Annual Report 2007-08 - the Parliamentary and Health Service ...

Parliamentary and health service ombudsman annual report 2007-08Mr Z was an elderly patient who diedduring an in-patient admission. Ourinvestigation found that the NHSFoundation Trust providing treatmentfailed to undertake a wider review ofcare, which would have led to a moreco-ordinated approach to implementingimprovements.Applying the Principles for RemedyOur Principles for Remedy set out howNHS bodies and individual practitionersshould put things right when injustice orhardship results from maladministrationor poor service. We see far too manyexamples of cases where the NHS hasfailed to apply these Principles.Despite the power of an apology whensincere and well timed, providers andpractitioners are too often reluctant toapologise when something goes wrong.As the case of Mrs M demonstrates, anapology is often an important first stepto remedy. As a result of ourrecommendations in Mrs M’s case theTrust and the Healthcare Commission,which investigated the case before itwas referred to the Ombudsman, agreedto apologise to Mrs M for theirshortcomings and the injustice she hadsuffered. Just as importantly, the Trustalso gave her an assurance that lessonshad been learnt from her complaint.Continuing care – bringing mattersto a conclusionIt is the responsibility of the NHS toprovide funding for the long termcontinuing care of people who need itbecause of accident, illness or disability.But for many years there has beenconsiderable difficulty in deciding fairlyand transparently who should qualify.In February 2003 the Ombudsmanpublished her second report intocontinuing care, showing that somepeople were paying for their care whenthe NHS should have been doing so.There were follow-up reports publishedin December 2004 and March 2007.However, for a significant number ofpeople the injustice from problems withcontinuing care funding has taken time tobe resolved. This has meant that in recentyears work on continuing care has been asignificant part of our workload. However,2007-08 was a year of significant nationaldevelopments in continuing care. We arepleased to report that, in general, PrimaryCare Trusts, Strategic Health Authoritiesand the Department of Health madesignificant strides last year to improvethe quality of their assessments,complaint handling and retrospective 1reviews of funding decisions and toremedy any injustice to those who havewrongly been made to pay for their care.The work undertaken by our ContinuingCare Team in setting out principles andexpectations appears to have led to agreater consistency and an end to thestrategic flaws seen in earlier years. Therewas also a reduction in delays, which atleast in part resulted from our work withthe Department of Health. Consequently,continuing care complaints have beena decreasing part of our workload as therole of the Ombudsman in supportingchanges partly arising from her previouspublished reports draws to a close.In 2007-08 under 10% (70) of the healthcases we accepted for investigation wereabout continuing care, compared with2006-07 when more than 27% (239)of the health cases we accepted forinvestigation were about continuing care.Whereas in 2006-07 we fully or partlyupheld 85% of the continuing carecomplaints investigated, in 2007-08 thisfigure fell to 56%.In last year’s Annual Report we said that,subject to successful resolution of theremaining applications, we intendedto publish a final special report onretrospective funding. We have notbeen in a position to do this becauseof the continuing delay in finalising manyof the complaints, although there hasbeen progress.In September 2007, on ourrecommendation, the Departmentof Health set a deadline of30 November 2007 for people to makeany remaining retrospective claims forcontinuing care funding. It encouragedPrimary Care Trusts and Strategic HealthAuthorities to publicise this deadlineas widely as possible in order to raiseawareness among potential claimants.The Department also gave Primary CareTrusts and Strategic Health Authoritiesa target of 31 March 2008 to completeall retrospective reviews, barring certainexceptional cases.1A retrospective continuing care review is one where all or the majority of the period for which funding is claimed is before 1 April 2004. 45