Personal opinion on the new Ombudsman Service Charter:  Della Reynolds coordinator of the PHSO Pressure Group.

Last Monday I attended the third user panel meeting to contribute to the new Service Charter aimed at bringing PHSO in line with the expectations of today’s citizens.     This project is being supported by OPM, an independent, not for profit, research organisation who plan to leave no stone unturned.

  • There are two panels one for complainants and one for advocacy groups.  Each panel meets four times.
  • There is a targeted survey sent to customers, staff, organisations the PHSO investigate and consumer advocacy groups.
  • Six in-depth interviews with customers to understand their complaint journey.
  • Four customer workshops in London, Birmingham and Manchester.
  • On-line surveys and discussion of key issues.
  • All wrapped up in an interactive, dedicated website;

At this third meeting we were asked to describe what ‘good’ looks like and write ‘positive’ statements onto little sticky notes.  To be honest the negatives crowded my mind more easily, but I was happy to partake of a little ‘blue sky thinking’ if it would help drag this organisation into the 21st century.  Soon the sticky labels started to pile up, yellow, orange, green; packed with cliché they included words such as ‘independent’,  ‘impartial’,  ‘evidence based’, ‘transparent’  ‘honest’ ….  I’m sure you get the picture.   Our ideas were then discussed, categorised and collated onto wall charts; all part of the journey towards a fair and accountable complaint handling service.

As I went home on the train, tired but satisfied that I had done my bit for the greater good, I started to read ‘My expectations’ otherwise known as the PHSO ‘Vision Report’.  Published in November 2014 this document was produced in response to the government’s ‘Hard Truths’ which in turn came on the back of the Francis’ inquiry into the failings at Mid Staffordshire.  PHSO along with LGO and Healthwatch England set about creating a vision which,  “…aims to align the health and social care sector on what good looks like from the user perspective when raising concerns and complaints about health and social care.”     Mmmm, sounds familiar.

In order to produce this ‘outcomes framework’ PHSO employed the services of ESRO Ltd to carry out the primary research and analysis.  ESRO set about the task by consulting widely on the issue with;

  • Unique primary research with over 100 patients and service users.
  • Input from representatives from over 40 different organisations across the health and social care sectors.
  • A desk-based examination of live complaints systems in various settings including hospitals, GP surgeries, local authorities and care homes.
  • Exploration of best practice in the commercial sector.
  • In depth interviews and discussion with pre-existing patient and service user groups.
  • Workshops for front-line staff, complaints service managers, policy makers and executives.

No doubt all were encouraged to imagine what ‘good’ looked like as they wrote  ‘I statements’ on coloured sticky notes.

“These statements present a model of good outcomes that can be easily understood by all patients and service users, as well as by staff at all levels within an organisation.”  

So there we have it.  Just last year this particular wheel was honed to perfection, yet here we are re-inventing it from scratch.  Let’s take stock and see what ‘good’ looks like in this context.

We are very good at;

  • Employing glossy, private companies to carry out research.
  • Asking questions.
  • Collating answers.
  • Writing reports.
  • Making recommendations.
  • Spending money.

We are in fact exceptionally good at all of the above.  Let us review some of our progress so far:

  • NHS Complaints Reform: Making Things Right   (2003)
  • Principals of Good Complaint Handling      (November 2008) 
  • Complaints about privately funded and privately arrange adult social care.  (2011) 
  • Aiming for the best – using lessons from complaints to improve public services.  (2011) 
  • Principals of integrated care (2011) 
  • What people think about complaining.   (2012) 
  • Patients First and Foremost     (March 2013) 
  • The NHS hospital complaints system. A case for good treatment.  (April 2013) 
  • Fear of raising concerns about care.  (April 2013) 
  • Designing Good Together  (2013) 
  • A Review of the NHS Hospitals Complaints System:  Putting Patients Back in the Picture.    (October 2013) 
  • Improving the health and social care complaints systems   (November 2013) 
  • Good practice standards for NHS Complaint handling  (2013) 
  • Hard Truths       (January 2014)
  • My Expectations    (November 2014)

So why are we still asking what ‘good’ looks like?   We know what it looks like even though we rarely see it in practice.

The missing link is the ability to turn any of these heartfelt words into action.

There is, however, one significant difference between the Service Charter and any of the previous reports which makes this process worthwhile.  This is the first time that the Ombudsman service has been put under the spotlight.  Generally good at wagging a finger from the shadows, the role of the Ombudsman has been painfully highlighted by the Patients Association damning report PHSO-The-Peoples-Ombudsman-How-it-Failed-us  the work of the Pressure Group  and James Titcombe’s continual search for answers as to why PHSO refused to investigate the death of his baby son at Morecambe Bay in 2010.  The Kirkup Inquiry, due to report soon, will undoubtedly provide further insight into the way PHSO contributes to this dysfunctional complaint process.

Once the Service Charter is complete the real work begins of bringing these words to life and the enemy is inertia.

“Every body continues in its state of rest, or of uniform motion in a right line, unless it is compelled to change that state by forces impressed upon it.”   Isaac Newton

PHSO must be compelled to change through public outcry, media spotlight and the active participation of parliamentarians to finally deliver a ‘People’s Ombudsman’ fit for a modern, democratic society.

Well that’s what ‘good’ looks like to me.

Comments welcome.