PHSO makes final decisions on unresolved complaints

Brenda Prentice made this Freedom of Information request to Parliamentary and Health Service Ombudsman

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

Parliamentary and Health Service Ombudsman did not have the information requested.

Dear Parliamentary and Health Service Ombudsman,

PHSO has made statements;

'It is the responsibility of every board of every UK government department and agency to make sure they learn from complaints to prevent others from suffering similar injustice in the future.'
And:
The Parliamentary and Health Service Ombudsman makes final decisions on unresolved complaints about the NHS in England and UK government departments and other UK public organisations.

From these statements is it possible to believe departments and agencies do get things wrong sometimes. After all they are peopled by human beings and we all make mistakes sometimes.

Please tell me how PHSO itself puts into practice the first statement and prevents itself making the same mistakes over and over again. How does PHSO learn from its mistakes?

What happens when the PHSO make a final decision which is wrong on an unresolved case? The internal review only ever looks at the process of the decision making and not at the wrong answer. The review method says if the process was correct the answer must also be correct, but that is not always the case.

How does PHSO 'quality control' the final decisions on unresolved cases without making mistakes. This is very important as the public have nowhere else to turn for justice.
How many cases per year does PHSO conclude it does not give justice to the publice?

The public cannot take a JR as PHSO sometimes suggests, as this will not win. PHSO's 'discretion' trumps all law.

It might be concluded that as the numbers of preventable deaths in the NHS is about 350 per week and the CQC's report 'Death Review' on the 13thDec said, 'no Trust has learnt lessons from preventable deaths', that the PHSO is not on top of its job.

Yours faithfully,

Brenda Prentice

informationrights@ombudsman.org.uk, Parliamentary and Health Service Ombudsman


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Dear Ms Prentice

 

Your information request: FDN-274265

 

Thank you for your email of 30 December 2016. I apologise for the delay in
acknowledging your request.

 

In order that I can comply with your request, can you please clarify what
you mean by:

·         ‘unresolved cases’. Do you mean, for example, complaints which
have not been investigated?

·         the question ‘how many cases per year does PHSO conclude it does
not give justice to the publice?’ Are you seeking information regarding
how many times the PHSO reviews decisions each year and the outcome of
those reviews?

 

Please be advised that section 10 of the Freedom of Information Act 2000
may apply. That section sets out the time for compliance with a request
where a public authority reasonably requires further information in order
to identify and locate the information requested.

 

Yours sincerely

 

Philippa Curran

Legal Assistant

Parliamentary and Health Service Ombudsman

W: [1]www.ombudsman.org.uk

 

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From: Brenda Prentice [mailto:[FOI #379371 email]]
Sent: 30 December 2016 16:18
To: InformationRights
Subject: FDN-274265 Freedom of Information request - PHSO makes final
decisions on unresolved complaints

 

Dear Parliamentary and Health Service Ombudsman,

PHSO has made statements;

'It is the responsibility of every board of every UK government department
and agency to make sure they learn from complaints to prevent others from
suffering similar injustice in the future.'
And:
The Parliamentary and Health Service Ombudsman makes final decisions on
unresolved complaints about the NHS in England and UK government
departments and other UK public organisations.

From these statements is it possible to believe departments and agencies
do get things wrong sometimes. After all they are peopled by human beings
and we all make mistakes sometimes.

Please tell me how PHSO itself puts into practice the first statement and
prevents itself making the same mistakes over and over again.  How does
PHSO learn from its mistakes?

What happens when the PHSO make a final decision which is wrong on an
unresolved case? The internal review only ever looks at the process of the
decision making and not at the wrong answer. The review method says if the
process was correct the answer must also be correct, but that is not
always the case.

How does PHSO 'quality control' the final decisions on unresolved cases
without making mistakes. This is very important as the public have nowhere
else to turn for justice.
How many cases per year does PHSO conclude it does not give justice to the
publice?

The public cannot take a JR as PHSO sometimes suggests, as this will not
win. PHSO's 'discretion' trumps all law. 

It might be concluded that as the numbers of preventable deaths in the NHS
is about 350 per week and the CQC's report 'Death Review' on the 13thDec
said, 'no Trust has learnt lessons from preventable deaths', that the PHSO
is not on top of its job.

Yours faithfully,

Brenda Prentice

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Dear InformationRights,

Dear Philippa,

The phrase 'unresolved cases’ is a phrase used by PHSO staff. I took it to mean cases brought to it that have not been resolved, unless you know something else?

The two quotes are from phso staff. If you understand maybe Dame Julie can help you?

