Office of the Ombudsman
This appeals procedure for the Office of the Ombudsman deals with a situation where a complainant is dissatisfied with the outcome of their complaint to the Ombudsman and wishes the Office to re-examine their complaint. The procedure may not cover every eventuality which may arise, but the general principles outlined below should be applied to any exceptional cases which may fall outside the scope of this document.
A separate procedure exists for complaints against staff of the Office.
1.2 General principles
It is a fundamental principle of an appeals framework that a person, who has had no previous involvement in the case and who is in a more senior position, will have responsibility for the decision to re-open a case and for reviewing whether the original decision was the correct one.
The original case worker (see glossary at end for definition) will have an opportunity to comment in every case on the merit of the appeal, having regard to the Criteria for Acceptance of an appeal as set out in section 3.0 below. In all cases the original caseworker will be notified of the reviewer’s preliminary decision and afforded an opportunity to comment in advance of his/her final decision.
Suitable arrangements will be made for caseworkers on leave.
All members of the organisation should respect the principle nemo iudex in causa sua and act professionally and impartially with complainants and colleagues when conducting appeal work.
The complainant will be notified of the process and updated on progress.
2.0 The Appeal Process
2.1 Making an Appeal
- The Appeals Procedure will be published on the Office website and in the Office’s Section 16 Manual.
- In the acceptance letter sent to complainants following screening of the complaint, the following will be explained:-
- an appeals procedure exists
- appeals must be made within one month of receipt of the closing letter
- only one appeal is allowed
- all necessary information must be provided in that appeal to assist in the decision to re-open the case and to review the original decision
- clear, substantive reasons for the appeal must be given
- Appeals will normally be sent to the original caseworker who will send them to the Appeals Manager according to the process below (2.2)
2.2 Processing of the Appeal
2.2.1 Stage 1 The caseworker
- The original caseworker, on receipt of the appeal, will examine its contents and write a note on the Complaints Examination System (CES) to the Appeals Manager, responding to the points made. In the note, the case worker should deal comprehensively with the arguments advanced by the complainant and state why he / she feels the case should or should not be re-examined or the appeal upheld
- Where the appeal is made on the basis of new, relevant information, the Appeals Manager should be informed of this
- The case worker will state whether his/ her liner manager was actively involved in the examination and decision making process
- The original caseworker will send the appeal and accompanying note to the Appeals Manager within 5 working days of its receipt and copy this to his line manager
2.2.2 Stage 2 The Appeals Manager
- On receipt of the appeal, the Appeals Manager will log it and acknowledge it. In the acknowledgement letter, the complainant will be reminded of the fact that there is only one appeal and asked to provide all relevant additional information or relevant argument within 7 working days
- If it is apparent that the request for an appeal does not meet the relevant criteria (listed in 3.0) the request will be denied and the Appeals Manager will notify the complainant of such
- Where an appeal is accepted by the Appeals Manager it will be recorded in the Complaints Examination System (CES) by the insertion of an "A" after the complaint number
- If the appeal is based solely on new, relevant information, the Appeals Manager will note this for the purpose of statistical records and the case will be returned to the original caseworker, where possible, for reexamination and closure. The Appeals Manager will have no further input into the case. The caseworker should endeavour to close the case within one month
- Where the appeal is based on perceived flaws in the original process or decision (see section 3.0), the Appeals Manager will forward the case to a Supervisor (other than the original line manager / supervisor, see glossary for definition of Supervisor)
- Where the appeal has been returned to the caseworker, or allocated to a Supervisor, the Appeals Manager will advise the appellant accordinglyThis letter will outline the likely timescale for completion
- The Supervisor will be at least one grade more senior than the original caseworker. Where the caseworker’s line manager was previously involved in the decision making on the case, the Supervisor will be a higher grade than the caseworker’s line manager. (See appendix for further detail)
2.2.3 Stage 3 The Supervisor
- The Supervisor accepts the appeal and notes the comment of the original caseworker
