PHSO orders for the audits of records

The request was partially successful.

Dear Parliamentary and Health Service Ombudsman,

The follow quote is from a doctor's Fitness to Practice Hearing. (2016)

:::::
8.. You did not admit that you had altered Patient A’s medical records until your letter to the Health Services Ombudsman (HSO) dated 3 January 2003 and only made a full admission to your misconduct to the HSO on 13 June 2003.

9. The Panel in 2005 took a serious view of your dishonest and misleading conduct. It found that:

‘Your dishonesty was compounded by the fact that you continued to maintain that you had prescribed aspirin and a GTN spray. You maintained this on several occasions...

The Panel further notes that you only admitted to this dishonest behaviour when you were made aware that at the request of the Ombudsman’s office a detailed audit was being carried out of the computer records at your practice , which would inevitably expose the facts, date, and nature of the alteration of [Patient A’s] prescription records. This behaviour undermines the trust which the public is entitled to place in the medical profession, and is totally unacceptable.’

::::

This case of medical note tampering - in 2003 - and is illustrative of other hearings involving note tampering on the site.

The Ombudsman followed up an allegation of note tampering ...Presumably becoming involved after a complainant had made his/her representations during an investigation, by ordering a 'detailed audit of computer files'.

Therefore the Ombudsman supported complainant's opinion - and took the necessary steps to investigate an accusation of the alteration of records.

I would like to know:

1. How many times were detailed audits of PA records /files were carried out ( computer or handwritten) by the PHSO in the past two years ?

2. And which locations, ( any Trusts, surgeries or other organisations ..not necessarily medical - but within the remit of the PHSO ).

3. Whether these audits were carried out by PHSO employees - or external companies.

4. In the case of external companies, please provide bills etc.

5. If the outcome of these audits is known, please provide details.

Please provide all data available under the FOIA.

NB If there are time constraints on this request, please limit the scope to health records only.
And limit the period to one year only.

http://www.mpts-uk.org/static/documents/...

Yours faithfully,

Jt Oakley

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


Thank you for your e-mail to the Parliamentary and Health Service Ombudsman. This return e-mail shows that we have received your correspondence.

D. Speers left an annotation ()

Await the response with interest! Thanks for asking!

Jt Oakley left an annotation ()

It would seem that the PHSO used to take medical note tampering seriously - and order extemal audits.

I am wondering whether or not it still does, or if it doesn't think in terms of the public interest any more - in order to inflate the Case Closed stats.

Because with the cases which are presented, it must be now very obvious that complainants are simply disadvantaged - ( and therefore receive injustices )by Public authorities illegal maladministration in the witholding of files - which logically should exist.

foiofficer, Parliamentary and Health Service Ombudsman

Dear [first name redacted] Oakley

 

Your information request – our reference:  FDN 247268

 

Thank you for your email dated 4 February 2016.

 

Please can you clarify by what you mean when you say “PA records /files”
as it is unclear what you are referring to.

 

Kind regards

 

FOI/DP Officer

Parliamentary and Health Service Ombudsman

 

 

From: Jt Oakley [mailto:[FOI #314647 email]]
Sent: 04 February 2016 20:50
To: foiofficer
Subject: Freedom of Information request - PHSO orders for the audits of
records

 

     Dear Parliamentary and Health Service Ombudsman,
    
     The follow quote is from a doctor's Fitness to Practice Hearing.
     (2016)
    
     :::::
     8.. You did not admit that you had altered Patient As medical
     records until your letter to the Health Services Ombudsman (HSO)
     dated 3 January 2003 and only made a full admission to your
     misconduct to the HSO on 13 June 2003.
    
     9. The Panel in 2005 took a serious view of your dishonest and
     misleading conduct. It found that:
    
     Your dishonesty was compounded by the fact that you continued to
     maintain that you had prescribed aspirin and a GTN spray. You
     maintained this on several occasions...
    
     The Panel further notes that you only admitted to this dishonest
     behaviour when you were made aware that at the request of the
     Ombudsmans office a detailed audit was being carried out of the
     computer records at your practice , which would inevitably expose
     the facts, date, and nature of the alteration of [Patient As]
     prescription records. This behaviour undermines the trust which the
     public is entitled to place in the medical profession, and is
     totally unacceptable.
    
     ::::
    
     This case of medical note tampering - in 2003 - and is illustrative
     of other hearings involving note tampering on the site.
    
     The Ombudsman followed up an allegation of note tampering
     ...Presumably becoming involved after a complainant had made
     his/her representations during an investigation, by ordering a
     'detailed audit of computer files'.
    
     Therefore the Ombudsman supported complainant's opinion - and took
     the necessary steps to investigate an accusation of the alteration
     of records.
    
     I would like to know:
    
     1. How many times were detailed audits of PA records /files were
     carried out ( computer or handwritten) by the PHSO in the past two
     years ?
    
     2. And which locations, ( any Trusts, surgeries or other
     organisations ..not necessarily medical - but within the remit of
     the PHSO ).
    
     3. Whether these audits were carried out by PHSO employees - or
     external companies.
    
     4. In the case of external companies, please provide bills etc.
    
     5. If the outcome of these audits is known, please provide details.
    
     Please provide all data available under the FOIA.
    
     NB If there are time constraints on this request, please limit the
     scope to health records only.
     And limit the period to one year only.
    
    
[1]http://www.mpts-uk.org/static/documents/...
    
     Yours faithfully,
    
     Jt Oakley
    
     -------------------------------------------------------------------
    
     Please use this email address for all replies to this request:
     [2][FOI #314647 email]
    
     Is [3][email address] the wrong address for Freedom of
     Information requests to Parliamentary and Health Service Ombudsman?
     If so, please contact us using this form:
    
[4]https://www.whatdotheyknow.com/change_re...
    
