"Substantial compensation" and use of discretion

The request was partially successful.

Dear Parliamentary and Health Service Ombudsman,

You recently disclosed (Assessment Manual 3.0) that you might not investigate a case:

"If the outcome sought is not reasonable in relation to the claimed injustice. For example, an investigation might not be appropriate if a complainant is interested  only in  substantial compensation and we consider that an upheld 
complaint  would be unlikely to result in us recommending such a remedy. "

1. Please provide all information held used to assist decision makers determine that a complainant is asking for "substantial compensation".

2. Please specify the closure code that is used when a case is dismissed on the grounds that the compensation sought is "substantial".

In avoidable death cases (Assessment Manual 3.0)

"76.  We start from the presumption that we will investigate health complaints  where there  are indications of serious service failure which could have impacted  on an individual’s chances of survival. However, we must still exercise discretion  appropriately and there will be  exceptional circumstances in which we do not  investigate such cases. "

3. Please provide all information held that aims to assist those who exercise the discretion referred to. Include all information held on what may constitute "exceptional circumstances".

https://www.whatdotheyknow.com/request/2...

Yours faithfully,

J Roberts

foiofficer, Parliamentary and Health Service Ombudsman

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Ombudsman. This return e-mail shows that we have received your
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foiofficer, Parliamentary and Health Service Ombudsman

3 Attachments

Dear J Roberts

 

Your information request: FDN 210495

 

I write in response to your information request dated 19 December 2014 in
which you asked:

 

1. You recently disclosed (Assessment Manual 3.0) that you might not
investigate a case: "If the outcome sought is not reasonable in relation
to the claimed injustice. For example, an investigation might not be
appropriate if a complainant is interested only in substantial
compensation and we consider that an upheld complaint would be unlikely to
result in us recommending such a remedy. "

 

Please provide all information held used to assist decision makers
determine that a complainant is asking for "substantial compensation".

 

We do not hold a specific definition or guidance in relation to
‘substantial compensation’. Investigators use their judgement to determine
whether the compensation sought by the complainant is proportionate to the
injustice claimed and whether it is an amount an investigation by us could
reasonably achieve.

 

2.  Please specify the closure code that is used when a case is dismissed
on the grounds that the compensation sought is "substantial".

 

We do not have one specific closure code for this. Possible options are
‘Reasonable to pursue legal remedy’, but could also be ‘Cannot reasonably
achieve more’ or ‘Other reason to decline’.

 

3. In avoidable death cases (Assessment Manual 3.0) "76. We start from the
presumption that we will investigate health complaints where there  are
indications of serious service failure which could have impacted on an
individual’s chances of survival. However, we must still exercise
discretion appropriately and there will be   exceptional circumstances in
which we do not investigate such cases.”

 

Please provide all information held that aims to assist those who exercise
the discretion referred to. Include all information held on what may
constitute "exceptional circumstances"’.

 

The discretion and powers of the Ombudsman are derived from our
legislation. We do not have specific guidance on all the factors
Investigators consider, as this is about exercise of judgment based upon
the specific circumstances of the case.  One example of a factor we would
consider if a case comes to us outside of our time limit is outlined in
paragraph 61 of Version 3.0 of the Manual, which refers to ‘scale of
injustice’. You can see that we would be very likely to put the time limit
to one side to investigate something as serious as a death that could have
been avoided.

 

I hope this information is helpful.

 

Kind regards

 

Rebecca Gadsdon

FOI/DP Officer

Parliamentary and Health Service Ombudsman

T: 0300 061 1516

E: [1][email address]

W: [2]www.ombudsman.org.uk

 

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J Roberts left an annotation ()

With individual investigators having the discretion to determine what is meant by "substantial" compensation there is a real risk that some complaints are closed by miserly investigators that would otherwise be upheld. An investigator inclined to view compensation of a few hundred pounds to a surviving relative as "substantial" is more likely to press the "cannot reasonably achieve more" button in cases where compensation of, say, £1,000 is asked for.