Developing Emotional Intelligence –a Priority for the PHSO?
By Margaret Whalley
Until my brother’s skiing incident in 2011 which led to a complaint about his follow-on care and death circumstances (2012), I admit to having been largely ignorant of the role of the Parliamentary and Health Service Ombudsman.
The Health Service Ombudsman was first established by the Health Service Reorganisation Act 1972 for the purpose of conducting investigations into complaints arising from health services concerning general practitioners, hospital trusts and the staff who are employed by them.
When a complaint is made- say about a failure to provide a service or maladministration- the Ombudsman may choose to investigate. When the Ombudsman chose to investigate my case, I held no preconceptions about the complainant’s journey ahead. I simply hoped, in 2014, that the investigation about to begin would be based on the solid written evidence I had carefully presented and that it would be carried out with integrity and efficiency. Empathy, beyond common courtesy, was not such a high priority for me.
It has taken many years for the PHSO to now accept that their lengthy Final Report, completed and pronounced as ‘robust’ in early 2016, may not be robust, due to PHSO staff service issues. This conclusion was conveyed in the Ombudsman Mr Rob Behrens’ Service review letter in September 2019.
This is sadly ironic. My MP Lisa Nandy and I appealed to the PHSO when it was clear, that documentary evidence I had submitted was being ignored by investigators and advisers alike. The juggernaut could not be stopped and the PHSO drove forward to the completion of their report, despite protest or logic.
Now Ombudsman Mr Behren’s case review letter (September 2019) informs that the PHSO have, ‘identified a significant number of failings in the handling of the original investigation’ and that now, five years after original submission, he is ’proposing to carry out a fresh investigation’.
The first time I heard the Ombudsman refer to ‘emotional intelligence’ was on Tuesday 22 January 2019 at a Public Administration and Constitutional Affairs Committee meeting. My husband and I had travelled from the North West to Parliament to join with others from the phso-thefacts support group. We were passive attendees. We had forwarded submissions ahead of the meeting regarding our experiences with the PHSO.
The then chair, Sir Bernard Jenkin’s written comments included:-
“we have heard from individuals and families who have had existing traumas compounded by an ineffective, inefficient complaints process, at both NHS and PHSO level. Whilst nobody doubts the complex nature of the Ombudsman’s role, there has been a need to rebuild public trust and ensure the service is up to scratch”
During that meeting (2019), Mr Rob Behrens communicated, ‘We have to be more emotionally intelligent to deal with…cases on a daily basis.’
Wondering just what he could mean, I looked up a definition online:-
‘..the capacity to be aware of, control, and express one’s emotions, and to handle interpersonal relationships judiciously and empathetically.’
This suggests that one of the reasons the PHSO believe that complainants may feel frustrated is that there is not enough empathy shown.
Mr Behrens admitted in his Radio Ombudsman podcast (2017) that he needed a workforce comprising of, ‘people who have the emotional intelligence to be able to understand and work with people who are stressed or bereaved in some way’ and conceded, ‘we haven’t been terribly good at that’.
However the PHSO also recognises that cranking up emotional intelligence may bring accusations of bias. A PHSO report into the handling of Mr Nic Harts’ case describes how PHSO has,
‘taken steps to support and challenge all staff members to achieve the right balance between being empathic and acting impartially during the complaint handling process’.
At the outset of my investigation into the care of my vegetative state brother, I had communicated that I wanted, ‘someone with influence to grasp the nettle and discuss futility especially if the patient in the vegetative state appears to be suffering’.
I questioned why ‘vegetative state’ was a term used only twice in the PHSO Final Report (43 pages) and why no standards were provided about relevant care for such vulnerable patients within their Report. The PHSO wrote in their review analysis:-
‘We seem to have been reluctant to use the phrase ‘vegetative state’. ..I wonder if this is because we felt awkward about how to refer to Mr Bowdler’s condition. This was silly if true because Mrs Whalley repeatedly used the phrase in her complaint. Instead we used other phrases – like brain injury- which as Mrs Whalley rightly says, don’t accurately reflect her brother’s condition. ..gives the impression that we downplayed Mr Bowdler’s unique vulnerability. ‘
Is empathy being used here as a scapegoat for poor practice? Is the real culprit lack of scrutiny – deliberate or otherwise?
I and members of the phso-thefacts support group would argue that complainants prize adherence to an investigative approach, with a respect for the evidence submitted, efficiency, fairness, transparency and impartiality above empathy.
