The Parliamentary and Health Service Ombudsman (PHSO) has recently published its response to the review carried out by Baroness Fritchie into its handling of complaints that NHS service failure led to avoidable death. The PHSO has accepted all of the recommendations made by Baroness Fritchie.

The PHSO was established by Parliament to make the final decision on complaints about the NHS in England. Baroness Fritchie was asked to undertake a casework review of a sample of complaints to the PHSO about potentially avoidable deaths. The purpose was to review the general approach taken by the PHSO, the impact it had and how that impact might be improved or increased.

One of the significant changes being made is that, as of 1 February 2013, the PHSO will begin the consideration of any complaint about a potentially avoidable death with the presumption that it will be investigated. This comes in response to Baroness Fritchie’s conclusion that, whilst it was apparent that the PHSO were treating cases seriously and giving them ample consideration, its “approach of formal investigations being a last resort, and the internal processes it follows can have unintended consequences that may not always provide the maximum benefit to the complainant, or to the wider public”.

The PHSO has stated that this presumption will only apply to future complaints. It will not be re-opening any cases that have previously been considered.

NHS organisations should therefore expect an increase in the number of formal investigations by the PHSO following a complaint being made to it regarding a potentially avoidable death. The PHSO has previously indicated that, as a general principle, the complainant should give the organisation complained about the opportunity of formally responding to the complaint that will be brought. It is hoped that the PHSO will also continue to attempt to resolve complaints through direct contact with the organisation concerned before commencing a formal investigation.

The other points of note are that the PHSO is likely to be carrying out more interviews with the individuals and organisations involved as part of a formal investigation. It will also be looking at whether NHS bodies have followed national guidance on patient safety. Finally, the PHSO has obtained the power to share its health investigation reports more widely and will be looking into ways to use this new power to best effect.