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    Hearing and listening to patients is at the centre of patient safety. As healthcare services in England work to bring to reality the transformation sought in the NHS Patient Safety Strategy (July 2019), independent sector providers have the challenge of ensuring that they too provide an equal opportunity for private patients' voices to be heard. Taking complaints seriously, having robust processes and learning from them is integral to this, as ISCAS Director Sally Taber explains in her blog. 


    The number of patients turning to the private sector to access care is increasing. Data shows that in the UK more and more patients are accessing private healthcare to address health concerns. Data from the Private Healthcare Information Network (PHIN), an independent organisation, shows there were 227,000 private healthcare admissions in the first three months of 2023, the highest since PHIN started collecting data.[1] This was 17,000 more private admissions than in the same quarter in 2022. David Furness, director of policy at the Independent Healthcare Providers Network (IHPN), which represents private health companies, said recent IHPN polling showed that more than 1 in 5 people expected to use private healthcare in the next 12 months and almost half of the public would consider private healthcare if they needed treatment. Bupa, Aviva and Vitality, three of the largest insurers in the UK, have collectively added 480,000 new customers since the beginning of 2022.[1]

    However, patients often do not appreciate that the ‘rights’ available to them with NHS services are not comparable with every private sector provider. This is despite recommendations from significant learning events, such as those following the Paterson inquiry.[2] Educating patients to ensure they select only those private providers who are open to listening and learning will be important to drive the shift in accountability for those organisations who have yet to acknowledge that all patients should have equal access to support in their complaints.

    While the NHS complaints procedure can be used to complain about all NHS-funded services, whether provided by an NHS or non-NHS organisation, it cannot be used for complaints about privately funded healthcare. Complaints about privately funded healthcare services need to be made to the healthcare provider directly in the first instance. Complainants may then have the option of referring the complaint for independent external adjudication.

    Services such as those offered by ISCAS (the Independent Sector Complaints Adjudication Service) provide patients with the fundamental right to have an independent external review of their complaint if they remain dissatisfied, to ensure it has been addressed fairly and responsively. ISCAS parallels the Parliamentary and Health Service Ombudsman (PHSO) in the NHS. It provides the services of independent adjudication as the third stage of a three-stage complaint process that is set out in a transparent ISCAS code. ISCAS has been working with PHSO to implement the Complaint Standards Framework in England. Patients will now be able to recognise the principles in both the PHSO and the ISCAS codes, as recommended by Recommendation 6a of the Paterson report.[3]

    Private Patient Units (PPUs) in the NHS remain behind the curve in the important provision of access to an independent external review stage in complaint management. PPUs are separate rooms or wards within NHS hospitals which are only used for private patients. You still pay if you are treated in these units; however, the money goes towards the hospital rather than a private company. ISCAS is collaborating with the Patients Association and together are working to establish the impact on patients treated in NHS PPUs who do not have access to an external review stage.

    Dr Henrietta Hughes, Patient Safety Commissioner for England, rightly advised that if “we listen to patients, they will give us the route map to success. We will have better patient safety, improved staff retention and better finances.

    We welcome the NHS Patient Safety Strategy as it brings patients and families into the conversation. When people take the time to tell us what is wrong, it’s vital to listen and to take action. However, it takes leadership from the top willing to understand that listening to patients is the answer. Too often we respond to criticism by defending ourselves and our organisations instead of regarding it as a valuable source of learning. Criticism is an opportunity to understand how others see us, and to reflect on how to improve the way we work and communicate.

    Patients have choice and as increasing numbers choose to explore accessing privately funded care in the independent sector, we must hope that they will choose selectively and ensure their provider is a listening, learning and safe organisation – demonstrated by the organisation's openness to offer external complaint reviews. The NHS in its evolution to provide increasing private services must address and act upon the inequality in its provision to its patients in complaint handling. 


    1. Private Healthcare Information Network. PHIN Private market update: September 2023. 12 September 2023.
    2. Lovett S. Nearly half-a-million take out private health insurance in 2022 as NHS crisis deepens. The Times. 7 January 2023.
    3. House of Commons. Report of the Independent Inquiry into the Issues raised by Paterson. February 2020.
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