Alternatives to Litigation: The NHS Complaints Procedure

Step Two: Independent Review

An Independent Review is only available once you have attempted local resolution of your dispute.  You cannot ask for an Independent Review as a first step in your complaint.

How Do I Request an Independent Review?

You must ask for an Independent Review in writing within 28 days of the date of the written response you have received to your initial complaint.  When making such a request, you should explain why you remain unhappy, and list which aspects of your complaint have still not been resolved to your satisfaction.  The letter you received in response to your initial complaint should tell you to whom your request should be addressed.

The Convenor

Your request for an Independent Review will be considered by a specially trained person known as a "Convenor".  The Convenor is appointed by the NHS organisation about whom you are complaining.  Often, he or she will be a non-executive, "lay" (not medically qualified) member of the Trust Board; in other instances, he or she will be a third party who has been specifically appointed to the position.  He or she will be assisted by an independent layperson from outside the Trust (often, from outside the area).  Between them, the Convenor and assistant have to decide whether your complaint deserves further investigation.  They can make a number of decisions:

  • They can conclude that further investigation would serve no useful purpose, and refuse your request for review.
  • They can refer your case back to the complaints manager who looked at it initially, with a request for matters that have been overlooked to be addressed.  As part of this, they may suggest that your dispute might benefit from conciliation (see above), if that has not already been attempted.
  • They can agree with your request for further review, and set up an "Independent Review Panel" (see below).

You should receive the Convenor's decision, in writing, within 4 weeks of your request for Independent Review.  When this is not possible, you should receive regular updates on the progress of your case, including an indication of when you can expect to receive a decision.

If your request for an Independent Review is turned down, you have the right to take your case to the Health Service Ombudsman (see below).

Independent Review Panel

If the Convenor decides to set up an Independent Review Panel, he or she should write to you, explaining what aspects of your complaint the Panel will review.

An Independent Review Panel is made up of three people:

  • an independent layperson who will act as Chair (sometimes, this will be the person who assisted at the convening stage);
  • another independent person (someone who does not work for the NHS, chosen from a list maintained by the Department of Health); and
  • the Convenor.

If your complaint relates to directly clinical issues, the Panel must seek guidance from at least two experts in the particular field in which you received treatment ("clinical assessors").  These experts will not have been involved in your care but, in some cases, they may be employees of the same organisation about which you are complaining.

You may be invited to speak to the Independent Review Panel in person.  If this is so, the discussion will be in private, and it will usually be separate from any discussions the Panel may also choose to hold with the clinician(s) about whom you have complained (though this will not necessarily be the case).

When the review process is complete, the Panel will prepare a report that gives details of its investigations, and lists any conclusions, comments, or suggestions it has to give.  You may be given the opportunity to comment on a draft version of the report, but you are not automatically entitled to do so.

You will be sent a copy of the final report.  You will also receive copies of any reports the Panel has commissioned from its clinical assessors.  The person who is in charge of the organisation about which you have complained should also write to tell you of any action being taken as a result of the Panel's findings.

How Long Does this Process Take?

The rules that govern time limits in Independent Reviews are rather complicated, and vary depending on the kind of NHS organisation that is involved.  In theory, the maximum length of time it should take between the date of your letter from the Convener, acknowledging that an Independent Review Panel is being set up, and the final report of that Panel is 80 working days (this equates to around 16 weeks).  Whether this proves possible in practice may be another matter, especially where the Panel is dependent upon the advice of clinical assessors (who tend to be very busy doctors).  If things are held up, you should - at the very least - be informed of the delay, and given a revised indication of when you can expect to receive the Panel's final report.

What If I Am Still Not Happy?

If, having completed the two initial steps, you still do not believe that your concerns have been adequately addressed, you have the right to refer your complaint to the Health Service Ombudsman.  This is the last stage in the NHS Complaints Procedure.