Julie Mellor: The ombudsman does act upon care complaints

Last month HSJ editor Alastair McLellan asked the question: “How should the NHS deal with individual cases of poor care where those affected feel the provider involved has failed to resolve their concerns?”

The simple answer to the question is individuals should come to the Parliamentary and Health Service Ombudsman with complaints about care failure made by NHS England.

The service was set up almost 50 years ago to give people a voice and power in relation to the state and public services. If people are not satisfied with a health service providers’ response to their complaint, they can bring it to us.

Outlining the Ombudsman

We can investigate and provide a final, independent and impartial adjudication on their complaint. Where we uphold it, health services will put things right.

‘We investigate complaints about any public health service provider in England’

We investigate complaints about any public health service provider in England including community and mental health trusts, acute hospitals, GP practices and NHS dentists.

We make recommendations for organisations to put things right when mistakes are made. These can include an apology from the organisation to the complainant, a financial remedy and actions to put things right, such as correcting a medical record, reinstating patients on GP lists and reviewing the treatment and care provided.

Meet the public need

To ensure we can fulfil our role in a way that best meets public need in the 21st century we are radically changing how we work. We are doing more to listen and respond to what people have told us they want from an Ombudsman service.

We are taking action now to improve our service: how we investigate, how long we take and how we provide customer service. These changes include using our discretion more positively to help more people.

‘We are doing more to use insight from complaints to help services improve’

We have already started to travel down that road. Over the last year we investigated six times as many health complaints as the previous year (from 300 to 1,778) and we have halved the time it takes to complete an investigation.

For serious health cases hat come to us outside the normal 12 month period specified in law, we will now positively consider whether an effective investigation is possible given the passage of time. Where we judge it is possible we will generally investigate.

We are also doing more to use the insight from complaints to help services improve.

Again, this is something people have told us they want us to do. So often when people complain they have a strong sense of public duty. They want their complaint to lead to learning and service improvement for others in the future.

Sadly, two-thirds of those who have complained to a public service say it did not make any difference.

Inspiring system change

We will be further improving our ability to identify learning from complaints.

However, we already make sure that where there are wider lessons for a health service provider from an individual complaint, we feed back to the provider in our investigation reports and expect an action plan to be developed to address the learning as part of the remedy for the complainant. These plans can include staff training and changes to policies and procedures.

‘We have more listening to do about what people want from our service’

Where there are quality and safety concerns we also share our findings with the Care Quality Commission or the relevant professional regulator.

Crucially, this year Parliament, through the Commons public administration committee, has used our reports about sepsis and midwifery regulation to hold the government and NHS England to account for acting on our findings and recommendations.

We have more listening to do about what people want from our service and there is more we will do to respond to what people tell us.

The important thing I want people to know is that they can come to us with individual complaints about poor care where they feel the provider involved has not resolved their concerns.

Dame Julie Mellor is chair and ombudsman of the Parliamentary and Health Service Ombudsman