     Disclaimer: This message and any reply that you make will be
     published on the internet. Our privacy and copyright policies:
     [5]https://www.whatdotheyknow.com/help/offi...
    
     For more detailed guidance on safely disclosing information, read
     the latest advice from the ICO:
     [6]https://www.whatdotheyknow.com/help/ico-...
    
     If you find this service useful as an FOI officer, please ask your
     web manager to link to us from your organisation's FOI page.
    
    
     -------------------------------------------------------------------

References

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3. mailto:[email address]
4. https://www.whatdotheyknow.com/change_re...
5. https://www.whatdotheyknow.com/help/offi...
6. https://www.whatdotheyknow.com/help/ico-...

Dear foiofficer,

Public Authorities ...the organisations which the public can complan about to the PHSO.

Yours sincerely,

Jt Oakley

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


Thank you for your e-mail to the Parliamentary and Health Service Ombudsman. This return e-mail shows that we have received your correspondence.

foiofficer, Parliamentary and Health Service Ombudsman

Dear J T Oakley

 

Your information request – our case reference: FDN 247268

 

I am writing in response to your Freedom of Information request dated 4
February 2016 in which you asked about audits carried out by the
Parliamentary and Health Service Ombudsman of bodies within our
jurisdiction. Specifically you asked:

 

1. How many times were detailed audits of PA records /files were carried
out (computer or handwritten) by the PHSO in the past two years?

 

2. And which locations, (any Trusts, surgeries or other organisations
...not necessarily medical - but within the remit of the PHSO).

 

3. Whether these audits were carried out by PHSO employees – or external
companies.

 

4. In the case of external companies, please provide bills etc.

 

5. If the outcome of these audits is known, please provide details.

 

I can confirm we do not hold a central record of the information you have
requested. To be certain about whether we carried out any audits of bodies
within our jurisdiction, we would need to manually check every complaint
we looked at in the last two years. To carry out this task we have
estimated it would take more than 18 hours to check every complaint; as
such, the information is exempt under section 12 of the Freedom of
Information Act 2000.

 

If you are dissatisfied with the outcome of your request, you can ask for
an internal review by emailing foiofficer[1]@ombudsman.org.uk

Yours sincerely

 

 

Sohifa Kadir

FOI/DP Officer

References

Visible links
1. mailto:[email address]

Dear Parliamentary and Health Service Ombudsman,

Please pass this on to the person who conducts Freedom of Information reviews.

I am writing to request an internal review of Parliamentary and Health Service Ombudsman's handling of my FOI request 'PHSO orders for the audits of records'.

Than you but the PHSO seems to be stating that it still cannot track the money it spends on its Audits in a timely and efficient way.

::

In the light of Dame Julie Mellor assuring PACAC that its overspending of £275k of the government's money last year was a thing of the past. And that the PHSO now has a grip on its expenditure , this would seem to be a contradiction of her statement to PACAC.

PACAC January 2016

Q5 Kate Hoey: Given all that, did it ever occur to you that you might want to resign, given that you were ultimately responsible?

Dame Julie Mellor: No. My job as accounting officer is to make sure that the issues that are identified are addressed and prevented from happening again. The NAO has noted what I have put in place, and I look forward to its audits confirming that it cannot happen again.

::::

Q6 Kate Hoey: Do you think that, if you had been in the private sector, you would still be in the job?

Dame Julie Mellor: Yes. I think, as an accounting officer, you cannot manage the money yourself, so I am not the person who is going to be monitoring the bank cash flow. I need to make sure that there are the appropriate arrangements in place. As I have said, one of the things that I have made sure of, as accounting officer, is that the assurance meetings that I have monthly with the executive now include more financial information than they did in the past.

:::::

Is the PHSO therefore sure that it wants to admit that it still hasnt got agrip as to how it has - and is - spending public money?

::::

A full history of my FOI request and all correspondence is available on the Internet at this address: https://www.whatdotheyknow.com/request/p...

Yours faithfully,

Jt Oakley

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


Thank you for your e-mail to the Parliamentary and Health Service Ombudsman. This return e-mail shows that we have received your correspondence.

D. Speers left an annotation ()

If PHSO and her Deputy survive this there is no justice!

++Feedbackaboutus@ombudsman.org.uk, Parliamentary and Health Service Ombudsman

Dear [first name redacted] Oakley

 

We are writing in response to your email of 03 March 2016.

 

We are sorry that you are dissatisfied with our handling of your
information request regarding 'PHSO orders for the audits of records'.

 

Under our internal complaints procedure, your complaint has been passed to
our Head of Risk, Assurance and Programme Management Office, Mr Steve
Brown.

 

Mr Brown will consider your concerns and will send you a full reply once
his review is complete. This review of your complaint is the only review
that we will undertake.

 

We aim to reply to such complaints within 40 working days.

 

Kind regards

 

Customer Care Team

Dear ++[email address],

Would you please address me as JT Oakley.

You cannot presume to know, or divulge, any other name.

Yours sincerely,

Jt Oakley

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


Thank you for contacting the Customer Care team at the Parliamentary and Health Service Ombudsman.
I can confirm we have received your e-mail and a member of our Customer Care Team will be in touch with you shortly.

Kind regards

Customer Care Team

Dear Parliamentary and Health Service Ombudsman,

Has Steve Brown managed to review this request yet?

Clearly I wasn't expecting any reply from the Black Hole that is Customer Care - as per normal, but Brown Steve ( as he's billed on WDTK requests) used to give a response within a reasonable time.

Yours faithfully,

Jt Oakley

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


Thank you for your e-mail to the Parliamentary and Health Service Ombudsman. This return e-mail shows that we have received your correspondence.

