Removing barriers to complaints: how can we make it easier for people to raise concerns about a health or care professional?

Summary

As we mark World Patient Safety Day, Polly Rossetti, Policy Adviser at the Professional Standards Authority for Health and Social Care (PSA), shares insights from their recently published report: Barriers and enablers to making a complaint to a health or social care professional regulator. The research seeks to understand the experiences of people who want to complain or who have complained about a health or care professional, and the barriers and enablers they face.

Complaints matter. If complaints don’t reach regulators, they can’t take action to protect the public from unsafe practitioners, nor can the system learn where improvement is needed.

The research reveals a range of barriers to complaining and suggests ways in which these could be overcome.

The PSA is committed to using the learning from the research to encourage improvements to the system of making a complaint to the organisations they oversee. They are also sharing the insights wider by presenting the research findings to an international audience of regulators at the Council of Licensure, Enforcement and Regulation (CLEAR) ‘s educational conference on 17 September 2025.

Content

Imagine you’re a patient and you have serious concerns about the health or care professional treating you; who would you complain to? The professional themselves? Their employer? A patient liaison service (if one exists)? A professional regulator? What if you’re in the middle of a course of treatment and need to keep attending appointments with the same provider (and maybe even the same professional)? Would it make you think twice about lodging a complaint? Would you worry about the impact on your care if you did?

Complaints are a vital source of learning and intelligence. If people don’t know how or where to complain, or feel reluctant to do so, we miss opportunities to keep people safe.

At the Professional Standards Authority, our overarching objective is public protection. In the context of professional regulation, this means ensuring that health and care professionals are safe, competent and trustworthy. If any of these elements are in doubt, professional regulators need to know—and they only find out if someone is willing to raise a concern.

It is the importance of complaints to patient safety that led to us commission qualitative research into the barriers people face complaining about a health or care professional, and to commit to taking action to address those barriers.  

What did the research tell us about barriers to making a complaint?

The research involved talking to a range of people from across the UK (42 in all) who had concerns about a health or care professional. It explored the reasons why they had, or had not, complained to a professional regulator and what helped or hindered them during their complaints journey. The researchers spoke to both patients and healthcare professionals, and examined the different challenges experienced by both groups and how these could be overcome.

Both patients and professionals described a complaints system that felt complicated, burdensome and, at times, even hostile. Some had the sense that their complaints were unwelcome.

Patients often didn’t know who they should complain to or didn't understand the role of professional regulators. In addition, they worried about whether their complaint was serious enough to raise, and what repercussions there might be for themselves and their future care:

“If I was to make a complaint and that GP had it in for me... they’d probably treat me differently in terms of getting appointments.” [Service user]

Healthcare professionals had many of the same concerns, but also worried about the impact on the person (usually a colleague) that they wished to complain about. Some also had serious concerns about how making a complaint would affect them professionally:

“There’s actually a worrying trend about doctors being victimised for raising concerns... There might be retaliation by my employers.”  [Healthcare professional]

Other barriers include difficulty collecting evidence, digital disengagement or simply not feeling mentally or physically well enough to embark on the process.

Even where people overcame the barriers and made a complaint, many describe their deep frustration and disappointment with the process. Much of this was a result of poor communication by regulators—correspondence was felt to be too slow and at times lacking in empathy. The process undertaken by regulators was also opaque—some people who made a complaint never found out whether the regulator investigated the case or took any action against the professional concerned.

What can we do to make it easier for people to raise a complaint?

The research highlights a number of key areas where the current complaints process is seen to fall short. These include failures to explain the process; not keeping people informed about their case; and failing to make the complaints process as accessible and supportive as it should be.

It recommends a number of ways in which these could be addressed, including:

• Regulators should clearly set out what types of complaint they investigate, what actions they take when a complaint is received and how long the process is likely to take.
• Regulators should provide regular updates to complainants throughout the process and provide more support (e.g. helplines and guidance).
• Regulators should consider allowing healthcare professionals to lodge their complaint anonymously (some already do).
• Regulators should raise awareness of their role and independence.

The above focus on processes, but equally important is how things are done. The updates regulators provide to those who complain should be timely, but they also need to be empathic and trauma-informed. Similarly, it isn’t enough to just have guidance or a helpline available, the information conveyed needs to be clear and sensitive. In short, regulators need not only to make it easier to complain, but to demonstrate that complaints, and complainants, are valuable and appreciated.

What is the PSA doing to address barriers to complaints?

We are committed to using the learning from the research to ensure that the regulators and Accredited Registers we oversee improve their complaints processes. We will do this both by sharing the learning with others (on World Patient Safety Day, on the 17 September, we are presenting the findings of the research at the CLEAR conference, an international community of professional regulators) and in more direct and tangible ways, such as making changes to our standards for regulators and Accredited Registers.

One of the most striking findings of the research is that most people who make a complaint are motivated by a desire to protect others from harm. We need to harness that altruism and do all we can to support people with serious concerns about a professional to speak up. It’s vital for patient safety that they do so.

Related reading on the hub:

• Barriers and enablers to making a complaint to a health or social care professional regulator: a qualitative study
• Speaking up for patient safety: A new interview series about raising concerns and whistleblowing
• How the Patients Association helpline can help you navigate your care
• How to make a complaint

About the Author

Polly Rossetti is Policy Adviser at the Professional Standards Authority for Health and Social Care.