It's so difficult to complain about the NHS that patients give up trying: Thousands put off lodging formal grievance as they fear it may lead to reprisals against relatives  

  • Care Quality Commission (CQC) review highlights poor complaint handling
  • Grievances ‘too often’ met with defensive culture rather than listening one
  • CQC is also worried about the lack of openness in adult social care


Hospital patients are so confused by NHS complaints procedures that many do not bother to speak out at all, a report warns today.

Thousands are put off lodging a formal grievance by baffling systems or concerns that their gripes will lead to reprisals against a loved one, say watchdogs.

A review by the Care Quality Commission (CQC) also pointed to poor complaint handling, slow investigations and patients not being taken seriously as key areas of concern in hospitals.


It said complainants were met ‘too often’ with a defensive culture rather than one that listens and is willing to learn.

But it is also worried about ‘very few’ complaints over adult social care and primary care, which could indicate the lack of an open culture in which concerns are welcomed. 

Professor Sir Mike Richards, chief inspector of hospitals at the CQC, said: ‘A service that is safe, responsive and well-led will treat every concern as an opportunity to improve, will encourage its staff to raise concerns without fear of reprisal, and will respond to complaints openly and honestly


‘Unfortunately this is not happening everywhere. While most providers have complaints systems in place, people’s experiences of these are not consistently good.

‘We know from the thousands of people who contact the CQC every year that many people do not even get as far as making a complaint as they are put off by the confusing system or worried about the impact that complaining might have on their or their loved one’s care.

‘More needs to be done to encourage an open culture where concerns are welcomed and learned from.’

The CQC received more than 18,000 complaints about poor care last year – 50 a day – while written complaints about the NHS to the Health and Social Care Information Centre topped 75,000. Healthwatch England recently estimated that 250,000 incidents went unreported last year because people felt unable to complain for various reasons.


The Patients Association last month found half of complaints were not handled well and warned the culture of secrecy in the NHS has barely changed since the Mid Staffordshire hospital scandal, in which hundreds of patients died due to neglect.

Health Secretary Jeremy Hunt said: ‘One of the biggest lessons of the tragedy at Mid Staffs is the need to listen and act on all complaints.

‘So as part of our drive to confront poor care we’re making sure people know how to complain and transforming complaints handling – now a crucial part of the CQC’s tough, independent inspection regime.’

The CQC’s inspection teams are now being told to take complaints handling into account during inspections in England.

The latest report follows a review of the NHS complaints system last November by health experts and Ann Clwyd, the Labour MP who broke down in the Commons as she described how her husband died in hospital ‘like a battery hen’.

Welcoming the report, she said: ‘I want the many thousands of people who wrote to me in the course of my review to know that change is expected as a result.’

Richard Lloyd of Which? said: ‘For too long the views of health and social care users have not been heard, so it’s good the regulator is taking steps to improve complaints handling and put patient feedback at the heart of what it does.

‘We now need greater detail on how complaints will trigger action from the regulator, to give people confidence it’s worthwhile speaking up and that something can, and will, be done.’