Pressure Group members attend NHS Complaints Conference.

Westminster Briefing Group (1) On 7th October three members of the PHSO Pressure Group paid to attend an NHS Complaints Conference called ‘Westminster Briefing’.  westminster-briefing.Agenda   It was to be a day of presentation and discussion centred around the Francis Report’s 290 recommendations for improvement.  The fact that there so many recommendations shows the degree of change required.

Unfortunately, there was not as much opportunity for debate as they hoped and it was clear from the morning session that the speakers were not really primed to answer questions; especially hard hitting ones from people who had first hand experience of using the complaint process.

There was a feeling among the Group that the morning speakers were simply ‘going through the motions’ and this was reciprocated from the attending delegates (mostly complaint managers) who asked very few questions.  A notable exception were two representatives from Moorfields Eye Hospital who asked particularly relevant questions and showed a keen interest in the speakers presentations.  Fiona from the Pressure Group wrote to congratulate them afterwards, on having two representatives in the room who engaged in a way that presented Moorfields as a centre who genuinely cared about patient’s safety and rights. So we ‘complainants’ do more than just complain.

John Dale, a consultant and organiser of the National NHS Complaints Managers Group chaired the meeting.  Among the morning speakers were Paul Durham speaking on behalf of CQC and Sally Sykes who represented PHSO.  Both of these speakers talked about how their organisations were listening to complainants and taking change on-board, but it all sounded like jam tomorrow for members of the Pressure Group.  Interestingly, this slide from Sally Sykes presentation shows in the ‘third phase’ key issues which are presently under consultation with the Cabinet Office and PASC.  These changes require new legislation, so are PHSO jumping the gun or is this a done deal? SALLY SYKES PHSO SLIDE

Roan Dyson spoke about the services offered by POhWER, who help complainants ‘get their voice heard’. Unfortunately, they don’t take on case work, so their support is limited.   The most revealing fact to emerge from the morning session was that there were 88 different public bodies dealing with NHS complaints.  No wonder we are all confused!

Kim HoltThen in the afternoon, things picked up when Dr Kim Holt (Chair and Founder of Patients First) the whistleblower on the Baby P case, fully engaged the audience  as she talked about the dreadful plights of some of the whistleblowers she has worked with since starting her campaign for a full public inquiry four years ago. You can see her website here:  www.gov.uk/whistleblowing/overview

She explained that bullying is used to stop the whistleblowers and instead of the concern being investigated, the individual who raises the concern is investigated.  Bullying is mainly in the form of verbal abuse and suggestions that the whistleblower is mentally deranged. This will invariably lead to loss of career and stress related health problems for those brave enough to speak out.  Dr. Holt mentioned a paediatric surgeon who after raising concerns, was taken to court by the PDSA and is now no longer working.  There was also mention of another bullying case where someone literally had their head banged on a table. Dr. Holt said it was all down to poor clinical leadership and is calling for management to take proactive steps to deal with issues raised instead of adopting a defensive stance when things go wrong.

(You can see the slides to her presentation, along with those of the others speakers, by following the link at the end of this article.)

The next speaker was Kim Morley (Sapphire Specialist Epilepsy Nurse, Solent NHS Trust) who also had first hand experience of what it was like to be the victim of poor care.  She described how poor care made a person feel invisible, uncared for and cast adrift.   She also pointed out that when patients complain the people who caused the harm carry out the investigation and that as long as this continues there will be no justice.  Ms. Morley also mentioned a lack of diagnosis, which then denies the patient the treatment they require.  No diagnosis or strategic misdiagnosis has featured in cases within the Pressure Group causing unnecessary suffering for many years as people try to discover the real reason for their illness.

The last speaker was Ruth Evans (Patient Experience Network)   – she started by asking the direct question ‘What should a complaints system be like?’  Simple.  And ‘What does someone want when they complain?’  They want things put right.  She said Richard Branson’s organisation has a positive attitude to feedback/complaints, because it improves things; another positive speaker.  It is clearly the case that when someone makes an initial complaint they want a very simple response.  They want acknowledgement, an apology and some action taken to put things right.  It is the long fight for justice, when public bodies delay, deny and defend, which leads to permanent bitterness and litigation.

