NHS complaints data is just ‘tip of the iceberg’

Our new analysis of complaints data shows that over half a million incidents of poor care across NHS went unreported in last two years

This morning the Health and Social Care Information Centre has published its official figures for the number of written complaints received by the NHS reporting a total of 174,872 for 2013/14.

Yet new analysis by consumer champion, Healthwatch England, suggests that a potential 500,000 incidents of poor care and unsatisfactory patient experience across the NHS went unreported over the last two years.*

If we are going to help our GPs, hospitals and care homes to improve and really put people at the heart of the decision making process then we all need to be willing and able to challenge the service we receive when it's not up to scratch.

A YouGov survey of 1,676 adults across England showed, that in the last two years, roughly 1 in 3 people (30 per cent) had personally experienced poor care or witnessed a relative or friend receive poor care from a health or social care service. Of this group, well over half (61 per cent) did not make a complaint about it.**

Based on the HSCIC's report alone, this suggests the roughly 250,000 people every year are not only failing to get the standard of treatment and care they expect but feel unable to make their voices heard.

The findings also indicate a fall in the number of people who went on to make a complaint after a poor experience. A similar survey conducted for Healthwatch England in March last year showed that 54 per cent of people who experienced poor care chose not to report it.***

Worryingly, Healthwatch England's investigations in to why this is happening have shown that the health professionals people feel least comfortable complaining about are in fact doctors - most notably those who have most direct, intimate and immediate impact on their health such as surgeons and psychiatrists.****

Effectively the current systems has left the public more comfortable complaining about dodgy washing machines or dirty hotel rooms than they are about the treatment and care they get from health and social care professionals and institutions. On the high-street, for example, almost three quarters (73%) of UK adults feel that shops and services apply the principle that the 'customer is always right', with over half (51%) reporting that they not only know their consumer rights but are comfortable using them. *****

Yet when it comes to health, just over 1 in 10 (13%) reported knowing what their current legal rights are and how to use them to get the high quality care and support they are entitled to.*****

The NHS Constitution outlines people’s existing rights about complaints, including that they are properly investigated and patients are kept informed about the outcome of any investigation.

However, the need to improve the way the complaints system operates is well documented and Healthwatch England is working with the likes of the Parliamentary and Health Services Ombudsmen, the Local Government Ombudsmen and the Care Quality Commission, as part of the Department of Health’s Complaints Programme Board to provide a vision for complaints handling and ensure that people have access to the support they need to help them complain.

A full report from Healthwatch England into the state of the complaints system in health and social care is due in October.

Responding to the HSCIC report on NHS complaints, Anna Bradley, Chair of Healthwatch England, said:

"The report out today really is just the tip of the iceberg when it comes to complaints about health and social care services in this country, with the reported figures significantly underrepresenting the true number of incidents of poor care.”

"The need to improve the way the complaints system operates is well documented and we have been working with Government to simplify the often baffling process for patients and their families. But for things to work properly, health professionals clearly need to do more to make people feel less intimidated about making their voices heard."

On Healthwatch England's research findings about consumer rights, Anna Bradley, said:

"Consumer rights are second nature to us on the high-street, but when it comes to our health too few of us know what our rights actually are.

"If we are going to help our GPs, hospitals and care homes to improve and really put people at the heart of the decision making process then we all need to be willing and able to challenge the service we receive when it's not up to scratch.”


* There were 162,019 complaints recorded by the Health and Social Care Information Centre for NHS services in 2012/13 and 174,872 in 2013/14. Yet research by Healthwatch England identified that 61 per cent of those who experience poor care, or witnessed a friend or relative receive unacceptable treatment, did nothing to report it. If all these cases had reported their experiences then Healthwatch England calculated there would have been an additional 526,932 complaints over the last two years.

** Total sample size for the YouGov Plc. survey was 1676 adults. Fieldwork was undertaken between 20th - 21st August 2014.  The survey was carried out online. The figures have been weighted and are representative of all English adults (aged 18+).

*** The statistic on reporting of complaints is taken from an online YouGov survey commissioned by Healthwatch England between 25 and 27 March 2013 and the results were then weighted to be representative of all GB adults (aged 18+). Total sample size for the 2013 survey was 2076 adults, of which 1781 were based in England.

**** As part of an ongoing investigation Healthwatch England conducted a review of 403 people who came forward online with their experiences of complaining about health services. The full findings of this work will be published in our 'State of Complaints' report in October.

***** These results come from a YouGov survey of 2299 people, commissioned by Healthwatch England in March 2014 assessing the difference between consumer attitudes on the high street and in health and social care settings.

The NHS Constitution explains an individual's rights when it comes to making a complaint. Everyone has the right to:

  • have their complaint properly investigated

  • know the outcome of any investigation into their complaint

  • take their complaint to the independent Parliamentary and Health Service Ombudsman if they are not satisfied with the way the NHS has dealt with the complaint

  • make a claim for judicial review if they think they’ve been directly affected by an unlawful act or decision of an NHS body

  • receive compensation if they’ve been harmed by negligent treatment