The joint working process can be simply explained as follows. At the end of each stage a decision will be made about what should happen with the complaint.

Consulting

Before a case can be transferred to the JWT, PHSO and LGSCO staff will consult with the JWT team to check whether, on a brief consideration of the facts, the case meets the criteria for joint working. We call this an initial look task. We do not need consent to carry out an initial look task on a case by virtue of:

LGA 74 (and equivalent for Part 3a)

33  Consultation between Local Commissioner, the Parliamentary Commissioner and the Health Service Commissioners [and other Commissioners and Ombudsmen]

(1)     If, at any stage in the course of conducting an investigation under this Part of this Act, a Local Commissioner forms the opinion that [the matters which are the subject of the investigation include] a matter which could be the subject of an investigation—

(a)     by the Parliamentary Commissioner, in accordance with section 5 of the Act of 1967,

. . .

(b)     by the Health Service Commissioner for England . . ., in accordance with [the Act of 1993],

………

he shall consult with the appropriate Commissioner [or . . . Ombudsman] [about the matter and, where a complaint was made about the matter, he shall], if he considers it necessary, inform the person initiating the complaint under this Part of this Act of the steps necessary to initiate a complaint under the Act of 1967[, . . .][. . . the Act of 1993[, the Public Services Ombudsman (Wales) Act 2005] or under the Act of 2002], as the case may be.

(2)     Where, by virtue of subsection (1) above, a Local Commissioner consults the Parliamentary Commissioner, [a housing ombudsman,] [the Public Services Ombudsman for Wales][, the Scottish Public Services Ombudsman] or [the Health Service Commissioner for England] in relation to [a matter under investigation under this Part of this Act], he may consult that Commissioner [or] [that Ombudsman] about [anything relating to the matter], including—

(a)     the conduct of any investigation into the [matter], and

(b)     the form, content and publication of any report of the results of such an investigation.

[(3)     If at any stage in the course of conducting an investigation under the Act of 1967, the Parliamentary Commissioner] forms the opinion that the complaint relates partly to a matter which could be the subject of an investigation under this Part of this Act, he shall consult with the appropriate Local Commissioner about the complaint and, if he considers it necessary, inform the person initiating the complaint . . . of the steps necessary to initiate a complaint under this Part of this Act.

 

……..

 

(6)     In this section the “Act of 1967” means the Parliamentary Commissioner Act 1967 and [“the Act of 1993” means the Health Service Commissioners Act 1993] [and the Act of 2002” means the Scottish Public Services Ombudsman Act 2002].

HSCA 93

18  Consultation during investigations

(1)     Where [the Commissioner], at any stage in the course of conducting an investigation, forms the opinion that the complaint relates partly [or wholly] to a matter which could be the subject of an investigation—

(a)     . . .,

(b)     by the Parliamentary Commissioner under the Parliamentary Commissioner Act 1967,

[(ba)     by the Public Services Ombudsman for Wales under the Public Services Ombudsman (Wales) Act 2005,]

(c)     by a Local Commissioner under Part III [or 3A] of the Local Government Act 1974, . . .

(d)     [by the Scottish Public Services Ombudsman under the Scottish Public Services Ombudsman Act 2002], [. . .

(e)     . . .]

he shall consult about the complaint with the appropriate Commissioner [or . . . Ombudsman] and, if he considers it necessary, he shall inform the person initiating the complaint of the steps necessary to initiate a complaint to that Commissioner [or . . . Ombudsman].

 

(2)     Where [the Commissioner] consults with another Commissioner[, the Scottish Public Services Ombudsman] [or . . . Ombudsman] in accordance with this section, the consultations may extend to any matter relating to the complaint, including—

(a)     the conduct of any investigation into the complaint, and

(b)     the form, content and publication of any report of the results of such an investigation.

(3)     Nothing in section 15 (confidentiality of information) applies in relation to the disclosure of information . . . in the course of consultations held in accordance with this section.

Based on the above, both organisations can share information about a complaint to consult with each other without the express consent of the PA or REP. As this is set down in law, the rules around GDPR and consent do not apply because we will be carrying out a statutory function when we consult with each other. 

There is no mechanism for a PA or REP to appeal or challenge an initial look task decision. It is solely the JWT’s decision about whether a case should be transferred into the team. 