Not sure how;
'Please be advised that section 10 of the Freedom of Information Act 2000
may apply' works as I am asking for recorded information which the phso should have in the way of policies, staff guidance, or any other means to the end which the phases allude to.

Yours sincerely,

Brenda Prentice

Informationrights@ombudsman.org.uk, Parliamentary and Health Service Ombudsman

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Dear Ms Prentice

 

Your information request: FDN-274265

 

Thank you for your email.

 

I am still not sure what you mean by 'unresolved cases'. As such, I will
require more information from you in order to identify and locate the
information you have requested, as per section 1(3) of the Freedom of
Information Act 2000. Do you mean cases in which the complainant is not
satisfied with the outcome of the investigation of their complaint? Or do
you mean complaints which are under investigation but have not yet been
concluded? If you can please provide me with clarification and point me to
where the PHSO staff have used this phrase in context, that would be very
helpful. Without that clarification I will not be able to identify or
locate much of the information you have requested.

 

In the meantime, I will process the remainder of your request as follows:

·         ‘Please tell me how PHSO itself puts into practice the first
statement and prevents itself making the same mistakes over and over
again. How does PHSO learn from its mistakes?’

·         ‘How many cases per year does PHSO conclude it does not give
justice to the publice (sic)?’

 

A response to these questions will be sent to you on or by Monday 30
January 2016, in line with the time frames set out in the Freedom of
Information Act 2000.

 

I look forward to receiving your clarification as soon as possible so that
I am able to respond to your questions which relate to ‘unresolved cases’
.

 

Yours sincerely

 

Philippa Curran

Legal Assistant

Parliamentary and Health Service Ombudsman

W: [1]www.ombudsman.org.uk

 

Follow us on

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show quoted sections

Dear InformationRights,

Perhaps this will help:

http://www.civilserviceworld.com/article...

It is what DJM said and it is why I am requesting the information.

Yours sincerely,

Brenda Prentice

Informationrights@ombudsman.org.uk, Parliamentary and Health Service Ombudsman


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Dear Brenda Prentice

 

Your information request: FDN-274265

 

I write in response to your email of 30 December 2016 in which you
requested information held by the Parliamentary and Health Service
Ombudsman (PHSO). Thank you for the further clarification you provided on
12 and 16 January 2017.

 

I have considered your request in accordance with section 1 of the Freedom
of Information Act 2000 and have set out responses to each of your
questions below.

 

‘PHSO has made statements;

 

'It is the responsibility of every board of every UK government department
and agency to make sure they learn from complaints to prevent others from
suffering similar injustice in the future.'

 

And:

 

‘The Parliamentary and Health Service Ombudsman makes final decisions on
unresolved complaints about the NHS in England and UK government
departments and other UK public organisations.’

 

From these statements is it possible to believe departments and agencies
do get things wrong sometimes. After all they are peopled by human beings
and we all make mistakes sometimes.

 

Please tell me how PHSO itself put into practice the first statement and
prevent itself making the same mistakes over and over again? How does PHSO
learn from its mistakes?

 

The PHSO has publicly committed to prioritising improvements to the
quality of our services, so that we can achieve and maintain excellence in
our frontline customer services, investigations, decision making and
overall service delivery. You can read about these strategic aims here:
[1]http://www.ombudsman.org.uk/about-us/str...

 

The PHSO’s new Service Charter will play a key role in shaping delivery
and driving improvement. The Service Charter is a set of commitments that
we make to people about the quality of the service we provide. It sets the
standard by which we can judge people’s experience of complaining to us.
Our Service Charter can be found here:
[2]http://www.ombudsman.org.uk/__data/asset...

 

‘What happens when the PHSO make a final decision which is wrong on an
unresolved case?’

 

I have sought clarification from you in relation to what you mean by
‘unresolved cases’. I understand that you are referring to a report by the
PHSO, published in December 2016, in which the term ‘unresolved
complaints’ was used to describe complaints which have been through local
resolution with the NHS in England or a UK government agency and the
complaint remains unresolved.

 

The PHSO’s annual report at page 13 sets out what happens when the PHSO
receives a complaint about how we reach decisions:
[3]http://www.ombudsman.org.uk/__data/asset...

 

The Customer Care Guidance also sets out the process followed by the
Customer Care team in more detail:
[4]http://www.ombudsman.org.uk/__data/asset...

 

‘How does the PHSO ‘quality control’ the final decisions on unresolved
cases without making mistakes?’

 

The PHSO’s Service Model gives us a framework for checking the quality of
the decisions we make on complaints in a number of ways. The Service Model
can be viewed here:
[5]http://www.ombudsman.org.uk/make-a-compl...

