NHS services in London received the second most written complaints for secondary care of all English regions in 2023-2024, according to data from NHS England.
The region saw a total of 20,241 new complaints raised for Hospital and Community Health Services in 2023-2024 – more than twice the number received in the South West region, which saw the lowest number of new complaints.
The NHS experienced the busiest year on record for A&E and ambulance services in 2024, and the total number of written complaints has increased by 38% across England since 2013.
Among this increase, the number of written complaints for Primary Care (GP and Dental Care) has more than doubled since 2013 while secondary care faced a slight decrease of 6% but still increasing by 28% post Covid.
NHS England data also shows that for 2023-2024, 55.4% of NHS written complaints came from Primary Care and 44.4% from Secondary Care.
Hospitals under pressure
Calum Burke, a former healthcare support worker and student nurse who worked in a number of NHS trusts on the south coast of England, said: “I think there has been an increasing pressure on the services hospitals in the past couple of years.
“Lots of people struggle to get GP appointments and don’t know what sort of community health services are out there.
“As a result if they are feeling unwell or not sure what to do, the first place they go is A&E.”
Professor Sir Stephen Powis, NHS National Medical Director, said: “It is clear that hospitals are under exceptional pressure at the start of this new year, with mammoth demand stemming from this ongoing cold weather snap and respiratory viruses like flu – all on the back of 2024 being the busiest year on record for A&E and ambulance teams.”
NHS data reveals that accident and emergency departments were the third highest subject of complaints in 2023-2024 (including clinical treatment) with the first one being general medicine group complaints and second being surgical group.
Burke added: “Most complaints from A&E come from patients not having pain relief while they’re waiting or delays over scans and other diagnostics tests.
“There are situations where patients have raised complaints when waiting for clinicians from certain specialties and potentially people waiting quite a few hours to see them.
“As for people waiting for bed space in A&E, being stuck in chairs for 18 hours, it’s very understandable why they get frustrated.”
Londoner Viktoriia Glavatska experienced first hand the issues of A&E when she had to wait around six hours to get painkillers.
At the end of December 2024, Viktoriia had severe back pain that left her unable to get up from her knees and walk.
She said: “I called the ambulance but they said it wasn’t a valid reason for them to come even though I explained that I was home alone with a small child and couldn’t go to the emergency room by myself.
“They said to wait and that someone would call back but no one did.
“I had to call a taxi and ask the driver to help me get downstairs and walk to the emergency room myself where I waited over six hours to get painkillers.”
But Viktoriia’s experience will not be included in this year’s complaints figures: while she complained verbally, she did not file a formal complaint as she decided to focus on her health.
Overworked and burned out staff
Communication comes as the number one subject of complaints in 2023-2024, followed by patient care including nutrition and hydration, and then values and behaviour of staff.
A former junior doctor at a south east London trust who wishes to remain anonymous said: “Communication was the number one thing that was flagged by patients.
“It could be communications regarding outpatient appointments not being sent on time or being late, communications between staff members or staff to patients.”
Regarding this data, Calum Burke said that the majority of staff tend to become quite burned out and don’t treat people with respect.
He said: “I think part of it is also in a certain high stress environment where you don’t have the right staff, people are overworked.
“You tend to adopt a very task-oriented approach to managing situations. Unfortunately as a result of that you’re not communicating nearly as effectively.”
Regarding patient care like nutrition, Calum said that patients complained a lot about the quality of food and confirmed that the quality of meals was not the best.
He said: “Most of the people don’t find it appealing and the portions are not the best.
“As a result, you’ve got people who are hungry and not very happy with the food.”
How are the complaints handled in London?
““If it’s something I can fix myself I will go do that and fix the situation.”
Calum Burke
NHS data show that 99% of the complaints received in 2023-2024 for secondary care were resolved in London. But what does this mean?
Complaints resolved mean they were either upheld if substantive evidence is found to support the complaint, not upheld if there is no evidence to support any aspects of the complaint, and partially upheld if a complaint is made about several issues but not all are upheld.
NHS England states that if a complaint is resolved, patients will receive a written response.
The response should set out the findings and, where appropriate, provide an apology and information about what’s being done as a result of the complaint.
London recorded 44.7% of complaints being partially upheld, 30.5% being not upheld and only 24.9% being upheld.
Within London, the south east had the highest number of complaints with 5,136 new complaints in 2023-2024 and 55.2% being partially upheld – compared to south west London which recorded the lowest number of new complaints with 2,775 but a record of 38.1% of complaints not upheld, the highest registered across all London regions.
Regarding handling complaints, Calum Burke said: “I would say about 80% of the complaints I deal with are oral.
“If it’s something I can fix myself I will go do that and fix the situation.
“In the vast majority of times that resolve the complaint itself before it moves to Patient Advice and Liaison Service.”
According to NHS England, issues can be resolved quickly by speaking directly to the staff and the place where patients receive care and access a service.
Is London doing better regarding primary care?
Regarding primary care, London ranked third across all regions in England with 19,641 new complaints registered in 2023-2024 which is 33% more than the South West region.
Within London, the South East ranked second with 4,399 new complaints registered in 2023-2024 closing the gap with North East London which registered the highest number of complaints with 4,686 just 287 more than South East.
NHS data shows an increase of 48% of written complaints in England for primary care since 2016 with 56% more complaints to GPs and 27% more to dentists.
When it comes to the subject of complaints for primary care, the number one area of complaint is clinical treatment, followed by communication and prescription issues in 2023-2024.
Apeilash, an associate doctor from a dental practice in London, said: “I understand where complaints come from, especially in terms of miscommunications with patients.
“Patients who come for a dental treatment might expect the treatment to be done in a certain time frame that was told to them but sometimes it’s just not possible.
“A miscommunication and misconception of the time of treatment can happen and that’s why we need to communicate better.”
When asked about the reason why complaints in dental care have risen, Apeilash said that this was also due to a shortage of dentists and a struggle to recruit new ones.
He added: “Pay also plays a big factor and the system is not working in the dentist’s favour.”
What can be done to reduce the number of complaints?
The new Labour government is on the verge of “building an NHS fit for the future” by cutting NHS waiting times with 40,000 more appointments every week, implementing a new Dentistry Rescue Plan or even adding 8,500 mental health staff.
But would this help reduce the number of complaints?
As communication is the most common area of complaints for both primary care and secondary care, it is worth seeing what can be done to implement better communications between the patient and the medical staff.
Apeilash said: “Reducing complaints can be done by taking more time to discuss in detail with patients about their treatment plan and options.
“However this can be difficult due to the time constraints as dentists only have 15 minutes to relate all the information to the patient and a high chance of miscommunication can occur.
Calum Burke said: “There is no simple fix but if there is one thing that could potentially be done better is to try to improve the quality of communications.
“I think in many ways you can deal with so many issues just by listening to someone, giving them a little bit of your time and making them feel as if they are heard.”
The junior doctor from south east London reminded us that the NHS is a great system that was created for the benefit of the people but at the moment it’s being overwhelmed and under-run and managed by non-clinicians.
He added: “A lot of consultants are leaving the NHS and going to other administrations and leaving hospitals.
“They are just being let go and underappreciated.”
Feature image via Unsplash
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