Consultation – the Initial look stage

PHSO requests

PHSO staff will send an email to the LGSCO Intake dedicated email address containing:

• Name of PA

• Name of REP (if appropriate)

• The PHSO reference number

• Details of the organisations involved, where known

• A copy of the PHSO complaint form and any substantive BINJ responses 

• An explanation of the complaint and why the PHSO staff member thinks it might be suitable for JW; and

• The contact details of the PHSO staff member including direct dial phone number.

LGSCO Intake will set up new case on ECHO, save the JW screen and forward the case to Assessment. This creates a task for the JWTC. 

Copies of internal guidance provided to PHSO staff about joint working can be found here.

LGSCO requests

Intake

Where an adviser identifies during a phone call that there may be an opportunity for joint working they will:

• Ask the person if they want to complain about care/treatment by the NHS organisation as well as the Council/care provider
• If yes, the adviser will explore the following: 
• Do they want the JW team to consider the complaint? 
• Does the person provide consent for LGSCO to share their personal information with the PHSO? 
• The person making the complaint may ask what is involved regarding consent. If so, the adviser can use the consent letter and form in JWA letter template folder as a guide.
• Which NHS organisation(s) is it they are complaining about? (including name and address)
• If no, it is an LGSCO complaint and needs forwarding to the LGSCO assessment queue
• If yes, the adviser will save the JW screen which will put the case into the JWA queue and set a task for the JWTC. 

Alternatively, where an adviser identifies from a complaint form or letter that there may be an opportunity for joint working they will:

• Try to make phone contact with the person to clarify if they want to complain about care/treatment by the NHS organisation as well as the Council/care provider
• If yes, the adviser will explore the following: 
• Do they want the JW team to consider the complaint? 
• Does the person provide consent for LGSCO to share their personal information with the PHSO? 
• The person making the complaint may ask what is involved regarding consent. If so, the adviser can use the consent letter and form in JWA letter template folder as a guide.
• Which NHS organisation(s) is it they complaining about? (including name and address)
• If no, it is an LGSCO complaint and needs forwarding to the LGSCO assessment queue
• If yes, or no phone contact can be made, the adviser will save the JW screen which will put the case into the JWA queue and set a task for the JWTC. 

Assessment

If a case is at Assessment and the investigator thinks it may be suitable for joint working, they should

• Make a note in N&A to explain why they think the case may be suitable for JW, and
• Try to make phone contact with the person to clarify if they want to complain about care/treatment by the NHS organisation as well as the Council/care provider
• If yes, the investigator will explore the following: 
  • Do they want the JW team to consider the complaint? 
  • Does the person provide consent for LGSCO to share their personal information with the PHSO? 
• The person making the complaint may ask what is involved regarding consent. If so, the adviser can use the consent letter and form in JWA letter template folder as a guide.
• Which NHS organisation(s) is it they complaining about? (including name and address)
• Save the JW screen – this will put the case in the JW queue and set a task for the JWTC. 
• If the investigator cannot make contact with the PA/REP, they should just save the JW screen

NB: if a JW screen already exists, this will be because there will have been an Initial Look task carried out previously. The Assessment investigator, to request a new Initial Look Task, should create a new version of the Joint Working screen by clicking on ‘new’ and then saving the screen. 

Investigation

As the case is already at IU in ECHO we should not go through the regression process to try to get it back to AT. This adds too many complications and will cause reporting issues. We will therefore use the ‘shadow case’ process. A full process map is available here.

The IU TC should set up a new shadow case on ECHO and link it to the original case. The lead BinJ on the case will be the same as that on the original case. The contact method on the contact screen will be ‘JW Assessment Case’. The date of receipt will be that day’s date. The case should also be marked as ‘urgent’. The process will then be the same as if we had received notification from PHSO. 

The IU TC should set up a new shadow case on ECHO and link it to the original case. Whilst usually the ‘copy case’ function can be used, if the original case is an OCS case it should not be. This is because copying an OCS case automatically adds the new case onto the complainant’s OCS account. And since shadow cases are only to allow us to record the admin and we do not provide the complainant with the JW investigator’s contact details at this point, it is not appropriate for these to show on the OCS account. The lead BinJ on the case will be the same as that on the original case. The contact method on the contact screen will be ‘JW Assessment Case’. The date of receipt will be that day’s date. The case should also be marked as ‘urgent’. The process will then be the same as if we had received notification from PHSO.

