My name is Della Reynolds and in 2012 I submitted a complaint about Ofqual to the Parliamentary and Health Service Ombudsman. I had survived a two year battle through the first tier complaint process and was relieved to find that the Ombudsman was ‘independent’, ‘impartial’ and able to ‘put things right’. With hope of final resolution I passed over a fat file of evidence to my MP in September of that year. Just a month later I received the outcome of my assessment and was surprised to discover that the assessor could find no evidence of maladministration on the part of Ofqual and would therefore not recommend my case for full investigation.
I knew my case inside and out by that stage and knew that hard evidence had been ignored in order to come to this conclusion. This was confirmed just a month later when in November 2012 I received advice from a barrister who stated that OCR had breached the NVQ Code of Practice 2006 in three key respects. The NVQ Code of Practice is a statutory policy and Ofqual, as regulators, are charged with ensuring that OCR comply with this legislation. So how did my assessor miss the evidence so clearly identified by the barrister?
As the snow fell outside my window in the run up to Christmas, I sat at the dining room table and carefully composed a review request which ran to more than 5,000 words. I was now able to focus on the three key issues identified by the barrister and highlighted all references made to these in my original documentation to PHSO. There were a large number of direct quotes from the statutory policies and direct quotes from staff members at both Ofqual and OCR outlining their responsibilities, all confirming that breaches had been overlooked. I supported my case with direct quotes from the barrister’s advice; an expert witness and sent off my review request just within the three month time period in January 2013.
Amazingly, I received a letter from PHSO stating that despite my detailed review request they were unclear as to the nature of my complaint and asked if I could provide more information. This is quite likely a standard delay tactic on the basis that a percentage of people will finally throw in the towel at this point and give up. I took a deep breath and compiled yet another letter to confirm that my original assessment did not follow the PHSO’s 6 principles of good complaint handling and my assessor did not make evidence based decisions.
Following this further correspondence my case was passed to the review team for ‘a closer look’. It took them until early March to come up with their decision. Perhaps they were waiting for a new supply of whitewash for it was obvious that it hadn’t taken them two minutes to determine that all my evidence was just ‘subjective opinion’ and there was no reason to doubt the original assessment. The reviewer had no qualms in dismissing the opinion of the barrister, although he had no legal training himself. He had given me the standard phone call a few days before I received this review decision. Clearly it was all done and dusted by this time, but a box ticking exercise dressed up as public consultation required them to make a phone call to ensure that they had all the facts rights. I used the number he left on my answer phone to call him directly and ask him to explain how policy statements and expert opinion could be determined ‘subjective’. I could hear him backing away from the phone. Sounding as though he had just crammed a custard cream in his mouth, he told me to call customer services and to put an end to any further discussion he hung up.
My call to customer services revealed that they could not talk in any detail about my case as they were not party to it (convenient) but essentially my case was closed, there would be no further contact and my only option was to take out a judicial review. After some internet searching I discovered that my odds of winning a judicial review were infinitesimally small, so decided to save my time and money and channel my burning frustration and sense of injustice in another direction. I wrote the PHSO reviewer a scathing letter with mention of Winston Smith and the Ministry of Truth and closed with a threat of starting up a campaign. How that must have made him smile.
It was obvious that the whitewash I had received was standard practice for PHSO and there had to be others who had suffered in the same way. Possibly many others. In order to find them I opened a twitter account @phsothefacts https://twitter.com/phsothefacts and a facebook page https://www.facebook.com/ParliamentaryOmbudsmanCampaign and with no idea of how these two things to spoke to each other, I signed up for a social media course at my local adult education centre. I knew that social media was a powerful weapon and with the right knowledge I could use it as the slingshot which might bring down this particular Goliath. The course was a real eye-opener and with a bit of tweaking my facebook page started to gather likes and my twitter account started to gather followers. The campaign had begun.
On twitter I had used #NHS and found many angry campaigners with a great deal to say. With #PHSO I found nothing. Equally there were a large number of websites devoted to personal stories of NHS failure or rallying calls to the troops, but a PHSO google search revealed nothing but the LGO Watch site, dedicated to highlighting the corruption of the local government ombudsman. I read this site with great interest and found the parallels most illuminating. http://www.ombudsmanwatch.org/ Inspired by LGO Watch and realising that no-one had done a similar service for PHSO, I spent that summer (2013) putting together the phsothefacts website, without a single clue as to what I was doing. Thank goodness for Youtube and WordPress, who together held my hand through the hours of trial and error button pushing. By the end of September I was ready to launch and opened to 29 hits, mostly my own.
