NHS Complaints Procedure
The aim of the NHS Complaints Procedure is to resolve issues at a local level. If at the end of the process of ‘local resolution' you don't feel your complaint has been resolved satisfactorily you have the right to go to the Health Service Ombudsman. As a general rule the Ombudsman will only accept a case after local resolution has been completed.
Stage 1: Local Resolution
Stage 2: The Health Service Ombudsman
Stage 1: Local resolution
Local Resolution is your opportunity to explain what you are unhappy about and what you would like to happen. It gives you and the NHS organisation time to discuss the incident. Local Resolution is important because it aims to resolve your concerns and, where appropriate, use your experiences to improve local services.
The process begins when you first tell the people responsible for the service you are unhappy about that you want to complain. The aim is to sort out your problem directly with the NHS organisation. The NHS aims to respond to you efficiently, sensitively and promptly.
As a general rule, you should make your complaint within 12 months of the incident or within 12 months of realising that you have something to complain about. However, the NHS can use its discretion if particular circumstances prevent you from complaining in good time.
Who do I complain to?
If you want to complain about your hospital or ambulance service contact the complaints manager or the Chief Executive of the NHS Trust.
For complaints about primary care and independent providers such as your GP, dentist, optician, pharmacist, health centre or other independent NHS contractor, you have two options:
a) You can complain directly to the NHS organisation by contacting the person in charge of complaints. In most GP and dental practices, this will be the practice manager.
Or
b) You can complain to the Primary Care Trust (PCT). The PCT is responsible for all care in your local area and they work closely with primary care practitioners such as GPs and dentists.
If you choose Option A and you are not satisfied with the response you cannot then raise the issue with the PCT. The next stage of the complaints procedure will be to contact the Health Service Ombudsman. If you are not clear where to send your complaint, ask for advice from the Patient Advice and Liaison Services (PALS) or the Complaints Department in larger organisations such as hospitals.
If your complaint concerns more than one NHS organisation, you need only send a letter to one of the organisations. They will liaise with the other organisation(s) involved and provide a co-ordinated response.
NHS Trusts usually prefer receiving complaints in writing. If you would rather telephone or have a meeting, the complaints manager should make a written record of your complaint and you should be given a copy.
It is important to raise everything that concerns you at this stage, as new issues cannot be introduced at a later stage of the process. If your complaint is not resolved at this stage and you want to take it further, whatever you have raised here will be referred to later.
It may be helpful to keep a record of any phone calls and letters. To help you do this, you can use this Log Sheet and fill in details of who you wrote or spoke to, what was agreed and any action that needs to be taken.
If you would like advice on writing a complaint letter, please take a look at our complaint letter guide and sample complaint letter.
What happens next?
The person or department you have complained to should make contact to discuss your complaint and arrange a plan to resolve your concerns with you. They should also agree a timescale for resolving the issues and explain how they will keep you informed of progress.
The suggested timescales can be influenced by issues such as how many staff they need to speak to, how easy it is for them to access your medical records and if other NHS organisations are involved in your complaint. If there is a problem in keeping to the agreed timescale they should contact you before it expires to agree an amended timescale.
How should the NHS handle your complaint?
The Trust should try to resolve your issues in the most appropriate way.
This may include:
• an investigation
• a meeting which gives you the chance to speak to staff directly about what has happened.
• input from conciliation or mediation services.
A conciliator/mediator is a neutral and independent person who can arrange a meeting with you and those involved (either separately or together) so you can all express your views and try to resolve your differences.
A conciliator will become involved only if everyone affected agrees. The conciliation process is confidential.
Conciliation and mediation services differ from Trust to Trust, so if this is offered you should ask the complaints manager to explain how it operates in your area. You can take a friend, relative or advocate with you to any meetings.
What will happen next?
When the investigation is complete, the complaints manager should send you a letter signed by the Trust's 'responsible person' or someone authorised to act on their behalf.
This letter should contain:
• a summary of your complaint
• what the investigation found and any actions that are going to be taken as a result
• what to do if you are still unhappy with the answers given.
Depending on the Trust's investigation, the letter may contain:
• an apology if relevant
• what will be done, by when
• who is responsible for making this happen
• what steps have been taken to prevent the same thing happening to other people.
The letter should be balanced, factual and impartial, as well as clear and easy to understand.
If you haven't received this letter within the timescale agreed in the plan you may want to check when you can expect to receive it. If you haven't received a response letter within six months of your original complaint and the Trust hasn't agreed an extension they should write to you explaining the reason for the delay. The final response must then be sent as soon as reasonably practicable.
This is the end of the first stage of the NHS Complaints Procedure.
What if I am not happy at the end of Local Resolution?
If you are not satisfied with the reply you have been given, ask yourself exactly what you are unhappy about so you can decide what to do next.
It may help to review:
• any letters and meetings
• any conciliation or mediation process
• whether the plan you agreed was followed
• whether parts of your complaint have yet to be answered,
• whether you feel evidence you gave was not properly considered
• what more could have been done to achieve your desired outcome
• whether the complaints manager has followed the Ombudsman's good complaints handling principles.
What are my options?
• you can write another letter explaining what you think has not been covered
• you can call the person handling your complaint and explain why you are still unhappy
• you can request a meeting to discuss your outstanding concerns
• you can refer your concerns to the Health Service Ombudsman.
Further investigation into your complaint may be carried out. Again, the NHS organisation should discuss this with you and agree a plan, including timescales.
The NHS organisation you are complaining about may feel that everything has been done to answer your complaint and if so, they should inform you in writing.
Click here to continue on to Stage 2: The Health Service Ombudsman