Before the release of the Final Report in March 2016, I requested to see the material evidence from which Draft conclusions derived. I was unaware of the internal flurry my request brought. Instead of material evidence, I was provided with unflagged documents, most of which I had originally submitted. Recent review findings show that PHSO staff collectively endorsed a Final report despite the knowledge that conclusions were not based on identifiable evidence. Recently reflecting on this, the PHSO wrote in their review analysis (2019):-
‘It is incredibly difficult for us to defend our findings when we are fundamentally unable to identify and disclose the material evidence we relied on during our investigation. Should we be subject to JR (judicial review) on this case there is a significant risk we would be criticised…it is tricky to say with any certainty what we (and our advisers) did or did not consider…I think the best thing we could have done at that point was to ‘come clean’ (my emphasis)
When public servants collectively decide to do the wrong thing is this collusion? To my mind it is duping and doesn’t chime with, ‘handling interpersonal relationships judiciously and empathetically’.
Since it is for the Ombudsman to decide and explain what standard he or she is going to apply, should the complainant expect empathy when it is discovered there is a woeful lack of material evidence?
As a member of the support group phso-thefacts, I have witnessed over a number of years, the efforts of campaigners holding out in the hope for proper PHSO scrutiny of their case.
The Daily Mail came aware of their plight and commented in 2018 on the time taken to investigate cases.
‘Families are left distressed and traumatised ‘because the NHS watchdog is taking up to three-and-a-half-years to deal with complaints’.
The article also commented on how few cases are actually investigated:-
‘MPs on the public administration select committee found that PHSO was snowed under. Last year it received 31,444 complaints but he only investigated 8,119 of them.’
Honing emotional intelligence skills will not benefit those who brought carefully prepared cases which the PHSO will never investigate. Nor will this placate those left dangling for years awaiting a judgement or a review.
Ms Amanda Campbell CEO ‘recognises in the PHSO Annual Report, ‘how waiting for answers can be stressful for complainants and removing the queue is a significant milestone in improving our service’
Simply removing the queue is not impacting the underlying problem. There are concerns with the treatment people (or their relatives) have received from the health service. Complainants have felt a responsibility to prepare and submit a case for the PHSO to investigate, not for personal gain but purely in order to transmit a message that all is not well. Removing the queue should be achieved by addressing concerns, investigating thoroughly and establishing commonality to provide learning and ensure patient safety. If the PHSO is effective, if health services improve, then fewer will complain and the queue will shorten correspondingly.
In 2018 the PHSO faced accusations of discrimination arising from disability and a failure to make reasonable adjustments for PHSO staff. The tribunal (Miss H Rashid v PHSO) found this, ‘particularly difficult to comprehend’ concluding, ‘It must have been obvious to the respondent that she (the claimant) was being placed at a substantial disadvantage.’
If ‘obvious to the respondent’, this suggests the PHSO had much to learn regarding emotional intelligence.
The following year, the Ombudsman’s Annual Report 2018-2019 CEO Ms Amanda Campbell commented (p8) that management,
‘gave considerable attention to developing a positive working environment in which people can contribute in the best possible way.. ensuring that we operate with integrity, respect and empathy for colleagues,
It appears empathy didn’t translate to action. At the very time these comments were published, unrest was brewing amongst PHSO staff (article by Public and Commercial Services Union):-
‘On 16th October 2019, PCS members working as senior caseworkers, caseworkers and admin voted overwhelmingly for action following a below inflation pay offer. The bosses had made a 2% offer marking the 10th consecutive below inflation (RPI) pay imposition. This left PHSO members worse off each year. It appears management claimed that PCS costings were “unaffordable” despite acknowledging that a just pay rise would only cost £50k. Senior executives at the Ombudsman had been treated differently however, with many getting a 4% pay rise and executive directors receiving bonuses of up to £10,000.
PCS described the PHSO (online article) as employing a, ‘high-handed and dismissive approach to negotiation’. This was ‘followed by attempts to coerce our members into accepting the proposals in our pay ballot and, when this did not work, by attempting to circumvent collective bargaining. When even that did not produce the result and turnout management was expecting, they announced that they were imposing the proposals regardless.’
Was it emotional intelligence which propelled the PHSO management to ultimately improve the offer to 2.5% to PHSO staff (accepted by staff) or was it pressure brought by an outside agency?
Unfortunately for a PHSO complainant there is no agency card to play to help ensure fair play. Mr Scott Morrish (complainant) made just this point in his podcast with the Ombudsman outlining a need for:-
‘a mechanism in place whereby if you reach an impasse as a complainant or as an Ombudsman, you can basically refer that case in full to a third party who can look at it with real objectivity because they have no involvement in it, and no interest in its outcome other than making sure it’s good. And then its analysis can be fed back both to the complainants and also the Ombudsman.
Now, if the Ombudsman is as good as it’s hoping to be, it should be able to see this as belts-and-braces that enshrines its independence and its integrity. And actually it should be big enough and humble enough to accept any criticisms that come back, as long as it is then tasked with correcting any deficiencies.’
Rather than fret about emotional intelligence, it is my view that the PHSO, for the present at least, should leave their emotions at the door, roll up their sleeves and concentrate on the reason for their existence, namely the purpose of conducting investigations with integrity (see section above in bold).