A few days later on 22nd September my team and I turned up to speak at Hyde Park Corner at an NHS rally organised by a group of campaigners on twitter. It felt as though things were starting to take off, as I prepared my banners and dusted off my soapbox. Fortunately, there was not too much heckling from what is known to be a rather hostile audience at Hyde Park Corner, who attend this venue in much the same way as the Romans attended an amphitheatre. I guess they were all a bit bemused by my delivery which totally failed to mention God or aliens. They may also have been confused by the fact that the phsothefacts team, (my husband, my sister and my sister’s partner) were all sporting pink earmuffs to represent ‘not being heard’.
In all this time I had been writing to every man and his dog and getting the kind of replies you only get from the dog. MPs, if they bothered to reply at all, hid behind ‘parliamentary protocol’ and couldn’t possibly get involved for fear of treading on the toes of my own MP. Although I informed them that I was pretty certain that he wouldn’t be unduly bothered, well he certainly gave me that impression, they could not possibly go against such strict guidelines and went off to enjoy their steamed roly-poly in the commons dinning room with a clear conscience.
Many of my letters were sent to the long suffering MPs who sat on the Public Administration Select Committee, (PASC) now named PACAC. They had not heeded the obvious rule to avoid all connection with public sector complaints and were regularly in receipt of a large number of angry letters from disappointed PHSO customers, mine among them. Julie Bailey had kicked up a huge stink over the poor NHS care and complaint handling at Mid. Staffordshire and possibly to dismiss the lingering smell of scandal, PASC decided to hold an inquiry into complaint handling entitled ‘Complaints: do they make a difference?’ I duly submitted my evidence and was glad to have an outlet for my still simmering wrath. You can see all the written submissions here: http://www.publications.parliament.uk/pa/cm201314/cmselect/cmpubadm/writev/229/complaints.pdf
In October 2013 the Rt. Hon Oliver Letwin gave evidence to PASC as part of this inquiry. You can see a video of this meeting here. http://www.parliamentlive.tv/main/Player.aspx?meetingId=13946 and on the same day he was heralded in the press as the ‘Complainers Champion’ when he announced two reviews into the way public sector complaints were handled, which were to be launched in January 2014. http://www.bbc.co.uk/news/uk-politics-24548731
He vowed to create, for “the first time in history,” a system in which complaints are treated as “a huge potential mine of information on service delivery”, adding: “I am intending to drive that forward myself.”
Unexpectedly, a buff envelope arrived from the House of Commons inviting me to give oral evidence to the PASC committee as part of their on-going inquiry. I went to represent the phsothefacts website which was still in its infancy and duly had some business cards made up (which I forgot to take). On 26th November 2013, twelve total strangers from across the country gathered around the horseshoe table in the commons meeting room, to give evidence of poor PHSO complaint handling directly to members of the PASC committee. As we each told our story there was much nodding of heads as we realised that we had all been delivered the same standard closure service, regardless of the nature of our cases or the strength of our evidence. When mention was made of the head of the review team, who deals the final blow to persistent complainants, an audible sigh of recognition resonated from our side of the room.
When the bell rang (like a public school) the meeting was called to a halt and the participants filed out to meet up again in the cafe on the ground floor. We exchanged phone numbers and email addresses and while we listened with sympathy to each other’s stories we were joined by Lindsay Roy, an MP who sits on the committee. He congratulated us on our calm presentation and suggested that we form a pressure group. There was instant agreement among us that this would be a sensible plan and as I already had the facebook page, twitter account and website, I offered to be the coordinator. We agreed there and then on our two aims and have never deviated from them.
To improve the service for all those who follow, so that each receives a fair and unbiased investigation, remedy and closure.
To compel the Ombudsman to thoroughly investigate historic cases where there has been no satisfactory resolution.