Dr. Holt won the prize from our group members though they all commented on how refreshing the afternoon speakers were and the real insight they shared of the painful journey one takes as either a whistleblower or NHS complainant.

On that note you may wish to listen to David Drew speaking on Radio 4’s Midweek about his horrendous nightmare following his decision to blow the whistle regarding concerns for patient safety at Walsall Manor Hospital, where he worked as Head of the Paediatric department .bbc.co.uk/programmes If you want to cut to the chase his part starts at 11.41. He speaks of the culture of closed groups and once more makes the point that the perpetrators are the very same people who investigate the complaint.  This is unacceptable. You can get his book, ‘Little stories of life and death’ here: http://www.amazon.co.uk/Little-Stories-Life-Death-NHSwhistleblowr/dp/1783065230/ref=sr_1_1?s=books&ie=UTF8&qid=1414175857&sr=1-1&keywords=david+drew

We have seen it in Mid. Staffordshire, Rotherham and of course in the Saville affair.  When those in authority fail to listen and respond appropriately to complaints then nothing is done to halt the horror and many more suffer as a consequence.  It is not good enough for those who failed to say, ‘lessons have been learnt’ for these are hollow words, too easily spoken.  The fact that Dr. Kim Holt and Dr. David Drew are having such a tough fight to obtain a public inquiry into whistleblowing, demonstrates a government who is unwilling to learn from these many failures.

head up bum Link to slideshows from the day:  https://dub114.mail.live.com/mail/ViewOfficePreview.aspx?messageid=mg9mujqpNa5BG05AAiZMHWHA2&folderid=flinbox&attindex=0&cp=-1&attdepth=0&n=99258138

 

 

 

Can Oliver Letwin deliver an Ombudsman service fit for the 21st Century?

PHSO Pressure Group at cabinet office

Della Reynolds, co-ordinator of PHSO Pressure Group at the Cabinet Office.

On 7th October the PHSO Pressure Group attended a stakeholders meeting held at the Cabinet Office to discuss complaint handling and the role of the Ombudsman. We were invited by the Rt. Hon. Oliver Letwin and present at that meeting was Robert Gordon CB and his team.  Mr. Gordon has had a distinguished career in the Scottish Office where, among other things, he helped to set up the devolved Scottish Parliament.  http://www.inspiringscotland.org.uk/who-we-are/board-of-directors/robert-gordon

Mr. Gordon has been charged with researching the current Ombudsman landscape and reporting back to the Cabinet Office with suggestions for reform.  We were delighted to be able to speak directly to him and his colleagues.  This was a valuable opportunity to discuss the service user’s experience and share a little of our ‘gold-dust’. Our initial concern was that the inquiry process would deliver nothing more than a re-branded version of a fundamentally flawed process.  It will take more than a common portal and shiny new logo to restore public confidence in the Ombudsman.  There is sufficient evidence in the public domain (Mid. Staffs, Morecambe Bay, Morrish family)  to demonstrate that this service is not fit for purpose and requires fundamental reform.

Once the Cabinet Office conclude their inquiry, with the help of Mr. Gordon, they will be drafting new legislation.  The original legislation has been in place for 47 years and quite possibly has never served the public in all that time; it is therefore vital that we use this opportunity to create an Ombudsman service which meets the needs and expectations of the public in the 21st Century. At the core of this legislation there must be measures to provide effective accountability for users of this service.  The total discretion enjoyed by the Ombudsman to date has no place in a modern democracy.  We are aware that the Ombudsman must be the final arbitrator, but allowing this body to exclusively handle all complaints about its own service creates an Alice in Wonderland scenario where the omnipotent Queen of Hearts simply makes up the rules as she goes along.  If you need proof, look no further than this year’s annual report where the Ombudsman states that from upwards of 27,000 complaints handled they only had to review their decisions 0.2% of the time.  Any organisation which believes that it has a 99.8% accuracy rate needs a reality check.

