How do I make a complaint about my NHS care? A simple guide for patients and families in England

Summary

At Patient Safety Learning we often get asked by patients and families who have received poor healthcare what they need to do to make a complaint. Although we cannot get directly involved in individual cases, we have put together a simple guides on the steps you can take if you need to make a complaint about NHS care in England.

We also have the following guides:

• How do I make a complaint about my NHS care Northern Ireland: a simple guide for patients and families
• How do I make a complaint about my NHS care in Scotland: a simple guide for patients and families
• How do I make a complaint about my NHS care in Wales: a simple guide for patients and families
• How do I make a complaint about my private care: a simple guide for patients and families
• How do I make a complaint: Sources of help and advice

If you are a healthcare professional looking at these pages, the NHS Complaint Standards, model complaint handling procedure and good complaint handling guides set out how organisations providing NHS services should approach complaint handling. They apply to all NHS organisations in England and independent healthcare providers who deliver NHS-funded care.

Content

You have the right to make a complaint about any aspect of NHS care, treatment or service. Every organisation that provides an NHS service in England must have their own complaints procedure.

You can usually find information about how to complain in waiting rooms, at reception, on the organisation’s website or by asking a member of staff. Here are the steps to take if you would like to make a complaint. More information on each step is given below.

Step 1: Informal complaint

Many issues can be resolved quickly by speaking directly to the staff at the place where you received care or accessed a service.

You are under no obligation to make a complaint informally before you make a formal complaint. However, if you believe something has gone wrong with the healthcare provided to you or a loved one, it is almost always best to discuss your concerns with the medical staff as soon as possible, especially if your main concern is to have something urgently put right. Talk to the staff concerned or a manager and explain why you are unhappy.

If you prefer, you can contact the Patient Advice and Liaison Service (PALS) at the organisation and ask them to investigate the matter. Contact your local hospital trust for contact details of their PALS. If your complaint is about a family health service (such as a GP, dentist, optician or pharmacist) you can contact the practice complaints manager. They may be able to settle your complaint straight away. If you are not satisfied with their response, however, you can submit a formal complaint through local resolution procedures—see Step 2.

Step 2: Local resolution procedures

If you would like your complaint to be dealt with more formally, you should use the NHS complaints procedure. The first stage is local resolution, where the NHS is required to investigate and respond to your complaint.

You should make your complaint as soon as possible so that your memory of events is fresh. Your complaint must be made:

• no later than 12 months after the event(s), or
• no later than 12 months from when you first became aware of the issues.

NHS organisations may consider complaints outside these time limits—for example, if you have a long-term illness or condition.

A complaint can be made verbally, in writing or electronically. You can complain:

• Directly to the provider (such as a the hospital or GP surgery).
• To your local integrated care board (ICB) for complaints about primary care services (GPs, dentists, opticians or pharmacists) and secondary care (such as hospital care, mental health services, out-of-hours services, NHS 111 and community services like district nursing). Each ICB has its own complaints procedure, which is often displayed on its website. Find your local integrated care board.

AvMA (Action against Medical Accidents) has a number of self-help guides that provide clear and straightforward explanations of the procedure and guide you through making a complaint, including a helpful template letter.

Under the NHS complaints procedure, you can get:

• An explanation for what happened.
• An apology or other statement of regret.
• Steps to review procedures to avoid similar incidents happening in future.

In general, the NHS complaints procedure will not:

• Offer financial compensation.
• Address issues of staff discipline, for instance by sacking someone or having them struck off a professional register.

If you are not satisfied with the final response to your complaint, you have the right to request an independent review of your complaint by the Parliamentary and Health Service Ombudsman—see Step 3.

Step 3: Parliamentary and Health Service Ombudsman

If you have tried local resolution and are not happy with the result, or if the investigation has taken over six months, you can ask for an independent review by the Parliamentary and Health Service Ombudsman (the Ombudsman).

You must go through the NHS Complaint (local resolution) stage first—the Ombudsman will not consider your complaint until you do. Although you have a right to request an independent review of your complaint, the Ombudsman is unlikely to agree to a review if it thinks that more should be done to resolve the complaint at local resolution stage.

You should try to request a review within 12 months of the incident occurring or when you first became aware that something had gone wrong. If this is not possible, you can ask the Ombudsman to consider your request, particularly if you have a good reason for the delay such as trying to obtain other advice.

You can use the Ombudsman’s own forms to submit your complaint if you wish.

AvMA also provides further guidance on making a complaint to the Ombudsman.

Once the Ombudsman has confirmed its decision, this is the end of the NHS complaints procedure. If you still strongly disagree with the Ombudsman’s decision the only way to challenge it is via judicial review.

Step 4: Judicial review

Although the NHS complaints procedure finishes with a final decision by the Ombudsman, you may be able to challenge the Ombudsman’s decision by seeking a judicial review. You will need to take legal advice to see if you are eligible.

Judicial review is a legal process in which the courts assess whether a public body—in this case the Ombudsman—has reached or failed to reach a decision fairly. The grounds for this can include:

• There has been an unfair or biased process. This could be that the public body has failed to review evidence presented by one side or hasn’t given a fair hearing on the basis of the written information.
• The decision is irrational.

The most important point about judicial review is that it must be sought very quickly after the decision has been made. You should seek legal advice as quickly as possible if you are considering this route. An application for judicial review should be made as soon as possible and no later than three months after the public body’s decision has been made.

The Law Society provides a list of lawyers who specialise in medical matters.