NHS HDL(2000)14



Health Department



Dear Colleague

SCOTTISH HEALTH SERVICE OMBUDSMAN ANNUAL REPORT 1999-2000

Summary

1. This letter covers the report of the Scottish Health Service Ombudsman's investigations completed during 1999-2000. The report should be distributed widely and used by all Health Boards and NHS Trusts to review performance and take remedial action as required.

Action

2. This is the first year that the Health Service Commissioner (Ombudsman) has published separate reports for England, Scotland and Wales. Enclosed is the Scottish Health Service Ombudsman Annual Report which includes summaries of the 12 completed investigation reports.

3. Board General Managers and Trust Chief Executives are asked to note the contents and:

3.1 circulate the report as widely as possible; particularly drawing it to the attention of staff involved in the administration of the NHS complaints procedure;

3.2 check performance against the findings in the report and provide a note of action taken to improve procedures as a consequence of the failings which the Ombudsman has highlighted. This information will be used by the Chief Executive in the event of him being called before a Committee of the Scottish Parliament. These should be sent to Moira Milligen, Health Gain Division, Room 152, St Andrew's House, Edinburgh, EH1 3DG by Friday 27 October 2000.

3.3 the Health Service Commissioner's reports are available on the Internet - www.ombudsman.org.uk.

 



4th October 2000
_____________________________________

Addressees

For action
Chief Executives, NHS Trusts
General Managers, Health Boards
General Manager, State Hospitals
Board for Scotland
Chief Executive, Scottish Ambulance
Service
General Manager, CSA
Complaints Officers, Health Boards
and NHS Trusts

For information

Chief Executive, Health Education
Board for Scotland
Chief Executive, Clinical Standards
Board for Scotland
Executive Director, Scottish Council
for Postgraduate Medical and Dental
Education
Director, Health Technology Board
for Scotland
Director Scottish Association of
Health Councils
Chief Officers, Local Health Councils

______________________________

Enquiries to:

Mrs Moira Milligen
Health Gain Division
Room 152
St Andrew's House
EDINBURGH EH1 3DG
Tel: 0131-244 1773
Fax: 0131-244 2372
E-mail:
moira.milligen@scotland.gsi.gov.uk

______________________________

4. The attached Annex brings to your attention issues which the Ombudsman thought of particular importance.

Yours sincerely

 

HECTOR MACKENZIE
Head of Health Gain Division


ANNEX

ISSUES ARISING FROM THE SCOTTISH HEALTH SERVICE OMBUDSMAN'S
REPORT

1. During 1999-00 the Health Service Ombudsman's office in Scotland received 215 complaints
against NHS bodies and practitioners in Scotland, with 18 accepted for investigation and 12 completed investigation reports. 72% of the complaints investigated were concerned with matters of clinical judgement.

2. Two matters which the Ombudsman wished to draw particular attention to arising from this year's investigations concerned treatment by general dental practitioners and communications between NHS staff. Three complaints were investigated concerning dissatisfaction with the adequacy of the treatment received from their dentists. Only one complaint was upheld.

3. The Ombudsman believes that problems with communication are central to many of the complaints put to his Office. Good communication is an essential part of good clinical treatment. He feels that effective communications often feature some or all of the following:

  • clinical notes written for the purpose of communication between professionals and with patients and carers;

  • patients and carers are listened to;

  • staff provide information in terms which patients and carers can understand, and confirm that they understand what has been said;

  • difficult issues are tackled;

  • mutually respectful and co-operative communications between professionals.

4. While the Ombudsman sees evidence of NHS bodies handling complaints well, several cases were dealt with in which a Health Board or Trust acted contrary to the complaints guidance or a complainer's request for an independent review panel was mishandled. For example, there were failures of staff to recognise the matter as a complaint, delays in taking action, and extended periods of time between an independent review panel request and the panel's actual meeting.

5. The Ombudsman is aware of the concern of many that conveners are often not seen as impartial and that this is an emerging theme from the work of the evaluation team studying the NHS complaints procedure. He believes that there are some practices that help secure the confidence of complainers and those complained about. These include seeing that conveners:

  • are well trained and well supported (at an appropriate distance) by Health Boards and Trusts;

  • are completely familiar with the directions and guidance;

  • seek appropriate clinical advice;

  • seek advice from a lay chair promptly;

  • refrain from investigation of the complaint at convening stage;

  • address all issues raised by the complainant;

  • give full reasons for refusing a request to convene an independent review;

  • understand that the parties to the complaint may not see the convener as being impartial and conduct themselves accordingly.

6. . The Ombudsman believes it is important that the public know of the recommendations he makes and of their implementation. The Ombudsman's staff make recommendations in order to reduce the risk that a shortcoming or failure will be repeated, whether or not an investigation takes place. In eight cases this year organisations agreed to take further action to resolve complaints without the need for an investigation, and in a further seven cases, advice was given without an investigation.

7. The current legislation under which the public sector Ombudsmen work is inflexible and can put unnecessary difficulties in the way of people who want to complain about more than one area of public service. This can lead to members of the public having to put a complaint to more than one Ombudsman about the same problem.

8. A review recently carried out in England recommended that a new Commission should be set up, combining the three main public sector Ombudsmen schemes in England - Parliamentary, Health Service and Local Government. A similar review is now taking place in Scotland and the Ombudsman awaits the outcome with interest.