______________________________________________________________________
This email has been scanned by the Symantec Email Security.cloud service.
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phsothefacts Pressure Group left an annotation ()

Is SteveBrown still there? I thought that the legal team were now taking control of FOI requests. I do believe he left them his 'everything was handled appropriately' rubber stamp.

Jt Oakley left an annotation ()

FOIA team has stated Steve Brown WILL review it( above)

Who am I to disagree?

D. Speers left an annotation ()

Who is anyone to disagree!?

Jt Oakley left an annotation ()

Well I give up.

Off to the ICO.

Jt Oakley left an annotation ()

Complaint to ICO:

Reference - PHSO orders for the audits of records

::

Complaint: Review failure to respond within reasonable time frame.

(Waiting since 7th March )

1. Details of the organisation your concern is about
Organisation:    
Parliamentary and Health Service Ombudsman

Contact name:   Customer Care- 7th march


'Thank you for contacting the Customer Care team at the Parliamentary and Health Service Ombudsman.
I can confirm we have received your e-mail and a member of our Customer Care Team will be in touch with you shortly'.

Kind regards

Customer Care Team

Address:  The Parliamentary and
Health Service Ombudsman
Millbank Tower, Millbank
London,


Postcode:   SW1P 4QP 
Telephone:  
Customer helpline
0345 015 4033

  
Email:  via WDTK
    
2. Your relationship with the organisation
     
Member of the public
3. What is your concern?

https://www.whatdotheyknow.com/request/p...
     
Please send us copies of relevant documents that support your concern.

https://www.whatdotheyknow.com/request/p...

4. What have you done to raise your concern with the organisation?

https://www.whatdotheyknow.com/request/p...

5. What did the organisation say?
https://www.whatdotheyknow.com/request/p...

1. That ombudsman Dame Julie Mellor contradicts the initial response to this request - in evidence to Parliamentary Committee (PACAC).

2. That a review would be done.

3. The PHSO also disclosed my personal information - which had to be removed.

     
Please send copies of any documents you have showing the organisation’s response to your concern.
6. Reference number
FDN 247268

Please tell us any reference number that the organisation has given you, eg account number, policy number etc.

As above.

Lant Mark, Parliamentary and Health Service Ombudsman

1 Attachment

Dear JT Oakley,

Please find enclosed our response to your request for a review. I would like to apologise for our delay in replying to your request.

Yours sincerely,

Mark Lant / Assistant Legal Adviser
Parliamentary and Health Service Ombudsman
Millbank Tower, 21-24 Millbank, London SW1P 4QP
E: [email address]
www.ombudsman.org.uk

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show quoted sections

Dear Lant Mark,

Thank you - but the request concerns audit.

Are you stating that NO payments were made to the auditors or that audits cannot be traced within your financial expenditure records?

Because I cannot understand the argument that payments for audits are not easily retrievable within the PHSO's accounting system.

.Surely this would be included in information given to the NAO?

.Which, as you will be aware, has had cause to scrutinise the PHSO's financial records very closely.... Admittedly finding them wanting.

::

In addition, you have provided no S16 help and assurance as to how my request could be narrowed.

As you will know, FOIA Tribunal courts are keen to see S16 applied as a fair balance applied and, as cost saving measure, - to prevent more work for the ICO and courts, when organisations subject to FOIA do not offer assistance ....and are unhelpful.

1. Please therefore confirm that the PHSO still has no intention of offering and S16 help and assistance in narrowing the request.

2. Please therefore confirm that the PHSO has made no payments to external auditors and therefore the data is not on its financial records .

3. If there have been audits carried out by PHSO employees, please confirm that it is impossible to trace them, as the finance department does not keep records of audits.

Yours sincerely,

Jt Oakley

Lant Mark, Parliamentary and Health Service Ombudsman

Dear JT Oakley

Thank you for your further email.

Your original information request was concerned with audit of patient records undertaken during the course of the Ombudsman’s investigations.

In your most recent correspondence you appear to refer to issues regarding the Ombudsman’s own internal audit function. This is separate to our investigation work.

Bearing in mind the terms of your original request, to the extent you sought clarification around audits undertaken by the Ombudsman of patient records during the course of the Ombudsman’s investigations we would have to search all of our files to ascertain whether we held such information. There is no way to narrow this bearing in mind the information you have requested.

Should you wish to ask for information about our internal audit function then it is open to you to do so by way of a new information request.

It also remains open to you to contact the ICO should you remain dissatisfied with our handling of your request.

Yours sincerely,

Mark Lant / Assistant Legal Adviser
Parliamentary and Health Service Ombudsman
Millbank Tower, 21-24 Millbank, London SW1P 4QP
E: [email address]
www.ombudsman.org.uk

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Watch our short animations to find out how we deal with complaints

Before you print think about the ENVIRONMENT

show quoted sections

Dear Parliamentary and Health Service Ombudsman,

The follow quote is from a doctor's Fitness to Practice Hearing. (2016)

:::::
8.. You did not admit that you had altered Patient A’s medical records until your letter to the Health Services Ombudsman (HSO) dated 3 January 2003 and only made a full admission to your misconduct to the HSO on 13 June 2003.

9. The Panel in 2005 took a serious view of your dishonest and misleading conduct. It found that:

‘Your dishonesty was compounded by the fact that you continued to maintain that you had prescribed aspirin and a GTN spray. You maintained this on several occasions...

The Panel further notes that you only admitted to this dishonest behaviour when you were made aware that at the request of the Ombudsman’s office a detailed audit was being carried out of the computer records at your practice , which would inevitably expose the facts, date, and nature of the alteration of [Patient A’s] prescription records. This behaviour undermines the trust which the public is entitled to place in the medical profession, and is totally unacceptable.’

