MPs criticise NHS ombudsman for not investigating ‘less serious’ complaints

MPs have criticised the Parliamentary and Health Service Ombudsman (PHSO) over the handling of patient complaints and branded the Government’s refusal to reform processes “unacceptable”.

The Public Administration and Constitutional Affairs Committee raised concerns over the continuation of a PHSO policy to halt investigations into the majority of complaints deemed “less serious”, which was initially introduced to reduce a backlog of cases caused by the Covid-19 pandemic.

In a report published on Friday, the committee said the approach by the PHSO, a post held by Rob Behrens since 2017, was not an “appropriate long-term solution”.

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Public Administration and Constitutional Affairs Committee chair William Wragg called on the Government to bring forward reform of the PHSO (Chris McAndrew/UK Parliament/PA)

The committee said it was disappointed the policy had not been fully reversed, despite the backlog being reduced, and criticised the absence of plans to cope with the ongoing impact of a high level of Covid-19 cases in the PHSO’s corporate strategy.

Less serious complaints are categorised by the ombudsman as either “level 1” or “level 2” cases.

The PHSO said level 1 cases “typically arise when what has gone wrong has had a relatively low impact on the person affected”.

Level two complaints relate to when a GP administered injections to a complainant in their feet rather than their arm and this did not make their condition worse but did delay appropriate treatment.

“Where we are unable to determine the severity level, we continue to progress cases so that we do not disadvantage a complainant in a vulnerable situation,” the PHSO said.

In the 18 months to November 2022, around 1,700 complaints were assessed as being in these categories, with the PHSO saying resolution was achieved in 114 cases.

“This indicates that a large number of cases are not being considered at all”, the report said.

Responding to the report, a PHSO spokesperson said: “The changes we made to the way we handle complaints about the NHS mean we are making good progress reducing the queue of people waiting for us to look at their case.

“Since making these changes, we have continued to look at all complaints that are brought to us, and if a complaint can be resolved quickly, we will do so.

“This proactive approach continues to be necessary to focus our resources on the complaints that raise the most serious issues. We will keep this process under review.”

The committee also noted evidence of public dissatisfaction with the way the ombudsman handled complaints.

Concerns raised included lengthy investigations sometimes lasting several years, poor communication and the complexity of the complaint review process.

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Targets for completing investigations following complaints about the health service had been missed, the committee found (Peter Byrne/PA)

The committee also highlighted a failure of the PHSO to meet its targets on the timeframe for all investigations to be completed.

The ombudsman considered 36,000 complaints in 2021/22 following a brief pause on health-related cases at the height of the pandemic.

This was a 24% increase on pre-pandemic levels, driven by 120,000 enquiries.

During that year, 81% of cases following further investigation were closed within 52 weeks, significantly lower than the PHSO’s target of 95%.

Half of cases following further investigation were closed within 26 weeks, despite a 75% target, and 32% closed within 13 weeks against a target of 50%.

The committee welcomed the PHSO’s bid to raise awareness of its service, which involves examining complaints that have not been resolved by a Government department, the NHS or another public body.

But the committee said the strategy did not explain how the organisation would respond to a potential increase in demand.

Committee chair William Wragg said: “When individuals are failed by a public service, they deserve the right for their complaint to be heard and any injustice redressed.

“While it is positive that the PHSO’s backlog of cases has been brought down substantially this year, we are disappointed that its policy of not investigating health complaints deemed as less serious will continue for at least another year.

“We have asked the PHSO to provide its evidence base for continuing this approach.”

The committee repeated its call for the Government to bring forward reform of ombudsman law first drafted seven years ago, adding there was “general consensus” on the need to reduce complexity and bring statutory frameworks in line with international best practice.

Mr Wragg added: “Yet again, we are calling on the Government to bring forward the long-awaited reform of the ombudsman and bring the UK in line with international standards.

“This committee and its predecessors have made this recommendation for two decades. It is unacceptable the Government has not addressed this sooner.”