A pain to complain: Why it's time to fix the NHS complaints process
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Written complaints in the NHS reached a record high in 2024. With public satisfaction with the NHS at record low levels, the way the NHS handles, responds and learns from complaints is vital.
A high quality, responsive NHS complaints process not only provides a key way for services to learn and improve care, it also shows patients that the NHS values their feedback.
When Healthwatch England first reviewed the NHS complaints process over a decade ago, we found major failings and called for reform. To establish if people’s confidence or experience has improved, we conducted new research between September and December 2024.
Almost a quarter (24%) told us they had experienced poor NHS care in the past year. Yet more than half (56%) of people who experienced poor care took no action, and fewer than one in 10 (9%) made a formal complaint.
Of those who didn’t make a complaint after poor care, 34% believed that the NHS wouldn’t use their complaint to improve services, 33% thought organisations wouldn’t respond effectively, and 30% felt the NHS wouldn’t see their concern as ‘serious enough’.
Over half (56%) of people who made a formal complaint were dissatisfied with both the process and the outcome of their complaint.
The budget allocated to councils to arrange statutory NHS complaints advocacy for local people has declined by more than 20% over the last decade
On average, integrated care boards (ICBs) took 54 working days to respond to complaints they handled as commissioners of NHS services. Response times ranged from between 18 and 114 working days.
NHS organisations do not effectively capture the right data about who makes complaints, do not welcome complaints or fail to fully demonstrate learning from complaints. There is little national oversight and accountability over the complaints process.
The report includes a number of recommendations on the following topics:
- 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