How can the NHS complaints system be improved?

Healthwatch England 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 poll shows that out of 2,650 adults living in England who had experienced poor NHS care since October 2023, over half took no action about their care, and fewer than one in 10 made a formal complaint.

Several barriers prevented those who had a poor experience to make a formal complaint:

• 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 and the outcome of their complaint. 

We need an effective NHS complaints system

Introduced in 2009, the NHS constitution pledges to listen and learn from complaints and drive improvements in patient care. 

Thus, 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.

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.

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.”