Patient experience, Quality, System design

Changes to the way we work will mean more impact for more people, says Dame Julie Mellor

Dame Julie MellorAs new NHS organisations formally take on their responsibilities, at the Health Ombudsman service we are also beginning a new phase, with the roll out of our new strategy and changes to the way we will handle complaints.

Our vision is to make sure that complaints make a real difference ― to public sector health organisations, GPs, dentists and others, as well as individuals. The public have told us they want to be confident that complaining about public services is straightforward and fair. They also want the NHS and those who provide services to learn from complaints and use them to improve the service they provide to everyone.

Our four key objectives over the next few years are:

  • to make it easier for people to find and use our service
  • to investigate more complaints and help more people
  • to use what we learn to help others make public services better ―  sharing information about what went wrong so that mistakes can be avoided in the future
  • to lead the way to make the complaints system better.

We’ve already started to put this into practice. In April, we embarked on a new approach to our work. From now on, we will be investigating more complaints and sharing more information with the NHS and other public organisations so that they can benefit from more feedback about complaints at an earlier stage in the process.

Under the new plans, the starting point will be that once a complaint meets some basic tests, it will usually be investigated. This means we will be investigating thousands more cases each year, sharing the learning from these investigations and publishing summaries of more cases. We will also be automatically investigating any cases brought to us concerning unavoidable deaths.

What this means for the NHS and for organisations that provide NHS-funded services is that they will get feedback about more cases and have more access to information about cases showing where a complaint has led to substantial improvements. But we still want complaints to be resolved locally wherever possible. By sharing more of the learning from complaints that do come to us, we will help organisations get better at resolving the complaints themselves.

Just one example shows how this can happen. When a disabled man (Mr T) with a rare, potentially life-threatening spinal condition called autonomic dysreflexia (AD) was rushed to hospital in an emergency, he tried to explain to the paramedics and triage nurses about his condition and why it needed treating urgently. But his pleas fell on deaf ears as none of the staff were familiar with AD. He only received treatment from a doctor after a worrying two-hour wait when he could have died.

When Mr T brought the complaint to us, we were able to resolve the issue without the need for a formal investigation. Following our intervention, both the hospital and ambulance trusts met Mr T to discuss how to raise awareness of AD and were able to  put his advice into practice, so that when another person with a spinal condition was admitted to hospital, staff asked whether the patient had AD. This was exactly the outcome Mr T wanted.

The announcement of a review of NHS complaints handling, led by Ann Clwyd MP and Professor Tricia Hart, is timely and welcome. We will be working closely with both of them, along with government ministers, regulators and other partners by providing evidence from our own case work. As part of this work, we will be producing a critique of complaint handling in the NHS, which will be followed by research on what constitutes good practice.

Our mission is to make public services better and achieve more impact for more people. We can all work together to make this happen.

Dame Julie Mellor is the Parliamentary and Health Service Ombudsman

About NHSConfed .

The NHS Confederation is the membership body for the full range of organisations that commission and provide NHS services. We are the only body to bring together and speak on behalf of the whole NHS. We have offices in England, Wales (the Welsh NHS Confederation) and Northern Ireland (Northern Ireland Confederation for Health and Social Care) and provide a subscription service for NHS organisations in Scotland.


4 thoughts on “Changes to the way we work will mean more impact for more people, says Dame Julie Mellor

  1. I’ve always had good service from the PHSO. The service has been prompt, courteous and the rulings fair.

    In 2010 you ruled that my local acute hospital had not followed DoH guidelines for consent to procedures when I had a biopsy without permission or being told (I found out when I read my patient notes to find out why I was traumatised and mute). You gave me additional information, which explained that the surgeon should have foreseen complications, given my history, and that alternative procedures should have been discussed pre-op. You agreed that the gaps in my notes, errors in my notes, lack of follow-up care was all unsatisfactory / unreasonable. You agreed that the aneasthetist and pre-assessment staff should have made accurate notes, and that recovery staff should have given me appropriate care and not caused pyschological harm and suffering. You agreed that some of the care on the ward was below the minimum standard. You noted the unreasonable length of time the hospital took to investigate and give feedback to me.

    In 2012 you ruled that my local mental health trust had “serious failings” when they published my person identifiable clincial information. You also noted that the complaint procedure had ‘failings’, that the length of time taken to conclude investigations, write letters etc, were ‘unreasonable’. You left some of the investigation to the ICO who have a different perspective and remit — and different powers.
    You noted the Trust’s commitment to involve me in PPI (rather than sue) … and you intervened after my 23 week wait to inform me that I had missed the closing date by 1 day – the Trust did not contact me.

    Neither of these Trusts indicated clearly that they had come to the end of their investigations – neither concluded by giving PHSO details. Both times the MP wrote to confirm.

    If you think that you will make a difference to complaint procedures, staff competence and attitude, then dream on!
    That mental health trust has overhauled its complaint procedure and now we are going to be treated with compassion because we’re people, not washing machines.
    Yet I reported yet another breach of confidentality on 8 Feb, and the promised feedback was 15 March, and its now May and I’m still waiting …..

    Posted by Patient zero | May 2, 2013, 6:44 am
    • Anyone who complains is NOT listened too either via PALS from my last letter they want me to pay about 100 pounds to receive my notes. Theres so much GREED and CORRUPTIONS going on in many places and the audits have been wrong for decades aswell.If wrong doings go on they are just put onto disciplinery hearing meaning months off work under investigations fully paid. So everyone knows that if they do wrong they can get time off fully paid. The whole infrastructure is wrong from start to finish. In other walks of life , people are sacked with no pay offs . The system needs to change

      Posted by LYNNE HEAL | May 2, 2013, 9:18 am
  2. I too nearly died with MS complications in 2010 and NOT had any help at all concerning this. UK needs CCSVI via our NHS for us all who have blocked veins or valves in our necks over 40,000 worldwide have now had. Basically its angioplasty thats done daily in the NHS to heart patients which they wont do for us. Its discrimmination and unethical. CCSVI is very undangerous and easy to do via IVR we need to move forward in a new direction. The cost approx is 500 pounds only which many are against who are earning profits, shares and commissions on MS drugs that will never cure MS and have been very dangerous drugs too some have killed MS patients

    Posted by LYNNE HEAL | April 29, 2013, 11:38 am
  3. The system has to be changed to help patients lots. Have had lots of my notes destroyed after being disgnosed with SPMS all my MRI notes my list is endless and have still not had the right help at all via our NHS its a disgrace

    Posted by LYNNE HEAL | April 29, 2013, 11:29 am

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