- The Supervisor may examine the case him/herself, or may call upon the assistance of another caseworker not previously involved in the case
- The Supervisor should endeavor to reach his/ her decision on the case within one month
- If seeking assistance from another caseworker, the Supervisor will examine his/her conclusions when received. The Supervisor will make his/her own decision on the case. He /she will, if deciding to overturn the original decision on the case, consult with the original caseworker(s) before finalising his/her decision
- Where a full decision on the outcome of the case is not possible due to the complexity of the case, but reason has been found to re-examine the case, the Supervisor may decide to return the case to the original caseworker with instruction, or to give it to the second caseworker more recently involved in the case
- The Supervisor will document his/her decision (final outcome or decision to re-open case) and rationale and notify the Appeals Manager of this decision. The supervisor will include a proposed draft reply to the complainant and include point 3 of 2.2.4 below
- If a decision is made to complete further extensive re-examination, the recommended outcome will be forwarded when available to the Supervisor. The Supervisor will make the final decision. Again, this will be reported to the Appeals Manager
2.2.4 Stage 4 The Appeals Manager (AM)
- The AM will note the Supervisor’s proposal for closure of the case. The AM will satisfy him/herself that everything has been covered.
- With the Appeals Manager’s approval the Supervisor will sign the closing letter and issue it.
- The AM will ensure that where the appeal is upheld, the complainant is given an apology and an explanation for the change in outcome. Where the appeal is denied, reasons for this will be provided.
- Where the appeal is upheld, the Appeals Manager will discuss with the Supervisor whether any organisational learning can result and agree how this might be done.
- The Appeals Manager will maintain statistics on the numbers of appeals and the numbers upheld. He/she will also identify the number of appeals based on new information only. These statistics will be shared with the Office annually.
2.3 Persistent Appellants
- Where a complainant continues to make appeals on an issue that has already been decided, these should be forwarded to the Appeals Manager.
- If an exceptional circumstance exists, whereby new information has come to light that was not available to the complainant at the time of making his original appeal, then the Appeals Manager, in consultation with the Supervisor or the original caseworker, may decide to process the case again as an appeal / review.
- In most circumstances a standard letter will issue stating that an appeal was provided and the Office will take no further action. With the Ombudsman's approval in each case, the complainant will be told that, in view of earlier decisions and actions, their most recent and future correspondence concerning an appeal of the Ombudsman's decision will be placed on the file without further action/comment.
3.0 Criteria for acceptance of an appeal
In deciding whether to re-open a case, regard should be had to the following criteria in order to decide whether the complainant has made a reasonable case for the complaint to be re-opened. The complainant should be able to show that:
- new relevant evidence/information has become available which might have had a bearing on the original decision in the case
- there was a failure on the part of the Office to examine a relevant and substantial issue
- there was a failure on the part of the Office to obtain relevant and necessary information from the body concerned
- the body's stated position is incorrect; this should be supported by evidence, if possible
- the complaint has been misinterpreted or misunderstood by this Office
- the decision of the Office was incorrect or unreasonable in the context of the complaint made or the particular circumstances of the case
- the appeal is made in reasonable time i.e. not more than one month since the decision was made. Where an appeal application is received beyond this time, the Appeals Manager may accept it on a discretionary basis, depending on the particular circumstances.
Definition of Caseworker
A caseworker is the person who was primarily dealing with the case, perhaps with some assistance or supervision from a line manager. A caseworker may be any grade from CO, EO, HEO to Investigator.
The Supervisor may be at Investigator, Senior Investigator or Director General level; on occasion it may be the Ombudsman. The grade of Supervisor will depend on who "signed off" on the decision/final letter. "Signed off" means the file shows that the person concerned decided the case or was aware of, or approved of, the decision. For example, a decision letter signed by a case worker in Support Unit, but approved by an Investigator, is "signed off" by the Investigator. Therefore the Supervisor in that case will be a Senior Investigator.