Can a leopard change its spots?

Elizabeth and Jill attended the AvMA conference in Manchester on Tuesday on behalf of phsothefacts expecting to see Dame Julie Mellor,  give a progress report on improvements in complaint handling from PHSO.  Without warning or explanation she was replaced by Sally Sykes.  You can read their full report below.   Let us hope that Dame Julie still has the Health chat with Roy Lilley pencilled into her diary at the Kings Fund on 15th April as we have booked four front row seats.

sally sykes

Sally Sykes – PHSO

The Action against Medical Accidents Conference:

NHS Complaints – Putting Recommendations into Action.

24th March 2015, Manchester Piccadilly.

 Attended for PHSO the Facts by Jill Mizen and Elizabeth Gould

CAN A LEOPARD CHANGE ITS SPOTS?

 

When Sally Sykes Executive Director of External Affairs and Strategy at the PHSO sauntered in to the AvMA Conference in Manchester she was wearing a leopard-print coat.

Fitting attire for a representative of an organization that, despite its refrain of “Believe us, we’re changing for the better”, hasn’t changed at all. If you’ve ever engaged with the PHSO the tone would’ve been familiar.  Patronizing, disingenuous and mendacious; the nonsense dished up might have been last year’s leftovers.

The programme of the AvMA Conference had certainly changed. Dame Julie Mellor who had been billed to speak first was nowhere to be seen with no reason given. The running order had also changed as Ms Sykes arrived late and Chris Bostock, Complaints Policy Lead at the Department of Health stepped into the breach as the first speaker. He explained that the imminent Election means that discussion of the future has to be put on hold. His presentation therefore focussed on what had been achieved in NHS culture change since the Francis Inquiry.

The very good news for us is that Mr Bostock has invited PHSO the Facts to meet with him once the new administration has settled in – perhaps a month after the Election. Whilst his focus is policy relating to NHS complaints, we left him in no doubt that we considered the PHSO as not fit for purpose.

Next up Ms Sykes herself and all the usual platitudes. You’ll be pleased to know that:

“We are changing, and are interested in and listening to feedback”

“We want complaints to make a difference and help to improve public services for everyone” 

“We are leading improvements to the complaints handling system”.

Ms Sykes last presentation slide read “Thank you for listening” and “Any Questions?”  We held back.  Why provide a platform for Ms Sykes to deliver more PHSO PR spin?

The rest of the Programme involved speakers from the NHS and the private and the voluntary sector. All the presentations were thoughtful and interesting.

The Head of Complaints, PALS and Legal Services at Pennine Acute Hospitals NHS Trust, John Culshaw, described a complaints management system that, if it delivers what it claims, is a model of good practice. If there is anyone out there who currently has a complaint being handled by that Trust it would be good to hear if their practice does what it says on the tin.

The Chief Executive of Patient Opinion, James Munro, described the power of social media in bringing patients and providers together to share and act on patient feedback. If 104 year old Ivy Bean could use Twitter to compliment the staff in her Care Home, then none of us can plead that the technology is beyond us. But as Dr Munro recognized such communications are not a substitute for a formal complaints system; they are a complement.

We heard from a Patient Service and Experience Lead in an NHS Commissioning Support Unit, and speakers from the Care Quality Commission, the Patients Association, Verita Consultancy, and the AvMA.

Finally we heard from Julie Bailey founder of Cure the NHS who successfully campaigned for a Public Inquiry into the failings at Mid Staffs. Calm and dignified, her moving presentation documented “The Torture of the NHS Complaints procedure”.

It is difficult to believe that someone could have been so personally vilified in bringing the Mid Staffs failings to the public attention. Difficult to believe unless, like many of us in PHSO the Facts, you too have met walls of denial, defensiveness and delay; you too have been smeared; and you too have been accused of being vexatious, obsessive and intransigent.  We felt it was a privilege and an inspiration to hear Julie Bailey speak.

Like us Julie said that she was unconvinced that the PHSO were changing. And where was Ms Sykes to hear this? Long gone, back to London no doubt for more radio interviews, more gushing assurances about the PHSO as a listening organization. They may be listening but they are certainly not hearing us.

And as for the leopard and its spots?

Well the spots are essential to camouflage a stalking leopard. That’s not something that’s changing anytime soon.…and neither is the PHSO.

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/