When we consider complaints about NHS clinical care and treatment, we use the Ombudsman’s Clinical Standard to establish what would have been good clinical care and treatment in the situation complained about. We then consider whether what actually happened fell short of that.
We will seek to establish what constituted good clinical care and treatment based on the facts of the case by reference to a range of material, including:
- relevant standards or guidance
- the accounts of the complainant and the clinician or organisation complained about
- any other relevant records and information.
The Ombudsman’s Clinical Standard
- When we are considering complaints about clinical care and treatment we consider whether there has been 'good clinical care and treatment'. We aim to establish what would have been good clinical care and treatment in the situation complained about and to decide whether the care and treatment complained about fell short of that.
- We will seek to establish what constituted good clinical care and treatment on the facts of the case by reference to a range of material, including relevant standards or guidance, the accounts of the complainant and the clinician or organisation complained about, and any other relevant records and information.
- Relevant standards or guidance we may consider include: National Institute for Health and Care Excellence (NICE) guidance, clinical pathways, professional regulators’ Codes of Practice and guidance, guidance from Royal Colleges, local protocols or policies, and published research including clinical text books or research reported in peer review journal articles.
- In deciding whether a standard or guidance was relevant in the situation complained about we will consider factors such as whether it was in place at the time of the events complained about and whether it was applicable to the care and treatment the person received and to the setting in which the care and treatment took place.
- We will ask the clinician or organisation complained about to tell us what, if any, standards or guidance they based their practice on, whether they followed them or departed from them in the situation complained about and why. If there is a relevant standard or guidance and the clinical decisions, actions and judgements do not appear to have been in line with it, we will consider what evidence there may be to explain this. We will reach a decision about whether there has been good clinical care and treatment. In doing so we will consider the explanations of those complained about and balance them against the relevant standards or guidance.
- We will also consider the ‘Principles of Good Administration’ insofar as they apply to the clinical context.