Our latest Case Digest shares learning from a selection of complaints brought to NIPSO about the experience in the health and social care sector of patients with a learning disability.

The Parliamentary and Health Service Ombudsman (PHSO) and NHS Resolution (NHSR) have signed a memorandum of understanding signalling their commitment to working more collaboratively over the next year.

Both organisations hold valuable insight on emerging safety issues, recurring failings, and areas of operational pressure across the health system. More effective sharing of this information between the two organisations will enable them to:

• provide robust evidence to the NHS about areas of safety concern
• help prevent future failings in care and support the safe delivery of services
• better plan for demand on their services, recognising that an increase in complaints could signal an increase in future claims, and vice versa.

Their work will also focus on making sure their own services are accessible and designed around the needs of the people who use them. They will work together more closely to:

• clearly explain to service users the differences between PHSO and NHSR’s functions
  • improve mutual understanding between staff in both organisations to support more effective collaboration 
  • strengthen and standardise signposting between the two organisations 
  • improve communication in cases where both PHSO and NHSR are carrying out an investigation.  

Rebecca Hilsenrath KC (Hon), Chief Executive of PHSO, said: 

“This agreement will strengthen the existing partnership between our two organisations. We have a clear shared focus: sharing the learning from complaints and disputes to improve patient safety across the NHS. I look forward to working in closer collaboration with Helen and her team at NHSR to see how we can jointly use our insight to prioritise the patient voice and drive service improvements.”

Helen Vernon, Chief Executive of NHSR, said:

“Partnership working to achieve shared objectives is a priority for NHSR. We are delighted to be taking forward work with the PHSO to make the most of our shared data and expertise to support wider improvements for the benefit of patients.”

Many of us will face the moment when someone we love needs end of life care - whether in a care home, at home with support, or in a council-funded placement. How that care is delivered does not just affect the person who is dying: it shapes how their family grieves, and how they remember those final days, for years to come.

Mistakes made at the end of a loved one’s life cannot be corrected. But unlike almost any other public service failure, there is one chance to get it right, and the Local Government and Social Care Ombudsman (LGSCO) is today calling on councils and care providers to take that opportunity, every time.

The report, No Second Chances: What Complaints Teach Us About End of Life Care, sets out the most common failures seen in the complaints it receives: poor communication with families, inadequate care plans, services not working together, insensitive handling of death notifications, difficulties around visiting, and unfair charges after death.

Real cases drawn from the ombudsman’s work illustrate the human cost of these failings - families not called in time to say goodbye, a daughter learning of her mother's death before anyone offered condolences, and a woman who discovered her cousin had died over a year earlier, her grave unmarked and overgrown.

The report sets out what families have a right to expect: to be kept informed as a loved one's condition changes; to be treated with warmth and honesty; to have the person they love cared for as an individual, with their own wishes and preferences respected. And when the worst happens, to receive the news with the sensitivity and compassion it deserves.

These things do not require significant extra resources or investment. They simply need more compassion and a human touch. These are acts of basic humanity, and they shape how families grieve for years to come.

Amerdeep Clarke, Local Government and Social Care Ombudsman, said:

"Most of us will face the death of someone we love. How that experience unfolds – whether we feel informed, included and treated with kindness, or left confused and shut out – becomes part of how we remember that person and how we grieve them. Those memories do not fade.

"We know that the people working in care homes and councils want to do their best for the people they look after. This report is for them. It is a practical guide to help them ask honestly: could every family we work with look back on this time with as much comfort as possible?

"The changes we are asking for do not require significant new investment. They require compassion, good planning, and a genuine commitment to treating every dying person as a human being with people who love them. There is only one chance to get this right. We want to help the sector take it."

The report includes practical guidance and self-review questions for councils and care providers on end of life care.

The Ombudsman also has a free toolkit, to help care providers strengthen their complaints handling more generally. The toolkit can be downloaded from asctoolkit.lgo.org.uk.

Local authority leaders have an historic opportunity to rebuild public trust in local services through local government reforms, says the Local Government and Social Care Ombudsman.

New figures, showing a 33% rise in complaints made to the Ombudsman about English authorities over the past year, suggest the case for change is more urgent than ever.

The Ombudsman’s annual review of complaints argues the sweeping programme of local government reorganisation and devolution underway across England is a chance to break down the barriers that have held back joined-up delivery of public services for decades.

The LGSCO received 27,625 complaints in 2025-26, more than doubling the 16% rise recorded the previous year, across every service area from housing and adult social care to special educational needs and children's services. The scale of the increase is striking:

• Complaints about benefits and tax rose fastest, growing by 65% followed by housing (46%) and children’s services (41%).
• Housing complaints were the most common issue brought to the Ombudsman – making up almost 20% of complaints received, with complaints about homeless services and social housing allocations the most common issues raised.
• London Boroughs saw the sharpest rise of any authority type at 45%.
• In education, complaints about support for children with special educational needs made up more than a third of all the cases we upheld, more than any other single issue.

Ombudsman, Amerdeep Clarke said the figures reflect not just individual service failures, but a broader and deepening crisis of public confidence - a pattern visible across all UK public sector Ombudsman bodies.

Mrs Clarke added:

"A 33% rise in complaints is not a statistical blip. It is a signal. When people cannot get the help they need, and feel they have no other recourse, they come to us. That so many are doing so tells us something important: there is a serious and growing gap between what residents expect and what they are receiving from their local authorities.

"The once-in-a-generation programme of local government reorganisation and devolution now underway presents a genuine opportunity to redesign services, break down the silos that have frustrated joined-up delivery for decades, and find locally-driven solutions to problems that have persisted through successive waves of national reform.

“New authorities should not inherit old failures: they should inherit the learning that comes from them. That intelligence, if left uncaptured, cannot be recovered.

"The problems documented here are serious. But they are not insurmountable. And the opportunity to address them, at pace and at scale, has rarely been greater."

The report also gives reason for optimism. When someone brings a complaint, the Ombudsman first assesses whether it needs a full investigation. In a growing number of cases - up 20% this year - the Ombudsman found that the authority had already dealt with the complaint properly through its own process. This suggests authorities are improving how they handle complaints. When the Ombudsman does make formal recommendations, local authorities act on them in 99.9% of cases, though in more than 750 instances, agreed actions were carried out later than required.

The review also highlights independent University of Manchester research, funded by the Nuffield Foundation, which found many of the problems driving complaints are rooted in national systemic failures, including inadequate funding and chronic shortages of educational psychologists among them. That research concluded that how seriously local authorities engage with learning from complaints makes a measurable difference to residents' lives.