Working with Advocacy Services for the benefit of the public
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The document discusses opportunities for advocacy services and the Parliamentary and Health Service Ombudsman to work together for public benefit. It notes an unmet need for advocacy support, as 30,000 cases come to the Ombudsman each year but 24,000 people need help making and responding to complaints locally. The Ombudsman aims to support people who bring complaints, share insights from complaints to improve services, and collaborate with advocacy services to strengthen local complaint handling.
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Working with Advocacy Services for the benefit of the public
- 1. Working with advocacy services for the benefit of the public Dame Julie Mellor, Parliamentary and Health Service Ombudsman Thursday 8 October 2015 1
- 2. Working together for public benefit 2 • Addressing unmet need for advocacy support • Supporting people who come to us • Sharing insight from complaints to inform our thematic work • Collaborate on improvements in local complaint handling
- 3. Unmet need for advocacy support 3 • 100,000 contacts to our office • 30,000 cases • 24,000 need help to make a complaint and get a response locally • 6,000 not resolved locally and so for us to consider
- 4. Supporting people who come to us: our role
- 5. Supporting people who come to us: our strategic objectives 5
- 6. Supporting people who come to us: our development 6 • Meeting demand • Being clear what people can expect from us • Ombudsman reform
- 8. Improving local complaint handling: My Expectations
- 9. Thank you 9 http://www.ombudsman.org.uk/ Follow us on twitter @PHSOmbudsman
Editor's Notes
- Purpose You are giving a keynote speech at our national conference for NHS complaints advocacy providers. The purpose of the event is to increase bilateral understanding, and agree ways in which PHSO and the advocacy sector can work together to deliver good outcomes for clients. The purpose of your speech is to clearly explain our role and strategic objectives, how we are developing and to highlight the benefits for the public of PHSO working effectively with advocacy providers. Key messages We want to work effectively with advocacy providers for the benefit of the public so they can support people to achieve redress. To underpin this, we are keen to understand what we can do to make your roles easier. We are keen to share insight with advocates so we can place our own casework in context and identify areas for improvement. Format You will be giving a 15 minute keynote speech at 10.35, which will be preceded by a speech from the three chief executives of POhWER, VoiceAbility and SEAP. There will be a general questions and comments session reserved for later in the afternoon (3pm) where you and the others speakers can respond, and give your reflections on the day. Audience Up to 90 complaints advocates, two Chief Executives and a senior rep of POWhER, Voiceability and SEAP. A small number of PHSO staff (Conference chair, members of the Executive Team and workshop facilitators and scribes).
- We recognise the key difference that advocacy makes both for the public and our organisation: Advocacy addresses unmet need - according to Healthwatch, two thirds of those who experienced poor care but did not complain said they would be more likely to in the future if they were offered advocacy and support. Advocacy helps people come to us with clear expectations and a coherent complaint, which means they can go through our processes more quickly. Mrs L’s case is typical of the positive roles advocates can play in our investigations – in particular ensuring people’s needs are met: Mrs L made a complaint to us about a delay in diagnosis of her late husband’s cancer. She was keen to pursue her concerns with us, but was also reluctant to speak to us ahead of a long planned holiday as she felt this would be upsetting and stressful. Mrs L’s advocate was helpful in facilitating communication and ensuring the timing and method of our contact did not unduly upset Mrs L. We made very serious findings that the diagnosis of cancer could have been reached 12 months sooner, and the investigator said the advocate ‘helped to broach the subject with Mrs L and prepare her for the outcome’. At the local (and PHSO) level we want the public to benefit from the key difference that advocates make, and we are regularly signposting people where there is a need for advocacy to tailored support services. It’s important that we continue to work together effectively to ensure people’s needs are met in the complaints system. Finally, we want to share insights with advocacy providers so we can place our own casework in context, and identify areas for improvement. Closing remarks: Finally, I want to use today’s conference as an opportunity to ensure our organisations continue to work together effectively for the benefit of the public. We want to understand what more we can do to make your roles easier. We are committed to using the insights and outcomes from today’s conference to inform how we operate.
