The NHS aims to provide a friendly and reliable service to ensure you get the treatment you need. However, sometimes things go wrong, and there are procedures in place to help you voice your concerns. If you are not happy with the service you have received from any part of the NHS, you can make a complaint.

It is important that to make your complaint as soon as possible after the event. The NHS will usually only investigate complaints that are either:

• made within 6 months of the event; or
• made within 6 months of you realising that you have something to complain about, as long as that is not more than 12 months after the event itself.

These time limits can be waived if there are good reasons why you could not complain sooner.

There are some things that cannot be dealt with under the NHS complaints procedure. These include:

• complaints about private treatment,
• complaints about Local Authority Social Services,
• events about which you are already taking legal action.

Talk to the complaints manager, or the doctor, dentist or optician treating you, if you are unsure whether your complaint

All NHS trusts, primary care trusts, GPs, dentists, opticians and pharmacists have a complaints procedure. These are structured in the same way, and there are a series of steps you should follow to get your complaint resolved.

It is important for you to contact someone in the organisation about the cause of a complaint as soon as possible; this helps them to investigate the complaint properly. The steps you should take are as follows:

• Talk to someone close to the cause of your complaint such as a doctor, nurse or receptionist. Explain what you are unhappy about either in person, over the telephone, by email, or in writing. Alternatively, you can ask to talk to a complaints manager who is not involved in your care. Your local family health service practitioners - GP, dentist, pharmacist or optician – will have their own complaints procedures. Staff in these practices will be able to give you details of how to complain, and they will aim to respond to your complaint within 10 working days.
• The complaints manager may offer to bring in a conciliation service (a neutral person) - this can often help to resolve complaints more quickly and amicably.
• If you are still unhappy, you have the right to have your complaint reviewed by the Healthcare Commission. This organisation is independent of local NHS trusts. The Healthcare Commission has a wider range of options available to them to try and resolve the complaint.
• Finally, if your complaint is still not resolved to your satisfaction, you should contact the Health Service Ombudsman

To resolve your complaint locally

Wherever possible, you should tell someone close to the cause of your problem about your complaint - a doctor, nurse, receptionist, or practice manager, for example. In many cases, it should be possible to sort out the problem straight away.

If you don’t want to talk to someone who has been involved with your care, you can write to or telephone a complaints manager. All NHS trusts and primary care trusts (PCTs) have a complaints manager who can advise you. GPs, dentists, opticians and pharmacies should also have someone who oversees their complaints procedure. If you are not sure who to contact, get in touch with your local PCT.

You can ask the Patient Advice and Liaison Services (PALs) office at the hospital trust or PCT for information and help on using their complaints procedure. Alternatively, you can telephone NHS Direct on 0845 4647 for information on how to complain.

Trusts and PTCs will normally respond to a complaint within 20 working days. Family health service providers - GPs, dentists, pharmacists or opticians - should reply within 10 working days.

Conciliation to resolve complaint

sConciliation is a way of dealing with complaints that helps to avoid difficult disagreements. A neutral conciliator aims to come up with a satisfactory conclusion for both parties.

Either you or the organisation you are complaining about can ask for conciliation, but both must agree to the conciliation taking place.

Conciliation is most often used to help with complaints about primary care services - for instance GPs. Primary care trusts (PCTs) are required to provide conciliation services for these. However, your NHS trust or PCT may also offer you this service if you make a complaint to them.

Independent review of complaints

If attempts at resolving complaints locally are unsuccessful, you have the right to have your case reviewed by the Healthcare Commission. If you are eligible for this, you need to fill in a complaints form. These are available from local trusts, independent complaints advocacy services, online or can be sent by post. Alternatively, you can write or email your request to the Healthcare Commission with a copy of the report that was given at the end of local resolution.

Contact the Healthcare Commission complaints helpline on 0845 601 3012 if you:

• would like someone to complete the form with you over the phone,
• would like to receive the information in another language or format,
• have any queries.

Your case is not suitable for review if it is outside the Healthcare Commission’s legal authority, if you have not yet made a complaint to the local service, or if you are not eligible to complain under the NHS complaints procedure. In such cases, you may be advised to contact your local independent complaints advocacy service (ICAS) for help.

Once your complaint has been received, the Healthcare Commission will allocate a complaints manager to your case. They may contact you for further information, or ask for advice from health professionals. Sometimes, the Healthcare Commission will need to see your medical records, in which cases your permission will be requested. A course of action will be recommended within 10 days of the receipt of the complaint. Possible outcomes include:

• No further action. The complaint has already been thoroughly investigated and answered locally
• Referral back to the NHS organisation complained against. Recommendation of further action to resolve the complaint or review the organisation’s procedures.
• Referral to the Health Service Ombudsman.
• Referral to another body, such as the General Medical Council (if the Healthcare Commission does not have the legal authority to resolve the complaint).
• Action by the Healthcare Commission, who will investigate the complaint and, following the investigation, set up a panel if the complainant wants this.

If your complaint is referred back for further action locally and you are still dissatisfied, you can ask the Healthcare Commission to look at the complaint again. The complaint will normally be referred back to the local authority for a second time.

If an investigation is necessary to resolve your complaint, you have the right to request a panel of three members of the public to hear your complaint. The panel will hear evidence from you, the organisation you are complaining against, any witnesses involved, and the Healthcare Commission’s report. Based on their findings, the panel will make recommendations about how to resolve your case, and, when necessary, suggest service improvements.

The Healthcare Commission may refer some complaints directly to the Health Services Ombudsman. This happens when witnesses do not cooperate in the investigation, or the case falls within the jurisdiction of more than one ombudsman. The Health Service Ombudsman has additional powers to require witnesses to cooperate with the procedure. Health Service Ombudsman.

If you are not happy with Healthcare Commission’s decisions, you can appeal to the Health Service Ombudsman, who is independent of the NHS and the Government. The Ombudsman will not usually consider a complaint if you have not tried to resolve the matter through the NHS complaints procedure.  Contact the commissioner at: The Health Service Commissioner for England, 11th Floor, Millbank Tower, London SW1P 4QP. Tel: (020) 7217 4051

Anyone who is receiving, or has received, NHS treatment or services can complain. A complaint may be made by: 

• a patient,
• a former patient, or
• in the case of an NHS organisation, any person who is affected by or likely to be affected by the action or decision of the NHS organisation that is the subject of the complaint.

If you are unable to complain yourself then someone else, usually a relative or close friend, can complain for you. This may be necessary in cases when the patient:

• has died,
• is a child,
• is physically or mentally incapable of  making a complaint, or
• has requested a representative to act on their behalf.

The relative or close friend making the complaint must, in the opinion of the complaints manager, have an interest in the welfare of the person affected.

In cases concerning children, the representative must be a parent, guardian or other adult person who has care of the child. If the child is in the care of a local authority or a voluntary organisation, the representative must be a person authorised by the local authority or voluntary organisation. 

The Healthcare Commission is also responsible for reviewing complaints about the private sector, in cases when it is providing an NHS funded service.