PHSO Casework Decisions
3,622 published casework decisions from the Parliamentary and Health Service Ombudsman (Apr 2021–Mar 2026). PHSO selects a subset of completed investigations for public publication — these 3,622 decisions represent approximately 1.1% of the 321,459 total complaints received across the same period. Source: decisions.ombudsman.org.uk.
3,622
Published Decisions
3,089
Health
533
Parliamentary (Govt)
18%
Upheld / Partly Upheld
Showing 14 results matching "Bedfordshire Hospitals NHS Foundation Trust"
Bedfordshire Hospitals NHS Foundation Trust (P-004835)
NHS in England
Closed After Initial Enquiries
Transfer, discharge and aftercare
AI summary: Mr. X complained the Trust discharged his wife when she was not medically fit, questioning if more could have been done to prevent her death.
Bedfordshire Hospitals NHS Foundation Trust (P-004796)
NHS in England
Closed After Initial Enquiries
None
None
None
None
None
AI summary: Mrs E complained about failures in her father's care, including delayed angiosarcoma diagnosis, failure to realise severity, referral delays, poor communication and complaint handling.
Bedfordshire Hospitals NHS Foundation Trust (P-004503)
NHS in England
Partly Upheld
Treatment
Drugs / medication
Communication
Communication
AI summary: Mrs F complained her husband missed liver follow-ups and had medication stopped, leading to an ulcer and death. She also alleged poor communication about his condition and missed final moments.
Bedfordshire Hospitals NHS Foundation Trust (P-004498)
NHS in England
Closed After Initial Enquiries
Referral
Access
AI summary: Mrs P complained a medical centre (Trust A) refused a face-to-face appointment, delaying diagnosis, and a nurse (Trust B) failed to report identified haemorrhoids, further delaying care.
Bedfordshire Hospitals NHS Foundation Trust (P-004237)
NHS in England
Closed After Initial Enquiries
Diagnosis
AI summary: Mr A complained about a misdiagnosis of his brain injury, insufficient examination, rough skull examination, and manipulated CT scan results following a head injury in 2018.
Bedfordshire Hospitals NHS Foundation Trust (P-003662)
NHS in England
Partly Upheld
Nursing care
Nursing care
Treatment
AI summary: Mrs L complained the Trust failed to support her father's nutrition, oral care, and mobility, or provide physiotherapy after discharge, which she believes led to his death.
Bedfordshire Hospitals NHS Foundation Trust (P-003488)
NHS in England
Closed After Initial Enquiries
Choice and Consent
Communication
Drugs / medication
Diagnosis
AI summary: Mr G complained about an ear operation, alleging inadequate consent, incorrect surgery, uncommunicated infection, poor post-operative advice, and lack of pain relief for a follow-up procedure.
Bedfordshire Hospitals NHS Foundation Trust (P-002880)
NHS in England
Closed After Initial Enquiries
Treatment
AI summary: Miss Y complained about delayed fractured pelvis diagnosis, poor pain management, inadequate hydration, poor blood sugar monitoring, and delayed atrial fibrillation monitoring for her mother.
Bedfordshire Hospitals NHS Foundation Trust (P-002734)
NHS in England
Closed After Initial Enquiries
Treatment
Transfer, discharge and aftercare
AI summary: Ms L complained the Trust failed to act on her father's angiogram results in April 2020 and did not perform a follow-up, delaying heart surgery and potentially affecting his survival.
Bedfordshire Hospitals NHS Foundation Trust (P-002105)
NHS in England
Closed After Initial Enquiries
Treatment
Communication
AI summary: Miss H complained the Trust refused gastric sleeve surgery due to mental health issues without consulting her local team, and a letter contained rude comments.
Bedfordshire Hospitals NHS Foundation Trust (P-002013)
NHS in England
Partly Upheld
None
Communication
AI summary: Mrs C complained the Trust discharged Mr J while he was clinically dehydrated and immobile, leading to distress and readmission. She also cited poor communication of his condition to the family.
Bedfordshire Hospitals NHS Foundation Trust (P-001975)
NHS in England
Not Upheld
None
AI summary: Mrs S complained staff failed to refer her father to the safeguarding team despite his distress and mental health decline, potentially affecting his care.
Bedfordshire Hospitals NHS Foundation Trust (P-001495)
NHS in England
Closed After Initial Enquiries
Diagnosis
AI summary: Mrs E complained the Trust failed to diagnose her father's hiatus hernia, prematurely discharged him, and did not perform an endoscopy or treat his delirium, leading to his death.
