Latest Ombudsman annual report spells out areas for improvement in NHS

15 July 2004

Press release 04/04

In her latest Annual Report, published today, Thursday 15 July, Ann Abraham, the Health Service Ombudsman for England, highlights the key concerns raised by the public in the 4,700 complaints made to the Ombudsman's Office last year.

"We demand a lot from our NHS and sometimes it does not deliver. Perhaps this is not surprising but when it happens people rightly expect their concerns to be addressed and the Service to learn from its mistakes," says Ann Abraham. "The themes I highlight in my report demonstrate that there are areas where the NHS could do better."

One ongoing issue concerns NHS funding for the continuing care of elderly and disabled people. In February last year the Ombudsman published a report highlighting deficiencies in eligibility criteria and assessments which led to severe hardship in some cases. As a result the Government agreed to the Ombudsman's recommendation that strategic health authorities review all relevant cases dating back to 1996.

"I welcome the Department's positive response which has resulted in 770 people becoming eligible for the funding they were previously denied. The Department has said that it expects to pay out over £180 million when all cases have been reviewed," commented Ann Abraham. "However, despite my warning last summer that there were likely to be large numbers of people affected by these issues and that the Department of Health would need to provide adequate support and guidance, it would appear they have not done so. Cases for retrospective review totalled over 11,000 and the deadline for completion of these has been moved twice. The Department have said they now hope that they will all be completed by the end of this month. At the end of March more than four out of ten reviews were still outstanding. I am pleased that the Department have now committed to making a decision on all new requests for full funding within two months of receiving all the relevant information from the applicant"

Other themes addressed by the annual report include difficulties in living up to a patient-centred approach and poor handling of complaints once things have gone wrong. The former is usually characterised by poor communications with patients and between health professionals, and poor co-ordination between services. The latter, meanwhile, is typified by delays in responding to complainants' concerns, poor communication with complainants and inadequate record-keeping. The report makes clear the Ombudsman's disappointment that the introduction of a more accessible, patient-centred, responsive and independent complaints system has been delayed, especially when local practice remains patchy.

The 4,700 new complaints to the Ombudsman between April 2003 and March 2004 represent an increase of 18% over the previous year. Most of the increase reflects a rise in complaints about continuing care assessments but overall there has been a steady increase in the number of complaints coming to the Ombudsman over the last ten years.

Notes to editors

  1. For more information, or copies of the reports, please contact the Press Office on 0300 061 4996/3943, or by e-mail to Press@ombudsman.org.uk
  2. Health Service Ombudsman for England, Annual Report 2003-04 (HC 703). From 15 July the report can be seen on the website:www.ombudsman.org.uk
  3. Case studies involving poor communication include E.1637/03-04 (page 17) discharge of elderly man to his warden-controlled flat without informing the warden or the man's son and daughter in law. The man became unwell and died, alone, a few days later. The Ombudsman found that the trust should have involved the family and warden in the discharge planing.
  4. E.729/02-03 (page 21) A community psychiatric nurse(CPN) failed to check regularly enough on the well being of a patient in the community, who had refused her anti-psychotic medication and refused to turn up for medical appointments. The patient collapsed and later died in hospital. The Ombudsman found that by agreeing to stop the medication without consulting the woman's psychiatrist or GP, the CPN had acted beyond her responsibilities. She also found that the trust had no system of regular medical reviews and risk assessments in place. As a result of the Ombudsman's recommendations, the trust improved medical staffing and staff supervision and put in place a protocol for situations where a patient cannot be contacted.
  5. Cases involving poor complaint handling include E.798/03 (page 11) - a man who complained in June 2000 about the care given to his late uncle had to wait until January 2004 before being told that the trust had turned down his request for an independent review of his complaint. The Ombudsman found the delays were the result of a catalogue of poor practice and denial of responsibility. The trust agreed to improve and monitor its complaints handling performance and to make an ex gratia payment to the man as recognition of the trouble to which he had been put over such a long period.
  6. NO INFORMATION CAN BE GIVEN ABOUT THE IDENTITIES OF THE INDIVIDUALS INVOLVED IN THESE CASES