 

Final investigation reports are approved in line with the levels set out
in the PHSO’s Delegation Scheme.

 

Managers regularly review a sample of complaints – both active and closed
– for the service provided to the complainant, the methods used to look
into it and the final decision.

 

A sample of different complaints is reviewed by quality assurance staff
separate from the original investigation team, with others passed to
external experts for review.

 

Lastly, a Quality Committee of non-executive members from our Board gives
independent oversight on our processes, challenging us to demonstrate
continuous improvement.’

 

‘How many cases per year does the PHSO conclude it does not give justice
to the publice?

 

The public cannot take a JR as PHSO sometimes suggests, as this will not
win. PHSO's 'discretion' trumps all law. 

 

It might be concluded that as the numbers of preventable deaths in the NHS
is about 350 per week and the CQC's report 'Death Review' on the 13thDec
said, 'no Trust has learnt lessons from preventable deaths', that the PHSO
is not on top of its job.’

 

I have sought clarification from you in respect of this aspect of your
request but I am still not sure what you mean here.

 

The PHSO does not hold information on the number of cases per year the
PHSO concludes ‘it does not give justice to the publice (sic)’.

 

If you are seeking information about the number of decisions reviewed and
the number of those reviews upheld, this information is available in our
annual report, referred to above.

 

I hope that this information is helpful. If you are unhappy with the way I
have processed or interpreted your information request, it is open to you
to request an internal review. You can do this by writing to us by post or
by email to [6][Parliamentary and Health Service Ombudsman request email]. Beyond that, it is open
to you to complain to the Information Commissioner’s Office
([7]www.ico.org.uk).

Yours sincerely

 

Philippa Curran

Legal Assistant

Parliamentary and Health Service Ombudsman

W: [8]www.ombudsman.org.uk

 

Follow us on

[9]fb  [10]twitter  [11]linkedin

 

 

show quoted sections

Dear InformationRights,

Dear Philippa Curran

Sadly each and ever link you have sent does not work. It says 404 error.

You state;
"Final investigation reports are approved in line with the levels set out
in the PHSO’s Delegation Scheme".
What is the Delegation Scheme and what levels are involved?
What does it mean "in line with levels"?
Do they change on a case by case basis?

You say:
"Managers regularly review a sample of complaints – both active and closed – for the service provided to the complainant, the methods used to look into it and the final decision"
How many cases are reviewed as a sample over what time period?
What happens when services are found to fall below what is expected?
How many fall below below?
How many are sent to outside to external experts for review.?
Who chooses which cases go to external experts for review?
How is an expert defined and where are they found?

Also:
"Lastly, a Quality Committee of non-executive members from our Board gives
independent oversight on our processes, challenging us to demonstrate
continuous improvement.’"
Which members of the Board form this independent Quality Committee?
How do they give oversight?
How do they challenge staff and how do they measure 'improvement'?

I'm surprised you don't understand the quote from CQC "no Trust has learnt lessons from preventable deaths'.
I am asking why that should be and what policies does PHSO in place to prevent this learning?

I am asking for an internal review.

Yours sincerely,

Brenda Prentice

Informationrights@ombudsman.org.uk, Parliamentary and Health Service Ombudsman


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Dear Brenda Prentice

 

Your information request: FDN-274364

 

I write in response to your email of 2 February 2017, in which you made a
number of statements, asked a number of questions and made new requests
for information. I have set out responses to each, below.

 

Broken links

 

In relation to the response I sent to your previous information request
(our reference: FDN-274265) you wrote: ‘Sadly each and ever link you have
sent does not work. It says 404 error.’

 

I apologise that the links I sent you did not work. As I explained in my
email on 12 February 2017, the Parliamentary and Health Service Ombudsman
(PHSO) launched its new website on 31 January 2017. As such, links to the
previous website no longer work. The information I referred you to in
relation to your previous information request can now be found in the
PHSO’s publication scheme on the PHSO’s website here:
[1]https://www.ombudsman.org.uk/about-us/co...

 

Your information request: FDN-274364 - Responses

 

In your email, you request information in relation to the material I
disclosed to you in response to your previous request. I have considered
your requests in accordance with section 1 of the Freedom of Information
Act 2000 (FOIA) and I have addressed each question, below, in turn.

 

What is the Delegation Scheme and what levels are involved? What does it
mean "in line with levels"? Do they change on a case by case basis?

 

The PHSO’s Delegation Scheme sets out the activities delegated by the
Ombudsman and to whom they are delegated. The Delegation Scheme is
available on the PHSO’s website here:
[2]https://www.ombudsman.org.uk/sites/defau...

