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

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 Wales.

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 Scotland: 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

Since April 2011, the NHS Complaints Procedure in Wales has been replaced by a new system called Putting Things Right. A complaint under this new system is defined as a ‘concern’. This is when you feel unhappy about any service provided and funded by the NHS, which includes treatment funded by the NHS in Wales, even if this is provided in England. This may result in you having your concerns investigated, the offer of an apology or improvement of services.

Step 1: Raising a concern

If you feel able to do so, in the first instance you should try and speak to the staff who were involved in providing your care. This may enable your concerns to be resolved immediately. If this does not resolve your concerns or you do not feel able to speak to the staff, then you can contact a member of the concerns team at the NHS trust or your local health board.

If your concern relates to primary care (a GP, dentist, pharmacist or optician), you can either raise your concern with the primary healthcare provider directly or contact your local health board to investigate your concerns.

You should raise your concern within 12 months of the incident happening, but ideally as soon after the event as possible, so that the details are still fresh in your mind. Even if more than 12 months have passed, if there are valid reasons for the delay, such as coping with a bereavement or illness, the organisation may still agree to investigate your concerns.

If you need assistance with raising your concern, you can contact Llais. Llais is an independent body which provides free and confidential complaints advocacy and support.

Step 2: Public Services Ombudsman for Wales

If you are not satisfied with the outcome of the investigation, you have the right to take your complaint to the Public Services Ombudsman. The Public Services Ombudsman for Wales has legal powers to look into complaints about public services in Wales, which include health boards, NHS trusts and GP services. The Ombudsman can investigate concerns where you feel you have been treated unfairly or have received an unsatisfactory service due to a failure on the part of a public service provider.

You will normally be expected to make a complaint within 12 months of becoming aware of the problem. However, the Ombudsman will consider how much time the healthcare provider in question has spent dealing with your initial concern.

If you feel that you have experienced medical harm, further investigations may need to be undertaken as part of NHS Redress arrangements.

Step 3: Redress and compensation

Redress relates to situations where you may have experienced harm as a result of your treatment. Redress is made up of either one or a combination of all of the following:

• An explanation.
• A written apology.
• A report on the action which has or will be taken to prevent similar incidents happening in future.
• An offer of financial compensation and/or remedial treatment (remedial treatment refers to medical treatment which is offered to you to try and restore you— as near as possible—to the position you would have been in had the medical harm not occurred.).

Financial redress can only be considered if it is proven that the NHS organisation has failed in its duty of care and that that failure has caused the harm. This is also the case for pursuing a civil claim for negligence. Payment of financial redress will only be considered when both these tests are satisfied. Financial compensation is offered on the condition that you will not seek to pursue the same redress through further civil proceedings.

In accordance with the redress regulations, you will be able to access free legal advice, but this can only be sought from solicitors with known expertise in clinical negligence who are accredited by the Law Society or AvMA.