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Conclusions from many local healthcare complaints from patients and their families are kept secret in a “bizarre” lack of transparency, according to the Donaldson report.
The Northern Ireland Ombudsman has the power to investigate allegations made about services provided by any of the six trusts.
However, both its findings and its recommendations are not disclosed, leaving the public unaware of failures and potential improvements.
Patients, carers and families’ grievances are dealt with initially by senior officials at any one of the six trusts, presuming the allegation relates to relevant provision.
Trusts must respond with a chief executive’s letter within 20 working days, although Donaldson warns “performance is suboptimal and very variable in this respect”.
The Western Trust has the best record, responding within the 20-day period in 77% of cases; NIAS is the worst with a 32% success rate.
It is at this point, if a complainant is not satisfied, that the Ombudsman comes into view.
The report notes: “The best outcome is for the complaint to be resolved locally to the complainant’s complete satisfaction. This is not always possible and if the complainant is not satisfied with the response, the complaint can be re-opened and further investigation can be undertaken or external advice sought.
“If this still does not resolve the complaint, the complainant can make a submission to the Ombudsman. He will look at whether the process of responding to the complaint was undertaken appropriately. He can also investigate the substance of the complaint but under present legislation, he cannot make these reports public.
“This bizarre situation means that the public is unaware of where standards have fallen short and what the Ombudsman thinks should be done.”
Complaints about primary care are handled differently, raised directly with the Health and Social Care Board, but for those unhappy with services provided by the trusts, the Ombudsman – and guaranteed, not even discretionary, secrecy – is the end of the line.
An increasing number of people have been taking their issues to the Patient and Client Council (PCC), but it does not have investigatory powers and can only provide support.
Nearly 2,000 people contacted the PCC last year and “many” of these did so because of difficulties working through the complaints system themselves.
In its conclusions, the report recommends a number of measures to “strengthen the patient voice”, adding:
“More independence should be introduced into the complaints process; whilst all efforts should be made to resolve a complaint locally, patients or their families should be able to refer their complaint to an independent service.
“This would look again at the substance of the complaint, and use its good offices to bring the parties together to seek resolution. The Ombudsman would be the third stage and it is hoped that changes to legislation would allow his reports to be made public.”
Scope asked both DHSSPS and the Ombudsman to explain the rationale behind non-disclosure of recommendations.
The department said it was a matter for the Ombudsman, while a spokesperson for the latter said the Ombudsman is out of the country until next week but may comment upon his return. Check back for updates.
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