::::

This case of medical note tampering - in 2003 - and is illustrative of other hearings involving note tampering on the site.

The Ombudsman followed up an allegation of note tampering ...Presumably becoming involved after a complainant had made his/her representations during an investigation, by ordering a 'detailed audit of computer files'.

Therefore the Ombudsman supported complainant's opinion - and took the necessary steps to investigate an accusation of the alteration of records.

I would like to know:

1. How many times were detailed audits of PA records /files were carried out ( computer or handwritten) by the PHSO in the past two years ?

2. And which locations, ( any Trusts, surgeries or other organisations ..not necessarily medical - but within the remit of the PHSO ).

3. Whether these audits were carried out by PHSO employees - or external companies.

4. In the case of external companies, please provide bills etc.

5. If the outcome of these audits is known, please provide details.

Please provide all data available under the FOIA.

NB If there are time constraints on this request, please limit the scope to health records only.
And limit the period to one year only.

http://www.mpts-uk.org/static/documents/...

Yours faithfully,

Jt Oakley

I refer you to this long running original request (above) for which it appears that I still have not received a response which complies with FOIA Section 16 help and advice as to how to determine the audit system referred to - by the Ombudsman.

Personally would have thought the quotes which I have provided you with were self-explanatory.

However, could you therefore direct me to the S 16 help and assistance that you have previously provided as to framing the request.

You will be aware that the court frowns on the waste of public money when no S16 help and assistance is given and a request is unnecessarily drawn out.

I would therefore draw your attention to the court criticism of the PHSO for previously not complying with S16 help and advice and erroneously vexing a request, subsequently overturned by the court.

::

'The Appellant clearly was not getting satisfaction nor the meaningful response she deserved. This Tribunal reminds itself that there is duty on Public Authorities to assist mem- bers of the public in formulating and processing their requests. On hearing the Appellant on the facts in this case we are of the view that more could have been done to assist the proc- essing of this request.

'That is what this case is all about. This failure to properly or adequately respond to this request led to confusion and frustration and a break down in communications such that the Appellant did not seek or deserve.

'We are satisfied that a more constructive and helpful response form the public authority would have averted the resulting persistence that evolved through the frustration caused to the Appellant by a failure to provide appropriate assistance and answers in an unnecessarily long and drawn out process of dealing with the Appellant. The evidence of impact of any burden on the authority is not, in our view, a burden that can or should be placed solely on the Appel- lant on the facts in this case'.

http://informationrights.decisions.tribu... name redacted]%20EA.2014.0093%20(19.01.2015)%20.pdf

Please therefore attempt to respond to the request in a prompt and helpful manner -preferably before it is a year old.

Yours sincerely,

Jt Oakley

Brenda Prentice left an annotation ()

Please reply before this is a year old.....? Is there a rush on or something.
Do they need to take ICO time frames seriously then? I thought they are a law unto themselves......unaccountable.

Jt Oakley left an annotation ()

Update to ICO

I have -at last - got some sort of an answer to this. However, the PHSO is stating that it does not know how many external audits of public authorities (PA's) it has completed.

Since Dame Julie Mellor has assured the Parliamentary public accounts committee (PACAC) that the PHSO now knows how it is spending it's money ( after overspending last year) I cannot see why the expense of * auditing public authorities...the PA's it investugates ( such as the NHS) is not listed within its own records.

Nb *Auditing is a different procedure from investigating a complaint, which is the PHSO's remit. The audit may be carried out within the investigation.
::::

The response seems to try and evade the request by changing the criteria given in the request - by referring to the internal audit carried out on the PHSO.( I think..it is not clear)

But after all this time, I think the PHSO should respond to the request in a publicly responsible and helpful manner.

If the PHSO is stretching it's remit to help complainants - by auditing Public Authorities, it has no reason to conceal the fact and should give an appropriate answer to the request.

Brenda Prentice left an annotation ()

"The response seems to try and evade the request by changing the criteria given in the request - by referring to the internal audit carried out on the PHSO.( I think..it is not clear)"

Nothing new then.....Seen this before....many thimes!

Jt Oakley left an annotation ()

ICO has accepted the complaint and is investigating.

:::

Dear ICO

Thank you.

My reasoning:

As stated.... It's the money spent on 'record audits' ( scope of the request- external audits on Public Authorities, about which have been made complaints ) which has to be accounted for within the investigatory PHSO's own internal expenditure.

The PHSO is somewhat surprisingly conflating the two sets of auditing, as the scope of the request is clear....by examples given.

:::

This is a request about the way in which the PHSO either accepts what a Public Authority states, or investigates further, when the suspicion is that the evidential data presented is incorrect.

- Something of which the ICO might be aware.

:::

This is Dame Julie Mellor's evidence to Parliament on one such investigation :

On the 12.1.16 Dame Julie Mellor stated to PACAC the following;

To give you a concrete example, I was talking to a colleague yesterday who was saying that, wherever there is inconsistency in the evidence that is not congruent between what the complainant says and what the body says, we will look to triage that evidence. Recently, our director of investigations had a case where they felt the evidence was not congruent, so they went and looked in the cupboards of the trust, and their hunch was right and they found records that had not been supplied. We will always look to triage where there is that discrepancy between the parties. That could be interviewing; it could be going and visiting; it could be saying, “We know there are more records. We need those records”; or it could be threatening to use our powers to gather evidence.

::

So Dame Julie Mellor has cited an example in which the Director of Investigations has indeed ...investigated.
Externally.

Surely his department must hold the requested information, as it needs to be recorded in this department?

Unlike the PHSO FOIA respondee, I would have assumed that this was a 'central' source , simply because of the name of the department.

:::

Filing -other possibilities ...

