New national research shows a number of barriers are stopping people from making a complaint about their health care.
Healthwatch England commissioned a poll to find out whether people know how to make complaints and get support to do so, following Lord Ara Darzi’s independent investigation into NHS performance last year.
The investigation, known as A Pain To Complain, found serious failings in how the service listens to and responds to patient feedback. It highlighted that “the patient voice is simply not loud enough. There are real problems in responsiveness of services to the people they are intended to serve.”
You can download the full report here.
Key findings
The poll, conducted by YouGov, 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 did not formally complain when they had a poor experience, our research identified a number of key barriers to doing so:
- Around a third of respondents, 34%, did not believe the NHS would use their complaint to improve services.
- A third, 33%, thought NHS organisations would not respond effectively to their complaint.
- Thirty percent did not 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 did not 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%.
Key recommendations
The findings show that the NHS across England does not consistently welcome, handle, respond to or learn from complaints in a patient-centred manner. We need action to:
- Make the complaints process easier for patients and their families to navigate.
- Monitor and improve the performance of organisations that handle complaints
- Develop a culture of listening to and learning from complaints.
We call for a culture of listening and learning from complaints
Louise Ansari, Healthwatch England chief executive, 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 do not 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.”
Alex Stewart, chief executive of Healthwatch Norfolk (pictured above), added:
“One of the concerns we hear from patients in the county is that they decide not to make a complaint as they worry this could affect their care. In those situations, they often come to us for advice and reassurance around what to do and how best to ensure their concerns about care are addressed.
“As an organisation, we do meet with complaints managers across the health care system regularly so we can share issues of concern with each other and ensure there is an open dialogue across the health and care system.
“Overall, patients, their friends, families and carers want to feel they can speak to someone, share their concerns and if things have gone wrong, feel reassured the same thing will not happen to someone else.”
We need an effective NHS complaints system
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 of 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 including NHS Norfolk and Waveney taking on powers to handle primary care complaints where patients do not go to their service directly.
Most recently, the Parliamentary and Health Service Ombudsman, which handles concerns that have not 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”.
