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

National picture

The UK population is ageing. By 2030, around one in ten people living in the UK will be 75 or over5. Over the same period there will be a doubling in the number of people over 856. As the proportion of older people within the UK increases, so too will the number of people living with long-term health conditions, with over half of those aged 60 and over reportedly having a long-term condition7.

Given this, it is unsurprising to find that older people are the age group most likely to rely on and use health care services across the country. 

People aged 65 or over account for one in six of the population, but half of all the time spent in hospital beds. People aged 85 or over account for one in 44 of the population but one in six hospital bed days, and around 60% of community dispensed prescriptions are given to those aged 65 and over8

However, despite being the greatest users of health and social care, there is evidence to suggest that older people are often less likely to complain if they receive poor service. Complaints from those aged 65 and over about their healthcare only made up around a quarter of all the complaints we received about health care services in England in 2014-15. Research commissioned by the Care Quality Commission, conducted by ICM Research, also highlights this issue; among those aged 65 and over, 16% indicated that it is unlikely they would voice a concern or raise a complaint, compared to 10% of those aged between 25 and 649.

There are a number of broader issues more likely to affect older people, which impact on their ability to complain effectively:

Large numbers of older people live alone

3.5 million older people aged 65 or over live alone. Nearly half (49%) of over 75s live alone – that’s over 2 million people10. People aged 75 and over are the least likely of any age group to have at least one close friend; one in nine (11%) of them report having no close friend at all, compared to 2% of those aged 18 to 2411. As the case studies in this report show, older people can sometimes rely on close friends and family to make complaints on their behalf, particularly those living with conditions that may make it difficult for them to complain. The absence of support networks can affect the ability of some older people to raise concerns.

Many older people do not use the internet: 

Increasingly organisations are encouraging people to complain or give feedback online. The internet is often the first place that people look for information, including about how to complain. But only around a third of people aged 75 and over have the internet at home, compared to 94% of those aged 65-7412. Although having internet access at home can be common, a high percentage of older people living at home with limited day-to-day 
activities report they never use the internet13

Older people are significantly more likely to have ongoing health needs

58% of older people are living with a long term health condition14. As we show later in this report, many older people say they would be worried about the impact that complaining might have on the care they receive. This fear can be compounded  because of the likelihood of needing to continue to access the services
they want to complain about.

All of this evidence highlights how older people are at a particular risk of being excluded from the complaints system.  

5 UK Population projections (Office of National Statistics).
6 Ready for Ageing? (House of Lords Select Committee on Public Service and Demographic Change, 2013).
7 Long Term Conditions Compendium of Information: Third Edition (Department of Health, 2012).
8 Focus on the Health and Care of Older People (Health and Social Care Information Centre, June 2014).
9 Fear of raising concerns about care (ICM, 2013). 
10 Labour Force Survey (Office for National Statistics, 2015).
11 Inequalities in Social Capital by Age and Sex (Office for National Statistics, 2015).
12 Communications Market Report UK (Ofcom, 2014).
13 The Bigger Picture (James Lloyd and Andy Ross, Independent Age and The Strategic Society Centre, 2014).
14 Long Term Conditions Compendium of Information: Third Edition (Department of Health, 2012).