- Who we are We make final decisions on complaints that have not been resolved by the NHS in England and UK government departments and agencies. We do this fairly without taking sides. Our service is free for everyone. We are not part of government, the NHS in England or a regulator. We are neither a consumer champion nor arbitrator. We are accountable to Parliament and our work is scrutinised by the Public Administration and Constitutional Affairs Committee. 8 out of 10 of our investigations in 2014-15 were about the NHS so our health work forms the majority of the office’s business. What we do We look into complaints where an individual believes there has been injustice or hardship because an organisation has not acted properly or fairly or have provided a poor service and not put things right. When we look into a complaint, we listen carefully to both sides and collect the relevant information. We then compare what happened with what should have happened. We consider the evidence impartially and make a final decision. If we decide there were no failings and an organisation has done the right thing to resolve the individual’s complaint, we explain why. If we decide there has been an injustice or hardship because an organisation has got it wrong we say so and may make recommendations for it to put things right to prevent it from happening again. This can include an explanation, an apology, a financial payment to recognise the injustice caused and recommendations for the organisation to learn and improve its service. Supporting systemic improvements We have also published thematic reports around sepsis, midwifery regulation, and more recently, end of life care to highlight systemic issues in our casework, share learning and establish what needs to change.
- In 2013 we introduced a new strategy to achieve more impact for people failed by public services as we found significant unmet demand for complaining about public services. We know that: 2 in 3 people who are unhappy with a public service don’t actually make a complaint. 29% of those say they believe that complaining will not make a difference. The public and Parliament also wanted us to make final decisions on more complaints that hadn’t been resolved with the service provider. Our response to this feedback was a five year journey - we have five strategic aims: 1) We will make it easier for people to find and use our services. 2) We will help more people by resolving and investigating more complaints and providing an excellent customer service for everyone who contacts us. 3) We will make public services better by working with others to share what we learn from complaints. 4) We will work with others to make it easier to complain about public services and to help public services resolve complaints better. 5) We will make sure our organisation works well to help us achieve our aims. In particular, working productively with advocacy providers will help us achieve Aim 2.
- To deliver more impact for more people we now investigate 4,000 cases a year and are meeting demand in the complaints system. In 2014-15: We created 28,189 new cases, completed 6,815 assessments and completed 4,159 investigations into 4,670 organisations. 2. We are sharing more of what we see. Through meeting demand and investigating more cases, we are producing more learning for the NHS, regulators and Parliament to drive improvements. We now publish quarterly anonymised case summaries so we can share with the public and NHS more of the learning from our casework. We have an online search facility where you can see what we have investigated in your area – take a look! 3. Being clear about what people can expect from us We are developing a Service Charter – a set of promises that people who use our service, organisations we investigate, and other stakeholders can expect when they use our service. This will ensure our services meet the needs of today’s complainants and are delivered in a modern and responsive way. We are engaging with past, existing and future users of our service, including consumer and advocacy groups, and organisations we investigate. Our draft Service Charter will shortly be out for consultation. I know that advocates have already been feeding into the charter through research workshops, and the consultation will provide further opportunities to share your views. To get involved visit: www.ombudsmanservicecharter.org.uk 4. Ombudsman reform Public service delivery models have become more complex and users are often left confused about which Ombudsman to turn to if their complaint hasn’t been resolved. We want a unified Ombudsman service that covers all public services (including health and social care) delivered in England and UK non-devolved matters. Most importantly this reform will make it easier for you and your clients to navigate the complaints system. We are therefore delighted that Ombudsman reform was included in the Government’s legislative programme.
- My Expectations is a user-led vision for what good looks like for service users look like if complaints are handled well. It is unique because it is outcomes-based, developed with over 100 service users (as well as advocates) and universal, covering health and social care. The CQC is now using My Expectations in its inspections to assess complaint handling and we’re now working with NHS England to develop a model survey based on My Expectations. This can be used to measure patient satisfaction with the complaints system across h&s care in England. As we work with others to help implement this vision across the system, we think that advocates can play a positive role in challenging health and social care providers that they’re meeting My Expectations for their clients.