1. It's not unreasonable for the data to be held at one point, as there are legal implications if data is found to be withheld, or altered etc.

I would have expected the legal department to have been informed, even if the scoped external audit ( which is quite often contracted out in other public authorities -being specialist work ) is not logged specifically in the PHSO's own internal audit.

Public since money spent has to be accounted for, I would assume this to be highly unlikely.

2. Security implications about attending premises, other than the PHSO's.

Visitors to other Public Authorities would have to be agreed.

The PHSO can't just batter down the doors in dawn raids.

3. Even if the information lies within the PHSO's own internal audit since PHSO employees have been used to examine the disputed information at work bases other than their own, the cost should show up in it.

Best Wishes

Jto

On 4 Apr 2017, at 11:57, casework@ico.org.uk wrote:

4th April 2017

Case Reference Number FS50651442

Dear Ms Jto

Freedom of Information Act 2000 (FOIA)
Your FOIA request to Parliamentary and Health Service Ombudsman (PHSO) dated 4 February 2016 about audits of records

Ref: FDN 247268 – PHSO orders for the audits of records

Further to our previous letter, I write to inform you that your case has now been allocated to me to investigate. This letter will explain how I intend to do this. It will also provide you with contact details so that you can get in touch with me if you need to.

What happens now

Where possible the Information Commissioner prefers complaints to be resolved informally and we ask both parties to be open to compromise. With this in mind, I have written to the public authority and asked it to revisit your request. It may wish to reverse or amend its position. If it does, it will contact you again directly about this.

In any event, it must provide us with its full and final arguments in support of its position. Once I receive its arguments, I will consider its reply before either contacting you to discuss the matter further or preparing a decision notice. Further information is available on the Information Commissioner’s website:

http://ico.org.uk/guide_to_freedom_of_in...

The request

On 4 February 2016 you made the following request for information under the FOIA:

‘The follow quote is from a doctor's Fitness to Practice Hearing. (2016)
:::::
8.. You did not admit that you had altered Patient A’s medical records until your letter to the Health Services Ombudsman (HSO) dated 3 January 2003 and only made a full admission to your misconduct to the HSO on 13 June 2003.
9. The Panel in 2005 took a serious view of your dishonest and misleading conduct. It found that:
‘Your dishonesty was compounded by the fact that you continued to maintain that you had prescribed aspirin and a GTN spray. You maintained this on several occasions...
The Panel further notes that you only admitted to this dishonest behaviour when you were made aware that at the request of the Ombudsman’s office a detailed audit was being carried out of the computer records at your practice , which would inevitably expose the facts, date, and nature of the alteration of [Patient A’s] prescription records. This behaviour undermines the trust which the public is entitled to place in the medical profession, and is totally unacceptable.’
::::

This case of medical note tampering - in 2003 - and is illustrative of other hearings involving note tampering on the site.
The Ombudsman followed up an allegation of note tampering ...Presumably becoming involved after a complainant had made his/her representations during an investigation, by ordering a 'detailed audit of computer files'.

Therefore the Ombudsman supported complainant's opinion - and took the necessary steps to investigate an accusation of the alteration of records.

I would like to know:
1. How many times were detailed audits of PA records /files were carried out ( computer or handwritten) by the PHSO in the past two years ?
2. And which locations, ( any Trusts, surgeries or other organisations ..not necessarily medical - but within the remit of the PHSO ).
3. Whether these audits were carried out by PHSO employees - or external companies.
4. In the case of external companies, please provide bills etc.
5. If the outcome of these audits is known, please provide details.

Please provide all data available under the FOIA.
NB If there are time constraints on this request, please limit the scope to health records only.
And limit the period to one year only.’

On 12 February PHSO requested clarification of ‘PA records/files’ and on the same day you explained that it was ‘Public Authorities…the organisations which the public can complain about to the PHSO’

On 3 March 2016 the PHSO responded that ‘we do not hold a central record of the information you have requested. To be certain about whether we carried out any audits of bodies within our jurisdiction, we would need to manually check every complaint we looked at in the last two years.’

PHSO refused to provide the requested information citing Section 12 of FOIA as it estimated that the cost of determining whether it held the information would exceed the cost threshold of £450.

On 3 March 2016 you requested an internal review. You argued that ‘PHSO seems to be stating that it still cannot track the money it spends on its Audits in a timely and efficient way’.

After the intervention of the Commissioner, the PHSO sent the outcome of its internal review on 14 December 2016 upholding its original position.

On 28 December 2016, PHSO responded to your further email:

‘Your original information request was concerned with audit of patient records undertaken during the course of the Ombudsman’s investigations.

In your most recent correspondence you appear to refer to issues regarding the Ombudsman’s own internal audit function. This is separate to our investigation work.

Bearing in mind the terms of your original request, to the extent you sought clarification around audits undertaken by the Ombudsman of patient records during the course of the Ombudsman’s investigations we would have to search all of our files to ascertain whether we held such information. There is no way to narrow this bearing in mind the information you have requested.

Should you wish to ask for information about our internal audit function then it is open to you to do so by way of a new information request.’

On 1 January 2017 (received 11 January 2017) you contacted the Information Commissioner.

The scope of the case

The focus of my investigation will be to determine whether the PHSO handled your request in accordance with the FOIA. Specifically, I will look at whether the PHSO is entitled to rely on exemption Section 12 as a basis for refusing to provide the withheld information

Please contact me within the next 10 working days, that is, by 20 April 2017 if there are matters other than these that you believe should be addressed. This will help avoid any unnecessary delay in investigating your complaint. If I do not hear from you by this date, my investigation will focus only upon the matters identified above.

If you have any queries at any time you are welcome to write to me at the above address, at casework@ico.gsi.gov.uk (please ensure that you quote the above case reference) or by telephoning me on 01625 545691.

