According to a study by the office of the health service ombudsman, more than 40% of NHS investigations into patient complaints are simply not up to standard.
They reviewed 150 cases of allegations of avoidable harm, or death, and found failings in the handling of 61 of those complaints by the NHS trusts in England.
While the Government said it is working to create a ‘more open NHS culture’, the review looked into the quality of the investigations and the evidence that was relied upon, as well as the statements and records.
The public administration select committee has called for the ombudsman; Dame Julie Mellor, to appear before them while they are looking into the issue of NHS complaints and clinical failure. Her office has been accused by many of failing patients; cases include a hospital that admitted there were mistakes made in the delivery of a baby only after the parents had paid £250 for an independent clinical review. In another case the family of a 36-year-old man, who died after a life-threatening condition was undiagnosed, were told that they would have to take legal action to find answers.
The review being carried out by Dame Julie’s office found that 28 of the 150 cases should have been investigated as serious incidents. Situations like that of a 77 year-old man who died from sepsis two days after admission to hospital should have automatically triggered a ‘serious untoward incident’ but the findings were not identified in the hospital’s investigation.
Dame Julie said: “When people make a complaint that they have been seriously harmed, they should expect it to be taken seriously and thoroughly investigated. The NHS must tackle the variation in the quality of its investigations but also needs to recognise when to initiate an investigation. When the NHS makes a mistake their duty is to investigate – these investigations shouldn’t be about attributing blame but should find out what happened and why in order to prevent the same mistakes from happening again. Our evidence too often shows this is not the case.”
According to Roy Lilley, a former NHS trust chairman, the investigations are simply being carried out by the wrong people: “The trust is absolutely the wrong person to investigate this because the trust is investigating the trust, it should be done independently and outside the purview of that organisation,” he said.
Gavin Moat, senior Partner at Mercury Legal, was sympathetic to the situation, but defended his profession saying “The NHS is under intense pressure to perform under sometimes very challenging circumstances. We understand that in these conditions mistakes will occur, but rather than NHS Trusts hiding from their responsibilities, the work carried out by solicitors helps to highlight serious cases which are not satisfied by the complaints procedure.”
The government have been clear on their ambition to ensure that the NHS is the safest health service in the world, but only by making sure that when things do go wrong, patients can be confident in the procedures in place, can the costs of unnecessary and time-consuming investigations begin to decrease.