents

Conclusions and recommendations

Independent Peer Review

1.Based on the evidence they presented we accept the Peer Review Panel’s conclusion that the PHSO is “moving out of critical care and into recovery”, and that it is “on its way to becoming an efficient and effective modern ombudsman service, which provides significant value for its stakeholders”. We note Peter Tyndall’s confidence in the leadership of the PHSO to continue this turn-around, but also his warning of the need to guard against complacency. (Paragraph 18)

2.The Committee has no doubt in the peer review panel’s personal independence and integrity. There is considerable value in the insight that leading practitioners and experts in a field, such as the panel that carried out this review, can bring. A single review, no matter how authoritative, is, however, only a snapshot. It will always have to be taken with the other available evidence, and that is how the Committee has approached it. (Paragraph 23)

3.The Committee recommends that the PHSO repeat a peer review process every three to four years. For future reviews it also recommends that the PHSO considers how to reach outside the Ombudsman sector to obtain informed perspectives from professional peers with relevant experience in related sectors. This would potentially add further value to a review’s conclusions in the eyes of Parliament and the public. Engaging directly with people with direct experience of the PHSO’s service and other stakeholders would also add value and complement existing customer satisfaction data. (Paragraph 24)

PHSO’s Performance in 2017/18

4.The PHSO’s dip in productivity in 2017/18 is unfortunate, especially following its performance in previous years. The Committee is very aware that this means that some individuals have suffered delays and poor service from the PHSO. However, it accepts that it is likely to be a consequence of the restructuring the Ombudsman had to carry out in 2017/18. Given the PHSO’s evidence that the position had already improved in the current year and the backlog of cases had been cleared, the Committee expects to see improvements in 2018/19 and beyond. (Paragraph 28)

5.It is encouraging that the complainant feedback remained broadly stable during a period when, by its own admission, the PHSO’s productivity dropped and backlogs built up. From a single year’s figures, it is impossible to know if this is because the PHSO was successful in maintaining the quality of its service, even as it processed fewer cases more slowly, or if complainants’ views as measured by the service charter are independent of the organisation’s actual performance. We therefore expect to see an improvement in the service charter scores in the current and future years because of the Ombudsman’s restructuring. Given that the PHSO has used the service charter to focus its revised training for staff on the areas where it is currently weakest we also expect to see this significant investment to be reflected in better scores in these areas. (Paragraph 35)

6.Impartiality is the only issue the PHSO does not ask for complainant feedback on. As the Committee concluded last year public confidence in the Ombudsman’s impartiality is core to his role. It is inevitable that the outcome of their specific complaint will colour some complainant’s views of the PHSO. This, however, as the PHSO has strenuously argued, is true of many of the subjective issues the complainant feedback survey asks about. It is unclear why perceptions of impartiality are a special case that is not open to quantitative analysis. (Paragraph 36)

7.The Committee welcomes the PHSO’s commitment to introduce a qualitative assessment of complainant’s views of impartiality in the next service charter tender. However, unless strong evidence is provided to show why it is a special case, we stand by our recommendation that a question on impartiality should be included in the service charter survey. (Paragraph 37)

8.The PHSO’s leadership, and wider staff team, are to be congratulated on the evident turn around in the internal health of the organisation in such a short period. We attach great importance to the significant improvement in engagement index derived from the annual staff survey. This was however a recovery from a low base. That it was able to deteriorate to such a state indicates the ongoing need to reform its outdated governance and accountability arrangements to prevent such a failure in the future. This reinforces the need for legislation to be introduced as a matter of urgency. (Paragraph 40)

9.We therefore reiterate our predecessor committee’s recommendations from 2014 on the need for fundamental reform of the PHSO’s governance. This will require legislation. The Government and Parliament must ensure that the Draft Public Service Ombudsman Bill is scrutinised by a Joint Committee of both Houses of Parliament as soon as possible. It is disappointing that the draft Bill has been waiting for pre-legislative scrutiny since it was published in December 2016. The Bill must then be included in the Government’s legislative programme at the earliest opportunity, or it will continue to be much harder than necessary for PHSO to continue and to sustain its recovery. (Paragraph 41)

PHSO’s role in improving public services

10.The Committee agrees with Dr Gill that “if the ombudsman is only serving individual complainants, then it is not serving the public”. Impartially adjudicating complaints and providing redress to individuals who have suffered injustice or harm is its first responsibility. However, of itself, that is too narrow an interpretation of the Ombudsman’s role, and it is right to consider how else he can improve public services and potentially prevent people from suffering harm or injustice in the first place. (Paragraph 45)

11.Based on the clear and strong evidence from the members of the Independent Peer Review we reiterate the recommendation of our predecessor committee, PASC, that the Ombudsman should have the power to begin or expand investigations on his own initiative and be able to set local complaint handling standards. The Government should carefully consider the case made by the independent peer review panel when it decides to take the legislation forward. (Paragraph 54)

12.The loss of momentum on the proposed Public Services Ombudsman Bill is disappointing. Given his detailed knowledge of the issue the Ombudsman’s view that momentum on improving local NHS complaints handling has “fizzled out”, despite the repeated conclusions of this and other Select Committees on the need for them to improve, is very concerning. Such a fizzling out would be unacceptable. We support the PHSO’s work to improve complaints in partnership with others. However, the PHSO cannot address a lack of resources or a failure to take complaints seriously within the NHS. That is a matter for Ministers and NHS England. The Committee invites the Ombudsman to use his powers to lay a report before Parliament setting out the PHSO’s insight from its casework into the state of local complaints handling in the NHS, and Government Departments. We also expect the Department for Health and Social Care to provide the update on its strategy on complaints that was promised last year as a matter of urgency. The Committee invites the Ombudsman to use his powers to lay a report before Parliament setting out the PHSO’s insight from its casework into the state of local complaints handling in the NHS, and Government Departments. We also expect the Department for Health and Social Care to provide the update on its strategy on complaints that was promised last year as a matter of urgency. (Paragraph 55)

Published: 25 March 2019