Our research shows that a quarter of older people don’t know where to go to complain about the NHS, despite using the service more often than people under 65. Complaints are a gift to the NHS because that is how improvements are achieved. Older people should be encouraged to complain and should be taken seriously when they do.
But my fear is that too many older people are suffering in silence. Almost 80 per cent of all the investigations we carry out are about NHS services. Even though nearly half of NHS care and services are given to older people, only a third of the health complaints we investigate are about the care of older people.
The Parliamentary and Health Service Ombudsman is the final step for people who have been treated unfairly or received a poor service from the NHS in England, or a government department or agency.
Our role is to investigate complaints without taking sides and make recommendations to put things right. But older people’s reluctance to complain coupled with their not knowing where to go to make a complaint could mean we are just seeing the tip of the iceberg of serious failings in the care of people who are 65 and over.Of the cases we do see, there are common themes running through the complaints about the care of older people.
Misdiagnosis, staff attitudes, poor communication with patients and families, substandard nutrition, and patients not being treated with dignity, just to name a few. We believe there still needs to be a significant cultural shift in the way complaints are handled across the health and social care system. More needs to be done to tackle the toxic cocktail of reluctance by patients, carers and families to complain and a defensive response from the NHS, when they do.
Making a complaint should be easy and transparent. And people should be supported to do so. Often older people fear negative repercussions when they make a complaint or they simply don’t like to ‘make a fuss’.But complaining can make a difference and often people tell us they made a complaint because they don’t want the same thing happening to somebody else.If people aren’t satisfied with the way the complaint has been handled by the NHS, then they can make a complaint to us, the Parliamentary and Health Service Ombudsman.
We know older people often rely on both NHS and social services and our joint investigations of treatment and care failings, with the Local Government Ombudsman
– which scrutinises complaints about local authorities and social care services – have highlighted the heart-breaking consequences when older people fall through the gaps between health and social care services. In one of these cases
, an older man suffering from Alzheimer’s and diabetes, was prevented from going home to die beside the brother he had lived with his whole life, because of a string of errors by the five organisations across health and social care tasked with looking after him. They left it a month before they had a meeting about his care, by which time he’d passed away without his dying wish being honoured.
People need and deserve a joined-up complaints system that covers health and social care services so they only need to raise their complaint once and so it can be dealt with by the same person throughout the complaints process.And that’s why we want a single Public Ombudsman Service for England and the United Kingdom, which puts people at the centre of the complaints process, to be responsible for all complaints concerning public services, including health and social care. It should cover all public services delivered in England and provide a common approach to the investigation of complaints.
Only with a significant change in attitudes towards complaints and a drive to reforming the complaints system will the NHS make the improvements it needs to ensure all older people are treated with dignity and respect.
The report found 56% of people over the age of 65 who had experienced a problem had not complained because they were worried about how it might impact their future
Almost one in five did not know how to raise a potential complaint, while about a third felt that complaining would not make any difference.
One carer from a focus group in Manchester told the authors: “When people have a problem they don’t know where to go; they are referred to a computer which they don’t have; they are referred to a library which is too far away to get to… (and) they wouldn’t know what to do anyway.”
The research was based on a national survey of almost 700 people over the age of 65, as well as focus groups and case studies.
Parliamentary and Health
Service Ombudsman Julie Mellor said: “Older people are some of the most frequent and vulnerable users of health and social care services but are the silent majority when it comes to complaining.”
She added: “Their reluctance to complain could mean that they are suffering in silence and could lead to missed opportunities to improve the service for others.”
The research is a cause for concern and it is vital every hospital patient or health care client feels any potential complaints would be properly addressed, according to Age UK.
Charity director Caroline Abrahams said: ” Patient feedback is a great barometer of the quality of care and this report suggests hospitals need to do much more to reassure older patients that they can complain if they need to, free from fear.”
She added: “Seeking and responding to older people’s views and experiences is crucial if we’re to prevent future care scandals like those that have too often blighted our hospitals and care homes
in recent years.”
The report urged action, particularly due to Britain’s ageing population. By 2030, around one in 10 people living in the UK will be 75 or over, according to the Office for National Statistics.
It recommended a more proactive approach from NHS providers, which need to make sure all clients are aware of how to complain and reassure them there would be no repercussions.
Commissioners of healthcare
should also use the ombudsman’s complaint-handling guidelines, My Expectations, as a way of measuring their own performance, the report recommended.
The report also pointed out progress was being made, including steps by the Government to explore options for a new streamlined public ombudsman service to handle complaints.
A universal, independent complaints advocacy service that was easy to find and simple to use would improve the situation, Healthwatch England said.
A spokesman said: “We know the NHS is under pressure at this time of year, it is therefore vital that if things do go wrong patients are informed how to raise concerns and how to get help to do so if they need it.
“Without this support, thousands of incidents will continue to go under the radar every year and mistakes will never be learnt from.”
Healthwatch England said there was support available for those let down by the NHS but added: “When it comes to care homes and home care services there is little to no complaints support at all, leaving very vulnerable adults with little protection.”