Among the many improvements outlined as part of the government’s 10-year plan for the NHS is a commitment to both reform the complaints process and improve response times to such complaints.
1. What can NHS staff do to support this?
In its 3 July policy paper, 10 Year Health Plan for England: fit for the future, the government acknowledged that: “The NHS does not take patient feedback seriously enough.” As a result, the government has pledged to update complaints regulations and increase the use of AI tools to ensure complaints data is collected and responded to more quickly.
The recent policy paper said that one AI tool is already in development and being tested on the Federated Data Platform – an approach that it intends to further resource and expand across 2025 and 2026.
2. Survey reveals “no confidence” in NHS complaints system
In January, YouGov carried out a survey of 2,650 adults for Healthwatch England and found that 24% of respondents reported having a poor experience with the NHS in 2024. Despite this, 56% of those people said they took no action. Just 9% chose to make a formal complaint.
The survey discovered that 34% of those who did not complain, said it was because they had no confidence in the NHS to use the complaint to make improvements. A third did not feel that the NHS would respond effectively and, perhaps most worryingly, one in five were concerned that making a complaint might negatively affect their ongoing treatment.
Compounding all these issues around a lack of confidence in the process itself was the fact that 19% said they did not know how to make a complaint.
Of those that managed to navigate the complaints procedure, 56% said they were dissatisfied with the process and the same proportion reported being unhappy with the outcome.
With public confidence in the NHS already at rock bottom, this apparently barely functioning complaints system is a major barrier to improvement. “We can only improve if we know what is working well and what is working less well,” the government’s recent policy paper stated at the start of this month.
“Though many providers already have their own feedback systems, comments or complaints often receive a formulaic response from someone who is far removed from the frontline. This feedback is too rarely aggregated and translated into quality improvement actions.”
3. But NHS complaints are on the rise
While the complaints process is clearly not working for patients, the system is seeing more demand. According to the Parliamentary and Health Service Ombudsman’s July 2024 figures, there were 28,780 complaints about the NHS in England between 1 April 2023 to 31 March 2024. The organisation has since gone on to change the way it handles complaints, reducing its scope to just the most serious cases.
NHS England released data in October 2024 that revealed that between 1 April 2023 and 31 March 2024 in England the total number of all reported written complaints in the NHS was 241,922, an increase of 12,464 (5.4%) from 2022-23 (229,458).
Hospital and community health services received 107,745 of that total number of complaints in 2023-24, an increase of 3,871 (3.7%) from 2022-23 (103,874). The largest proportion of new complaints received by individual subject area was communications with 17.1%. Of the total number of complaints received, 26.4% were upheld.
Primary care, which includes GPs and dentists, received 134,177 complaints in 2023-24, an increase of 8,593 (6.8%) from 2022-23 (125,584). The proportion of complaints that were fully upheld was 31.6%. The largest proportion of new complaints received by any individual subject area was clinical treatment with 14% (GP) and 25.6% (dental).
4. What can NHS staff do to improve their complaints process?
The government’s policy documents found that the number of complaints to the ombudsman for healthcare is nearly seven times higher than for railways. “This cannot be right. The problem is that the NHS doesn’t listen well enough. The most common reason for complaints is poor communication,” the paper said.
Patrick Keenan, lead complaints handling trainer at Bond Solon agrees. “Getting it right at the point of initial contact is essential for successful complaints management. If the triage process of the complaint does not achieve a consensus, it is very unlikely that the product, despite how well intended, will address the issues that the complaint clearly wanted investigated. This is often where the most challenging conversations must take place and where indicated unreasonable asks are refused. The establishing of an ‘agreed agenda’ additionally has benefits for complaints teams as right it serves as the direction of travel towards an informed response and keeps both sides focused on the core complaint.”
With the government itself saying that “the NHS complaints procedure is far from where it needs to be”, improvements are needed across the board. Professionals working within the NHS must be alert to the risks of falling short in this area. Not only, as the government points out, do complaints highlight areas for improvement but handling them correctly will help rebuild public trust overall.
Bond Solon offers a nationally recognised qualification in Complaints Handling and Investigations. The qualification is made up of three one-day training courses designed to equip those handing complaints in the NHS to do so with confidence and to best practice standards.
The three courses are Process, Procedure and Information Gathering, Questioning and Communication Techniques and Responding to Complaints – Letter and Report Writing. For more information, or to start the qualification, please contact info@bondsolon.com or call 020 7549 2549.