The roles of the Caseworker, Advisors and the Policies & Procedure of the Health Ombudsman (PHSO).

R Tozer made this Freedom of Information request to Parliamentary and Health Service Ombudsman

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The request was successful.

Dear Parliamentary and Health Service Ombudsman,

The Freedom of Information requests deals with the roles of the Caseworker, Advisers and the Policies & Procedure of the Health Ombudsman (PHSO).

Background. In my limited understanding, the caseworker, who is little more than an administrative assistant has, at times, to call on knowledgeable Advisers to assist in that role in determining the outcome of any complaint.

1. Please forward a Person/Competence Specification which may be the advertised requirement, for the post of Caseworker

2. Please forward a Person/Competence Specification which may be used for the advertised post of Adviser to the Caseworker.

3. Please advise the current salary range for the post of (a) Adviser (b) Caseworker

4. For the past whole year, I would like to understand the number of Advisers the PHSO use and to be able to relate the number of Advisers consulted, compared with the number of Complaints investigated. Within that list I would also like to see the experience, qualifications and area of expertise of the Advisers consulted. Please provide me with the necessary information to allow me to be able to understand.

5. Do you use Advisers who have specific knowledge or specific expertise of the Law pertaining to clinical/medical matters?

6. Is there a limit, in terms of cost or other such issue, on the number of times Advisers could be asked for assistance by the caseworker on a single complaint? If there is such limit please specify the criteria used.

7. How does a caseworker determine the area of expertise of the Adviser to assist them to formulate the Ombudsman’s decision? As an illustration please say, how the caseworker would decide when the complaint features a Percutaneous Endoscopic Gastrostomy tube and whether a Consultant Gastroenterologist (Adviser) should be asked rather than a Consultant Upper Gastrointestestinal Surgeon (Adviser). Please say how Advisers are selected to assist the Caseworker dealing with this specific aspect, and send the Policy and Procedures document covering this question so that I may understand the criteria used by the Caseworker.

8. Are case conferences called by Caseworkers so that all Advisers can contribute, at a single time to the caseworker’s determination of the complaint? If so what is the criteria for calling such conferences?

9. Is there any Right or Policy or Procedure for a Complainant in challenging the advice given by the Adviser to the Caseworker, even at such times when sound factual and substantial evidence contradicts the Advisers advice? Please specify & forward that Right or Policy or Procedure.

10. Following the completion of an investigation by the caseworker, what is the process of determining whether the complaint, is upheld, partially upheld, not held? Who (in terms of hierarchy) actually makes that final decision before it is sent out, in Report format, to the Complainant?

11. Who (in terms of hierarchy) carries out and how often is the Caseworkers work audited for compliance with both the Rules/Regulations/Law and the Aims & Objectives of the PHSO?

12. Who (in terms of hierarchy) carries out and how often is the Advisers work audited for compliance with both the Rules/Regulations/Law and the Aims & Objectives of the PHSO?

Yours faithfully,

R Tozer

foiofficer, Parliamentary and Health Service Ombudsman

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[Name Removed] (Account suspended) left an annotation ()

We'd all like to know what the role of caseworker is.

And what qualifications are needed.

As far as I know, no one who has ever referred anything to the PHSO has ever managed to find out.

foiofficer, Parliamentary and Health Service Ombudsman

1 Attachment

Dear Mr Tozer

 

Your information request (FDN-176291)

 

Further to your email of 19 October 2013, I am writing with my response to
your information request.  I will respond to each of your questions in
turn.

 

1.    Please forward a Person/Competence Specification which may be the
advertised requirement, for the post of Caseworker

 

Please find attached an information pack for the role of caseworker.

 

2.    Please forward a Person/Competence Specification which may be used
for the advertised post of Adviser to the Caseworker.

 

Please find attached an information pack and outline for the role of
clinical adviser. 

 

3.    Please advise the current salary range for the post of (a) Adviser
(b) Caseworker

 

The caseworker role salary, as detailed in the information pack is
£36,500.  The D2 pay band goes from £36,500 to £42,280.

 

There are three pay bands for the post of clinical adviser: SA1, SA2 and
SA3.  The range for each pay band is detailed below.  You should note
that, as explained in the information pack, these are part-time roles for
individuals who continue to work in NHS clinical practice.  These pay
bands reflect the pay grades in the NHS.

