Quarter of England Faces Poor NHS Care: Complaints Go Unheard, Trust Eroding

In the past year, a report by Healthwatch England revealed that approximately a quarter of people in England had experienced poor care in the NHS. Alarmingly, fewer than one in ten of these individuals filed complaints about their experiences, with more than half of those who did not satisfied with the process or the outcome. This report highlights a persistent issue with how the NHS handles complaints, raising questions about whether the system is truly learning from patient feedback to improve the quality of care.

The findings are part of an ongoing concern about the state of healthcare in England, with many patients feeling that their voices are not being heard. Healthwatch England’s survey paints a picture of a healthcare system where poor care is prevalent, complaints are difficult to resolve, and a lack of public trust in the process remains widespread.

A Widespread Problem

The data provided by the report, which surveyed 2,042 adults about their experiences with NHS care and a second group of 2,650 individuals who had experienced poor care, paints a stark picture of the healthcare system’s struggles. 24% of patients reported receiving poor care over the last year. In real terms, that means 10.7 million people in England have suffered from inadequate healthcare services. Despite this alarming statistic, 56% of those affected did not take any action, and just 9% lodged an official complaint.

There are many reasons why individuals may refrain from making complaints, with one in five patients (20%) fearing that it could negatively impact their treatment in the future. Another 34% did not trust the NHS to take their complaints seriously or to use them as a means to improve services. These statistics highlight the erosion of confidence in the NHS’s ability to effectively address concerns raised by patients.

The right to complain is enshrined in the NHS Constitution for England, which obligates the health service to learn from complaints and use them to improve care. However, this report suggests that the system is failing in its duties, with little evidence that complaints are being used in a meaningful way to drive improvements.

Failures to Learn and Adapt

Louise Ansari, the Chief Executive of Healthwatch England, expressed deep concerns about the NHS’s failure to take complaints seriously. She accused the system of being “stuck in a cycle of repeating the same mistakes” and failing to heed warnings that have been raised over the past decade. One significant example of this is the patient safety scandal at Mid Staffordshire Hospital, which prompted widespread calls for reform in how the NHS handles patient concerns.

Ten years later, the report suggests that the public still lacks confidence in the NHS complaints system. Healthwatch England has been urging the NHS to overhaul its approach to complaints handling, calling for a culture of “listening and learning” so that patients’ concerns are taken more seriously and lead to meaningful change. The NHS, however, has shown limited progress in addressing these systemic issues.

The Process of Complaints and the Lack of Timely Responses

The report highlights significant delays in the NHS’s ability to respond to complaints. NHS Integrated Care Boards (ICBs) are currently taking between 18 and 114 working days—an average of 54 working days—to address complaints. This delay is further exacerbated by the fact that there is no standardized timeframe for response, with ICBs operating at different speeds.

Healthwatch England has called for mandatory response times to be set by the Department of Health and Social Care, in order to ensure that patients’ complaints are handled in a timely and consistent manner. Additionally, the report stresses the need for ICBs to measure patient satisfaction with the complaints process and the outcomes of their complaints, as a way to ensure that complaints are not just acknowledged but acted upon.

Increasing Complaints Amidst a Struggling NHS

The number of complaints against the NHS has risen sharply in recent years, with a record 241,922 complaints filed in 2023-24. This represents a 5.4% increase compared to the previous year and a 38% increase from 2013-14. While some may interpret this rise as a sign of increasing public confidence in the complaints process, Healthwatch England suggests that it could also be indicative of a decline in the quality of care, exacerbated by ongoing pressures faced by the NHS, particularly in the wake of the COVID-19 pandemic.

The health service has been under immense strain, with hospitals and GP surgeries treating record numbers of patients in 2024. However, the increasing number of complaints, combined with the low public confidence in the NHS’s ability to address them, paints a grim picture of a healthcare system struggling to keep up with demand.

A Culture of Complaints

A key finding of the report is that the NHS has not embraced a “patient-centred” approach to complaints. Instead of using complaints as a means to improve care, there is a lack of proactive engagement with patient feedback. The report describes the NHS as lacking a culture of “welcoming, handling, responding, or learning from complaints in a way that prioritizes the patient experience.”

This reflects a broader issue within the NHS, where complaints are often viewed as an inconvenience or a burden rather than an opportunity for improvement. Patients are often left feeling that their concerns are not being taken seriously, and that the system is more focused on maintaining its operations than on addressing the real issues that patients face.

The Broader Implications for the Healthcare System

Healthwatch England’s report paints a troubling picture of a healthcare system that is failing to meet the needs of its patients. The lack of trust in the NHS complaints system, coupled with the slow response times and the lack of meaningful change, suggests that the system is not equipped to handle the demands of modern healthcare.

Furthermore, the report suggests that these issues are contributing to a broader decline in public confidence in the NHS. With just 24% of people in Great Britain expressing satisfaction with the NHS in 2024—its lowest level in 40 years—the healthcare system is facing an existential crisis. Patients are increasingly feeling abandoned by a system that is struggling to meet their needs, and the lack of action on complaints only exacerbates this sense of frustration and disillusionment.

A Call for Reform

The findings of Healthwatch England’s report represent a stark call for reform in how the NHS handles complaints and patient feedback. There is a pressing need for a cultural shift within the NHS, where complaints are seen not as a nuisance, but as an opportunity for growth and improvement. The NHS must take its duty to learn from complaints seriously, and ensure that patients’ concerns lead to tangible improvements in care.

For this to happen, the NHS will need to prioritize patient-centred care, streamline its complaints process, and commit to addressing the root causes of poor care. Only then can the system begin to rebuild public trust and deliver the high-quality care that patients deserve.