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Private healthcare: how to make a complaint

Whenever you receive substandard medical treatment you are entitled to make a complaint. This document provides information about making a complaint about private healthcare.

First steps before making a complaint

If you are concerned about the treatment that you have received then you should always discuss this with the clinician or nurse who treated you. They may offer a useful explanation and advice on how to overcome any immediate concerns. If you do not find  the response useful, then you should next discuss any other potential treatment options with your GP, especially as you may require a referral for a second opinion.

Making a complaint to the medical organisation

Whether you received care from a hospital or a clinic, by law it is required that they must operate a complaints procedure. Therefore if you intend to make a complaint about private healthcare then you should enquire about the organisation’s complaints policy. Usually this is clearly available on their website but if not then you can request it from them directly.

If you cannot access their complaint’s policy, or if you cannot get a response to your complaint then you should make a complaint to their regulatory body as appropriate, depending on their role, e.g. the General Medical Council, The Nursing & Midwifery Council or the Care Quality Commission.

Is there a time limit to make a complaint?

A complaint should be made within six months of the incident occurring, or within 6 months of you learning of its consequences. If this time period has lapsed then you should write at the earliest opportunity and request that they extend their deadline to explore your complaint.

Tips to make the complaints procedure easier

If you need to make a complaint on behalf of a family member then you will require their written consent.

The process of making a complaint can be a lot easier if the complainant has gathered sufficient information to prove the major elements of their complaint. This may include keeping a record of any telephone calls, copies of any correspondence from the organisation and any meetings that you attend.

The Independent Sector Complaints Adjudication Service (ISCAS)

The ISCAS provides a framework that sets out how private care providers may deal with complaints made either by patients or someone else, on the patient’s behalf.

This framework sets out three progressive steps that can be used in order to deal with a complaint:

  1. Local resolution – at this stage it is the responsibility of the treatment provider to look into and respond to the complaint. A simple conversation between the professional and the patient may be all that is required. If this does take place then it will be beneficial to request a full written response that reflects what was discussed and agreed during the meeting. If the complaint is about an individual practitioner, then any complaint should be addressed to them. Although you can make a verbal complaint, it is easier to evidence a written complaint. It is reasonable to expect a response within 20 days.
  1. Internal appeal – if you are not happy with the outcome of the local resolution then you can apply for an internal review which should be made in writing within 6 months of your final written response from the treatment provider. The complaint will then be considered by the investigating director and they will review the actions that were taken at the local resolution stage.
  2. Independent external adjudication – if you are still dissatisfied with how your complaint has been managed at this stage, then you can request an independent external adjudication. This should be requested for in writing. Once a decision has been made by the adjudicator then this can be sent to the Care Quality Commission.

Contact us if you have any questions with regards to making a complaint relating to private healthcare that you or someone you know has received.