Alternatives to Litigation: The NHS Complaints Procedure

Step One: Local Resolution

The first stage is to raise your concerns wherever you received the treatment about which you are unhappy.  All NHS Trusts, GPs, dentists, opticians, and pharmacists are required to have a complaints procedure.  Although these procedures have to meet certain requirements, imposed by the Department of Health, it is up to each individual healthcare organisation to set up its own system for dealing with complaints.  They should give you details of the system they have in place.  Some organisations have leaflets explaining their procedures with which they can provide you.

NHS organisations are obliged to deal with any complaints they receive, so long as they are made within six months of the date of the incident(s) about which you are complaining.  Complaints that are made after this time may be considered, especially if there is a good reason for the delay (for example, when an unsatisfactory result only becomes apparent some time after the treatment in question).  One way or another, though, it is best to act as quickly as possible.

To whom Do I Complain?

If you are happy to keep your complaint fairly informal, then you may find that it is simplest just to speak or write to the doctor - or other healthcare provider - who was responsible for your treatment.  Sometimes, this will not be the person who was actually involved in the incident about which you want to complain.  An example would be where you have been in hospital, and believe that you have been treated poorly by a nurse.  In these circumstances, you might like to address your complaint to the Consultant who was in charge of your care, or a senior member of the nursing team.  However, do bear in mind that, if you put an informal complaint in a letter to a doctor, that letter will probably be added to your medical records.  This might be a positive thing (perhaps it will stop other people making the same mistake at a later stage in your care), but it might also be negative (no one wants to be seen as a trouble-maker).

If you would not feel comfortable raising your concerns directly with those who treated you, or if you want to make a formal complaint, you need to contact the person who has responsibility for complaints at the organisation in question.  Unfortunately, because different systems apply in different places, it can be difficult to know who that person is.  The following advice may help you to identify who you should be speaking to:

  • Larger organisations (such as hospital Trusts) employ a Complaints Manager, whose job it is to oversee all complaints.  If you do not know which Trust oversees the hospital at which you have received treatment, you can find out on the NHS's website (see the links section at the end of this page).  Once you have identified the relevant Trust, you should be able to obtain the name, address, and telephone number of their Complaints Manager easily enough (perhaps by telephoning the main switchboard, or by looking on the Trust's website).  If you cannot find this information, you can address a written complaint to the Chief Executive, who is obliged to pass your complaint on to the relevant person within the Trust.
  • Smaller organisations (such as GP surgeries) will not have someone whose sole job is to manage complaints.  Dealing with patients' concerns will often be part of the responsibilities of a "practice manager".  If you feel able to do so, ask your first point of contact (e.g. a receptionist) to whom you should address your complaint.  As a last resort, you could simply send your complaint addressed to "The Complaints Manager": even if the organisation to whom you are complaining does not employ someone with this job title, it will be passed to the person who takes responsibility for patient complaints.
  • Another approach, when complaining about the care you have received in a small organisation, is to address your complaint to the body that oversees the organisation in question.  Every GP surgery and community healthcare practitioner (health visitors, etc.) is responsible to a Primary Care Trust ("PCT" - these used to be known as Heath Authorities).  PCTs have complaints procedures, and most have a Complaints Manager.  You can speak to them, or send them a written complaint.  If you do not know which PCT oversees your area, you can look it up on the NHS website, by entering your postcode (see the links section at the end of this page).  This site will also provide all the contact details you need, including links to PCT websites.  Again, you can address your correspondence to the Trust's Chief Executive, if you cannot identify the PCT's complaints procedure or manager.

How Do I Make a Complaint?

Having identified the person who has responsibility for complaints at the relevant organisation, the precise manner in which you choose to raise your concerns is up to you, and depends on what you want to achieve.

You may decide that a sensible first step would be to have a telephone conversation with the person in question.  This can be especially useful if your complaint is a relatively minor one, as you may be provided with advice that helps you to resolve your dispute with a minimum of stress and "red tape".  It can also be worthwhile to speak to your complaints contact if your concerns are more serious, if only to establish a dialogue with the person who will be responsible for taking things forward.

Alternatively (especially if you believe that your complaint raises serious issues), you may decide that it would be best to put things in writing from the outset.  If so, you need to try to provide as detailed and logical an account of your experiences as you can.  You should make sure that you give the following information:

  • The name of the doctor or other clinician about whom you are complaining, and the address where he or she works;
  • An explanation of the events or incidents which concern you and, where possible, the dates on which these events took place.  If your complaint relates to hospital treatment, the ward name and your hospital number are often useful;
  • Copies of any relevant papers and of any other evidence you have; and
  • Names and addresses of anyone else who will support your complaint.

If you are raising more than one concern, it is useful to number each point; this helps your complaints contact to ensure that all of your concerns are answered.

Try to be as detached as you can be, in setting out your concerns.  You are bound to feel strongly about the events that are the subject of your complaint, but you will do yourself few favours by expressing yourself in a way that could be seen as hot-headed.  Do not give those to whom you are complaining the opportunity of writing you off as someone with a "chip on their shoulder".  Let the facts speak for themselves.

Some organisations have a particular system for accepting complaints.  It is quite common for there to be a standard form to fill in.  This is one reason why we advise that, if you feel able, it is sensible to talk to someone before committing your concerns to paper: it can be frustrating to set your story out in a letter, only to receive, by way of response, a form into which you have to insert exactly the same information again!

What Happens when I Have Made a Complaint?

Once a complaint has been made formally (in writing), it has to be taken seriously.  Again, each complaints service has slightly different procedures but, under the terms of their agreement with the NHS, they have to guarantee the following:

  • Your complaint will be investigated;
  • You will receive a full written reply from the relevant Chief Executive or Complaints Manager within four weeks of making your formal, written complaint.  When this is not possible, you should receive regular updates on the progress of your complaint, including an indication of when you can expect to receive a final response;
  • If your complaint is upheld, the organisation should offer an apology; and
  • If your complaint is upheld, the organisation should undertake to improve services to prevent the same problem happening to you - or anyone else - in the future.

Conciliation

Some healthcare organisations offer a conciliation service as part of their local resolution package.  This means that they will offer you the opportunity to have your dispute overseen by a neutral third party (a "Conciliator").  Conciliators are specially trained in the skills of resolving disputes.  Any Conciliator that is appointed in your case will be familiar with the NHS, but will be independent of the organisation about whom you are complaining.  He or she may want to meet with you on your own, and may also want to hold a meeting at which you and the clinician about whom you are complaining can discuss your concerns.  Someone who has no vested interest may be able to promote a constructive dialogue in a way that would not otherwise be possible between an angry patient and a threatened clinician.  You do not have to wait for the organisation to which you are complaining to suggest conciliation: you can request it yourself, if you believe that it would help to resolve your dispute.

What If I Am not Satisfied with the Response I Receive?

If, having received a written response from the organisation to whom you have complained, you are not satisfied that your concerns have been properly addressed, you have the right to ask for an "independent review" of your complaint.  This is the next stage in the NHS Complaints Procedure.