 

SA1: £80,000 to £106,700

SA2: £68,700 to £86,200

SA3: £68,700 to £82,900

 

4.    For the past whole year, I would like to understand the number of
Advisers the PHSO use and to be able to relate the number of Advisers
consulted, compared with the number of Complaints investigated. Within
that list I would also like to see the experience, qualifications and area
of expertise of the Advisers consulted. Please provide me with the
necessary information to allow me to be able to understand.

 

We have a total of 670 clinical advisers available to us for consultation
and clinical advice on our casework.  This includes 45 internal
professional advisers (posts as advertised in the attached information
pack), as well as 96 associate clinical advisers and 529 external clinical
advisers who we might ask to provide advice as needed.  Associate and
clinical advisers are remunerated on either a contractual basis or for the
amount of time incurred advising on a particular case.

 

In the period 1st November 2012 to 1st November 2013, we processed 5774
individual requests for clinical advice.  This figure will not solely
relate to investigations, and some complaints will require more than one
piece of clinical advice.  These figures are correct at the time of issue.

 

During the same period, 1744 health cases were accepted for investigation
and 648 were concluded. 

 

Due to these high numbers, it will not be possible to provide you with a
list of experience, qualifications and specialisms of each adviser used
over the course of the year without exceeding the appropriate limit as set
out at section 12 of the Freedom of Information Act 2000. Section 12
states that if extracting the information required to respond to a request
would exceed the appropriate limit (for PHSO, 18 hours or £450), a public
body is not obliged to respond to that request. 

 

If you are particularly interested in the qualifications and specialisms
of our clinical advisers, you may want to think about narrowing your
request to focus on a smaller group, for instance, our internal
professional advisers.

 

5.    Do you use Advisers who have specific knowledge or specific
expertise of the Law pertaining to clinical/medical matters?

 

As you will see from the attached clinical adviser information pack, we do
not require advisers to have legal knowledge.  This is because we have a
legal team which provides advice on casework-related issues.

 

6.    Is there a limit, in terms of cost or other such issue, on the
number of times Advisers could be asked for assistance by the caseworker
on a single complaint? If there is such limit please specify the criteria
used.

 

There is no such criteria and caseworkers commission as much clinical
advice as they need to be informed enough to make a decision on an
individual complaint or issue.

 

7.    How does a caseworker determine the area of expertise of the Adviser
to assist them to formulate the Ombudsman’s decision? As an illustration
please say, how the caseworker would decide when the complaint features a
Percutaneous Endoscopic Gastrostomy tube and whether a Consultant
Gastroenterologist (Adviser) should be asked rather than a Consultant
Upper Gastrointestestinal Surgeon (Adviser). Please say how Advisers are
selected to assist the Caseworker dealing with this specific aspect, and 
send the Policy and Procedures document covering this question so that I
may understand the criteria used by the Caseworker.

 

If a case requires specialist advice, a caseworker would refer it to the
Clinical Advice Support Team.  If the case required more complex advice
than nursing, surgical or physician advice, then a clinician would review
the case and advise which type of specialist should provide advice on it.

 

8.    Are case conferences called by Caseworkers so that all Advisers can
contribute, at a single time to the caseworker’s determination of the
complaint? If so what is the criteria for calling such conferences?

 

A caseworker would not usually consult with several clinicians in one room
at the same time, but would instead commission written advice from a
number of clinicians which could be considered in the round.  They may at
that stage wish to discuss the advice with the adviser concerned.

 

9.    Is there any Right or Policy or Procedure for a Complainant in
challenging the advice given by the Adviser to the Caseworker, even at
such times when sound factual and substantial evidence contradicts the
Advisers advice? Please specify & forward that Right or Policy or
Procedure.

 

Complainants are entitled to request a review of our service or a decision
on their complaint.  More information about this process is available on
our website at:
[1]www.ombudsman.org.uk/make-a-complaint/unhappy-with-our-service

 

10. Following the completion of an investigation by the caseworker, what
is the process of determining whether the complaint, is upheld, partially
upheld, not held? Who (in terms of hierarchy) actually makes that final
decision before it is sent out, in Report format, to the Complainant?

