Low confidence in NHS complaints process ‘stops patients flagging poor care’

A lack of confidence in the NHS complaints process means some people are taking no action when they experience poor care, according to the patient champion.

There is also “little evidence” that complaints being made to the health service are being used to improve services, Healthwatch England said.

It comes as a poll showed more than half of those who made a complaint to an NHS organisation were not satisfied with the process or outcome.

The survey of 2,650 adults in England, carried out by YouGov for Healthwatch, found almost one in four (24%) had a poor experience with the NHS in the last year.

However, 56% of these people took no action, with fewer than one in 10 (9%) making a formal complaint.

Of those who did not formally complain about their experience, some 34% said it was because they did not think the health service would use the complaint to improve care.

A third of people said they did not think NHS organisations would respond effectively, while one in five said they were worried that complaining would affect their ongoing treatment.

Some 19% of those who experienced poor care did not know how to complain, the poll found.

Of those who did complain, some 56% were dissatisfied with the process, with the same proportion unhappy about the outcome.

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.”

Figures published in October show the total number of all reported written complaints in the NHS in 2023/24 was 241,922, an increase of 5.4% compared with the 229,458 reported in the previous 12 months.

However, the Healthwatch report claims “low public confidence is preventing people from taking any action after experiencing poor care”, meaning that current complaint numbers “could just be the tip of the iceberg”.

It added that “there is little evidence that complaints are being systematically used to improve care”.

Analysis by Healthwatch shows there has been a 37% hike in complaints between 2013/14 and 2023/24.

It suggests this could mean people are more confident about speaking up, as more organisations adopt NHS Complaints Standards which were introduced in 2022.

However, it also claims the rise could be “driven by poorer quality of care caused by pressures on the NHS, especially since the pandemic”.

“Despite year-on-year increases, the health service may not have learned from complaints and remains in a cycle of repeating the same mistakes,” the report said.

Ms Ansari added: “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.”

An NHS spokesman said: “Every patient deserves high-quality care, and NHS staff are working tirelessly to respond to the increasing demand for services – with a record number of patients coming forward in both primary care and hospitals in the past year.

“The NHS takes patient experiences very seriously and we are committed to listening to patients and rolling out initiatives like Martha’s Rule, which is already having a transformative effect in some cases.

“This report highlights that there is still more to do to listen to patients, respond to complaints and improve services, which is why the NHS is working closely with the Government on this year’s 10-Year Health Plan to help us transform services to provide the best quality care for patients.”

A spokesperson for the Department for Health and Social Care said: “This report shows the NHS complaints system is failing far too many patients.

“We are determined to foster an environment where patients and NHS staff alike are able to speak up, knowing they will be supported and that their concerns will be listened to and acted upon.

“We must never turn a blind eye to failure, which is why we will build a culture of transparency in the NHS and ensure patients voices are heard.”

Isabel Lawicka, director of policy and strategy at NHS Providers, added: “Listening to patients and their families is a vital part of delivering a safe service.”