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

Our conclusions and recommendations

It is clear that older people can find it hard to know how to raise a concern or a complaint and feel less confident to push for what they need. We think this is for three reasons; they can lack the confidence and knowledge of how to go about complaining, they worry about the impact complaining might have on their own care and treatment, and they can also lack support. 

If people are not proactively invited to give feedback, and supported to raise concerns or complaints, then organisations that provide services across health and social care are missing key opportunities to learn from what they are doing well, and where improvements are needed. Therefore we are recommending two things:

  1. Organisations that provide health care services need to make everyone who uses their service aware of how to complain, point them to the support with making a complaint that is available to them, and make clear that their future care will not be compromised if they do complain. Organisations should use My expectations to measure how effectively they are doing this, and to understand those areas they need to improve, in order to meet peoples’ expectations of what should happen when they raise a complaint.
  2. Commissioners of health care services should use My expectations as a framework for seeking evidence to determine how well organisations that provide care welcome, listen to and respond to complaints as part of their quality monitoring activity. NHS England has developed toolkits for commissioners of primary care, and acute, community and mental health care services to support them to do this20.

These recommendations should have a positive impact for all people who use health care services, not just older people. However, because of the particular characteristics that older people have, and the particular barriers they face, implementing these changes would have a particular significance for the group most likely to rely on health care services.

Providing targeted support and information for older people and their carers, via advocacy groups, was something older people and their carers felt was incredibly useful.'

What we will do

We will work with NHS England to develop a model survey based on the ‘I statements’ contained within My expectations. The survey, which will be available in summer 2016, should support individual organisations that provide health and social care services to measure public satisfaction with their local complaints service.  We will continue to work with the organisations that provide NHS services to improve local complaint handling, and provide clear signposting to our service.

Older people often need support in order to complain, yet a large number lack the necessary networks that can provide this. Providing targeted support and information for older people and their carers, via advocacy groups, was something older people and their carers felt was incredibly useful.  

We will continue to work with organisations that provide advocacy to raise awareness of our service, and offer targeted information and support to enable people to complain.  We are working with those that provide advocacy to streamline our approach to putting people in contact with local support when they first use our service, if they tell us this is something they would like. This is something we will look to introduce by summer 2016.

The creation of a single public ombudsman service should make it easier for older people to complain, by helping to reduce the complexity of the complaint system. Until that happens we will continue to work with the LGO to identify and investigate those complaints that straddle health and social care, to make it as straightforward as possible for older people to bring their complaints to us. We will also continue to raise awareness of our work by publishing information about the cases we resolve which highlight the difference complaining can make.

20 Assurance of Good Complaints Handling for Acute and Community Care - A toolkit for commissioners. (NHS England, November 2015).