Parliamentary and Health Service Ombudsman Scrutiny 2021–22 – Report Summary

Summary

The Parliamentary and Health Service Ombudsman (PHSO) examines complaints from individuals about public services that have not been resolved by UK Government Departments, the NHS in England, and other public bodies. The Ombudsman is independent of the Government, the NHS, and of Parliament. Under Standing Order 146, the Public Administration and Constitutional Affairs Committee (PACAC) scrutinises the reports the PHSO lays before Parliament, including its Annual Report and Accounts. The Committee has previously set out that it will scrutinise the PHSO under the following categories:

• Casework and productivity;
• Staff management;
• Value for money; and
• Impact on other organisations.

This year, the Committee also called for submissions on the PHSO’s Corporate Strategy for 2022–25, given that it had been recently published. We also took into consideration the findings of the Peer Review of the PHSO, which reported in November 2022.

The Committee welcomes the core aims of the PHSO’s Corporate Strategy, including providing a high quality, empathetic service to complaintants, and raising awareness of the PHSO’s services. Nevertheless, we recommend further information is provided on how the organisation would cope with potentially increased service demand, given the PHSO’s service has continued to be impacted by the Covid-19 pandemic.

It is positive that the PHSO’s backlog of cases has been brought down substantially within the past financial year, although the Committee remains concerned with the organisation’s continued policy of declining to consider less serious health complaints for another year. Despite the evidence that this is proving an effective means by which to bring down the caseload, we do not consider it to be an appropriate long-term solution. We request that the PHSO provides the Committee with the criteria being used to make a final decision on the future approach in relation to this policy. The Committee also notes the written evidence received detailing a perceived poor quality of service provided by the PHSO when handling cases, including the length of time taken to close cases. While we cannot generalise from individual examples provided to us, the Annual Report and Accounts show the PHSO has failed to hit its targets for the time taken to close cases. We welcome the PHSO’s ambition to improve these figures by next year through its casework improvement programme and recommend that the organisation provides examples to the Committee of how this will improve a complainant’s ‘user journey’.

On staff management and training, the Committee commends the pace by which the PHSO has increased its number of caseworkers across 2021–22, developed a 10-month training academy to support their induction and development, and invested in wider learning and development opportunities for staff. This appears to have been positively reflected in staff survey results. We do, however, note lower satisfaction with pay and benefits, following similar trends across the wider economy and public sector, and encourage the organisation to consider staff retention strategies in light of this. We welcome that momentum has not been lost on implementing the recommendations from the Donaldson Review to improve the provision of clinical advice for health-related cases. However, as we are now four years on, we urge the PHSO to bring forward measures to conclude the remaining two recommendations from that Review in the near future.

In line with our recommendation in the 2020–21 Scrutiny Report, we welcome the fact that the PHSO underwent its second independent Peer Review in 2022 and that the panel included auditor experience. Although the findings did not provide any in-depth value-for-money analysis of the PHSO’s service, it has helpfully identified areas where the organisation is performing well and where it could improve in the future. We encourage the continued use of periodic peer reviews and have recommended that the PHSO provide the Committee with a timetable setting out when the 2022 Peer Review recommendations on casework management will be implemented.

The Committee also reiterates calls for new legislation to update the PHSO’s statutory framework. It is unjustifiable that it has now been seven years since the publication of the draft Public Service Ombudsman Bill by the Government. Ombudsman reform needs to be prioritised. Nevertheless, in the absence of broader reform, the Committee commends the efforts of the PHSO to improve the quality of the complaints-handling landscape through the development of Complaint Standards for the NHS and UK Central Government. We recommend that the Cabinet Office takes a leading role in working with other Government departments and their public bodies to adopt the UK Central Government Complaint Standards, given that legislation would be required to give the PHSO complaints standard authority powers.

Recognising the seriousness of the issues raised in PHSO reports being laid before Parliament, we also recommend the PHSO further engages with departmental Select Committees to encourage them to scrutinise PHSO reports that relate to findings against individual departments and public bodies under their remit. This is particularly important when they relate to cases of non-compliance with PHSO recommendations, and ultimately, will improve access to justice for complainants.