May 17, 2020

Why the NHS can’t afford to ignore complaints

Digital health
Patient Care
Martin Ellingham, Senior Produ...
5 min
The NHS is in the greatest danger of collapse than ever before.

Patient complaints – the hidden virus in the NHS

Complaints are a major issue for t...

The NHS is in the greatest danger of collapse than ever before.

Patient complaints – the hidden virus in the NHS

Complaints are a major issue for the NHS. It’s one thing attracting criticism from outside forces pursuing their own agendas. But, when the criticism comes from the very people the health system was set up to look after, there quickly becomes a problem.

The bad news is that the number of complaints is rising steadily. During 2016/17, the NHS received 208,400 written complaints – an increase of 4.9% on the previous year, according to NHS Digital. This represents an average of more than 550 complaints every day; far from an ideal scenario.

Should this trend continue, the NHS will be faced with a catastrophic loss of patient trust. This could be the beginning of the end for the NHS. With private healthcare companies already taking a larger share of tendered contracts, NHS services could find it even harder to make the case for why they should be chosen as preferred providers.

Trust in the NHS is everything, and complaints threaten to fatally undermine public confidence in their healthcare service as it passes its 70th birthday.

Four reasons the NHS is receiving more complaints than ever

  1. Funding cuts lead to reductions and delays in services

The NHS is under huge financial pressure, leaving providers in a perilous position. By 2022/23, the NHS in England could be facing a funding gap of more than £24bn.

Funding growth throughout 2018/19 will only reach 0.4% – a real-term fall in spending on healthcare per person that leaves providers underfunded to the tune of £4bn.

This cuts into NHS organisations’ ability to deliver high-quality and timely care, which will only lead to a further increase in the number of complaints.

  1. An ageing population means more people need care

As funding gets tighter, demand for NHS services is increasing. An ageing population means more people are living with ongoing and complicated conditions, putting services and personnel under an unprecedented amount of strain. This makes it increasingly difficult for NHS providers to meet ambitious waiting time targets while still providing the highest quality of care.

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Added to this is the growing crisis in social care – all of which will see more and more complaints directed towards the NHS.

  1. The NHS is facing an urgent staffing crisis

Two-thirds of trusts say that maintaining an effective workforce is their number one challenge due to major shortfalls in medical staff. The teams on the ground have also voiced their unease at the situation, with eight out of ten health professionals raising concerns about a chronic lack of staff.

This places patient safety at risk and will only serve to undermine trust in the NHS. The former Health Secretary, Jeremy Hunt, set ambitious recruitment targets that are highly likely to be missed, with the NHS losing a growing number of doctors and nurses from EU countries as part of the fallout from the EU Referendum in 2016.

  1. Patients have higher expectations than ever before

The rising number of complaints is also partly the result of the UK population becoming more demanding. A nation of consumers, we've come to expect high quality and convenience in every part of our lives – and, when we’re made to wait, we're more likely to complain.

The NHS is working hard to improve standards, but it continues to face an uphill battle to close the gap between expectation and a reality in which you can order your groceries online and have them delivered on the same day, but you’d struggle to get an appointment with your GP in the same week you called them.

The true cost of poor complaint management

A rise in complaints might not sound like a dangerous thing, but a 2015 document from the Ombudsman highlighted what's known as ‘the human cost of poor complaints handling within the NHS’.

The report found that nearly half of written complaints were about how complaints and issues had been handled, providing potential to destroy patient trust in the NHS. If people believe their complaints aren’t being listened to, how can they be expected to believe that services will improve?

In 2013, an enquiry into the Mid Staffordshire NHS Trust led Robert Francis QC to state that poor complaints handling had allowed problems to remain unchecked and poor practices to persist.

“A health service that does not listen to complaints is unlikely to reflect its patients’ needs,” he wrote.

NHS trusts have to prioritise complaint handling to improve care

Effective complaint handling is critical for the NHS and should be a top priority. Otherwise, it’ll see a reduction in patient safety lead to a lack of trust in its healthcare services. Part of the problem is the complexity of current complaint-handling systems. The NHS is keen to be transparent and learn from complaints, but the literature and processes involved can be complicated. On top of that, administration systems are often out-of-date, paper-based and fragmented.

