Clinical Advice Review: Final report and our response

The Clinical Advice Review

In summer 2018, fulfilling a commitment made in PHSO’s new 3-year strategy we established a Review Team looking at the use of clinical advice in the Ombudsman’s casework, and in particular in those cases where advice from an independent clinician has been sought.

The Review Team was chaired by Sir Alex Allan and its membership included Dr Julia Tabreham, both non-executive members of the PHSO Board. It also included a mix of senior PHSO staff and was supported by a small, internally resourced, secretariat. In addition, Sir Liam Donaldson, the former Chief Medical Oficer and currently the World Health Organisation’s Envoy for Patient Safety was commissioned to act as an Independent Adviser to the Review.

The Review Team issued a consultation paper in September 2018, asking for feedback on the principles that underpin the Ombudsman’s use of clinical advice, the quality and comprehensiveness of the clinical content of PHSO’s reports, as well as the level of information about clinical advice provided to complainants, the organisations investigated and the general public. Views were also sought on the new clinical standard used by the Ombudsman that was published in August 2018.

We also published a background paper with detailed information on our current clinical advice process. 

In line with our commitment to transparency, we have also published the Review Team and Independent Adviser’s full final reports on our website. The Review Team’s report includes a detailed summary of findings from the consultation, its response to each of the Independent Adviser’s recommendations and additional recommendations from the Review Team’s own detailed analysis.

The Independent Adviser has also provided written assurance to the Ombudsman that the Review’s final report is in line with the key elements of his proposals.

This Response sets out our high level summary of the Review’s recommendations, related findings and what we will now do to implement the change that is needed.

For ease of reference, we have clustered the Review’s recommendations under five core themes:

  • Greater integration of clinical advisers into the casework process
  • Effective and consistent communication with those involved in a complaint
  • Balancing evidence and ensuring everyone understands how we have used it to reach decisions
  • Applying the appropriate range of methods to investigate the causes of poor care, and share learning
  • Staffing