 

As you can see, certain actions can only be carried out by certain
designated staff members, which is what is meant by ‘in line with levels’.
The delegation scheme does not change on a case-by-case basis.

 

How many cases are reviewed as a sample over what time period?

 

Investigation Managers sample 1-3 cases each month from each
investigator. 

 

What happens when services are found to fall below what is expected?

 

Managers provide feedback to each investigator, and/or the investigator’s
line manager, who take the appropriate action.

 

How many fall below?

 

The PHSO’s quality results, and other performance measures, will be
published on the PHSO’s website, on the ‘Performance against our Service
Charter’ page, in March 2017. As such, this information is exempt from
disclosure under section 22 FOIA (information intended for future
publication).

 

How many are sent to outside to external experts for review?

 

40 cases each month.

 

Who chooses which cases go to external experts for review?

 

The cases are selected randomly from the cases closed the previous month.

 

How is an expert defined and where are they found?

 

The external quality reviewers were chosen during a recruitment exercise
in 2016. They were selected based on their analytical skills and their
ability to provide fresh perspectives on our casework decisions.

 

Which members of the Board form this independent Quality Committee?

 

This information can be found on the PHSO’s website. As such, this
information is exempt from disclosure under section 21 FOIA, as it is
accessible to you t by other means.

 

However, to be helpful, I can advise that the members are:

 

o Elisabeth Davies, non-executive Board member (Committee Chair)
o Dr Jane Martin, non-executive Board member
o Dr Julia Tabreham, non-executive Board member
o Helen Walley, non-executive Board member

 

How do they give oversight?  How do they challenge staff and how do they
measure 'improvement'?

 

Information in relation to these two questions can be found in the PHSO
Quality Committee’s terms of reference, attached.

 

Reiteration of your previous request for information

 

In your email, you write: ‘I’m surprised you don't understand the quote
from CQC “no Trust has learnt lessons from preventable deaths”. I am
asking why that should be and what policies does PHSO in place to prevent
this learning?’

 

As you are aware, FOIA gives rights of public access to recorded
information held by public authorities. The PHSO does not have ‘policies
in place to prevent this learning.’ As such, I can confirm that the PHSO
does not hold information falling within the scope of this particular
request.

 

 

I hope that this information is useful. If you believe I have made an
error in the way I have processed your information request, it is open to
you to request an internal review. You can do this by writing to us by
post or by email to [3][Parliamentary and Health Service Ombudsman request email]. You will need
to specify what the nature of the issue is and we can consider the matter
further. Beyond that, it is open to you to complain to the Information
Commissioner’s Office ([4]www.ico.org.uk).

 

Yours sincerely

 

Philippa Curran

Legal Assistant

Parliamentary and Health Service Ombudsman

W: [5]www.ombudsman.org.uk

 

Follow us on

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From: Brenda Prentice [mailto:[FOI #379371 email]]
Sent: 02 February 2017 21:02
To: InformationRights
Subject: FDN-276364 Internal review of Freedom of Information request -
PHSO makes final decisions on unresolved complaints

 

Dear InformationRights,

Dear Philippa Curran

Sadly each and ever link you have sent does not work. It says 404 error.

You state;
"Final investigation reports are approved in line with the levels set out
in the PHSOs Delegation Scheme".
What is the Delegation Scheme and what levels are involved?
What does it mean "in line with levels"?
Do they change on a case by case basis?

You say:
"Managers regularly review a sample of complaints both active and closed
for the service provided to the complainant, the methods used to look into
it and the final decision"
How many cases are reviewed as a sample over what time period?
What happens when services are found to fall below what is expected?
How many fall below below?
How many  are sent to outside to external experts for review.?
Who chooses which cases go to external experts for review?
How is an expert defined and where are they found?

Also:
"Lastly, a Quality Committee of non-executive members from our Board gives
independent oversight on our processes, challenging us to demonstrate
continuous improvement."
Which members of the Board form this independent Quality Committee?
How do they give oversight?
How do they challenge staff and how do they measure 'improvement'?

I'm surprised you don't understand the quote from CQC  "no Trust has
learnt lessons from preventable deaths'.
I am asking why that should be and what policies does PHSO in place to
prevent this learning?

I am asking for an internal review.

Yours sincerely,

Brenda Prentice

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C Rock left an annotation ()

There has still not been any evidence of any Quality Procedures at PHSO and no evidence of any skills in the field or any evidence of external standardised referenced assessment and that is why so called resolutions deliver failure and no learning. A corrupt system by design.

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