Fortunately for NHS trusts, there are ways to improve their systems and transform the way they handle complaints. New technology offers them a future in which complaints are acted upon quickly across the entire NHS – leading to better care and increased patient trust. It’ll also take the pressure off of already-stretched medical teams.

The NHS has reached a remarkable milestone of providing universal healthcare for 70 years, and better complaint handling will be a critical part of helping it to thrive for another 70 to come. The first step, however, is to recognise the problem, diagnose its symptoms and prescribe a course of action.

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Jun 21, 2021

How health plans can reduce healthcare inequalities

4 min
Jim Clement from Inovalon on the role of health plans in improving access to healthcare

The COVID-19 pandemic has put inequalities accessing the healthcare system in the spotlight. Jim Clement, Vice President of Product & Services at cloud provider Inovalon, tells us that health plans play the most integral role in advancing the health equity movement.

Why did it a global pandemic to highlight the issue of healthcare inequities? 

Health inequity in the US has been well understood by healthcare professionals for many years, but it has become more evident due to the COVID-19 pandemic. It wasn’t until the racial and ethnic differential seen in response to COVID-19 related infections, deaths and vaccinations that many Americans became acutely aware of the health inequity due to sociodemographic factors such as race, geography, education and income.

Fortunately, there’s now a growing health equity movement afoot in America which aims to improve public health and achieve equity in health status for all people by ensuring opportunities are available to attain the highest level of health. While the entire healthcare ecosystem is important to this transformation, it is health plans that arguably play the most integral role.

How can health plans help? 

Achieving health equity means obstacles to health must be removed, including poverty, discrimination, powerlessness, and lack of access to the basics like physicians, hospitals, medicine, technology, and health education. This is not only a social justice initiative, but also a clear call to action for health plan organisations that are bearing the economic brunt of the costs due to health disparities. 

Health plan organisations that recognise the alignment between efforts to improve health equity and broader member engagement initiatives will be in the best position to move the needle. Plans must also understand that the provision of medical services within hospital walls, physician offices and other health services providers is necessary, but not sufficient. 

By recognising that health inequity also includes non-medical factors such as employment, income, housing, transportation, childcare, and more, plans will be better equipped to ensure their members are set up for success. 

What do healthcare providers need to do generally to address inequities? 

Outreach by both health plans and providers is critical to ensuring people have knowledge of available services, the reason those services are critical to their health, and options to access those services based on their unique circumstances. With both stakeholders beating the same drum, progress can be made quickly.

Given the impact of social determinants of health (SDOH), should healthcare providers take a more active role in addressing these, or other agencies? 

While communicating with patients is critically important, what is truly required to address inequalities is helping patients take medical  actions – like regular PCP visits, monitoring A1C and accepting health coaching – that are necessary to maximise their health, along with non-medical actions –like availing themselves of community resources that address homelessness, food insecurity and employment services. 

The most progressive providers and payers have or are putting in place programs to address these non-medical issues.  In addition, non-medical tools such as transportation services can certainly help drive the effectiveness of medical services. 

How important is it to educate patients about their health and how can this be done? 

Education is a social determinant of health and a key lever to be used to drive health equity.  Patients who do not understand their medical conditions or the consequences of non-compliance with their treatment plans are prone to poor outcomes. 

For health plans, understanding member needs is one of the biggest drivers of quality care. A continuous cycle of engagement through feedback and appropriate responses will provide health plans with an opportunity to uncover, discuss, and resolve problems faster. 

Improving member outreach and engagement can be made easier with a programmatic approach involving four stages of intentional outreach: Getting to know your members, educating members, seeking feedback from members and gaining member loyalty. Each stage not only contributes to a better member experience but also to improved outcomes and higher satisfaction scores.

Now that the issue has come to the fore, what do you think things will look like in 5 years or so?

I predict that health plans that get member engagement, education and equity right will achieve better health and greater value, faster. Those who get it wrong or delay will suffer the consequences of competitive disadvantage and pay a larger share of the rising costs associated with health inequity.

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