A call by a committee of MPs for the role of the Health Service Ombudsman to be reformed has been labelled ‘redundant’ by the ombudsman herself.
The health select committee says that the role, currently held by Ann Abraham, needs a ‘complete overhaul’ if it is to be an effective part of the NHS complaints system.
However, the recommendation that the ombudsman’s role should be widened so that she can launch investigations independently is based on a ‘misunderstanding’, an ombudsman spokeswoman has said.
In a report published today, the committee concludes that, under the present system, the ombudsman can only launch an investigation if she is satisfied in advance that there will be a ‘worthwhile outcome’.
The report, Complaints and lititgation, says the existing two-stage system aims to resolve complaints at the local level, with the NHS organisation being complained about investigating first.
Only if this is not successful does this go to the second stage of independent investigation by the ombudsman, whose powers should be extended to match the patient perception of it as a ‘general appeals process’.
Committee chair Stephen Dorrell said: ‘Patients should be able to seek an independent review of the findings of internal reviews by care providers. The terms of reference under which the ombudsman works prevent her from properly fulfilling this role.’
However, a spokesman for the ombudsman said this recommendation was ‘redundant’ as there already is the authority to review any complaint referred by a complainant following an initial rejection. ‘We have informed the committee of this error and hope that they will take steps to address the inaccuracy.’
The report also finds that there is an ‘unacceptably wide variation’ in how complaints procedures operate within the NHS.
The ombudsman called for the establishment of clear national guidelines for the handling of NHS complaints as long ago as 2005, but the MPs said regulations governing complaints remain inadequate.
Specifically, the reporting of complaints by foundation trusts is voluntary, and the committee said that it ‘remains unclear’ how patient complaints over primary care will be handled following passage of the Health & Social Care Bill and the abolition of primary care trusts.
Dorrell said all providers of NHS care should in the future owe ‘a duty of candour’, under which they provide timely reports to commissioners of all complaints made to them by NHS patients.
‘In cases when complaints are upheld, Complaints Action Plans should address the weaknesses which have been revealed, and progress reports of the actions required,’ he said.
Dorrell added: ‘We believe the most fundamental change which is required is a change of culture within the service. We look to both the NHS National Commissioning Board and HealthWatch England to monitor progress in delivering this fundamental change in the direction of a less defensive and more open culture.’
A Department of Health spokesman said that its NHS reforms would ‘put patients at the heart of our health service’ following the changes announced earlier this month.
He said: ‘Under the plans, patients will have a stronger voice and the NHS will be more accountable for the quality of care it provides for patients. In addition, local HealthWatch will champion the views and experiences of patients, helping to drive improvements in the quality of health and social care services.’
The committee also examined litigation in the NHS, finding that the existing clinical negligence framework offers patients the best opportunity possible to establish the facts of their case, apportion responsibility for errors, and provide compensation.
It does not support a switch to no-fault compensation, which had been backed by the British Medical Association as a non-adversarial litigation method, and is planned for introduction in Scotland.
