How Does it Work?
Once the hospital’s or surgery’s own investigation is complete, the patient can complain to the PHSO. Traditionally, it doesn’t have the power to investigate if no one lodges a complaint.
Once a complaint is received, however, a case worker will be assigned and they will then ask for details from the patient and the care provider. It’s important to remember that the PHSO is not investigating the quality or reasonableness of the treatment provided; rather, it’s allowed to investigate only whether the previous internal investigation was acceptable.
That said, it will often need to consider the underlying medical treatment in order to decide whether the initial investigation was sufficiently fair and objective. In these circumstances, the case worker will need to seek assistance from a medically-trained clinical advisor to try to achieve this.
Improving the Process
The recent review has highlighted several areas where the PHSO can improve the quality of its investigation process. It has agreed to implement these over the next 2 years as part of a wider approach to reducing patient harm.
One of the most important developments is that the clinical advisors will be empowered to investigate issues which weren’t highlighted by the case worker or patient. This gives them the important freedom to investigate serious failings they identify which have not been covered previously.
The information provided to the patient during the investigation will also be made clearer and more accessible. The role of the clinical advisor will be explained along with their qualifications and the reasons they were chosen for this particular investigation. This is much closer to what happens in a medical negligence case where the choice of expert is often crucial to winning. The clinical advisors will also use more straightforward language to make it easier for the patient to understand how they’ve reached their conclusions.
The PHSO has also agreed to do more to share the lessons learned from their investigations in the hope that the same mistakes aren’t repeated by the NHS. It is improving its ability to identify the severity of potential harm and this will help to highlight ‘near miss’ events where serious injury or death was narrowly avoided.
Is it a More Reliable Process?
These changes represent a genuine desire to help patients better understand the complexities of their treatment and the reasons why things happened as they did. In the longer term, they should also help to highlight the repeat nature of many of these harmful events and sub-standard initial investigations which occur.
Since the PHSO is independent of the NHS, it provides a valuable service objectively scrutinising the standard of NHS internal investigations which is not provided by other organisations (such as NHS Improvement or NHS Resolution). However, until it gets the power to investigate before it receives a complaint, it remains at risk of becoming involved too late to make a difference.
What Should Patients Do?
Currently, patients need to exhaust the internal complaints procedure before contacting the PHSO. Once they do so, they should be willing and able to provide all of the necessary information promptly. Although better information is to be provided by the PHSO, patients must still feel able to ask questions.
If you’re dissatisfied with the way in which the PHSO investigation has been conducted, it does have its own complaints procedure. However, that is limited to considering whether its own standards were met, not whether the original treatment or internal investigation was reasonable. By the time this stage is reached, there’s a significant risk that time to consider other options will be running out.
In some cases, it’s appropriate to seek compensation to help you live with the effects of negligent treatment. In this instance, it’s essential you get specialist legal advice from an experienced Medical Negligence Solicitor.