NB: While the ‘shadow case’ will be used to record outcomes, any notes and documents etc should be held in the original case.

Handling Initial Look Tasks

The JWTC will check the ILT unallocated report for new cases and will assign the case to a team member as soon as possible. This is done through the fields on the JW screen. 

The investigator will then consider if the case needs full JW consideration and will record their decision in the fields on the JW screen. The initial look task will be completed within five working days of the request. 

Hints and tips for considering initial look tasks can be found here. More information about completing the joint working screen for initial looks tasks case be found here. 

NB: There may be more than one version of the Joint Working screen so check which one needs completing.

Possible outcomes after Initial Look 

Referral from PHSO

If a case is not suitable for a full joint working assessment, the investigator will advise the PHSO staff member of the outcome. The investigator will complete the allocation screen and early decision screen on ECHO, using the invalid decision reason - ‘not a body in jurisdiction’. The investigator will also complete the Joint Working Screen with an outcome of ‘not for Joint Working’. They will also complete the ‘no longer JW’ field. More information about the Joint Working screen can be found here.   If the complaint contains parts which LGSCO could investigate, PHSO staff will be advised to signpost the complainant to LGSCO. 

If a case is suitable for a full joint working assessment, the investigator will advise the PHSO staff member by email, ask them to get written consent from the PA/REP and to send over the relevant documents on the case once written consent has been received.  The transfer documentation will be sent directly to the JWTC. 

PHSO will also confirm the date PHSO received the complaint. PHSO cannot send documents over until written consent is received. PHSO will also write to the PA/REP advising the complaint is being passed to the JWT for further consideration. This letter should explain possible outcomes i.e.

• whether we could or should investigate
• whether we should consider the complaint jointly; or
• whether each or both organisations should consider the complaint but separately of each other. 

Copies of internal guidance provided to PHSO staff about joint working can be found here.

Referral from LGSCO Intake

The JWT investigator will consider the case. If they decide that the case:

• Is suitable for further JW consideration, the JWTC will send a notification to the PA/REP which will explain about JW, ask for written consent and explain possible outcomes:
  • whether we could or should investigate
  • whether we should consider the complaint jointly; or
  • whether each or both organisations should consider the complaint but separately of each other. 
• Is not suitable for JW consideration, they will record their decision in the fields on the JW screen and enter a date in the ‘no longer JW’ field. This will put the complaint back in the AT queue as long as the AT allocation screen has not been saved. The team will remain as JWA however this will change once the case is allocated at AT. AT can then allocate and assess as usual.  They should also include a note in N&A if the PA/REP needs signposting to PHSO. It will then be for the AT investigator to do so during their consideration and contact with the PA/REP Does not have enough information on it to decide if it is JW, they should contact the PA/REP for the additional information they need.
• Does not have enough information on it to decide if it is JW, they should contact the PA/REP for the additional information they need.
• If the outcome of the ILT is that the complaint is ‘not for joint working’ but the investigator can see that the case appears to be premature, they will task the nominated Assessment Team Co-ordinator so they can deal with the premature referral.
• If there are consent/capacity issues that need to be considered on a case that is ‘not for joint working’, they should task the ATC user using the relevant task template

Referral from LGSCO Assessment

The investigator will consider if the case is suitable for a full joint working assessment and record their decision in the fields on the JW screen. If they decide that the case:

• Is suitable for further JW consideration, they will ask the AT Investigator to send a notification to the PA/REP which will explain about JW, ask for written consent and explain possible outcomes:
  • whether we could or should investigate
  • whether we should consider the complaint jointly; or
  • whether each or both organisations should consider the complaint but separately of each other. 
• It is the responsibility of the AT investigator/TC to ensure that written consent is received. 
• There are autotexts staff can use to create consent letters or add text into N&A around consent discussions. They are:
  • JW consent letter
  • JW consent

• Is not suitable for JW consideration, they will record their decision in the new fields on the JW screen and enter a date in the ‘no longer JW’ field. They should then reallocate the case back to the investigator who raised the original query and set them a task to advise the JW consultation is complete. Reallocation back to the original AT investigator should be done by overwriting the Assessment allocation screen. They should also include a note in N&A if the PA/REP needs signposting to PHSO. It will then be for the AT investigator to do so during their consideration and contact with the PA/REP
• Does not have enough information on it to decide if it is JW, they should ask the original AT investigator to contact the PA/REP for the additional information they need.

