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• Read the summary
• Read the conclusions and recommendations
• Read the full report: PHSO Annual Scrutiny 2017/18: Towards a Modern and Effective Ombudsman Service

The PHSO is the final tier of complaint for people unhappy with their experience of the NHS in England and Government departments. Ombudsman Rob Behrens assessed a total of 32,389 new complaints in 2017-18. Of these, 2,429 were referred for investigation, of an eligible 8,291.

PACAC has produced its report based on the PHSO’s annual report and accounts, evidence sessions with the Ombudsman and PHSO Chief Executive Amanda Campbell, and the team that carried out the independent peer review of the PHSO published in November 2018. Its findings centre on the review’s outcomes, the PHSO’s performance in 2017-18, and its future role in improving public services.

Chair's comments

Chair of the Committee, Sir Bernard Jenkin MP said:

“As a Committee, we have heard from individuals and families who have had existing traumas compounded by an ineffective, inefficient complaints process, at both NHS and PHSO level. Whilst nobody doubts the complex nature of the Ombudsman’s role, there has been a need to rebuild public trust and ensure the service is up to scratch.

“Our report finds that this process is underway. For this, the Ombudsman and PHSO are to be commended. We need to guard against complacency, but we are increasingly confident that under Rob Behren’s leadership the PHSO is putting its recent challenges behind it as far as it can.

“Completing the task depends on Government support however – support that has been promised and not yet delivered. The “fizzling out” of momentum on improving NHS complaints the Ombudsman has identified is unacceptable. There is also no good reason for the draft Public Services Ombudsman Bill to have been languishing at pre-legislative scrutiny stage for over two years. The Ombudsman and his team must be empowered if they are to build on what has been achieved over the past twelve months.” 

Key findings

Independent Peer Review

The Committee endorses the Peer Review Panel’s conclusion that the PHSO is becoming a modern ombudsman service worthy of public confidence. It echoes the warning against complacency, and underlines that a review, no matter how comprehensive, can only provide a partial picture. The Committee therefore recommends repeating the peer review process every three to four years, with perspectives from beyond the Ombudsman sector included. Those with direct experience of the PHSO’s service are one example of a stakeholder group with much to contribute to future reviews.

PHSO's performance in 2017-18

Whilst the Committee accepts that a productivity dip can be viewed as a consequence of internal restructuring, it emphasises the considerable impact that this has had on individuals. The Committee expects the restructuring to yield results, particularly an improvement in the PHSO’s service charter scores. To ensure these properly reflect the experiences of complainants, the Committee also reiterates its previous recommendation that the service charter survey cover issues relating to impartiality.

The improvement in the PHSO’s internal health is highlighted for praise by the Committee. However, given that this recovery was from a low base, the underlying need for fundamental reform to the PHSO’s governance structure remains. This must be undertaken via the Draft Public Service Ombudsman Bill, which has remained stalled since December 2016.

PHSO’s role in improving public services

Another area where the Bill’s lack of progress is being felt is the urgent need to improve the complaints handling process at local NHS level. Whilst the PHSO is to be commended for aiding where possible, it is NHS England and Government Ministers who should be held accountable for the current state of affairs. Having promised an update on its complaints strategy as a matter of urgency last year, the Department for Health and Social Care cannot evade its responsibilities to patients.