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What is the Health Ombudsman, how can I utilise it?

Author: Neil Fearn  Bullet  Dated: 21/05/2014

The Health Ombudsman, or to give it it’s full name the ‘Parliamentary and Health Service Ombudsman’ (PHSO), investigates complaints from the public if they are unhappy with the service they have received at the dentist, hospital, doctors or any other service provided by the NHS.

Taking on Your Case

If you have tried to resolve your issue with the NHS by using the local resolution option (NHS Complaints procedure) but you were unhappy with the response, you could complain to the Health Service Ombudsman. Although the Ombudsman was set up by Parliament, it is completely independent of them and the NHS. They make the final decision about your complaint.

If the provider of your care can prove they did all they could to resolve your issue, or if you just don't agree with the complaint response without any evidence demonstrating why it is wrong, this may not be enough to bring a claim to the Ombudsman.

If they are satisfied after checking that all other options have been exhausted by you in terms of making a complaint, and that they have the legal authority to take on your complaint, they will investigate. In some cases, the Ombudsman can address your complaint easily by talking to the organisation you are unhappy with. However, in cases where it is more complicated, they will look into the details of your complaint and aim to gather additional information and even expert advice.

How Long Do I Have to Complain?

If you do wish to make a complaint to the Ombudsman, you will have 12 months in which to do this from the date of the event you are complaining about. There are a number of things the Ombudsman cannot deal with in terms of a complaint. Two of these things are social care and privately funded healthcare. If you were privately provided with NHS funded healthcare services in an NHS hospital, they may be able to take on your complaint. However, before doing so, you will need to complete the NHS complaints procedure. Social care however, cannot be looked at by the Ombudsman at all.

What Happens Next?

The Ombudsman will aim to get a clear explanation of what went wrong in your situation. In some instances, they may decide that the organisation has acted correctly or if they had made a mistake they had already taken steps to put things right.

Where the Ombudsman decides the organisation is in the wrong, they will work with them to rectify issues identified. If, after receiving the Ombudsman’s detailed report you are still not happy, you can ask to have your concerns reviewed. After the review, the Ombudsman’s procedure is complete. There is no opportunity for a second review.

If after doing all of this you are still not happy with the answers you received, you may want to consider legal action.

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