Referral from LGSCO Investigation 

NB: While the ‘shadow case’ will be used to record outcomes, any notes and documents etc should be held in the original case.

• The investigator will consider if the case merits a full joint working assessment and record their decision in the fields on the JW screen. 
• If it is not JW, they will contact the LGSCO investigator to advise. They will also need to complete the allocation screen and early decision screen on ECHO on the shadow case. The decision reason they will use is one of the invalid decision reasons - ‘not a body in jurisdiction’. They can then close the case. If the complaint contains parts which PHSO could investigate separately, the original investigator will signpost the complainant to PHSO. 
• If the case is suitable for JW consideration, the original investigator must ensure we have written consent from PA/REP for information sharing and joint working between PHSO/LGSCO. We cannot accept the complaint into JW until we have written consent. The JW Investigator will complete the relevant fields on the Joint Working screen to record the outcome of their initial look task. 

The Assessment stage

Where, following an initial look task, a case needs a full joint working assessment, it will appear in the JWA unallocated post look task report. The JWTC will use this report to allocate cases to investigators for assessment. The case should be allocated to the individual investigator with the team of JWA.

When a case is allocated, the TC will complete the AT allocation screen and send out an allocation letter which will explain the assessment aspects of the function – to manage expectations and ensure the PA/REP does not get the impression we will definitely be investigating fully. The JWTC will task the investigator to advise they have a new case.

The investigator will then assess the case to decide:

• Who are the BinJs
• Could we investigate
• Should we investigate 
• Should we investigate jointly

Cases that are flagged as urgent will be prioritised for allocation. 

Where the JW investigator decides that a case needs investigating but not jointly, and there are issues that will require an LGSCO mainstream investigation, the JW investigator should follow the standard process as set out in the Assessment Manual. 

Assessing cases already at investigation

Where a case has come from LGSCO IU, when a case is allocated, the JWTC will complete the AT allocation screen (on the shadow case) and will task the investigator to advise they have a new case. The JWTC should not send out the joint working allocation letter to the PA/REP but should send it to the additional JWBinJs.

The JW investigator will then assess the case as above. If the JWT Investigator decides the answer to all of the above is yes, they will support the IU investigator to clarify the scope of the complaint and to send the appropriate letters to the additional health BinJs. The JWT investigator will, on the shadow case, complete the Assessment decision screen for the existing lead BinJ and the JWBinJ Location holding/invalid screens for each of the health BinJs. They will use the following decision reason – ‘IU case accepted for JWI’. They can then close the shadow case. The JW Investigator should then task the JWTC to advise that the main case is for joint working, The JWTC will then completed the JW screen – use the date you are saving the screen for the ‘allocated to’, ‘outcome date’ and ‘JWTC Notified – Actual date’ fields. The ‘Allocated to’ field should be the JW investigator who carried out the assessment’. The case will remain with the original IU investigator who will be supported by the JWT as necessary to investigate the health organisations and complete the additional ECHO screens. 

If the case is not suitable for joint working, the JWT investigator should complete the early decision screen on ECHO on the shadow case. The decision reason they will use is ‘IU case NOT accepted for JWI’. They can then close the shadow case. If the complaint contains parts which PHSO could investigate separately, the original investigator will signpost the complainant to PHSO.

NB: 

The cases where the contact method is ‘JW Assessment Case’ will be excluded from the annual statistics for Part 3/3a BinJs, otherwise we will end up double counting against some BinJs. The decision reasons of ‘IU case accepted for JWI’ and ‘IU case not accepted for JWI’ can be found under the ‘invalid/forwarded’ dropdown list and should only be used by JW team. 

While the ‘shadow case’ will be used to record outcomes, any notes and documents etc should be held in the original case.

