• Phil Austen-Jones

'Forgot' to follow policy? Just lie and claim it was never policy in the first place

This blog post is shorter than more recent ones, but to get the full impact (and transparency) I have referenced a couple of documents that evidence what I have written here - they can be found here. It is part of my Modus Operandi to cite relevant paragraphs from policies, legislation, guidance, etc. My experience of West Hampshire CCG is that they prefer not to. You can probably guess my thoughts on that.


After receiving the complaint response regarding the January 2018 review (highlighted in my previous blog post), I contacted the PHSO office regarding the omissions, errors, misinformation, etc. I was advised to write to West Hampshire CCG with follow up questions to get clarification on these points.


It is fair to say I sent a detailed response - found in the link above. Thirty-two follow up questions were sent in direct response to the claims in the West Hampshire CCG response letter. Everything was cross-referenced against policies, legislation and guidance. As a result, there were twenty-seven appendices highlighting the relevant paragraphs that West Hampshire CCG should be following. I informed West Hampshire CCG that if an appropriate response was not received, I would report individuals to their relevant regulatory bodies.


In the spirit of openness, honesty, integrity and transparency, the response from West Hampshire CCG to each question was overwhelming.


“Reviews

Please be advised that West Hampshire Clinical Commissioning Group have investigated your complaints regarding this matter and have concluded that the principles of the National Framework for NHS Continuing Healthcare have been adhered to.


Complaints

All complaints follow a robust investigation in line with the NHS Complaints (England) Regulations 2009. The review and approval process for your complaint investigation responses include review and approval by Ciara Rogers Deputy Director for Continuing Healthcare and Ellen McNicholas Director of Quality and Nursing (Board Nurse). Furthermore the complaint investigations were undertaken by the operational manager, who is unrelated to the complaint.”


This is a reduced form of the letter but shows the contempt they had for openness, honesty, integrity and transparency. The full letter can be found here.


My thoughts on their letter?


If West Hampshire CCG have concluded that the principles of the National Framework have been upheld, where is the evidence? By their statement, they are claiming that my questions are inaccurate. To this day, I have not been provided with evidence to back up their claims, and they still insist the process was correct. And in greater irony, the National Framework in guidance. They should be referencing their policy as well.


And as for a robust investigation – this seems to be a total lie. Their policy includes making records of investigations. They didn’t. West Hampshire CCG then claimed in September 2020 that creating investigation records is a new practice for them and was not in place at the time.


THIS IS A LIE.


When will they learn not to lie to me? Here is the proof of their lie.

In preparation for a meeting, I asked West Hampshire CCG to “provide, inter alia, emails, letters, local and national policies and legislation that allows… ignoring local policies and national guidelines for investigation records.”Their response, approved by the Chief Operating Officer, was as follows:


“At the time of your complaints, information was not pulled into an investigation record. The NHS Complaints Regulations do not explicitly require a complaint investigation record to be made. However, it would be deemed good practice. WHCCG has now added this step to its complaints process has now added [sic].”

(WHCCG, 7 September 2020)


So, what was their policy in 2017/2018?


“3.9.6 The investigation officer will:

· Establish what happened, what should have happened and who was involved and make written records of the investigation/staff statements

“3.10.8 All statements, letters, phone calls and actions taken in an investigation must be

documentedand kept in the complaint file in chronological order. A complete complaint file is required should the complaint be referred to the Parliamentary and Health Service Ombudsman.”

“4.1.2 It is the responsibility of all directorates and teams to adhere to the Complaints Policy.”

“4.1.3 Staff will be made aware of the complaint and asked to prepare written or verbal

statements as part of the investigation.”

“4.2.2 The Director of Quality (Board Nurse) is responsible for overseeing the complaints

management process, ensuring that complaints are handled in accordance with the policy.”

(WHCCG Policy for the Management of Complaints, Version 2.03, November 2015, updated October 2016, formatting by me for emphasis)


Now I have no doubt that West Hampshire CCG will try to assert that their claim was not a lie, just an honest mistake. Considering I have repeatedly asked for the investigation records over the last three years and often cited their policy to them, I cannot fathom how it could be deemed anything other than a lie.


What is more, the evidence from internal CCG documentation, obtained via a Subject Access Request, makes no mention of any complaint interviews/reports from the January 2018 reviewer or the senior manager that aided the changing of the review outcome. Furthermore, there is no evidence that there was any communication with them at all.


Perhaps it would be pertinent for West Hampshire CCG to explain its concept of a ‘robust investigation’ because it is clearly different to my interpretation.


And as for the Head of CHC being unrelated to the complaint, she unlawfully (through lack of consent or valid legal basis) re-reviewed sensitive data to make clinical judgement of my wife, in agreement with the Deputy Director of NHS Continuing Healthcare, and only then ‘investigated’ the complaint for which the outcome was pre-determined.


I guess that a ‘robust complaint procedure’ means a process that robustly protects the interests of the CCG, whether that is in the patient’s interest or not.


And as for answers to my questions, I would be delighted to receive an evidence-based response from West Hampshire CCG. But it seems my chances of getting this from them lie somewhere between Bob Hope and No Hope. Seriously Maggie MacIsaac and West Hampshire CCG, is this the kind of service you believe is appropriate in the NHS?


In the letters between myself and West Hampshire CCG, there are references to my claims of breaches of data protection. This will be the focus of my next blog. The internal emails evidence a truly awful approach to data protection law and consent.


And did I report individuals to their respective regulatory bodies? Yes. But that is a story for another time.


POST SCRIPT

Having sent this blog post to West Hampshire CCG prior to publication to check for factual inaccuracies (they did not report any), I asked senior board members of the relevant CCGs (Sarah Schofield, Judy Gillow, Dr Stuart Ward and Dr Peter Bibawy) the following question:


“Maggie MacIsaac has accepted that there were failing and my wife is clearly eligible. Considering the contents of my on-going blog posts to date, do you agree with Mike Fulford that West Hampshire CCG acted appropriately and that the complaint investigations were appropriately robust.”


I have received no response. It seems that the boards of the relevant CCGs that they are totally complicit in this malpractice. I will be raising the issue of the Nolan Principles with them.

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