For a new group, we hit the ground running. Mr Greg Mulholland, Lib Dem MP on the PASC committee had shown an interest in seeing written evidence from our group in support of our verbal claims. We got straight to work and evidence files buzzed through our email accounts to eventually find their way into a annotated folder of collective complaint handling chaos. As Oliver Letwin had also shown an interest in the ‘huge potential mine of information on service delivery’ we prepared a file for him as well. I doubt that he expected to receive quite so much information quite so quickly because we didn’t hear a peep out of him. Both of these files were personally handed in by Pressure Group members at the next PASC meeting which was on the 10th December 2013 when the regional Ombudsmen gave evidence to PASC. http://www.parliamentlive.tv/Main/Player.aspx?meetingId=144
A number of us met up again a few days later for the pre-christmas meeting between the Ombudsman, Dame Julie Mellor and PASC. This is an annual scrutiny event, but I do believe the large audience sitting (without earmuffs) in the public seats to observe, gave a certain nuance to this particular occasion. Just like a panto, there was an element of audience participation as we nodded in agreement with tough questions from the committee and shook our heads in disbelief to the replies from the Dame. We stopped short of calling out ‘Oh no you didn’t’ but our body language spoke a thousand words. http://www.parliamentlive.tv/Main/Player.aspx?meetingId=14478
In order to achieve fresh reviews of our historic cases we needed to apply pressure directly to PHSO. However, improvements to the service as a whole required changes to legislation to remove the total discretion currently enjoyed by the Ombudsman and to deliver effective accountability. So in January we got ourselves organised to lobby parliament on the basis that only MPs can pass the legislation required to improve the Ombudsman service. We sent out a mailshot to all 650 MPs. Not an easy venture, downloading all those email addresses. We took a section of the alphabet each and coordinated our timing to send them out over the same two days. For all our efforts we got not a single response; such is the way with mail shots.
We then moved from scatter gun to sniper bullet and targeted individual MPs who looked as though they might be receptive to our cause. On the 5th February we received a reply from Michael Meacher MP who simply asked, ‘What can I do to help you?’ After many years of fruitless letter writing as individuals, the door to parliament had finally swung open. We asked if Mr.Meacher could arrange a meeting for us with Mr. Letwin as we still had no response to our file of submitted complaint evidence and we wanted to contribute to his inquiry into complaint handling. Mr. Meacher, good as his word, promptly wrote Mr. Letwin a letter to that effect.
In the meantime, through more persistent letter writing, one of our group had managed to secure a meeting with Dame Julie Mellor at Millbank tower for the 6th February. Although this meeting was primarily to discuss her case, she invited me to attend to represent the PHSO Pressure Group. I happily agreed. Individually, we had experienced nothing but a closed door from PHSO. No matter what we sent them they were ‘not hearing us’ so it was a great opportunity to ask them directly if they would review our historic cases. The reality is that these cases only became historic because of the neglect to deal with them effectively in the first place. Once our cases were closed we were all supposed to go away and lick our wounds, but some of us just kept coming back, year after year after year. (Will Powell, James Titcombe, Julie Bailey are notable examples – there are many other unsung heroes doing the same.)
At the meeting in Millbank Tower I found the atmosphere to be cold and defensive. The staff sat on one side of the table and we sat on the other. Between us was an impenetrable wall of defensiveness. This was bolstered by graphs, data and statistics which were used by Dame Julie to prove that all the problems were in the past, things were different now and that PHSO would quell all complaints with their new business initiative, ‘ More impact for more people’, which promised to investigate far more cases in the future. There was plenty of jam for tomorrow, but on the issue of historic cases a line was firmly drawn in the sand by Ms Mellor who stated that PHSO simply didn’t have the resources to look into historic cases. The physical door may have been opened, but the psychological one was still firmly shut. We had been listened to, but not heard.
At this meeting I requested a seminar for members of the Pressure Group, in the style of the ‘listening events’ put on by CQC following the scandals of Mid. Staffordshire and Morecambe Bay. Our request was to be considered, but I didn’t hold out much hope as I left their office that day. Surprisingly, a short time after we were informed that PHSO agreed to hold a listening event and a date of 10th April was initially made.
It was at the AvMA conference on 20th March that we first heard the name Robert Gordon. Mr. Gordon was writing a report concerning complaint handling and the Ombudsman landscape. I circled his name on my crib sheet at the time, but we were unable to locate any direct contact details for him, so no immediate follow up.
Then in April 2014 we had another Westminster breakthrough when Rosie Cooper MP agreed to meet with us in the House of Commons.
