Between 2020 and 2021, the NHS received over 170,000 (NHS Digital, 2022) formal written complaints from patients themselves and on behalf of patients. Of the 83,899 written complaints about Hospital and Community Health Services made, 18% of them were due to communications. Of the 86,114 written complaints about Primary Care (GP and Dental), 13.5% related to communications. This figure is not even wholly representative of the number of complaints each year. We know that not all complaints are submitted formally. Many people are reluctant to complain.
Through our research, we have found that when interviewing patients and their carers using cancer services, they are reluctant to complain. As one patient once said, “you don’t mess on your own doorstep” When asked what he meant by this, he explained doctors were powerful, and if he challenged them, they might withhold his treatment. A similar sentiment was echoed by other patients who also feared they might compromise their care somehow.
I wonder, how many people do you know who have been dissatisfied with a service or dissatisfied with the way someone has spoken to them but won’t complain? What were they afraid of? What stopped them from making a complaint?
We recently spoke to a family who was extremely angry about the care of a relative in hospital. They were reluctant to make a formal complaint for several reasons  they didn’t have the energy,  were fearful that the complaints process would be time consuming and  they questioned whether or not anyone would take their complaint seriously.
Furthermore, many people are not aware of the formal complaints procedures and services that help patients with this process. Would you know how to complain?
Improving patient stafety
Complaints help to improve local policies and guidelines, highlight deficiencies in healthcare provision, and improve overall patient safety (Abdelrahman, 2017). By complaining, the relevant people can learn from a situation and take the necessary steps to improve it. However, by not complaining, nothing will change, and others will proceed to have similar experiences.
This blog serves as a guide to what services are out there to help with the complaints procedure and raise patient concerns.
The Patient Advice and Liaison Service (PALS)
The Patient Advice and Liaison Service (PALS) is a service offered by the NHS which offers confidential advice, support and information to patients, their relatives and their carers. PALS is an invaluable service for patients to voice their concerns.
According to the NHS, PALS officers can help with health-related queries, help resolve problems when you’re using the NHS and advise you on how to get more involved in your healthcare. PALS officers should be able to point you in the right direction for help if they are unsure of information and should be the first point of contact for any patients with concerns related to their healthcare.
PALS can have a different name depending on what part of the UK you live in:
- England, it is the “Patient Advice and Liaison Service (PALS).”
- Scotland, it is the “Patient Advice and Support Service.”
- Northern Ireland, it is the “Patient and Client Council.”
- Wales, it is your local “Community Health Council.”
You can search for your local PALS on the NHS’ website and learn more about the NHS complaints procedure on their website.
Here is a short video by the PALS team at Leeds and Yorkshire Partnership NHS Foundation Trust, explaining what they do and how patients can get in contact with them: https://youtu.be/5pFY73LyN1w
Healthwatch is a health and social care advocacy body that gathers feedback from people’s experiences with the NHS and other care providers. Healthwatch uses this feedback to understand the challenges that health and social care providers are undergoing. Information is then brought to the attention of NHS leaders and other decision-makers. Leaders are then urged to make changes to standards of care based on this feedback.
They also have many articles offering advice to help you identify what type of support you need. Plus, advice on how to access that support for various health issues. You can search for their guidance here.
You can also find your local Healthwatch using their location search tool and comprehensive access guides on what they do on their website.
Here is a short video explaining what they do: https://youtu.be/FDwavhFOHLU
Care Opinion is an independent non-profit feedback platform for health and social care. They receive anonymous patient letters and feeds back the information shared to the relevant care teams. Consequently, thus enabling them to enact changes.
Care Opinion is passionate about sharing both the good and bad patient stories. Furthermore, they want to make sure they make a significant difference in health and social care practices.
To learn more about Care Opinion, check out their website and their guide on using their services.
Here is a short video by Care Opinion that explains what they do and how they make an impact, using patient cases: https://vimeo.com/215724873
A Final Note
All patients should feel comfortable sharing their experiences, feedback and concerns with their health and social care providers. Although this process can sometimes feel daunting, the above services are here to help support you and make it easier.
You can make a difference by making informal and formal complaints. Do not feel afraid to speak out when things aren’t right. Remember, if we don’t speak out about our concerns, services and people won’t know they need to change.
If you would like to share a story about your personal care experience regarding communication, please click on this link. We would love to hear from you.