Our research shows that a quarter of older people don’t know where to go to complain about the NHS, despite using the service more often than people under 65. Complaints are a gift to the NHS because that is how improvements are achieved. Older people should be encouraged to complain and should be taken seriously when they do.

But my fear is that too many older people are suffering in silence. Almost 80 per cent of all the investigations we carry out are about NHS services. Even though nearly half of NHS care and services are given to older people, only a third of the health complaints we investigate are about the care of older people.

The Parliamentary and Health Service Ombudsman is the final step for people who have been treated unfairly or received a poor service from the NHS in England, or a government department or agency.

Our role is to investigate complaints without taking sides and make recommendations to put things right. But older people’s reluctance to complain coupled with their not knowing where to go to make a complaint could mean we are just seeing the tip of the iceberg of serious failings in the care of people who are 65 and over.Of the cases we do see, there are common themes running through the complaints about the care of older people.

Misdiagnosis, staff attitudes, poor communication with patients and families, substandard nutrition, and patients not being treated with dignity, just to name a few. We believe there still needs to be a significant cultural shift in the way complaints are handled across the health and social care system. More needs to be done to tackle the toxic cocktail of reluctance by patients, carers and families to complain and a defensive response from the NHS, when they do.

Making a complaint should be easy and transparent. And people should be supported to do so. Often older people fear negative repercussions when they make a complaint or they simply don’t like to ‘make a fuss’.But complaining can make a difference and often people tell us they made a complaint because they don’t want the same thing happening to somebody else.If people aren’t satisfied with the way the complaint has been handled by the NHS, then they can make a complaint to us, the Parliamentary and Health Service Ombudsman.

We know older people often rely on both NHS and social services and our joint investigations of treatment and care failings, with the Local Government Ombudsman – which scrutinises complaints about local authorities and social care services – have highlighted the heart-breaking consequences when older people fall through the gaps between health and social care services. In one of these cases, an older man suffering from Alzheimer’s and diabetes, was prevented from going home to die beside the brother he had lived with his whole life, because of a string of errors by the five organisations across health and social care tasked with looking after him. They left it a month before they had a meeting about his care, by which time he’d passed away without his dying wish being honoured.

People need and deserve a joined-up complaints system that covers health and social care services so they only need to raise their complaint once and so it can be dealt with by the same person throughout the complaints process.And that’s why we want a single Public Ombudsman Service for England and the United Kingdom, which puts people at the centre of the complaints process, to be responsible for all complaints concerning public services, including health and social care. It should cover all public services delivered in England and provide a common approach to the investigation of complaints.

Only with a significant change in attitudes towards complaints and a drive to reforming the complaints system will the NHS make the improvements it needs to ensure all older people are treated with dignity and respect.