Mr. Gordon’s suggestion for robust accountability was to set up a monitoring board of ‘independent’ members who would scrutinise the Ombudsman’s performance against key indicators.  It is not too difficult to see the obvious flaws in this plan.  Firstly who are these ‘independent’ people and who appoints them?  There seems to be a cartel of like-minded people who are willing to sit upon each other’s boards and do little more than maintain the status quo.  PHSO currently have a Unitary Board, chaired by the Ombudsman herself and stuffed full of PHSO employees,   http://www.ombudsman.org.uk/__data/assets/pdf_file/0014/21614/Annual-Report-About-Us.pdf plus an Audit Committee led by Sir Jon Shortridge KCB http://www.ombudsman.org.uk/about-us/who-we-are/the-board/audit-committee and it is questionable whether either of these committees do any more than rubber stamp the decisions put before them.  The suggestion was made by the PHSO Pressure Group that board members for any panel which is designed to hold the Ombudsman to account should be drawn from recognised campaign groups and charities such as the Patients Association, AvMA and the PHSO Pressure Group itself, to include fierce critics such as James Titcombe and Julie Bailey.

 If you really want to know how an organisation delivers then ask those who have received.  

Hopefully, this possibility will be investigated by Mr. Gordon and his team.  Other suggestions for accountability included giving the Public Administration Select Committee (PASC) the powers it needs to hold the Ombudsman to account for poor service delivery.  Currently PASC cannot pursue any individual complaint nor can it ask questions of the Ombudsman relating to individual complaints.  To say that the Ombudsman is accountable to parliament for service delivery is unrealistic given that PASC is so severely handicapped.

 The truth is that the Ombudsman is accountable to no-one but herself and we all know of the corrupting influence of ‘absolute power’.  

The use of the word ‘corruption’ makes politicians feel uncomfortable and Mr. Letwin shifted in his seat as he pursued this subject, questioning why this would be the case.  It is our belief that both PHSO and LGO are morally corrupt in that they have total disregard for the plight of individuals as they manipulate the evidence to find spurious reasons to close cases down.  Complainants, who have been denied evidence in drawn out complaint processes where public bodies have ultimately lied and covered up the facts, then find themselves duped once again by the shiny rhetoric on Ombudsman’s websites promising impartiality and remedy.  In 2013-14 only 11% of all formal complaints were upheld by PHSO to some degree following an investigation.

The Ombudsman’s office has never been staffed in a way that shows real commitment to honestly resolving cases.

A quick comparison with the Netherlands http://phsothetruestory.com/2014/08/08/compare-and-contrast-two-different-ombudsmen-services/ reveals that their Ombudsman service employs 70% of staff to carry out investigations and the vast majority are trained lawyers, whereas PHSO currently have only 30% of staff as investigators and none of them have either legal or clinical training.  The front-line staff at PHSO are being asked to take on 10x more cases this year to comply Dame Julie Mellor’s plan to ‘give more impact for more people’ by increasing the number of investigations.  The drive to improve ‘quantity’ has further impacted on the key issue of ‘quality’ with investigators required to take on up to 15 cases simultaneously.  Although PHSO have promised to address an investigation methodology which has been accepted by Mick Martin, Managing Director as ‘not fit for purpose’ this organisation moves at the pace of a three-toed sloth on sleeping tablets.

Only Churchill expects so few to do so much and the staffing levels and skill mix required for proper investigation must be urgently reviewed.  Currently PHSO have no option but to close down a large percentage of cases in order to prevent complete system breakdown. The Pressure Group put forward the idea of dividing the Ombudsman service into a designated Health Service Ombudsman for England in line with devolution.  This could then be staffed by experts in clinical care.  NHS England recently reported that complaints topped 3,000 per week http://www.which.co.uk/news/2013/08/nhs-england-complaints-top-3000-per-week-331968/ and Dame Julie Mellor has been promoting Ombudsman services across the media to encourage more people to come forward.  There can only be disappointment ahead as newcomers join a backlog of over 1,000 cases currently waiting in the system. PHSO cannot be trusted to put their own house in order.  Senior management appear to be caught in a torpor of indecision. Mr. Gordon must do more than consult with the usual suspects in order to carry out his review and the Pressure Group suggest that he would benefit greatly from discussing matters with representatives from the PSU staff union among others.

We are convinced that Mr. Letwin is set on reforming the Ombudsman landscape and in order to achieve this aim we urge him to discuss the way forward not with those who caused the problems but with those who have suffered from them.  The public. 

You can see the full summary presented by the PHSO Pressure Group to Mr. Letwin and Mr. Gordon here: http://phsothetruestory.com/2014/10/12/phso-pressure-group-go-to-the-cabinet-office/