Navigating the NHS Complaints Procedure

If you are unhappy with the care or treatment you have received from the National Health Service (NHS), you have the right to make a complaint. The NHS strives to provide high-quality care, but when things go wrong, it is important that patients are able to share their experiences to facilitate learning and improvement.

Who Can Make a Complaint?

You can make a complaint if you are a patient, a relative, a carer, or someone acting on behalf of a patient. If you are complaining on behalf of someone else, you will generally need their consent, particularly if you are accessing their medical records or personal health information. In cases where the patient lacks the capacity to consent or has passed away, specific guidance applies regarding how to proceed.

The Two Stages of the NHS Complaints Procedure

The NHS complaints process is generally split into two distinct stages:

• Local Resolution: This is the first stage where you raise your concerns directly with the service provider (such as your GP practice, dentist, or the hospital trust).
• The Parliamentary and Health Service Ombudsman (PHSO): If you remain dissatisfied after the local resolution stage has concluded, you can escalate your complaint to the independent Ombudsman.

Stage One: Local Resolution

Most complaints are resolved at the local level. You can choose to complain either to the organization that provided the service (e.g., the hospital) or to the organization that commissioned the service (e.g., the Integrated Care Board). It is usually recommended to contact the service provider directly first.

Once your complaint is received, the organization must acknowledge it within three working days. They will then agree on a plan with you regarding how your complaint will be handled and how long it will take to reach a conclusion. They should keep you updated throughout the process.

Stage Two: The Ombudsman

If you have gone through the local resolution process and feel that your complaint has not been adequately addressed, you have the right to take it to the Parliamentary and Health Service Ombudsman. The Ombudsman is completely independent of the NHS.

The Ombudsman will review your case to decide if the NHS has acted unfairly or provided poor service. It is important to note that they will generally not look at your complaint until the local organization has had the opportunity to investigate and respond first.

Time Limits

It is important to act promptly. The general rule is that you should make your complaint within 12 months of the incident occurring, or within 12 months of you becoming aware that you have a reason to complain. Extensions may be granted if there are exceptional circumstances, but it is best not to rely on this.

Support and Advocacy

Making a complaint can sometimes feel daunting. You do not have to do it alone. The NHS Complaints Advocacy Service provides free, independent support to help you navigate the process. They can help you write letters, prepare for meetings, and understand the responses you receive.

The Importance of Feedback

Complaints provide valuable data for the NHS. They highlight systemic issues that might otherwise go unnoticed. By raising a formal complaint, you are not only seeking a resolution for your own situation but potentially preventing the same issue from occurring to another patient in the future.

What You Can Expect from the Process

A good complaints procedure should be transparent and fair. While it may not always result in the outcome you personally desire, you are entitled to a thorough investigation, a clear response, and, where appropriate, an apology or a commitment to change. If you feel that you need legal advice regarding a specific medical negligence claim, that is a separate legal process and you should seek professional counsel from a solicitor.