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

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 step you can take if you need to make a complaint about NHS care in Scotland.

We also have the following guides:

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

In Scotland, your right to complaint is covered by the Charter of Patient Rights and Responsibilities. The Charter explains your rights to:

• Give feedback, make comments or raise concerns or complaints about the healthcare you receive.
• Be told the outcome of any investigation into your concerns or complaints.
• Have independent advice and support when providing feedback.
• Take your complaint to the Scottish Public Services Ombudsman (Ombudsman).

Step 1: Frontline resolution

Since April 2017, the NHS in Scotland aims to deal with more straightforward complaints within five days. This is known as frontline resolution.

If you have a concern about health or social care issues, you can complain to any member of staff or ask to speak to the Feedback and Complaints Officer for the NHS organisation involved. If you are still at the place where you have received care, you can raise your concerns with the GP, nurse or other health professional you are dealing with. They may be able to resolve the complaint immediately and offer an apology.

You can complain directly to the provider (GP practice, NHS dentist or hospital). If you do not wish to deal directly with the provider or if your complaint involves more than one NHS provider (such as a GP and a hospital or more than one hospital) the NHS Board can enable a co-ordinated investigation and response. Find your local NHS Board.

Specific contact details for complaints can be found at NHS Inform.

The provider will consider if the matter is a complaint and whether the issues are relatively straightforward and can be resolved with little or no investigation. If so, your case will be dealt with under frontline resolution. If your complaint is not resolved, see Step 2: Investigation.

Step 2: Investigation

This is the complaints handling process for cases which have not been resolved at the frontline stage or where the complaint is complex, serious or ‘high risk’.

When will stage 2 be triggered?

If frontline resolution has been attempted but you remain dissatisfied and request an investigation; this may happen immediately after the frontline stage decision or sometime later.

• If you refuse to take part in frontline resolution.
• If the issues raised are complex and require detailed investigation.
• If the complaint relates to serious, high-risk or high-profile issues.

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.

The investigating officer may wish to contact you to discuss the scope of their investigation and to see whether the resolution you are seeking is achievable and realistic. They may ask you for additional information needed to investigate the complaint and should explain if they are going to seek such additional information. At this point they may offer you a meeting or telephone call to discuss the complaint. You do not have to agree to this.

You should receive a full response to your complaint, by your preferred method of communication, within 20 working days.

If you are not satisfied with the outcome but think that the provider could still put things right, you should respond setting out what you are unhappy with and how you think it could be resolved. If you do not think your concerns can be settled by the provider, you can contact the Scottish Public Services Ombudsman—see Step 3.

Mediation is a service where independent mediators help the relevant parties to reach an agreement. You can request, or health boards may offer, to provide this service. Both parties must agree to take part before this can go ahead. You can get help finding mediation services in your area by asking the Feedback and Complaints Officer at your local health board.

Step 3: Scottish Public Services Ombudsman

If you are dissatisfied with the response you have received then you can contact the Scottish Public Services Ombudsman. Before you approach the Ombudsman, you must have completed the local resolution complaints process above.

You will need to put your complaint in writing and include copies of all correspondence from the local resolution stage of your complaint. You should make your complaint to the Ombudsman within 12 months of the events or incident in question, or within 12 months of you becoming aware that there were grounds for complaint.

Step 4: Judicial review

In some cases, it may be appropriate to use the judicial review procedure, particularly if you urgently need to challenge the way in which the NHS has made a decision which affects you (for example, not to provide certain treatment).

The Court of Session in Edinburgh can:

• Look at how the decision was made on a procedural basis. This is not an appeals process and cannot change or reverse the actual decision.
• Check that the NHS did not abuse its powers.
• Check that the NHS acted properly and lawfully.

Judicial review is a remedy of last resort and is only very rarely applicable to NHS complaints. You will need specialised advice from a solicitor on whether there are grounds to apply for judicial review. The Law Society provides a list of lawyers who specialise in medical matters.