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Breaking down the barriers: Older people and complaints about health care

‘I’m not sure what difference it would make’

Of those aged 65 and over who had made a complaint to the NHS or another public service in the past 12 months, 40% felt it made (or would make) no difference.

Older people can lack confidence in the complaints system. This lack of confidence can have an impact on individuals’ views on the value of complaining. While some older people who receive a poor service will feel determined to make a complaint, over time people can become fatalistic or feel resigned that the service they have always been used to is the one they have to accept. 

What have we seen?

Data from our national survey shows that 76% of the UK population aged 65 and over had used an NHS service in the past 12 months. Of these, 14% indicated there was something they were unhappy with when using these services. Of those older people who indicated they were unhappy with an NHS or another public service, only half went on to complain.  Among those older people who didn’t complain, our survey shows how 32% of those aged 65 and over felt that complaining would not make a difference. 

Among many of the older people we spoke to there was a prevailing sense that making a formal complaint when something goes wrong wasn’t worth the time or effort.'

Across the three focus groups, participants were generally positive about the NHS and care services they have used, and felt that on the whole the health and social care system delivered an excellent service in often difficult circumstances. 

Nevertheless, we also heard about a number of negative experiences. Dissapointingly, among many of the older people we spoke to, there was a prevailing sense that making a formal complaint when something goes wrong wasn’t worth the time or effort:

‘There is no point [complaining about somebody being rude].’ (Manchester focus group participant, older person).

‘Fill in this form, speak to that person, it’s such a faff.’ (London focus group participant, older person). 

‘I know it is probably something to be doing, but you have other priorities.’ (Poole focus group participant, older person). 

We asked older people about the factors which would encourage them to complain, to better understand how we can increase the likelihood of them raising concerns when something is not right. As well as an overall focus on getting their problem solved, there was also a desire to see that the issues that affected them, did not affect other people in the future:

‘When I think about what I would like to complain about, my problem has gone, it’s happened. So what I want now is an explanation of why it happened, I want to know what went wrong... and make sure it doesn’t happen to anyone else.’ (Manchester focus group participant, older person). 

This puts an emphasis on organisations that provide care services, and those that handle complaints like ourselves to highlight the positive impact that complaining can have, not just on the individuals involved, but also for other people who may find themselves in a similar position. 

One complaint can often improve the experience of others who use the service, now and in the future.'

The recommendations we make at the end of an investigation not only focus on putting right the individual’s complaint but, where we recognise that others may be affected by the same situation, we can recommend changes to ongoing procedures and practice. This means that one complaint can often improve the experience of others who use the service, now and in the future.

The following case that we investigated highlights the positive difference that one complaint can have on many people. 

Mr F’s story

Remedying individual injustice; improving the experience of others

Miss D complained about the care provided to her father in 2010, and the way the Trust dealt with her complaint.

What happened

Miss D’s father, Mr F, was admitted to hospital for a routine bladder operation. He developed an infection and died around a week later. Miss D complained to the Trust about the care her father received after his operation. It responded to say there had been problems with the nursing staffing levels at the time but it now had a new system to monitor staffing.

Miss D was not satisfied with this response and pursued her complaint. There were serious delays in responding to her. In a meeting with Miss D, the Trust acknowledged that the nursing care had been poor, leading to a missed opportunity to recognise the deterioration in her father’s condition sooner. The Trust explained that it had made improvements to its care and complaint handling since.

Miss D brought her complaint to us because she was not satisfied that the Trust had done enough to put right the failings in the care or the complaint handling.

What we found

The Trust failed to monitor Mr F’s condition and did not give him the nursing care he needed. It could have identified the deterioration in his condition sooner and treated his infection sooner. Because the infection was very severe, there was a 70% to 80% probability that Mr F would have died even if the care had been provided as it should have been. But an opportunity was missed to save his life.

The Trust also missed the opportunity to learn lessons from Miss D’s complaint. However, it had made substantial improvements to both the care and the complaint handling since, which should prevent the same thing from happening to other people.

Putting it right

The Trust wrote to Miss D to acknowledge the failings we found and apologise for them. It also explained how it would make sure that it learnt lessons from complaints. As a result, the backlog of customer complaints has now been resolved and changes have been made to ensure the complaints process is better managed, and complaints are resolved faster.

The Trust also paid her £1,500 in recognition of the effect of its failings on her.