• Phil Austen-Jones

Tampering of Documents

In this week’s blog post, I’m going to play a little game – Spot the Difference.


After West Hampshire CCG (WHCCG) refused to accept that they had lied, altered outcomes unlawfully, processed sensitive data unlawfully, pre-determined the outcome of a complaint, used fake guidelines, etc, we reported them to the Parliamentary and Health Service Ombudsman (PHSO), as well as several nurses to the Nursing and Midwifery Council (NMC). Future posts will expose the disgraceful actions of those organisations.


But this post is simple. I’m just going to share a single document that I received from WHCCG as part of a Subject Access Request (SAR).



The document may seem innocuous, but it is extremely serious. It is part of the proof that WHCCG pre-determined the outcome of our second complaint (about the January 2018 review), conducted an additional review of my wife’s care needs and processed sensitive data unlawfully. We had no knowledge of these actions; it is not part of any due process or policy and we certainly did not consent to it. And for clarification, the complaint was about due process, not clinical judgement.


To help understand the document, the abbreviations are as follows

· CR – Associate Director of NHS Continuing Healthcare at WHCCG

· PD – Head of NHS Continuing Healthcare at WHCCG

· LT – A complaint manager at WHCCG

· 13/2 – 13 February 2018 – two days before the Local Resolution Meeting where PD and LT told us the outcome of the complaint that they had not investigated

· DST – Decision Support Tool – PD was to reconsider the judgement of the January review

· MDT – Multi-Disciplinary Team – The meeting held that considers eligibility. (WHCCG had been trying to force an MDT, including by using fake guidelines.)


And we had never met or communicated with CR or PD. PD was making a clinical assessment, that determined the outcome of a clinical review and a formal complaint, when she had never even met my wife. And what was her judgement? My wife may no longer be eligible so must go to MDT.


Let’s consider this with what the medical experts, who have known us for many years, were saying. PD had access to these documents (although the access was without our knowledge or consent).


Dr Clare Galtrey (Consultant in Neurology) “The seizures remain unpredictable and can happen at any time and she needs constant monitoring for her own safety.”


Dr Ruth Sommerville (GP) “…result in full tonic clonic seizures, often requiring oxygen and are, at times, life-threatening.” … “Her current package provides her with a carer whenever her husband is not available and as her epilepsy has got worse since the package was introduced [2009], rather than better, I fully support Rachael in continuing her package at its present level.”


Jan Arevalo (Sapphire Epilepsy Nurse) “I would echo the contents of Dr Sommerville’s letters.” … “Due to the unpredictable and fluctuating nature of her condition and the cognitive impairment she is experiencing she is not safe to be left unsupervised.”


Dr Louise Payne (GP) “She has recently had an assessment where it has been suggested that her care is reduced. I would categorically say that this should not be done. This lady requires help throughout the day and not just at certain times. I feel it would be incredibly dangerous for her. She sometimes stops breathing and needs slapping on her back to get her to breathe.”


The judgements made by West Hampshire CCG are contrary to case law. In the High Court judgement of Clarke v London Borough of Sutton (2015), which has striking similarities to our own case, His Honour Judge Sycamore wrote:


“I conclude on the particular facts of this case, notwithstanding the high hurdle faced by the claimant, that the decision by the defendant failed to give appropriate weight to obviously relevant material and relied excessively on the non-expert view of a social worker in a face of a wealth of evidence to the contrary from appropriately qualified and experienced experts.”


Whilst the decision makers for WHCCG were not social workers, the first reviewer was a mental health nurse, the second reviewer was a paramedic, the senior manager who changed the outcome of the second reviewer was a discharge nurse, and then there was the Head of CHC. None of these people are experts in epilepsy. Between the four of them, two of them met my wife for the first time at the reviews, and the other two had never met my wife. Compare that to the combined fifty years of knowledge of my wife that the four experts above had.


NOW LET THE GAME BEGIN


In reporting our case to the PHSO, WHCCG had to submit the information they held in the complaint file (although, as stated in my last blog, there were no investigation records).


SPOT THE DIFFERENCE



“Pre-meet – CR, LT, PD (by telecon) 13.02” has been deliberately removed.


To the PHSO, this document means nothing. This no longer provides evidence of an agreement between the three participants to conduct a clinical assessment prior to investigating our complaint.


HOW HAS WHCCG RESPONDED?


What a silly question that is! Denial. Denial. Denial.


After several denials, the final formal response received on 8 November 2019 from Mike Fulford, Chief Operating Officer and Chief Finance Officer, wrote,


“As the Senior Information Risk Officer for West Hampshire CCG I have sought definitive information from the PHSO, that show conclusively that West Hampshire CCG provided a full copy of Mrs Austen-Jones’s complaint records to the PHSO and that no redactions or alterations to the records had been made.”


SO WHAT DID THE PHSO ACTUALLY SAY?


First of all, the response from the PHSO to WHCCG was on 25 September 2019. We had made it very clear that delays from WHCCG were causing serious harm to us and strongly requested a quick reply. For a reason yet to be provided, Mike Fulford delayed the response until 8 November 2019.


Anyway, the formal response from the PHSO was:


“Please see attached for a copy of the files that I sent to Mr Austen-Jones in response to his request for access under the Data Protection Act 2018. The response was December 2018.


“The password is as you specified over the phone.


“As I stated in our conversation, I have not redacted these files. I scanned in the paper files that we received from the CCG and provided it in full to Mr Austen-Jones.”



This video shows that rather providing conclusive proof that WHCCG did not tamper with the documents, Mike Fulford actually provided proof that they did. Statistically, there is a 1 in 1.322 trillion chance that it could have been a scanning error (in over two hundred pages, the only changes happened to documents that had been written / scanned in, rather than emails and letters, hence the ability to calculate a probability), but I don’t think I’m that unlucky.


This is just one document that was altered. I will continue the game of Spot the Difference with other documents on Twitter. You can follow me @PhilAustenJones.


Please also follow @NHSCHCSCANDAL for updates on the campaign led by Philip Mathias for a judicial review into the NHS Continuing Healthcare scandal.


POST SCRIPT


Like many of my blog posts, this was provided to West Hampshire CCG in advance of publication for a factual accuracy check. No errors have been reported.


More worryingly, there has been no contact at all. Despite the evidence, it appears that Maggie MacIsaac (CEO), Mike Fulford (Chief Operating Officer), Sarah Schofield (Clinical Chair of Board), Dr Stuart Ward (Board member) Judy Gillow (Board member) and Dr Peter Bibawy (Chair of North East Hampshire and Farnham CCG) believe that this behaviour is acceptable in their organisation, even when they know that it is causing harm to individuals.

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