Yours sincerely

ICO

J Roberts left an annotation ()

If it is necessary to check every complaint manually to ascertain whether a "detailed audit" was carried out, then it would appear that a caseworker can visit or organise a visit to a PA's premises for such an audit without any record of it being made outwith the case file. What about expenses claimed or details of notifications to others to visit the premises?

Jt Oakley left an annotation ()

Exactiy J Roberts .

Or the PHSO had a slush fund to pay for its Investigation department outings.

Jt Oakley left an annotation ()

ICO decision,

Yet again - The PHSO has failed to produce S16 help and advice .

How long can this organisation treat requesters with such arrogant contempt as to ignore the ICO's own guidance in the matter and fail to respond by the legally due dates?

The main complaint point has been lost:

If the PHSO pays for audits, why can't they be traced via these payments ?

:::::

The decision. Garbled as taken from PDF.

Reference: FS50651442
o
lco. lnformatlon Commlslorer's Otllce
Date:
Public Authority: Address:
Complainant: Address:
Parliamentary and Health Service Ombudsman
Millbank Tower Millbank London
swlP 4QP

Freedom of Information Act 2OOO (FOIA) Decision notice
O8 May 2OL7
Decision (including any steps ordered)
* 1  The complainant has requested information about orders for the audits of records. The Parliamentary and Health Service Ombudsman (PHSO) says it is not obliged to comply with the request under section 12(1) of the FOIA, as it would exceed the appropriate cost and time limit to do so. 

* 2  The Commissioner's decision is that PHSO is not obliged to comply with the request under section 12(1). However the Commissioner is not satisfied that PHSO met its obligation under section 16 to offer advice and assistance. 

* 3  The Commissioner requires the public authority to take the following steps to ensure compliance with the legislation. 
. PHSO is required to provide appropriate advice and assistance to the complainant pursuant to the duty provided by section 16 of the FOIA. The advice and assistance should be given with a view to determining what, if any, information relevant to the request can be provided within the appropriate costs limit and to allow the complainant to make a new request should this be possible. 

* 4  The public authority must take these steps within 35 calendar days of the date of this decision notice. Failure to comply may result in the Commissioner making written certification of this fact to the High Court pursuant to section 54 of the Act and may be dealt with as a contempt of court. 

1

5 On 4 February 2016 the complainant made the following request for information under the FOIA:
'The follow quote is from a doctor's Fitness to Practice Hearing. (2016)
8.. You did not admit that you had altered Patient A's medical records until your letter to the Health Services Ombudsman (HSO) dated 3 January 2003 and only made a full admission to your misconduct to the HSO on 73 June 2003.
9. The Panel in 2005 took a serious view of your dishonest and misleading conduct. It found that:
'Yottr dishonesty was compounded by the fact that you continued to maintain that you had prescribed aspirin and a GTN spray. You maintained this on several occasions...
The Panel further notes that you only admitted to this dishonest behaviour when you were made aware that at the request of the Ombudsman's office a detailed audit was being carried out of the computer records at your practice , which would inevitably expose the facts, date, and nature of the alteration of [Patient A's] prescription records. This behaviour undermines the trust which the public is entitled to place in the medical profession, and is totally unacceptable.'
This case of medical note tampering - ¡n 2003 - and is illustrative of other hearings involving note tampering on the site.
The Ombudsman followed up an allegation of note tampering .,.Presumably becoming involved after a complainant had made his/her representations during an investigation, by ordering a 'detailed audit of computer files'.
Therefore the Ombudsman supported complainant's opinion - and took the necessary sfeps to investigate an accusation of the alteration of records.
I would like to know:
7. How many times were detailed audits of PA records /files were carried out ( computer or handwritten) by the PHSO in the past two years ?
2. And which locations, (any Trusts, surgeries or other organisations ..not necessarily medical - but within the remit of the PHSO ).
3. Whether these audits were carried out by PHSO employees - or external companies.
4. In the case of external companies, please provide bills etc.
5. If the outcome of these audits is known, please provide details.
2

a
lco. lnformatlon Commls¡one/s offlce
Please provide all data available under the FOIA.
NB If there are time constraints on this request, please limit the scope to health records only.
And limit the period to one year only,'
On 12 February PHSO requested clarification of 'PA records/files' and on the same day the complainant explained that it was'Public Authorities...the organisations which the public can complain about to the PHSO'
On 3 March 20L6 the PHSO responded that 'we do not hold a central record of the information you have requested. To be certain about whether we carried out any audits of bodies within our jurisdiction, we would need to manually check every complaint we looked at in the last two years.'
PHSO refused to provide the requested information citing Section L2 of FOIA as it estimated that the cost of determining whether it held the information would exceed the cost threshold of f450.
On 3 March 2016 the complainant requested an internal review. She argued that'PHSO seems to be stating that it still cannot track the money it spends on its Audits in a timely and efficient way'.
Reference: FS50651442
6
7
8
9
10. After the intervention of the Commissioner, the PHSO sent the outcome of its internal review on 14 December 2016 upholding its original position.
11. On 28 December 20L6, PHSO responded to a further email from the complainant:
'Your original information request was concerned with audit of patient records undertaken during the course of the Ombudsman's investigations.
In your most recent correspondence you appear to refer to issues regarding the Ombudsman's own internal audit function. This is separate to our investigation work.
Bearing in mind the terms of your original request, to the extent you sought clarification around audits undertaken by the Ombudsman of patient records during the course of the Ombudsman's investigations we would have to search all of our files to ascertain whether we held such information. There is no way to narrow this bearing in mind the information you have requested.
3

