Factsheet for NHS organisations about the Joint Working Team

Who we are and what we do

The Local Government and Social Care Ombudsman (LGSCO) and Parliamentary and Health Service Ombudsman (PHSO) have a team of investigators who consider complaints for both Ombudsmen. This is the Joint Working Team.

We look at complaints that are about both health and social care services where we decide that a joint consideration of the complaint would be beneficial. Generally, we handle complaints where the health and social care issues are so entwined that we need to investigate both functions at the same time.

In some circumstances it is difficult to distinguish which of the events complained about are health care and which are social care. We focus on the nature of the function or duty being complained about, rather than on the source of the funding.

The Joint Working Team is based across both LGSCO and PHSO offices. We primarily use LGSCO procedures. That means you will find that some aspects of our approach and communication differ from what you may be used to seeing from PHSO. We explain more about this below. However, our fundamental approach to considering complaints is the same.

Who we investigate

LGSCO can investigate complaints about councils and social care providers (including privately funded care providers). PHSO can investigate complaints about services delivered by or on behalf of the NHS and about parliamentary services, however parliamentary services are not within the remit of the Joint Working team. 

The law says that, where a council has commissioned another organisation to provide a service on its behalf (for example, a care home or domiciliary care agency), the LGSCO will hold the council responsible for any failings that are identified. In contrast, in most cases PHSO investigates whichever organisation provided the NHS service, rather than the commissioner.

The Joint Working Team follows LGSCO’s approach for complaints about social care, and PHSO’s approach for complaints about health care.

For complaints about care provided under s.117 of the Mental Health Act 1983/2007 we will always include the relevant council and CCG. This is because both have a legal duty to provide s.117 services and neither councils nor CCGs can delegate the accountability for this. We may also include a commissioned NHS provider as well, if relevant to the complaint.

Similarly, for complaints about or involving Continuing Healthcare funding (CHC) we treat the CCG as a responsible organisation even if another organisation delivers that service.

When complaints are ready for us

The complaints procedure for councils and NHS organisations is set out in the Local Authority Social Services and NHS Complaints (England) Regulations 2009. Section 9 covers complaints that concern more than one responsible body. It states that, in these circumstances, the responsible bodies must co-operate in handling the complaint. This includes duties to: establish who will lead the process; share relevant information; and provide the complainant with a coordinated response.

In view of this legal duty, PHSO and LGSCO have agreed that it is generally not reasonable to expect a complainant to have exhausted two or more separate complaints procedures where the initial local response should have been provided jointly and covered all elements of the complaint. Therefore, if one organisation has investigated and responded to the complaint but other(s) have not, we may use our discretion to investigate the complaint against both or all organisations even if some parts of the complaint have not been answered through local complaints procedures.

Providing information to us

Under section 12(1) of the Health Service Commissioners Act 1993 and section 29(1) of the Local Government Act 1974, the Ombudsmen have the powers of the High Court to require the production of evidence or witnesses. You do not need the consent of the complainant or patient to provide us with medical or other records.

Please try to respond with the information we request by the date we request it. If you have difficulty with this please contact us before the deadline to explain why. If we do not receive information we have requested, and we are not satisfied that there is a good reason for the delay, we may serve a warrant on the head of the organisation for the information.

We request information from you by email. Our email addresses are in the format Initial.Surname@coinweb.lgo.uk. Our email system is compatible with Egress. There is a 20MB limit on incoming emails so you may need to break information down into smaller subsets.

Answering our questions

If we decide to investigate a complaint, we will ask you for your comments and for information. Often, we will ask you to supply written answers to the investigator’s questions. Please respond fully and openly and provide evidence to support what you say. This is your opportunity to explain what happened and the basis for your decisions. Alternatively, if something went wrong, this is an opportunity to recognise, apologise, and possibly suggest a remedy you could provide to the complainant.

It is a legal requirement that any person or organisation directly involved in the actions complained about is made aware of our investigation and given the opportunity to comment.  Please ensure you make all relevant persons aware. Current employees should provide their comments along with the organisation’s, former employees or contractors can respond directly to us if they prefer. 

Complaints about clinical care and treatment

When we request clinical records, please only provide them for the specific period we requested. Do not provide the whole file, if the patient has had more than one period of care. Please provide the records in good order, and include all relevant records for the specific period of care.

With clinical records, please reference or provide details of any relevant clinical standards, guidance or policies you used in the care or treatment complained about. If you departed from any relevant policies or guidance, please explain this.

When appropriate, the Joint Working Team will obtain clinical advice via PHSO to assist our investigations. If there is a relevant standard or guidance and the clinical decisions, actions and judgements do not appear to have been in line with it, we will consider what evidence there may be to explain this, including any explanations you have provided.

Our decisions

We publish all our decisions on LGSCO’s website. You can see examples of decisions on joint working complaints here: https://www.lgo.org.uk/decisions/health. All decision statements are published unless there are specific reasons why we should not publish, for example a risk of breach of anonymity. We name the organisations involved, but not individuals. We wait three months after the decision has been issued to publish a decision statement on our website. Decisions stay on the website for five years and are then removed.

Financial remedies

When we uphold a complaint, we may recommend that the organisation(s) make a financial payment to remedy the injustice.  To determine the amount, we use LGSCO guidance for social care parts of the complaint and PHSO guidance for health care parts of the complaint.  However, where more than one organisation is responsible for the fault and injustice we will not spend disproportionate time assessing how to apportion a financial remedy.  We may recommend one amount and leave it to the organisations to agree how to split it between them. 

Confidentiality and data protection

We will usually share written responses to our enquiries and clinical advice with the complainant.  However, complainants can also make subject access requests for complaint file material and clinical records.  We follow the Information Commissioner’s guidance that material on complaint files constitutes the complainant’s personal data, so any material sent to us is usually disclosable under the data protection rules, unless one of the exemptions apply.  We do not usually share any information about a third party or which is confidential for another reason.  If you are sending information which should not be disclosed, please clearly identify it, and send it separately to the information which can be shared. If any of your documents contain details of individuals with whom the complainant has had no previous contact and which are not publicly available, please provide two copies: one that has this personal information redacted and a non-redacted version.

Further information

You can find further information about the Joint Working Team here: https://www.lgo.org.uk/adult-social-care/complaints-about-health-and-social-care and here: https://www.ombudsman.org.uk/about-us/what-we-do/working-others/investigations-local-government-and-social-care-ombudsman-lgsco

You can find the Joint Working Manual with guidance for the team here: https://www.lgo.org.uk/information-centre/staff-guidance

You can find our manual for councils, which contains relevant information about working with LGSCO, here: https://www.lgo.org.uk/information-centre/reports/information-for-link-officers

May 2019