It was clear that she had heard all the appalling stories of poor NHS complaint handling compounded by collusion from PHSO. She nodded in agreement as we sat with her on the sofa in the commons ‘family room’ and it was obvious that we were pushing against an open door. As Ms. Cooper is a member of the Health Select Committee she has a direct role in holding the Ombudsman to account when Ms. Mellor and her team come before the HSC for questioning. In the months since we had formed we had collectively written a full report listing the flaws of the PHSO processes and putting forward possible solutions. This was a major piece of work undertaken and delivered by dedicated pressure group members. http://phsothetruestory.com/report-into-reform-of-the-ombudsman/ We sent Ms. Cooper a link to our full report (as above) and handed her a hard copy of our summary report which contained the key points. She asked us what we would like her to do to help promote our cause and once again we asked for a meeting with Mr. Letwin as none had been forthcoming. As complainer’s champion and the key driver in reform he was clearly the man we needed to speak to. Ms. Cooper agreed to pass on our request and a copy of our report directly to Mr.Letwin.
After a number of false starts with changes in dates and venues, we eventually met with the senior staff at PHSO for our seminar on 26th June 2014. Twenty representatives from the group attended the meeting in London and we each took three questions to which we hoped PHSO would supply answers. It was a very emotional meeting as people re-lived their original trauma with the added pain of continued injustice. You can read more about the seminar here http://phsothefacts.com/phso-seminar-we-talked-they-listened-what-next/
We had no idea when we left if our request for historic case review would be accepted. Mick Martin the new Managing Director spoke convincingly at the end of the meeting about doing all he could to put things right. We all waited for the outcome and over the next few months we were contacted individually by senior staff members and it emerged that PHSO were prepared to re-examine our cases in order to learn the lessons as part of their ‘modernisation’ programme. This was a major breakthrough for our group and one which will hopefully bring closure to many grieving families who have had a long fight for acknowledgement and justice.
We were growing in strength as a group, with new members joining and increased attention for the phsothefacts website which has now received over 26,000 hits. By coming together we had found a voice loud enough to be heard.
Meanwhile wheels within wheels were moving in Parliament and Mr. Meacher secured a meeting for us with Mr. Letwin at the Cabinet Office, for the 24th July 2014. We are extremely grateful to both Mr. Meacher and Ms. Cooper for smoothing the way and after seven months of waiting we were able to speak directly to the man who will draft the new legislation. Mr. Gary Powell from LGO Watch was invited to attend and give evidence gathered over a decade regarding the appalling state of the Local Government Ombudsman. Dr. Richard Taylor from the National Health Action Party was invited to put forward ideas for reforming the NHS complaint system. As both a doctor and previous MP he knew the failings of this system from both sides. I attended to represent the Pressure Group and put forward our ideas for reform of PHSO. We had only 30 minutes in total so focused on two key questions each. My first question was whether Mr. Letwin would agree to a further meeting with campaign groups and charities who have a wealth of knowledge to add to his inquiry. He agreed without hesitation. It certainly did appear to all present, that Mr. Letwin was keen to learn more about possible solutions to improve complaint handling across government. http://phsothefacts.com/can-oliver-letwin-redeem-himself-as-the-complainers-champion/
On 7th October we met again with Mr. Letwin and also the elusive Mr.Robert Gordon. Mr. Powell once again represented the views of users of the Local Government Ombudsman service, Ms. Katherine Murphy CEO of the Patients Association represented NHS complaint handling issues and I represented the Pressure Group and reform of the PHSO. Unfortunately, by this time Mr. Gordon had almost completed his inquiry and was due to finalise his report. We are hopeful that he took on board the comments made at this meeting and the links to key evidence sent in follow up correspondence. http://phsothefacts.com/can-oliver-letwin-deliver-an-ombudsman-service-fit-for-the-21st-century/ We will be monitoring his report closely once it is released and hope to see some of the points raised addressed within his recommendations.
From our coffee shop beginnings,in less than a year, a group of ordinary people, unfairly shut out in the cold, had managed to find a way into the heart of government. Collective power has untold strength, but in order to harness it you must remain united and focused on clear, attainable goals. Through the PHSO seminar we have achieved our aim to have historic cases re-examined and through our contact with MPs we are now directly contributing to the Cabinet Office inquiry into complaint handling and the role of the Ombudsman.