Should you wish to ask for information about our internal audit function then it is open to you to do so by way of a new information request.'
Scope of the case
12. The complainant contacted the Commissioner on 1 January 2017 (received 11 lanuary 2017) to complain about the way her request for information had been handled.
13. The Commissioner's investigation has focussed on whether PHSO correctly applied section 12. She has also considered whether PHSO met its obligation to offer advice and assistance, under section 16.
Reasons for decision
Section 12 - cost exceeds the appropriate limit
14. Section L2 of the FOIA allows a public authority to refuse to deal with a request where it estimates that it would exceed the appropriate limit to:
o either comply with the request in its entirety, or
o confirm or deny whether the requested information is held.
15. The estimate must be reasonable in the circumstances of the case. The appropriate limit is currently €600 for central government departments and Ê450 for all other public authorities. Public authorities can charge a maximum of 825 per hour to undertake work to comply with a request;
18 hours work in accordance with the appropriate limit of 8450 set out above, which is the limit applicable to PHSO. If an authority estimates that complying with a request may cost more than the cost limit, it can consider the time taken to:
(a) determine whether it holds the information
(b) locate the information, or a document which may contain the information
(c) retrieve the information, or a document which may contain the information, and
(d) extract the information from a document containing it.
16. Where a public authority claims that sectíon 12 of the FOIA is engaged it should, where reasonable, provide advice and assistance to help the
4

requester refine the request so that it can be dealt with under the appropriate limit, in line with section 16 of the FOIA.
L7. In its submission to the Commissioner, PHSO stated that PHSO is an ombudsman service which carries out thousands of investigations each year. For example, it handled 29,046 complaints in 2015/L6.Each complaint has a different case file allocated to it on one of the two case management systems, and many contain hundreds of documents, especially where a complaint proceeds to statutory investigation.
18. PHSO stated that potentially, any of these investigations case files could contain evidence of PHSO conducting audits as part of its investigation work. While an audit may arise as part of a statutory investigation, it is not a routine process or one which would normally be recorded separately to the investigation case file itself.
19. PHSO referred to their Service Model, which sets out the processes taken in relation to complaints handling:
https : //www. om bu dsma n. org . u k/a bout- us/corporate- information/freedom-information-and-data-protection/our-oublication- sch em e/o u r- se rvice- m od el
20. The Commissioner read the summary investigation sheet that shows that an audit of records is not a usual part of the assessment or
i nvesti gation proced u re.
https : //www. om bu dsma n. org. u k/sites/defa u lt/fi les/Service model I nve stigation A3 sheet 20160919.pdf

21.
22.
23.
24.
PHSO also stated that whether an investigated organisation's records were audited is not routinely recorded and is not something which PHSO's systems can extract and report from its case management system. It would therefore require manual checks to determine whether any relevant information was held.
In response to the Commissioner's questions PHSO estimated that if it took only five minutes to manually review each of the complaints handled in 20L5/L6 (29,046 files - half of the request), this would equate to a total of 2420.5 hours.
PHSO were convinced that section 12 applies to the request and that there was no way it could meaningfully respond without the request being significantly revised.
Given the specific information requested and the volume of records in PHSO's record and case management systems, the Commissioner is prepared to accept that the PHSO would take more than the 18 hour limit to respond to the request. She is therefore satisfied that PHSO is correct to apply section 12(1) to the request.
5

o

25. Section 16(1) of the FOIA provides that a public authority should give advice and assistance to any person making an information request. Section 16(2) clarifies that, providing an authority conforms to the recommendations as to good practice contained within the section 45 code of practice (the "code")l in providing advice and assistance, it will have complied with section 16(1).
26. The Commissioner notes that PHSO did not offer the complainant any advice or assistance in refining the request.
27. In their submission to the Commissioner, PHSO recognised that Section 16 imposes a duty of advice and assistance but stated that'there was no clear way to assist the requestor in refining the request and so no
assistance was provided.'
28. Whilst the Commissioner notes the PHSO's position she considers that the PHSO's failure to even provide the complainant with an opportunity to refine the request is sufficient for her to conclude that it has not met its section 16 duty.
Reference: FS50651442
Section 16(1) - The duty to provide advice and assistance
t http://www.justice.gov.uk/downloads/info... section 45 -cod e-ofpractice. pdf
6

Other matters
o
lco. lnlorffi tlon Commlssione/s Olfle
29. The Commissioner's guidance explains that when a public authority receives an internal review request, it should ensure the review takes no longer than 20 working days in most cases, or 40 in exceptional circumstances.
30. The Commissioner notes the long delay between the request for an internal review (3 March 2016) and the outcome of the review on 14 December 20L6. This was explained to the complainant as 'an administrative error'. The Commissioner has made a record of this delay and this issue may be revisited should evidence from other cases suggests that there are systemic issues preventing PHSO from responding to requests promptly.
7

Reference: FS5065t442
Right of appeal
o
lco. lnformtlon Commlss¡oner! Off lce
31. Either party has the right to appeal against this decision notice to the First-tier Tribunal (Information Rights). Information about the appeals process may be obtained from:
First-tier Tribunal (Information Rights) GRC & GRP Tribunals
PO Box 9300
LEICESTER
LE1 BDJ
Tel: 0300 L234504
Fax: 0B7O 739 5836
Email : GRC@hmcts.qsi.qov.uk
Website : www.j u stice. gov. u k/tri bu na I s/genera l- reg u latory- chamber
32. If you wish to appeal against a decision notice, you can obtain information on how to appeal along with the relevant forms from the Information Tribunal website.
33. Any Notice of Appeal should be served on the Tribunal within 28 (calendar) days of the date on which this decision notice is sent.
Signed .
Pamela Clements
Group Manager
Information Commissioner's Office Wycliffe House
Water Lane
Wilmslow
Cheshire
SKg 5AF

B

Dear Lant Mark,

You will now have read the ICO's Decision.

