NHS complaints system lets people down, new research warns
We commissioned a poll to find out whether people know how to make complaints about their NHS healthcare and get support to do so, following Lord Ara Darzi's independent investigation into NHS performance last year.
The investigation 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."
Key findings in our research
Our 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 didn’t 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%, 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%.
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, 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".
Beth’s story: "I feel let down by the NHS"
Beth, 60, made a formal complaint to PALS in March 2024 after she was taken to A&E the previous year.
She believed she had been misdiagnosed at A&E. During her 18-week treatment at hospital, her possessions, including engagement and wedding rings, went missing, she found a wound on her leg, and she was treated poorly by a hospital staff member.
Following her complaint, an investigation was launched and a meeting scheduled few months later. Beth said:
"They were unable to answer any of my questions. The hospital couldn't even find a record of the staff member I mentioned. I had to fight for answers about what happened, but now it doesn't feel like this will do anything at all. Instead of taking my complaint seriously and fixing the problems in their system, the hospital staff just circle the wagons and deflect. I feel let down by the NHS.”
Beth’s experience has shattered her confidence to raise complaints again. It's also made her feel uncomfortable getting any treatment at her local hospital, to the extent that she now feels privately funded care is the only way she’ll continue her recovery.
We call for a culture of listening and learning from complaints
Louise Ansari, our 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 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.”
Key recommendations
Our findings show that the NHS 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.
Read our 'A pain to complain' report
About the poll
YouGov undertook polling on people’s experience of NHS complaints systems. It consisted of two parts:
-
Nationally representative sample of 2,042 adults (18+) living in England polled between 17 and 22 October. The polling aimed to find out their confidence in making a complaint about poor care and the prevalence of people in the population who had had an experience of poor NHS care since October 2023. It found nearly one-quarter, 24%, had a poor experience of NHS care in the past 12 months. This would equate to an estimated 10.7 million adults when applied across the current population.
-
Boosted samples to find out the experience of people who had had a poor experience of the population. Fieldwork was carried out between 17 and 23 October 2024. Total sample size was 2,650 adults (18+) living in England that had a poor experience of NHS healthcare since October 2023.