JWA decisions

We aim to make an assessment decision on a case within 20 working days of allocation to a JWT investigator. There are a number of different outcomes following a joint working assessment. The table below summarises how JWA decisions should be communicated to PAs/REPs and BinJs:

JWA decision	How to communicate final outcome to PA/REP	Decision reasons to record on ECHO
Forward for investigation	By standard notification letters	Forwarded to investigation
Separated - LGSCO and PHSO to consider issues separately	By letter to explain health issues referred back to PHSO and LGSCO issues to be investigated by LGSCO investigation team	Lead BinJ – Forwarded to Investigation JWBinJs – Separated – Referred back to PHSO, Council case forwarded for LGO investigation
Separated – LGSCO complaint not to be investigated, health complaint to be referred back to PHSO	Decision statement for LGSCO complaint & cover letter to explain PHSO referral	Lead BinJ – Relevant assessment decision reason JWBinJs – Separated – Referred back to PHSO, Council case closed at assessment
Separated – LGSCO complaint has previously been investigated, health complaint to be referred back to PHSO	Decision statement for LGSCO complaint & cover letter to explain PHSO referral	Lead BinJ – Relevant assessment decision reason JWBinJs – Separated – Referred back to PHSO, Council case closed at assessment
Separated – LGSCO complaint has previously been investigated, health complaint to be referred back to PHSO	Decision statement for LGSCO complaint & cover letter to explain PHSO referral	Lead BinJ – Already considered and decided JWBinJs – Separated – Referred back to PHSO, Council case closed at assessment.
Separated – LGSCO complaint has previously been investigated, health complaint to be referred back to PHSO	Decision statement for LGSCO complaint & cover letter to explain PHSO referral	Lead BinJ – Already considered and decided JWBinJs – Separated – Referred back to PHSO, Council case closed at assessment.
Separated – LGSCO complaint to be investigated, health complaint not to be investigated	Decision statement for health complaint and cover letter to explain LGSCO complaint forwarded for investigation	Lead BinJ – Forwarded to Investigation JWBinJs – Separated – Single Council (no health case to investigate)
Neither LGSCO or health parts of complaint to be investigated	Decision statement	Lead BinJ – Relevant assessment decision reason JWBinJs – Relevant assessment decision reason
Premature decision	By letter	Lead BinJ – Premature JWBinJ - Premature

Assessment decisions on LGSCO matters should be logged on ECHO using the LGSCO’s standard decision reasons and decisions on PHSO matters should be logged using PHSO’s decision reasons. A full list of these reasons can be found at appendix one. 

Decision statements are structured in accordance with the LGSCO’s Statement of Reasons Manual. Where we decide that a case should not be investigated by JWI and that the issues can be separated, the JWT investigator does not need to issue a formal decision statement on those parts which are to be investigated solely by PHSO or LGSCO. We can communicate this decision by letter. These letters should be put into the Decision and PDR decision folder in ECHO. If we make a decision which relies on either LGSCO or PHSO jurisdiction, either with or without discretion, this must be communicated in a decision statement. This does not apply to premature decisions. 

Where we decide that the case is no longer a joint working case, for example a complainant has withdrawn consent for joint working, or all the functions complained about are the responsibility of either the Council or health body, the JWT investigator should enter the relevant date in the “No longer Joint Working” field in the “Joint Working” screen on ECHO. This should be done before the case is forwarded on ECHO, if it is a case which warrants further mainstream consideration.

Transferring cases back to PHSO

If the complaint needs to go back to PHSO, and the LGSCO part investigated separately, the JWT investigator will advise the PA/REP as such, complete the ‘no longer JW’ flag (before forwading on ECHO), and fill in the decision screens for the health bodies using the separated reasons. They will complete the form ‘summary for case transfer from LGSCO to PHSO’. They should then email PHSO Business Support to inform them the case needs to be dealt with by PHSO. The email should also include the ‘summary for case transfer from LGSCO to PHSO’ form and any relevant documents. The investigator will then complete the early decision record and forward the case to investigation for the LGSCO part, ensuring the relevant assessment process is followed. 

If the complaint needs to go back to PHSO, but the LGSCO part not investigated, then the investigator will issue a draft and final decision on the LGSCO part of the complaint and also explain that the case will be transferred back to PHSO. If any comments on their draft decision have no impact on their conclusions, the JWT Investigator will complete the early decision screen. They will then refer the health case back to PHSO for priority consideration. They will complete the form ‘summary for case transfer from LGSCO to PHSO’. They should then email PHSO Business Support to inform them the case needs to be dealt with by PHSO. The email should also include the ‘summary for case transfer from LGSCO to PHSO’ form and any relevant documents.