Please comply with S16 as advised.

:::

Reminder- S16 help and assistance is STILL with an explanation on why audits cannot be traced via the PHSO's payment system.

Yours sincerely,

Jt Oakley

Lant Mark, Parliamentary and Health Service Ombudsman

I have now left the PHSO as of 30 December 2016.

 

Please re-direct your email to either:

 

·         Helen Holmes - [email address]

 

·         Fiachra Pilkington - [email address]

 

Thank you.

Mark Lant

 

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Jt Oakley left an annotation ()

Audit
ˈɔːdɪt/
noun
1.
An official inspection of an organization's accounts, typically by an independent body.
"audits can't be expected to detect every fraud"
verb
1.
Conduct an official financial inspection of (a company or its accounts).
"unlimited companies must also have their accounts audited"
synonyms: inspect, examine, survey, look over, go over, go through, scrutinize, probe, vet, investigate, look into, enquire into, check, check into, assess, appraise, evaluate, review, analyse, study, pore over, peruse, sift, dissect, go over with a fine-tooth comb, delve into, dig into; More

J Roberts left an annotation ()

Mr Lant wasn't there for too long.

Here is something interesting I read on sections 12 and 16:

“We consider that in this case, like in many others, section 12 cannot be regarded independently of section 16. … We consider that before the Tribunal can find that a given public authority is not obliged to comply with a request for information because it estimates that the cost of doing so would exceed the appropriate limit, it may need to consider whether, with assistance and advice that it would have been reasonable for the public authority to provide pursuant to section 16, the applicant could have narrowed, or re-defined his request such that it could be dealt with without exceeding the cost limits in section 12. If so, it may mean that the public authority’s estimate that the cost of complying with the request would exceed the appropriate limit has not been made on a reasonable basis. To hold otherwise could allow section 12 to be used in a way that significantly undermines the effect of section 16."

It was quoted in this Decision:

http://www.bailii.org/uk/cases/UKIT/2008...

Jt Oakley left an annotation ()

Thank you J Roberts - very interesting indeed.

The information above will be applicable if the PHSO fails to respond adequately -because I think it's one case that could be taken to court on the basis of the PHSO using its usual tactic of diverting the request into something else, so it can give its own response, rather than the one requested.

::

IMO the PHSO has distracted the ICO .....by maintaining that the information could ONLY be found by going through all the cases. The ICO doesn't seem to realise that audits -by their very nature- must be independent adjudicators of the audited material -Or they aren't audits..... They are checks.

Nb An audit is done by an independent person, who keeps their own files , whether internally or externally.
So there logically must be an independent record - out of the casework files.

It looks very much that the question has been asked of the Customer Care department ( which can't audit itself),although it can check cases.... instead of the auditor. Or audit section or external auditor

::::

I don't think I need to cite the other times the PHSO has produced a complete r ed herring, or misdirection on a request as a response - there are too many examples on WDTK. And it just wastes everyone's time.

Jt Oakley left an annotation ()

Mr Lant once called a request I made 'absurd' -on PHSO record.

I would presume that it became slightly less absurd .....when I won my case in court.

Jt Oakley left an annotation ()

35 days =June 13 .

InformationRights, Parliamentary and Health Service Ombudsman

3 Attachments

 

[1][FOI #314647 email]

 

Your information request (FDN-247268)

 

Dear J T Oakley

 

I am writing further to correspondence from the Information Commissioner’s
Office of 8 May 2017 in which we were asked to provide some guidance on
how you might refine your request, so that it could be processed within
the statutory time limit.

 

As you might recall, to comply with your original request would have meant
manually searching through a large number of records; we estimated that to
do this for only 1 year would take 2420 hours (the statutory limit is 18
hours).  Unfortunately the extensive nature of the request means that we
could only comply with a refined request if it’s scope was reduced to only
3 days.

 

If you would like to refine your request to cover only 3 days, please let
us know and we will process the request as quickly as possible. 

 

I hope you find this information useful and I look forward to hearing from
you 

 

Yours sincerely

 

Information Rights

 

Follow us on

 

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References

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Dear InformationRights,

Thank you but logically these are not handwritten notes, they must be kept on Dame Julie Mellors secretary's IT system.
Therefore they are in one place and can be searched. As per previous request.

I note that under s16 - you have not stated the computer system on which these records are held.
And how it's search facility operates. Which might allow me to assist you in your search.

So that information would, of course assist me in clarifying my request and would be an acceptable S16 application of 'help and assistance'.

In addition, since the PHSO has provided perfectly adequately provided FOIA information in Dame Julie's diary before, am I right in assuming that you are stating that the staff now involved in responding are much less efficient than they were before? Even with the new upgraded computer system?

Because this seems to be the implication in your response. A n unusual point which the the FOIAct doesn't the seem to cover.

Yours sincerely,

Jt Oakley

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


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Dear Parliamentary and Health Service Ombudsman,

This seems to be reply to Dame Julies diary - instead audits of records, could yiu please reply on the right request?

Yours faithfully,

Jt Oakley

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


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Jt Oakley left an annotation ()

To the ICO -

An audit is an overview and separate to cases, therefore it stands alone ...so not is clearly not necessary to go through every case, as has been stated.

‘An audit is a systematic and independent examination of books, accounts, statutory records, documents and vouchers of an organization to ascertain how far the financial statements as well as non-financial disclosures present a true and fair view of the concern’

It has been stated an audit already exists, therefore the time for searching cases is irrelevant.

I am not asking the PHSO to start to audit cases, just asking for the audit/s that already exist.

Therefore the PHSO is failing to respond to this request.

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