How and why we’re trialling an appeals unit

Ombudsman Services | Nov 28, 2019

In several recent forums Ombudsman Services has shared with member companies that we are operating an appeals unit on a trial basis. Here’s some more information on the trial.

Background

Dispute resolution by nature often leaves one party disappointed with the outcome, so it’s to be expected that decisions are sometimes questioned.

As an ombudsman we recognise that our decisions should be right first time, every time. This trial is designed to enable us to get the insights we need to make improvements.

How the trial works

Member companies have requested that appeals made against initial Ombudsman Services decisions be reviewed by a different investigation officer, so that these cases are seen from a fresh perspective by someone who is independent of the original decision.

This is the approach being adopted by the appeals unit in this trial.

For the duration of the trial the appeals unit will be looking at up to 50% of cases where post-initial decision appeals are logged – either by a consumer or a member company.

We chose to apply the trial to energy complaints only because this enabled us to effectively secure the necessary sample volumes in a ring-fenced test environment, without causing disruption across the board to our normal processes and procedures.

Evaluation and assessment

The effectiveness of the appeals unit during the trial will be defined using a set of criteria (see below – Objectives).

The three-month trial will conclude at the end of January 2020. We expect to be able to share the progress and initial findings of the trial at the end of each month, and to share the final results with member companies in Q1 2020.

The long-term expectation is that, if this trial provides overall quality improvements, reduces the volume of post-initial decision appeals and improves overall outcomes, it will be ultimately be rolled out across cases in both the energy and communications sectors.

Objectives

To understand if a change in our current appeals process has a beneficial impact on:

  • Improving the overall quality and consistency of our decision making
  • Reducing the number of post-initial decision appeals
  • Sharing learnings within Ombudsman Services in the interests of making continuous improvements
  • Reducing the number of post-initial decision complaints logged by consumers
  • Improving the overall capacity and volume of initial decisions by reducing the number of repeat investigations
  • Improving the training, knowledge, application and understanding of investigation officers (IOs) as they attain feedback following the review
  • Providing managers with data and insight to assist with ongoing performance management and quality assurance

Pre-decision process in trial appeals unit

  • An initial decision by an investigation officer (IO) is pre-checked by a senior investigation officer (SIO) prior to it being issued
  • The SIO completes a quality assurance (QA) checklist and tracks the case to the QA framework and database
  • Feedback is given to the IO by the SIO or operational team manager (OTM) depending on the nature and complexity of the case or level of changes required, with any required changes being made
  • Approval to issue the decision is provided by the SIO or OTM
  • If required at this point, our coaching and feedback framework enables SIOs and OTMs to address any learning and development needs

Post-initial decision process in trial appeals unit

  • The current, standard pre-decision process as detailed in the above applies
  • A post-initial decision appeal is logged by a consumer or member company
  • The case is assigned to an SIO so that it can be reviewed by a different and independent SIO
  • The SIO contacts the consumer and member company within our case management system to advise that the case will be reviewed and that the case is now assigned to them. The SIO will also discuss and manage expectations with the customer or member company
  • The SIO reviews the case and reasons for appeal
  • The SIO completes a QA checklist and tracks the case to the QA framework and database
  • The SIO will issue the response to consumer and member company via the messaging facility on our online case management system
  • All post-appeal work is completed by the new SIO
  • At this point the coaching and feedback framework facilitates for the SIOs and OTMs to address the learning and development needs directly to the IO who completed the initial decision
  • The Key Account Management / Relationship team are informed, who will feed back to the member company if required
  • The appeal process ends

Note: in both processes, each investigation officer (IO) and senior investigation officer (SIO) is assigned to an operational team manager (OTM) within investigations.

Request to member companies

During the trial it will become apparent that there are inconsistencies in the way cases are managed by Ombudsman Services because some cases will fall under the new trial process and some cases will not.

We ask that member companies bear with us for the duration of the three-month trial.

In order to gain a true reflection of the impact of this trial we ask that member companies log post-initial decision appeals within the case management system as usual and follow normal, current processes.

We are not able to respond to requests to escalate a specific case with a post-decision appeal to the trial appeals unit and member companies won’t be able to dictate or select which cases are dealt with by the unit.

Feedback

We welcome feedback from member companies on the impact of this trial. Please send your comments and observations to our Account Development Consultant team, whose contact details you can find here.