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Insight

Is The Healthcare Ombudsman Working For You?

Caron Heyes
18/11/2014
Today's press carries a report of criticism by the Patient Association of the Healthcare Ombudsman for repeated failings to provide an adequate investigation service for patients who remain unhappy with the NHS complaint process.

If a patient or the family of a patient are unhappy with the care they have received from an NHS body, including GP practices and Hospitals, they can make a complaint. However if the patient/family feel the complaint is inadequate in its response, or does not give a true reflection of the care they received and the failings in that care, their only option then is to either pursue their complaint to the Healthcare Ombudsman, or in a very small handful of cases to pursue a legal claim against the institution that provided the treatment.

Contrary to urban myth, the majority of NHS users do not think immediately of suing for poor delivery of care, and genuinely want to obtain answers regarding the failings in care and an apology. In fact most patients would prefer to refer their case to the Healthcare ombudsman. However the Healthcare Ombudsman offers very limited assistance; firstly it only takes on a very small number of cases referred to it. Secondly it will only investigate a complaint if the family/patient are not pursing a legal case as well. Finally and importantly, their investigations take a very long time, in excess of years.

The reports today by the Patient's Association echoes our experiences of using the Ombudsman to further a complaint, and goes further in reporting that they are receiving far too many calls from families and patients who feel failed by the ombudsman because the ombudsman fails to in the following ways to support them:

In my experience of litigating claims for families, where they have first tried to pursue their complaint through the Ombudsman, the Ombudsman's enquiries take a phenomenally long time to carry out. During the time they are investigating the case a family are not able to pursue a legal claim and because it takes so long for the Ombudsman to investigate the case, even if the Ombudsman advises at the end of the case that they patient/family have been given very poor care that has caused them injury, the time period for pursuing a claim may have passed. It cannot be right that in order to use the Ombudsman's service a patient is required to give up the right to pursue a claim, which is what the delays in investigations mean in real terms. Nor is it right that patient who has been harmed by medical treatment does not have their complaint dealt with fairly and openly and within a short period of time.

The delays in investigation also lead to many missed opportunities for the NHS to learn from its mistakes and improve treatment, and to effect change within the NHS organisation that has failed firmly in their care. The Ombudsman is then the right place for the complaint to be reviewed.

Therefore we congratulate the Patients Association on their work to improve the Ombudsman service and look forward to seeing the charter that the two organisations are drawing up between them to improve the standard of service.

Caron Heyes is a clinical negligence specialist solicitor. She has brought many cases for families who have pursued a complaint through the Ombudsman only to be advised that the care their loved one received contributed to their death. In one case the Ombudsman took over 2 years to investigate their complaint, which centred on failings by the deceased's GP service to test her blood sugar levels (she was diabetic) and recognise signs of serious illness on a home visit. When the family complained to the GP they were told they could not have done anything better. The intervention of the Ombudsman led to a second complaint response being prepared that accepted failings in the care of the deceased. On the basis of that we were able to act swiftly to begin protective court proceedings and pursue a claim for the deceased's widower to recover damages. In that case the widower was left without the income his late wife brought into the home and that had caused him financial hardship. However what was most important was obtaining a concession by the GP service that they had got the care wrong, and changes in the equipment the GP service carried with them to improve treatment of others.

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