NHS complaints system lets people down, warns patient champion

• A poll of 2,650 adults who had a poor experience of NHS healthcare last year shows over half didn’t take any action. 
• Of those who had a poor experience but didn’t formally complain, a third thought the NHS wouldn’t use their complaints to improve services, while a similar proportion didn’t believe their concern was ‘serious enough’. 
• Making a complaint is a right enshrined in the NHS Constitution. 
• Healthwatch England urges the government and NHS leaders to make the complaints system easier for patients and families to navigate, monitor its performance, and develop a culture of listening and learning from complaints across the sector.

New research warns that people have low confidence in the NHS complaints system and struggle to navigate it, which prevents them from acting when they have a poor experience. 

Healthwatch England conducted a poll to assess people’s experiences of NHS complaints, following Lord Ara Darzi's independent investigation into NHS performance, which found serious failings in how the service listens to and responds to patient feedback. 

The poll found that out of 2,650 adults living in England who had a poor experience of NHS healthcare, over half, 56%, took no action about their care, and fewer than one in 10, nine per cent, made a formal complaint. 

Among those who didn’t formally complain when they had a poor experience, research identified a number of key barriers to doing so: 

• Around a third of respondents, 34%, didn’t believe the NHS would use their complaint to improve services; 
• A third, 33%, thought NHS organisations wouldn’t respond effectively to their complaint; 
• Thirty percent didn’t believe the NHS would think their complaint was serious enough; 
• One in five, 20%, were scared that complaining would affect their ongoing treatment; 
• Nineteen percent said they didn’t know who to contact to make a complaint. 

Overall, over half of people who made a complaint to an NHS organisation were dissatisfied with both the process of making a complaint (56%) and the outcome of their complaint (56%). 

Making a complaint is a right enshrined in the NHS Constitution. Introduced in 2009, the constitution pledges to listen and learn from complaints and drive improvements in patient care. 

An effective complaints system should be an essential part of improving health services and restoring public satisfaction with the NHS, which is at a record low, 24%, according to data from The King’s Fund. 

In recent years, numerous public inquiries and reports have called for changes to the complaints system after providers and regulators failed to act in serious safety cases. 

In 2014, Healthwatch England published a report on people’s experiences of health and care complaints systems, following the scandal at Mid-Staffordshire Hospital. Suffering in Silence concluded that people found “making complaints overly complex, incredibly frustrating and largely ineffective”. 

Since then, there have been structural changes in complaints handling, with England’s 42 integrated care boards taking on powers to handle primary care complaints where patients don’t go to their service directly. Most recently, the Parliamentary and Health Service Ombudsman, which handles concerns that haven’t been resolved locally, saw a significant rise in complaints about the NHS. They have called on the Government and the NHS to listen and learn "when things go wrong".

 Louise Ansari, Chief Executive of Healthwatch England said: “We know that public satisfaction with the NHS is at record low levels, with too many patients receiving poor care. When patients feel their complaints are not taken seriously or don’t take any action due to a complex system, services miss out on vital information to help them improve. 

“We flagged failings with the NHS over a decade ago, following the patient safety scandal at Mid Staffordshire Hospital. Ten years on, our research shows that the public still lacks confidence in the NHS complaints system. 

“We need a step change in how people’s complaints are handled and acted on. Healthcare leaders should focus on developing a culture of listening and learning from complaints across the sector. Making it easier for patients and families to navigate the complaints system through the NHS App, setting mandatory response times, and measuring people's satisfaction with the process and the outcomes from complaints will be a key part of this.”