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Selected Investigations Completed April - September 1999 > Foreword

Foreword

Investigations completed between April - September 1999

CHAPTER ONE

Introduction

This volume presents reports of investigations completed between 1st April and 30th September 1999. I publish such reports roughly every six months for four main reasons.

Accountability

While the main vehicle for reporting on the work of my Office is my Annual Report, the twice-yearly volumes of investigations keeps Parliament and others abreast of the way that the work is developing. This is particularly important for investigations of complaints about clinical services.

Education

I know that many educators use case reports as teaching material. This means not only educators in teaching institutions, but also Regional Offices, Health Authority and Trust Chief Executives and local complaints managers in training and development activity.

Openness

I wish to demonstrate to the public, and to health care professionals, that complaints made to my office are carefully considered, and that appropriate expert advice is commissioned to support the work of my investigators. Publishing a wide selection of reports helps, I believe, to provide reassurance that my office works to high professional standards and is completely impartial and objective.

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Partnership

I hope, too, that publishing reports in this way, as a working document for National Health Service, professional and consumer-based organisations, will support efforts to create effective partnerships between us. We all have a part to play in improving health services, and we are likely to do better on the basis of co-operation and freely exchanged information, subject to the requirements of patient confidentiality.

Themes from cases

In this volume, fifteen reports are presented in full, though anonymised, form and are accompanied by a single page summary that outlines their main features. The remaining reports are presented in the form of brief summaries.

In the six months from 1st April 1999 my office received 1450 complaints. The number was slightly less than in the same period last year. More than 40% came from people who had not yet approached local health services with their complaint. In general, the law does not permit me to investigate such complaints; and it is very clearly right that the body which is the subject of a complaint should be given the first opportunity to resolve it. This illustrates a continuing dilemma that faces my office. On the one hand, it is important that patients and others who have a complaint against the NHS should be aware of its role and existence. On the other hand no useful purpose is served by stimulating a large volume of premature or inappropriate complaints. We continue to give thought to our publicity; and I am publishing, for the first time, a summary version of this volume for wide distribution.

The cases reported in this volume arose mainly from events during 1998-99, and cover a wide range of issues, including in-patient and out-patient hospital care; initial diagnosis and discharge from hospital; the care provided by family health service practitioners; and decisions made by health authorities. I would like to draw attention to two particular points that are illustrated by these cases.

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The first is that I am now investigating cases of increasing complexity. Many are to do with clinically complex matters and care which involves a number of people. In others, the provision of care by more than one agency, an increasingly common pattern, clearly offers particular challenges to health service and other staff, and indeed for my own staff when complaints are referred to us for investigation. It is for this reason that we are forging an even closer alliance with our colleagues the Local Government Ombudsmen.

The second is that I am now dealing with what might be described as a second generation of problems to do with Independent Review Panels. The earlier, technical problems have given way to others that are to do with way Panel hearings are planned and managed. In recent months I have communicated concerns about the conduct of Panels direct to Regional Offices, so that they may draw them to the attention of all lay chairs. I am now also, as part of my investigations, asking chairs and convenors involved in the complaints I see about the training they have had, or need. Regional Offices may rely on my support for their training and development work in this area, and particularly with Primary Care Trusts as they come into being next year. It would be a pity if learning from the experience of the last three years were not passed on to these new organisations.

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Most reports that uphold complaints include one or more recommendations designed to provide redress, avoid a reoccurrence of the problem, or both. In coming months my office will be working to ensure our recommendations are of the greatest possible value. On all but a very few occasions those complained about accept my recommendations. A few, however, have declined to do so. I believed that a refusal to accept the outcome of the NHS complaints procedure and a fair and rigorous investigation by my office was unreasonable and unjust; and I made my view public. In the introduction to the last volume of completed cases, I said that I would usually name health service practitioners or others who refused to apologise for shortcomings identified by one of my investigations. I regret that Mr Gary Capon, a general dental practitioner [Case no.544/98-99] is the first such. Investigation staff and professional advisers concluded that Mr Capon's assessment and treatment of a patient was not of a reasonable standard. Mr Capon did not agree to implement the recommendation made in the report, or to apologise for the shortcomings found.

Referrals to my Office are slightly less than last year, but more are coming under investigation. Evidence suggests that the caseload is of growing complexity and this is no less true for my Edinburgh and Cardiff Offices . However, since the last volume of cases was published health matters for Scotland and Wales have been devolved to the Scottish Parliament and the Welsh Assembly. Accordingly, I do not report any Scottish or Welsh cases in this volume, but will publish relevant information to those bodies in due course.

Finally, this volume contains a letter that invites readers to tell me what use they plan to make of the publication and how they think it might be improved. Your comments and suggestions will be very welcome.

M S BUCKLEY
Health Service Commissioner
(Ombudsman)

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Last updated: 9 January 2006