Source · Select Committees · Public Accounts Committee
Recommendation 12
12
Accepted
Confusing and poorly handled patient complaints system hinders early resolution efforts.
Recommendation
The 2025 Dash review of patient safety found that the current system for raising complaints and concerns is confusing, with issues often poorly handled and patients subject to delays and poor-quality responses. Research commissioned by NHS Resolution found that improving the NHS’s initial response to harmful incidents could reduce the number of patients who pursue clinical negligence claims.21 However, in their written submissions to us, multiple organisations raised concerns about how inconsistently NHS trusts apply the statutory requirement to be open and transparent with patients, known as ‘duty of candour’.22 NHS Resolution told us that in its experience openness and transparency are the best way to prevent a claim in the first place.23 When questioned about inadequacies in the existing complaints system, NHS England told us it is very keen to do more to improve patient experience and is looking at alternative models for the NHS complaints system. When asked about how it is learning from complaints, NHS England told us that complaints are collected centrally in themes with around 200,000 to 250,000 reviewed each year nationally.24 NHS Resolution explained that it is also working across all areas locally with NHS trusts to identify complaint issues that might escalate into clinical negligence claims further down the line.25
Government Response Summary
The government agrees to review the NHS complaints system and improve the number of cases resolved without litigation, aiming for implementation by Summer 2028, including updating complaints regulations and increasing use of AI.
Government Response
Accepted
HM Government
Accepted
2. PAC conclusion: The NHS has not done enough to tackle the underlying causes of harm to patients. 2b. PAC recommendation: The Department must review the NHS complaints system and improve the number of cases that are resolved without recourse to litigation. 2.7 The government agrees with the Committee’s recommendation. Target implementation date: Summer 2028 2.8 The government wants the NHS to resolve concerns as early as possible, reducing the need for patients to pursue further action and ensuring the NHS learns from feedback and improves. DHSC notes the Committee’s findings that the complaints system is confusing and unresponsive – reflecting what was heard during engagement for the 10 Year Health Plan, where patients and carers expressed confusion about where and how to complain and described their struggle to get responses to their concerns. 2.9 The 10 Year Health Plan emphasises the importance of a stronger patient voice, greater transparency, and a culture of learning from concerns. It sets out a commitment to improve how the NHS listens to and acts on patients’ and carers’ voices and experiences. In Chapter 6 of the 10 Year Health Plan, the government commits to significantly improve the complaints process within all NHS commissioner and provider organisations; and to set clear standards for both the timeliness and the quality of responses to complaints. The department will update complaints regulations and increase the use of AI tools to ensure complaints data is collected and responded to far more quickly. 2.10 The 10 Year Health Plan also commits to bringing patient voice in-house by abolishing Healthwatch England (subject to Parliamentary approval) and establishing a new Patient Experience Directorate within DHSC during 2026-27. This new Directorate, once introduced, will take responsibility for significantly improving the NHS complaint’s function and delivery of complaints reform by summer 2028.