Bedfordshire Hospitals NHS Foundation Trust (P-001453)
NHS in England
Closed After Initial Enquiries
Diagnosis
Diagnosis
AI summary: Mr A complained the Trust failed to investigate and diagnose Mr I's metastatic cancer, and the Practice missed opportunities to refer him for appropriate care.
Upheld / Partly Upheld
259 + 397
18% of decisions found fault with the organisation complained about.
Not Upheld
247
Complaint investigated but no fault found. 1 resolved during investigation.
Closed After Initial Enquiries
2,718
PHSO decided not to proceed to full investigation.
Most complained-about:
HM Revenue and Customs (80), University Hospitals Birmingham NHS Foundation Trust (72), NHS England (62), Manchester University NHS Foundation Trust (50), HM Courts and Tribunals Service (48).
Published Decisions Over Time
Excludes 2,718 closed before investigation. Quarterly, by outcome.
Annual Complaints (PHSO-wide)
Official PHSO annual statistics across all organisations
| Year | Received | Investigated | Upheld | Upheld % | Remedy % |
|---|---|---|---|---|---|
| 2019-20 | 54,478 | 12,275 | 1,216 | 9.9% | 0% |
| 2020-21 | 44,139 | 7,822 | 617 | 7.9% | 0% |
| 2021-22 | 62,553 | 13,426 | 727 | 5.4% | 0% |
| 2022-23 | 61,297 | 15,734 | 782 | 5.0% | 0% |
| 2023-24 | 63,471 | 17,321 | 946 | 5.5% | 0% |
| 2024-25 | 35,521 | 10,070 | 519 | 5.2% | 0% |
Remedy % = percentage of PHSO remedies complied with on time
Top Themes
Themes by Upheld Rate
AI-classified themes across PHSO casework decisions
| Theme | Decisions | Upheld | Rate |
|---|---|---|---|
| Delayed Recognition of Deterioration | 747 | 184 | 25% |
| Complaint record keeping failures | 632 | 108 | 17% |
| Clinical negligence harms learning | 460 | 92 | 20% |
| Care plan failures | 436 | 121 | 28% |
| Care and discharge planning | 288 | 77 | 27% |
| No person-centred care | 215 | 46 | 21% |
| Inaccurate and inaccessible patient records | 204 | 37 | 18% |
| Patient dignity and privacy | 147 | 40 | 27% |
| Inadequate Pre-Operative Risk Assessment | 136 | 44 | 32% |
| Duty of Candour implementation | 134 | 43 | 32% |
| Medication Contamination/Misadministration | 128 | 33 | 26% |
| DWP policy impact assessment | 106 | 12 | 11% |
| Poor health and social care integration | 97 | 21 | 22% |
| Mental Health Crisis Referral Delays | 74 | 10 | 14% |
| Coroner family information gaps | 74 | 25 | 34% |
PHSO Complaint Categories
PHSO Categories by Upheld Rate
PHSO's own issue classifications — broad categories such as 'Treatment' cover a wide range of clinical complaints
| Category | Decisions | Upheld | Rate |
|---|---|---|---|
| Treatment | 1,610 | 418 | 26% |
| Diagnosis | 850 | 206 | 24% |
| Communication | 792 | 233 | 29% |
| Complaint handling | 534 | 161 | 30% |
| Drugs / medication | 463 | 130 | 28% |
| Nursing care | 388 | 154 | 40% |
| Access | 363 | 87 | 24% |
| Transfer, discharge and aftercare | 353 | 119 | 34% |
| Referral | 262 | 58 | 22% |
| Administration | 191 | 30 | 16% |
| End of life care | 170 | 50 | 29% |
| Choice and Consent | 165 | 48 | 29% |
| Continuing healthcare | 160 | 14 | 9% |
| Surgery | 145 | 32 | 22% |
| Record keeping and management | 133 | 30 | 23% |
Organisation Accountability
Combines PHSO annual complaint statistics (volume, remedy compliance) with published decisions portal data (uphold rate). Sorted by upheld rate for organisations with 5+ investigated decisions. Benchmark: 73% average upheld rate among fully investigated decisions. This differs from the headline 18% figure, which includes all 3,340 published decisions — most of which were closed before full investigation (upheld/not upheld only applies to fully investigated cases). Sparklines show complaint volumes received 2019–20 → 2024–25.
Received = complaints received in most recent year (PHSO annual data). Remedy compliance = % of PHSO-recommended remedies complied with across all available years. — = no data in that dataset for this organisation.