PHSO will then prioritise these cases for its own primary investigation so that these cases can follow PHSO processes and the complainant is not adversely affected by having had to wait for a JWT assessment and then a PHSO one. 

If we have contacted a health body for information during the assessment, but then decide that part of the complaint will not be investigated, we must advise the health body of that decision. 

Copies of internal guidance provided to PHSO staff about joint working can be found here.

Cases needing a detailed joint working investigation 

If the investigator, at the end of their assessment, considers the case needs further consideration before they can make a robust decision on the complaint, they will draft the scope of the complaint and issue the notification of investigation letters – these mirror the letters being used by LGSCO around BinJ notification. The same letter will be used to gather relevant information from BinJs/make enquiries. 

The investigator will then forward the case to investigation. The same investigator will need to complete the IU allocation screen on the same day they forward the case so the case stays with them. The team for allocation at this point should be JWI.

JWT investigations should be carried out in accordance with this manual, the LGSCO Investigation Manual and other relevant guidance.

If either the PA/REP or BinJs provide any comments on the proposal to investigate, these should be considered before any further enquiries are sent. A response to any comments can then be included in any further enquiry letter that is sent. If the JWT investigator decides they have enough information to be able to form their provisional conclusions on the complaint and the PA/REP or BinJ has responded to the proposal to investigate letter, they should respond to those comments before issuing any draft decision documentation. 

If we are continuing to investigate, the investigator will then record their investigation in the investigation, PV and decision sections of workflow. 

At the end of the investigation, the Investigator will issue a decision to the complainant and each of the bodies in jurisdiction.

Where to send health decisions and action plans

If the investigator makes recommendations for systemic improvements to a health body, they will need to ask that body to share a copy of the final decision statement with the relevant regulatory agency. The full list of where decision statements and action plans should be sent can be found here. 

If the complaint is about Continuing Healthcare Funding, we also need to send a copy of our decision to the relevant regional office of NHS England. The full list of contacts can be found here. 

Hard copy documentation

The general expectation remains that organisations will provide the information we request electronically. However, if this is not possible, it may be necessary for them to send this information in hard copy. 

Hard copy papers should be sent to the Coventry LGSCO address. 

PHSO may hold additional information relevant to the complaint. This could include health records. Where possible, all transfers of information will be done electronically but any paper files retained by PHSO can be transferred to the allocated investigator’s office.

When the documents can be scanned

Intake will scan what is ‘scannable’ when it arrives and task the case owner, or JWTC if the case has no owner (Intake will add a note to N&A including which BinJ sent the documents. These hard copies will then go into the normal Intake storage area and will be destroyed after 12 weeks in line with standard procedures. 

When the documents cannot be scanned

Where the case is unallocated, for any documents that cannot be scanned, LGSCO Intake will make a note in N&A that they have the documents, including which BinJ sent them, task the JWTC and keep the hard copy documents for six months. A task will be set for ITL and the Intake staff member to remind them of the documents’ existence in Intake. We expect that by six months, the case should have been allocated and the documents should then have been sent to the case owner. It is important to remember that hard copy records may include CDs of X-rays or scans, and the allocated investigator will need to make sure they obtain the hardcopy documents from the post archive team. Where documents arrive and the case is already allocated, the hard copy documents will be forwarded to the allocated investigator. 

Where we have hard copy documents related to a case, a note of their existence and where they are stored must be in N&A and we must ensure they are subsequently destroyed in line with LGSCO’s document retention policy.

Obtaining clinical advice

JW Investigators request clinical advice using the Clinical Advice Request form on ECHO. The principles about when we might decide to obtain clinical advice are contained here.

There are two types of clinical advice:

• A documented discussion – where the investigator will talk through the issue with a clinical adviser. The investigator then writes up a summary of the discussion which the advisor will check and agree. PHSO’s target for a discussion is five days from when the request was allocated to the adviser
• Written advice – the adviser will provide a written explanation of their views. PHSO’s target is twenty days from when the request was allocated to the adviser.

If you are unsure what type of clinical advice you might need, you should contact one of the PHSO Lead Clinicians to discuss the issue, their contact details are available on the contact sheet.

