Making a complaint against the NHS – what you need to know
Please note: this guide concerns making a complaint to the NHS in England, there are slightly different procedures for making a complaint in Wales, Scotland and Northern Ireland.
Not many people are familiar with it, but the NHS constitution promises you:
- the right to have any complaint you make about the NHS properly investigated
- the right to receive an appropriate explanation
- the right to compensation where you have been harmed by negligent treatment
- they will ensure that lessons are learned to avoid similar incidents in the future
Who can make a complaint against the NHS? Can I complain on behalf of my relative or friend?
You can make a complaint on behalf of a family member or friend, but you will usually need their permission to do so. It is also possible to complain on behalf of a child or someone who does not have mental capacity.
If you are being assisted by a patient advocacy service, such as: Patient Advice and Liaison Service (PALS), the Citizens Advice Bureau (CAB) or SEAP (Support, Empower, Advocate, Promote) you can request that they deal with all matters related to the complaint on your behalf.
Shall I make a Formal or Informal Complaint?
Informal Complaint – You could make an informal complaint if the matter is not serious or complicated or you would like something done right away. For example, if you notice the meals are not being taken away very quickly once they are finished, or your relative is having trouble reaching the call bell, this would be an informal complaint.
To make an informal complaint you should speak with a member of staff or a manager. As an informal complaint, it is unlikely that any record will be kept.
Formal Complaint – The formal complaints process is for more serious or complicated concerns.
For example, if you think that you or a loved one may not have received the correct treatment, this treatment has made you worse not better, or perhaps you were ‘lost to follow up’ and as a result your condition has progressed to a point where it is now worse than it otherwise would have been.
Are there any time limits for the formal complaints process?
Yes, you must make your complaint within 12 months of the incident in question, or within 12 months of the knowledge of that incident.
How do I make a formal complaint against the NHS?
A formal complaint can be made verbally (if you formally complain verbally the NHS must keep a record and send it to you), electronically or in writing.
You must first decide to whom to complain, you may complain directly to the institution that treated you who will have their own complaints procedure, or you may complain to:
- The Commissioner (for primary care services such as GPs or Dentists): NHS England Complaints Manager, PO Box 16738, Redditch B97 9PT, Email: firstname.lastname@example.org, Tel: 0300 311 22 33 (Mon-Fri 8am to 6pm)
- Clinical Commissioning Group (for hospital services and some community services): Clinical Commissioning Groups, Find the appropriate clinical commissioning group at www.nhs.uk/service-search
- Care Quality Commission (CQC) for mental health services. Care Quality Commission, CQC Mental Health Act, Citygate, Gallowgate, Newcastle upon Tyne NE1 4PA, Tel: 03000 616161
What should I say in my complaint to ensure I get a full response?
To ensure that you get a full and frank response, you need to try to be as specific as possible. You will need to say who or what you are complaining about, as well as where and when things took place; names and dates are really useful.
It may be helpful to say whether you have complained about this previously, perhaps informally, and mention what was done. It is also useful to set out how you want your complaint resolved, perhaps with a meeting, or perhaps you would just like some answers. Maybe you are even looking for further action to be taken.
For further information see our sample complaint letter here.
What response can I expect to my complaint against the NHS?
Under the NHS complaints procedure, you can expect to receive an explanation or an apology and/or a statement detailing how such incidents will be avoided in future. You are very unlikely to receive any financial compensation as a result or achieve any form of formal disciplinary action against a member of staff.
You may receive a written response to your complaint in the first instance, or you may be asked to attend a meeting before a written response is made. Meetings can be a really useful part of the process.
In order to ensure that you get the most out of a meeting it is a good idea to take a list of questions with you or send them to the complaints manager in advance. It may also be advantageous to ask for the minutes of the meeting one it has concluded. You may wish to take someone with you to help you explain your concerns, this may not be a legal representative but it could be a friend, family member or patient advocate.
Whether you have attended a meeting or not, you should always receive a formal written response which should address all of the issues which you have raised. You should ensure that you fully understand what is being said within the response and that any medical terms used have been fully explained.
If there is anything you don’t understand you can ask them to explain or expand upon certain points. However, if you are still not satisfied with the response you may take further action by asking the Parliamentary Ombudsman for Health to review your complaint.
How long will it take for the NHS to deal with my complaint?
There is no formal time limit; the time limits should be agreed with you as part of the process.
If you feel that your complaint is not being dealt with quickly enough, patient advice charities such as AvMA would suggest that six months is too long to wait, you may wish to take things further by contacting the Parliamentary Ombudsman for Health. https://www.ombudsman.org.uk/ .
Sample complaint letter:
Take a look at our example of a complaint letter below, or download a copy to take away with you.
56 Primrose Avenue,
HospitalGloucestershire NHS Foundation Trust,
Formal Letter of Complaint on behalf of Mr.Gerald Gough, DOB. 18.12.1947
I am writing to complain about the treatment of my father, Mr.Gerald Gough, DOB. 18.12.1947. He was admitted to your hospital on 19.02.2017 having fallen and fractured his wrist. He had general confusion and was later diagnosed with a urinary tract infection.
On 19.02.2017, after having his wrist put in plaster, he was brought to Nutmeg ward for observations. We told the nursing staff that he was confused and that he would need to be monitored as he kept trying to wander off. He was not steady on his feet and he was likely to fall over. We left him in the care of the nursing staff that evening.
The following day my brother and I came into hospital to visit our dad, we stayed from around 9.00 to 11.00 and we were told by nursing staff that he had tried to find the toilet in the night but had fallen over and hit his head. They did not think that this was a serious fall.
During the course of our visit we noticed that our dad seemed very confused and was complaining of pain in his head. We brought this to the attention of nursing staff, but nothing appeared to be noted or done about it.
We stayed with him for 2 hours during which time his speech became slurred, we were told that this was probably as a result of the pain killing medication he was on and not to worry about it, at around 11.00am we left and told our dad that we would be back at 5pm.
When we returned at 5pm, our dad seemed worse and after around 20 mins he appeared to have a seizure, we pressed the emergency button and the room filled up with people. Nobody told us what was going on or who was in charge. They took dad away and after 40 mins of waiting told us that he was going for a CT head scan. Following a number of investigations they diagnosed dad’s urinary tract infection and told us that as a result of the fall that he had had in hospital he had suffered with a subdural haematoma.
It is now 4 months following his discharge and dad has been put into a residential nursing home, he still has slurred speach and he is unable to care for himself. He gets very frustrated and upset because he cannot do things, his quality of life is dramatically reduced. Prior to this he lived on his own and was able to enjoy a range of activities and didn’t need any care at all.
My brother and I want to know:
- Why my dad was allowed to walk around on his own after we specifically told staff that he was likely to fall?
- Did the bump on the head cause dad’s subdural haematoma?
- Without the subdural haematoma would dad have gone back to normal?
- What treatment can dad have to make him better? He doesn’t appear to be having much physiotherapy or occupational therapy, can you assist with this?
- Ideally we would like dad to regain his independence and quality of life, what are the chances of this happening?
- We are concerned that this will happen to someone else, what safe guarding measures have been put in place?
We look forward to hearing from you with a response within the next 4 weeks.
Jane Abrose and Mark Gough.