PHSO are once again in transition. The recent loss of both the Ombudsman, Dame Julie Mellor and the Deputy Ombudsman Mick Martin under a cloud of collusion has left the reputation of the Ombudsman’s office somewhat dented to say the least.

Public confidence is essential to public services.

 

No matter what chaos is happening on the ground the public must remain confident that the organisation is working for the common good. Rule number one in Sir Humphries Rule Book.

Rob Behrens took up the role of Ombudsman in April 2017 and is in charge of the new strategy to be launched in 2018 and last until another new strategy is introduced. His first priority has been to listen to critics, learn lessons and with improvements in place, restore public confidence in the Ombudsman service.

Fortunately, for PHSO most of the public are ignorant of their existence. They rarely manage to score above 20% on public awareness surveys. Equally, there is very little media coverage of the Ombudsman’s work apart from that released by their own media team. A media team who appear to be on something of a campaign to restore public confidence despite the fact that the hard work of making the service fit for purpose has yet to be done.  There are mixed messages here. In August Mr Behrens informed Shaun Lintern from the Health Service Journal that standards had not been adequate and substantial reform was required to make PHSO an exemplar service. It was, in his own words, ‘a big job but the transformation has begun.’ mr-behrens-makes-promises-of-change-for-the-future-but-what-about-the-past/

But just a month later and the media team are publishing letters in local papers such as the one below from The St Ives Times and Echo (27.9.17) encouraging people to make a complaint to the Ombudsman, despite the fact that just a month earlier Mr Behrens had stated that, ‘critically, we have not yet found a way of relating to complainants so that we understand their cases and that relationship is key to a good outcome for the process whether or not we find for them’

THE NHS provides excellent care to thousands of people day in, day out. We all have an understanding of the pressures the NHS faces, but this should not stop people from speaking up when things go wrong.

Data published last week by NHS Digital revealed that there were 208,400 complaints about the NHS in 2016-17. However, all too often, patients and their families are not fully aware of their rights. The NHS Constitution states that everyone has the right to complain, to have their complaint about NHS services acknowledged within three working days, and to have the matter properly investigated.

It is important that patients are also aware that if they are dissatisfied with the way in which their complaint is handled, they have the right to bring their complaint to us the Parliamentary and Health Service Ombudsman (PHSO)  for an independent and impartial view.

Where the PHSO upholds complaints, we recommend that the NHS puts things right by offering an appropriate remedy. This might be an apology, a financial remedy, the creation of action plans to ensure mistakes are not repeated, the introduction of additional staff training, or changes to policies and procedures. Throughout our work, we see a wide variation in the quality of NHS complaint handling so it is imperative that people know their rights and are not afraid to complain when mistakes are made.

ROB BEHRENS Parliamentary and Health Service Ombudsman

You may indeed have the right to complain to the Parliamentary and Health Service Ombudsman but you do not have the right to an investigation. That is up to the Ombudsman’s discretion.  In 2016-17 about 25% of the complaints made were assessed, only 13% made it to investigation and a tiny 4.7% achieved any type of uphold.  For 95% of the people submitting a complaint, it was nothing but a frustrating, waste of time.

It would appear that PHSO are focusing on restoring public confidence when they should be focusing on restoring a service fit for purpose.  In the  2017-18 Business Plan

there is a success criterion to consistently achieve 95% positive or neutral media coverage.  

By default, the media coverage will be positive when we all have something good to say, but it would appear that PHSO aims to meet the criteria without necessarily achieving the success.

PHSO regularly release positive statements on Facebook demonstrating the values of their organisation. Comments are then made by members of the public and in my experience, these comments tend to be negative. In fact, I have never read a positive one yet.  On recent postings, I’ve noticed that it is possible to see the number of comments made but for some reason, the comments themselves will not open. Mmmmm – very curious.  The same is true for PHSO posts to twitter. The comments are hidden from public view.  Why would this be?

Meeting the media target requires close monitoring of social media but it shouldn’t include censorship.

The PHSO media campaign is, however, in full swing and this month Mr Behrens has launched Radio Ombudsman in order to engage the public in dialogue. Guests will be invited where PHSO decide they are ‘informed or interesting’ and questions are selected from Twitter. Where is the locus of control in this arrangement? Firmly in the hands of Mr Behrens who chooses both the guests and the questions. I listened to the first podcast which was an interview between Mr Behrens and  Scott Morrish a previous complainant.  soundcloud.com/scott-morrish/phso-get-better-at-learning

To open, Mr Behrens stated that the Ombudsman is ‘independent’ and ‘impartial’ yet there is no evidence to support this view but that of the Ombudsman himself. The Patients Association, phso-thefacts and submissions to PACAC repeatedly cite bias towards the public body under investigation.  But no doubt Mr Behrens would disagree with that.  He disagreed on a number of points made by Mr Morrish but did not substantiate the reasons why. Is this a genuine attempt to listen and learn or just a masterclass in PR spin?

Disagreement without good reason is just denial.

On August 13th Bruce Newsome posted a raw and undoubtedly negative account of the way PHSO fail to manage risk on the Conservative Home website. conservativehome.com/platform/2017/08/bruce-newsome-the-key-problem-with-the-nhs-not-resources-not-culture-but-a-lack-of-accountability 

Mr Newsome is a lecturer in International Relations at the University of California, Berkeley and an expert in risk management. His aim was to draw attention to the lack of accountability for the work of PHSO and as previously articulated on this site, without accountability you get impunity. https://phsothetruestory.com/without-accountability-you-get-impunity-and-that-leaves-all-of-us-at-risk/

Within two days of publication, Conservative Home received a complaint from PHSO regarding the accuracy of the article. No doubt PHSO would have been delighted for the piece to be removed or amended to their satisfaction.  Fortunately, Mr Newsome did neither. But this is all very worrying.

When you achieve your media target by controlling the media coverage you have clearly missed the point.

My advice to Mr Behrens would be to get on and deliver a customer focused Ombudsman service, hold authorities to account and make sure that learning is acted upon. Let the positive media coverage follow all by itself and be a true measure of his success. I would be delighted to publish a good news story on phso-thefacts, I just don’t have one yet.

 

 

 

 

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