Investigators may also decide to see a clinical adviser informally (a ‘pop-over’) for advice about making enquiries about the case. Any advice gathered during a ‘pop over’ cannot be used as evidence to inform a decision; only documented discussions and written advice can.   Where health records are required by the clinical advisers, these will normally be sent to them by the JWT electronically. Investigators should also record in ECHO that clinical advice has been requested and the date it was provided (see a guide to using ECHO for joint working).

The Ombudsmen will not routinely share the name or personal details of a clinical adviser. This is to protect the adviser’s personal data and reduce the risk of them being approached within the context of their NHS work. The Information Commissioner’s Office (ICO) has supported this position in a number of judgements it has made.

In the event that a JWT investigator decides to share a copy of the clinical advice with a complainant, they should first redact the adviser’s personal details. 

There is also a spreadsheet here to record any issues with obtaining clinical advice. The information from this spreadsheet is used to feedback to the Clinical Advice Team.

Generally, requests for clinical advice will be sent to PHSO Clinical Advice Team (CAST) by encrypted email from ECHO. Emails from ECHO to CAST should be kept under 10mB.

Where we have emailed a clinical advice request, we should telephone and check that it has been received.

In exceptional cases, we can use MS Outlook to transfer information to PHSO CAST, when we are sending large volumes of information which makes it difficult to use ECHO email for this.

Using MS Outlook to email PHSO CAST

The advantages of using Outlook are (i) it is easy to see the total file size of the email as you add documents to it (ii) you can attach zip folders containing documents and sub-folders.

It is very important to follow the process below if using Outlook to submit a clinical advice request, to ensure we are not storing casework information outside of ECHO inappropriately in a way that breaches GDPR.

This is the only agreed exception to using Outlook for casework.

Moving the documentation to the K drive

1. Create a folder in K:\casework that you can use to store the documents you are going to send to CAST. Use the usual naming convention for the folder - [case ref, no spaces] - [PA surname]- [Team] - [Investigator] – CASE OPEN
2. Make a clear note in N&A that you are storing information in K:\casework on a temporary basis, for the purpose of transferring information to CAST.
3. Set an ECHO task in the case for 3 months later to remind you to review whether you can delete the information in K:\casework.
4. Download information for CAST from your ECHO case into the K:\casework folder you have created, and organise it in whatever way will be easiest for the clinical adviser to use and navigate. Make sure you check the Downloads folder on your PC after you have done this, to make sure none of the documents are still saved there and that they are all in K:\.

Creating ZIP folders within your K drive folder - optional

1. It’s not essential to create ZIP folders to transfer information to CAST, but it is easy to do, reduces the email attachment size, and is a clear and simple way to transfer information in folders and sub-folders. It’s quick and easy to learn how to do this, and can be quite useful. Instructions on how to do this are at the end of this section.

Emailing your request and documents to CAST

1. When you are ready to email the information in your K drive folder to CAST, open your Outlook email, and address the request to the usual email address. This email address has been added to the Outlook address list so please select it from there to avoid the risk of mistyping the address.  You must make sure you encrypt the email to send via Egress Switch, by typing ENCRYPT: before the subject line of your message. The word ENCRYPT must be in capital letters with a colon at the end and a space afterwards, for the Egress encryption to take effect.  The full encryption guidance is available here.
2. You can then attach your ZIP folders / folders / documents for your advice request, making sure the total attachment size for the email is under 25MB. You may need to split your request over several emails due to file sizes. If so, make sure you label each email with a number, so CAST can check they have received all the emails you are submitting.
3. If sending multiple emails to CAST, make sure each individual email is encrypted to send via Egress Switch, as outlined above.
4. Send a final email to CAST with no attachments, from your ECHO email address, asking them to confirm receipt of the earlier emails sent via Outlook. For example:

From:

Hi CAST Team

I’ve just sent 4 separate emails via Outlook, attaching the records folders and documents for this case.

Please could you check you have safely received all 4 emails, and let me know.

As previously advised, please continue to use my casework email address which operates within our ECHO casework management system (relevant email address) for all other contact on the case, including sending the clinical advice report when it is ready. We are only using Outlook for transferring large volumes of information to CAST, and our ECHO casework email is still our default for all other aspects of the case. Please do not reply to my Outlook email address when you send the clinical advice report.