Margaret Whalley – I am a retired teacher who brought a complaint to the PHSOmbudsman following my brother’s death in 2012. I am still awaiting proper scrutiny and resolution. The attached photograph is of my late brother Bob. email@example.com
(I don’t mind any readers contacting me by email)
Very well-written. PHSO has been failing the public for a long time and unfortunately, under Mr Behrens it’s no better. In fact, recent statistics show that they are investigating and upholding even less complaints. How could it have gone so wrong. There are those of us that term PHSO “corrupt by design”. Ignoring evidence is certainly a PHSO speciality. Telling complainants that just because they “disagree” with (the bizarre and nonsensical, not to mention unjust) conclusions they come to, that they don’t have to take any notice. Yes, they say this. Emotional intelligence? I’d like to see any form of intelligence from PHSO. Injustice, dishonesty and collusion are not intelligent in my book. I’d much rather have a fair and competent investigation than empathy thanks. Just check out all the reviews on Google, Trust Pilot, Money Saving Expert etc. The cost to the public of this sham is enormous. How on earth are they getting away with it. Meanwhile, the NHS continues to fail patients along with other public bodies. Because in PHSO’s book, they can. No oversight or consequences will never produce anything else.
I couldn’t agree more with this article. And in some instances the NHS wrongdoing can be remedied, but patients are left without proper care or diagnoses. It’s not only about looking for patterns it’s about existing processes that should work being abused, by individual clinicians being protected by colluding colleagues. PHSO is completely biased towards protecting the NHS and that’s why they ignore cast iron evidence, use incompetent and inappropriately qualified advisers, who make factually incorrect statements and manipulate scope of investigation so as to avoid investigating the complaint you submitted. I could say so much more, this organisation is bereft of integrity and honesty. Read my website for the full details with evidence of their malpractice: https://brightonnhsfailings.wixsite.com/spftfailuresexposed/ if you want to go straight to the web page specifically about PHSO: https://brightonnhsfailings.wixsite.com/spftfailuresexposed/single-post/PHSO-Lies-and-Systemic-Corruption
When PHSOtheFACTS, a grassroots group of citizens who have been badly let down by PHSO, first started to collectively monitor the work of the Ombudsman we could see, by sharing our responses, evidence of ‘institutional arrogance’ in the wording of PHSO replies. Basically, PHSO dealt with your complaint as they saw fit, then closed it down with little notice with the message that you could go to Judicial Review if you remained dissatisfied. They would no longer respond to any further evidence or pleas of injustice on the basis that there was ‘no worthwhile outcome’ in pursuing your matter further. PHSO at that time displayed zero emotional intelligence once you got past the more helpful initial contact team. Then Mick Martin brought in the ‘Customer Care Team’ (CCT) following substantive public criticism of PHSO including that from Health Secretary Jeremy Hunt who accused Dame Julie Mellor and her team of ‘faceless bureaucracy’ and implored that bereaved parents should be treated with compassion and sensitivity. Shocking that a Health Secretary should have to take such steps as to publicly instruct the Ombudsman to act with basic decency. The Customer Care Team was set up to support complainants after the end of the investigation process for as long as necessary. No cut off, no ghosting. When Rob Behrens arrived the Customer Care Team went through a further transformation and mutated into the ‘Review and Feedback Team’ (raft) From a FOI we learn that; Rob Behrens commended the work of the CCT, which had played an
important role in defending PHSO’s reputation. However, he believed that
Customer Care is an inappropriate name.”
This quote came from internal meeting minutes and it is interesting to note that Rob Behrens states that the important role of the Customer Care Team was to ‘defend PHSO’s reputation’ rather than to offer continued assistance to distressed complainants. He then stated that the words ‘customer’ and ‘care’ to be inappropriate as presumably the team was not primarily concerned with either the customer or the giving of care. Review and feedback just silos negative complaint about the Ombudsman and once again distressed complainants are told that their matter is at an end and they should seek legal advice if they remain dissatisfied. The facts speak for themselves. PHSO is an institution which cares more about its public image than it does about its customers. Any move towards improvement in ’emotional intelligence’ are just empty words set to distract from the appalling low uphold figures (2.4% of all complaints submitted in 2018/19) which must cause great distress to those who have taken much time (often years) and emotional energy to pursue their complaint through the Ombudsman’s office only to be let down with no uphold or a partial uphold for something insignificant. Upholding complaint in order to deliver better services is the core of the Ombudsman’s work and steps should be taken by academics and others to hold their feet to the fire when they fail to deliver on this fundamental objective.
Excellent article Margaret, anyone considering asking the PHSO for help should read this first.