I have attached a copy of the Ombudsman’s delegation scheme, which
explains what decisions can be made on behalf of the Ombudsman and by
whom.

 

11. Who (in terms of hierarchy) carries out and how often is the
Caseworkers work audited for compliance with both the
Rules/Regulations/Law and the Aims & Objectives of the PHSO?

 

All casework decisions are subject to quality assurance and peer review
before they are agreed and reports issued.

 

12. Who (in terms of hierarchy) carries out and how often is the Advisers
work audited for compliance with both the Rules/Regulations/Law and the
Aims & Objectives of the PHSO?

 

Clinical advice is regularly scrutinised by clinical peers and/or senior
clinicians within dedicated panels and by retrospective review to ensure
that performance standards for the provision of clinical advice are met.

 

I hope that this information is helpful.  However, if you are unhappy with
my decision not to give you all the information you requested, you can ask
for a review by emailing: complaints[2][email address]

 

If you still have concerns after that, you can ask the Information
Commissioner’s Office to look into your case.  Their contact details are
available on their website at: [3]www.ico.org.uk

 

Yours sincerely

 

 

 

Aimee Gasston

Freedom of Information/Data Protection Officer

The Parliamentary and Health Service Ombudsman

 

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References

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[Name Removed] (Account suspended) left an annotation ()

Well done R Tozer.

Dear foiofficer,

Thank you for your response. I have to say that I am a little disappointed that you have chosen to group some of the answers into some sort of singular haphazard PDF file. Maybe you could resend them as separate files relating to the separate questions, it certainly would make for better understanding/reading.

Yours sincerely,

R Tozer

foiofficer, 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.

show quoted sections

All email communications with PHSO pass through the Government Secure
Intranet, and may be automatically logged, monitored and/or recorded for
legal purposes.
The MessageLabs Anti Virus Service is the first managed service to achieve
the CSIA Claims Tested Mark (CCTM Certificate Number 2006/04/0007), the UK
Government quality mark initiative for information security products and
services. For more information about this please visit www.cctmark.gov.uk

foiofficer, Parliamentary and Health Service Ombudsman

4 Attachments

Dear Mr Tozer

Please find attached the documents you require in separate PDF documents.

Yours sincerely

Freedom of Information / Data Protection Team
Parliamentary and Health Service Ombudsman

Please email the FOI/DP team at: [email address]

show quoted sections

Dear foiofficer,
Many thanks for providing the separate PDF's, much appreciated

Yours sincerely,

R Tozer

foiofficer, 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.

show quoted sections

All email communications with PHSO pass through the Government Secure
Intranet, and may be automatically logged, monitored and/or recorded for
legal purposes.
The MessageLabs Anti Virus Service is the first managed service to achieve
the CSIA Claims Tested Mark (CCTM Certificate Number 2006/04/0007), the UK
Government quality mark initiative for information security products and
services. For more information about this please visit www.cctmark.gov.uk

C Rock left an annotation ()

I'm not sure that the questions relating to compliance with Rules/Regulations/Law /Aims & Objectives of the PHSO were answered at all. It was somehow translated into "Clinical advice" scrutiny, and "peer review".

Do you think the question was deliberately misconstrued? What qualifies the "peers" to advise and be well versed in all these aspects? Certainly not through 'Qualification', according to previous FOI admissions.

[Name Removed] (Account suspended) left an annotation ()

Apparently the PHSO is not following their own rules and regulations.

One of the witnesses at the PASC meeting pointed this out and was able to demonstrate how. The MP's looked very interested.

R Tozer left an annotation ()

There is only one way to look at EVERYTHING that I receive from the PHSO and it goes along the lines "we make it all up as we go along"

I'm also led to the conclusion the word rigour does not feature in the dictionary used by PHSO staff.

[Name Removed] (Account suspended) left an annotation ()

It does..

But it is used to explain the lower graded staff pay while senior management are still quids in:

'There has been a rigorous investigation as why the PHSO proles do not merit a reasonable pay rise. We've decided that they don't merit one from the £32m we are Brent on frittering away on being busy doing nothing much to help the public.'

Signed: The Management.