Many thanks

1. Once CAST have confirmed receipt of your Outlook emails, please ensure you permanently delete the emails from your Sent items in Outlook, and that you empty your deleted items folder, so we are not incorrectly storing the casework information outside of ECHO.
2. If CAST reply and send the clinical report to your Outlook mailbox, please delete it, and permanently delete from your deleted folder. Contact CAST and tell them what you have done and ask them to send it to the correct ECHO mailbox.
3. It makes sense to leave the documentation in the K drive at this point, with a 3-month ECHO task to review this, in case you might need to use it again e.g. for a second clinical advice request where you may want to organise the information differently before submitting to CAST.

Creating ZIP folders within your K drive folder - instructions

1. First, organise your documents in your K drive folder into folders and sub-folders. Here is an example of a folder structure you might have on a mental health investigation:

1. You can see from the above that the Action Plan and Clinical Records folders have sub-folders within them, as well as individual documents:

2. We are starting to get case records from organisations quite regularly that are organised into ZIP folders containing sub-folders and documents, so you may have the information organised in this way already in ECHO, which makes it easy to save it into the K drive with this structure.

3. Once you have the documents organised in the way you want in your K drive folder, you can create one or more ZIP folders to transfer the information to CAST. Please bear in mind we need to keep our email attachment sizes for CAST under 25MB, so you may need to split the information into a few ZIP folders that are 25MB or below.

4. Using an example from the mental health case above, the clinical records can be split into three ZIP folders containing sub-folders and documents, with each ZIP folder under 25MB:

5. To create ZIP folder ‘Clinical records 1’ in the example above, use the File Explorer folder on your taskbar and select the folders you want to put into a ZIP folder:

6. Right click your mouse once you have selected the folders and click Send to > Compressed (zipped) folder

   The zipped folder will then appear and you will be prompted to name it. It will then look like this:

   If you double click the zipped folder to expand it, you will see that your sub-folders and documents are still arranged in the same way within it.

   Continue to create as many ZIP folders as you need, using the above approach, and they can then be attached to your Outlook email(s) to CAST once ready

    

Legal advice

Legal advice may be sought by JWT Investigators from either the PHSO legal team or LGSCO’s legal advisors (Bevan Brittan), depending on which may be better placed to provide the advice, considering its subject matter. In addition, where PHSO legal team advise that a response to a legal advice request cannot be met within 10 working days, the investigator should consult with the AO about using Bevan Brittan instead. Bevan Brittan are contracted under a fixed fee retainer agreement to provide 15 minute telephone advice to Investigators and/or written advice on specific matters.  All requests for written legal advice from Bevan Brittan must be signed by the AO. More information about legal advice requests can be found in the Legal Manual.

Information sharing

The Information Sharing Manual contains instructions we must consider when sharing information with complainants, Bodies In Jurisdiction and others. Its key principles are:

• Only share what is relevant to the decision
• Do not share information from or about third parties
• Ensure you have consent to share
• Be mindful of safeguarding
• Delete irrelevant/ duplicate information
• Enquiries should be focused and specific
• Do not accept embedded documents
• Record reasons for sharing/ not sharing information
• Clearly mark information that cannot be disclosed and use the Do Not Disclose folder

The manual contains more detailed information about confidentiality, enquiries to the BinJ,  sharing data with complainants, use of the Do not disclose virtual folder, Data not shared virtual folder, Notes and Analysis, Redaction , Sending sensitive casework material by email or post and Frequently Asked Questions.

If you are unsure of how any of this relates to your complaint, please speak to your manager, or the Chair of the Information Working Group or our Data Protection Officer.

In addition, it is usually appropriate to share clinical advice. However, it should be redacted first to remove the adviser’s details. Clinical advice should also be shared with the relevant BinJ, unless there are exceptional reasons why it shouldn’t be. If a piece of clinical advice covers the actions of more than one BinJ, there is no need to redact it to remove advice about the other BinJs actions when you share it with each of the BinJs as this information will also be available in the draft decision statement. 

If a complainant or representative subsequently asks for all the documents we have seen, then we should share them, taking into account any other restrictions which may apply to the sharing of information. 

Decisions

JWI decisions should be structured in accordance with the LGSCO’s Statement of Reasons Manual using the JW decision template. 

Decisions on LGSCO matters should be logged on ECHO using the LGSCO’s standard decision reasons and decisions on PHSO matters should be logged using PHSO’s decision reasons. 

A full list of PHSO decision reasons is available at appendix one.