Following our first anniversary, we are aware that talking is good, but action is better. We await with interest the Cabinet Office recommendations for reform of the Ombudsman. Putting new legislation in place is a lengthy process and we aim to be directly involved at all stages. History has shown that previous administrations have side-stepped this issue and failed to provide time to debate the creation of a true ‘People’s Ombudsman’. Hopefully, with some encouragement from the Pressure Group, those in office will be in no doubt that in election year, 2015, the time has come to deliver an Ombudsman service which protects the people and not the perpetrators.
3.10.15 – Update:
With the election behind us and a Conservative majority, we are dealing with the same administration as before and Mr. Oliver Letwin is still in charge of making due progress towards the new Draft Ombudsman Bill. We managed to secure a meeting with Jeremy Hunt in December 2014 alongside James Titcombe, Katherine Murphy, Richard Taylor, Bernard Jenkin and others. The essence of this meeting was to find a way to improve complaint handling in the NHS and therefore ensure that patient safety issues were correctly identified and remedied. We put forward the proposal to bring back second tier complaint handling with local tribunals and therefore reduce the number of complaints going to the Ombudsman. This would also serve to close the regulatory gap. You can read our submission here: https://www.dropbox.com/s/j13r8d1c4v9g62g/Jeremy%20Hunt%20meeting%2010.12..doc?dl=0
Mr. Jenkin, chair of PASC had already decided to put forward the idea of an Independent Patient Safety Investigation Services (IPSIS) which would use the same methods as the aviation industry to analysis incidents in depth to find the root cause and provide improvements in patient safety. He began his review early in the new year and their report was released in March 2015. http://www.publications.parliament.uk/pa/cm201415/cmselect/cmpubadm/886/88602.htm
Much to the hard work of Mr. Jenkin and PASC this body is now in existence and beginning to form a coherent structure with the help of campaigners on the advisory panel. A massive step forward for the people’s voice.
In November 2014 the Patients Association released a damning report into the PHSO investigation process called ‘The Peoples Ombudsman – How it failed us’.
The case stories presented here mirrored our own experience. Reluctance on the part of PHSO to examine the whole complaint, unnecessary delay, an inability to get the facts right and flawed investigation reports which failed to hold NHS bodies to account. In March 2015 this was followed by a further report summarising the difficulties registered by hundreds of complainants to the Patients Association regarding their experiences at PHSO. ‘PHSO – Labyrinth of Bureaucracy’ confirmed that 66% of complainants found;
Final report factually incorrect, inconsistent or substandard level of investigation (weak justification for the PHSO decision); Queries about the investigator’s competency
On the back of these reports the Patients Association confirmed that PHSO was not fit for purpose and stopped recommending complainants to submit their cases for investigation.
In the days and weeks after the report was released we were inundated by calls, emails and letters
from patients, families and representatives and to date we have been contacted by over 200 people.
They are all at different stages of the process, some completing the initial paperwork, some left only
with an option to apply for a judicial review. All of them agreed with our report and all of them
described their experiences of the PHSO as being negative.
In response to public criticism PHSO invited critics of the Ombudsman to contribute to a new Service Charter. A set of promises which would set out realistic expectations of what the Ombudsman can achieve. The process started in December 2014 and I sat on the service users panel alongside other complainants and members of the Pressure Group. Unfortunately, this process has been hampered by delays and we are still waiting for a draft service charter to be presented. This service charter has obviously caused some difficulties for PHSO as staff who simultaneously took on 10x more complaint investigations with no extra resources and no specific training for front line staff. https://www.whatdotheyknow.com/request/money_spent_on_training_front_li#comment-58219
There have been other meetings many of which are recorded on the ‘News’ page here: http://phsothefacts.com/news/
All well meaning talking shops, but too often the voice of the service user is not heard. There is still a gulf between the professional complaint handlers who have the notion that good complaint handling is the speedy ‘disposal’ of grievances and those who see complaints as a personal trauma without end. This gulf needs to close and we need to be in the same room if we are to achieve that.
On that note I am pleased to confirm that Mr. Oliver Letwin has confirmed that he is happy to meet with us and other campaigners to discuss the new Public Service Ombudsman draft legislation; meeting date to be confirmed.
The PHSO Pressure Group goes from strength to strength. Our plan to submit complaints of Misconduct in Public Office to the Met Police has encouraged new people to come forward, desperate and frustrated by the service they have received. http://phsothefacts.com/misconduct-in-public-office/
For more information read Q & A on the Pressure Group blog. phso-the true story.