In December, the Health Service Ombudsman published her policy on publishing information about NHS complaints entitled Sharing and publishing information about NHS complaints: the policy and practice of the NHS Ombudsman for England. The policy acknowledges that the Ombudsman is subject to significant legislative constraints in relation to sharing and publishing information about complaints. The policy goes on to stress that despite those restrictions, the Ombudsman takes the view that one of the most effective ways of sharing the learning from complaints is to put the information about complaints made to her about the NHS in the public domain and plans to complement the information made available by NHS bodies by laying before Parliament several reports on her work on considering NHS complaints including:
- listening and learning, an annual report which will set out the numbers and types of complaints the Ombudsman receives about NHS bodies, the numbers and types of complaints investigated and their outcomes (the first report was published in October 2010);
- anonymised digests of case summaries;
- reports to raise awareness of particular issues that arise during her investigations;
- if necessary, a special report on an individual case where the Ombudsman has found injustice or hardship as a consequence of service failure;
When the Ombudsman investigates a complaint she is required to send the report to:
- the complainant;
- the NHS body complained about;
- the individual who took/authorised the action complained of;
- the NHS body who provided the service; and
- the Secretary of State for health.
As the accountability framework includes the commissioning bodies and strategic health authorities, she will also share the reports with those organisations. This will apply whether or not the complaint was upheld.
When the Ombudsman decides not to investigate a complaint, she must send a statement of her reasons to the complainant but is not permitted to send a statement of reasons to anyone else, unless an NHS body has provided information to assist her in assessing the complaint or where the Ombudsman has made enquiries of the NHS body to ask them to provide a resolution to the complaint. In those circumstances, the Ombudsman may notify the body of her decision not to investigate and pass on general learning points but does not share with that body a copy of the statement of reasons.
The Ombudsman has made proposals to amend the legislation to remove the constraints on disclosure with a view to ensuring that NHS bodies can share the learning that inevitably emerges from many of these investigations.
In addition, the Ombudsman plans to introduce tailored summaries of the key learning points that have arisen from the assessment of complaints. This will be piloted for 12 months with the top 50 NHS bodies by volume of complaints received.
If, during the course of her casework, the Ombudsman obtains information about an individual that leads her to conclude that that person is a threat to the health and safety of patients, she will use her powers to disclose information to whoever she thinks appropriate in the interest of the health and safety of patients.
Where the Ombudsman has obtained assistance from the Care Quality Commission or Monitor to investigate a complaint, she will alert those bodies to the recommendations she has made in order to ensure that those recommendations are properly followed up by the regulators in their inspections and monitoring programmes where she has found service failure and/or maladministration that extends beyond those individual cases she is investigating.