Sadly your experience mirrors mine. I contacted Mick Martin, then Deputy Ombudsman, after reading his high profile blog about the elderly being afraid to complain. My 88yr old mum’s 6 year Care Home residency was terminated without warning after I raised concerns. We were invited by the manager to meet the owners Chigwell Homes Ltd after I returned a feedback survey. I specifically asked by email what the meeting was about and who would attend. They lied. Thurrock CCG who were funding mum’s placement were not invited. We had no idea a 28 day Notice to Quit would be served at this meeting and mum had no representation. She had late stage dementia, her End of Life Care Plan was ignored, her wishes disregarded and she was forced to leave everything that was familiar to her. She died 7 weeks later.
The 1st investigation was concluded with no evidence. I engaged a leading Public Law Solicitor, the PHSO apologised and promised a “thorough, evidence based” reinvestigation. It was a sham, our evidence was ignored, we had discovered that someone else had raised similar concerns directly to the CQC because these emails were kept in mum’s file, but it wasn’t us. The Ombudsman refused to consider mum’s Human Rights (to home and family). They said even if Merrie Loots Farm had acted correctly the outcome would “most likely” have been the same!!
The investigation process took 3 years. If my complaint had been upheld the PHSO would have to admit to maladministration and most likely have been responsible for my legal costs..
This decision affects all vulnerable elderly people in Care Homes as most have the 28 day Notice to Quit clause in their contracts. According to a recent article in the Daily Express 6 OAP’s a day are having their Care Home residencies terminated: https://www.express.co.uk/news/uk/1176514/Care-home-scandal-elderly-residents-evicted
It’s time for Rob Behrens and Amanda Campbell to ensure the patient really does come first in everything the NHS does. If they don’t protect the vulnerable who will?
Margaret – a true account of the PHSO NOT being there to actually resolve complaints or ensure any future improvements. My own complaint was taken to the PHSO via my MP. However, their investigation is non-existent as there was just a mere enquiry of a member of staff from whence the harm I suffered occurred. The report is nonsense as it never mentions my injuries at all, but closes with a ficititious examination looking for ficititious injuries that were apparentely not present following the ficititious examination. This was six yeas ago and the PHSO will not explain this. They merely ingnore and more recently following my my recent enquiry say they have destroyed all the records and have no records of the emails containing promises to liaise with me on this. On asking when this happened, no answer is forthcoming. All contrary to their consistent and constant pr, so concluding that their remit cannot possibly be to support and resolve matters for the unwitting complainants but only exist to support the those who they claim they investigate.
Along with other cases that have been challenged as to validity it was labelled ‘historic’ and the new Ombudsman was to review and deal with them.
Yes we need to see the PHSO act with integrity, real integrity. An excellent article Margaret, an article of real quality.
An excellent and very perceptive article indeed. I also made a complaint to the PHSO and in 2016 received a report that was so deeply flawed and shoddy that a student would be ashamed to present anything of similar quality to their tutor.
When the new Ombudsman, Rob Behrens, was appointed in 2017 there was considerable hope that he would reform the PHSO to ensure that it would provide a high quality service. It was baffling when he chose to prioritise improving the empathy of caseworkers, and improving the media coverage, rather than improving the quality of the investigations and decisions.
Almost 3 years after Mr Behrens appointment, while the empathy of caseworkers may have improved, there is no evidence that the quality of their investigations and decisions has improved. The PHSO is a notoriously secretive organisation and releases very few of the statistics it collects relating to the quality of casework. However those that have been released show no improvement to date.
Even more frustrating is the fact that there is no superior body to which complainants can take complaints about the decisions made by the PHSO. Even the prohibitively expensive route of judicial review does not make any judgement about the quality of a decision made by the PHSO, only the way that the case was handled. This lack of accountability for decisions is a significant factor in enabling a poor quality service.
So, emotional intelligence is all well and good, but far more preferable would be a high quality service that produced outstanding investigations and decisions, even if those investigations and decisions were produced by emotionally illiterate caseworkers.
An absolutely brilliant article Margaret. I think you should consider sending it as a submission to PACAC when they call for evidence prior to their next PHSO scrutiny session.
So eloquently put Margaret Whalley, thank you on behalf of those who can’t use the pen so well.
My son’s case has also been waiting a long time for justice. He died an ‘avoidable’ death in 2009, that’s what PHSO said but no one has been held accountable.
I’ve had an apology for poor service but nothing more, apart from an assessment of the case, which surprisingly found nothing wrong.
The problem is that, as PHSO destroy evidence after one year, I don’t know what the assessment was based on as there could not have been any evidence!
I don’t need empathy, I need the truth and justice to be recognised, but for wanting that, I am labelled by my local trust, a difficult lady! Dear me, I only want to know why that happened to my son…?
Those who metered out such poor treatment that my son died, should be brought to account, or they will do it again. For all I know, probably have.
Children are not suppose to pre-decease their parents.