A Guide to NHS Complaints Procedure & Compensation Claims

A Guide to NHS Complaints Procedure

A Guide to NHS Complaints Procedure


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    The National Health Service (NHS) does a great job of providing prompt and quality medical care to the vast majority of patients under her care. However, things can go wrong on occasion. This article discusses how you can leverage the NHS complaints procedure if you are dissatisfied with the quality of treatment you received.

    What is an NHS Complaint?

    A complaint is an expression of displeasure about an action, error or decision of the NHS, either written or verbal, whether or not it is justified, in expectation of a response. The NHS complaints procedure provides an opportunity for patients and their families to express concerns regarding the quality of treatment received. It also gives the healthcare provider an opportunity to address these concerns by explaining what happened and, if something went wrong, take the appropriate steps.

    The NHS complaints procedure does not provide for financial settlements, but making a formal complaint can aid your quest for compensation.

    Who Can Complain?

    You can make a complaint against the NHS if you:

    • Have received medical services from an NHS organization.
    • Are affected, or likely to be affected, by the negligent action of the NHS body you want to complain about.

    You can also complain on behalf a person who has grounds to make a complaint if the person:

    • Is under the age of 18.
    • Has died.
    • Cannot make a complaint independently because of a mental or physical disability.
    • Has asked that you act on their behalf.

    Who Cannot Use the NHS Complaints Procedure?

    You cannot make use of the NHS complaints process if:

    • You have made a verbal complaint and it was satisfactorily resolved by the end of the next working day.
    • You are an employee of an NHS organization and want to make a complaint about an employment concern.
    • Your complaint has been sorted under the NHS complaints procedure.
    • Your complaint has been, or is currently investigated, by the Parliamentary and Health Service Ombudsman.

    What a Complaint Cannot Help You Achieve

    When making a complaint about a treatment received by an NHS body, you cannot expect:

    1. Compensation for medical negligence:

    • You can only receive financial compensation if you take legal action. You need to speak to medical negligence solicitors specialized in the area of medical negligence.

    2. Complaints against a private healthcare provider:

    • If you have received medical care from a private healthcare provider, you cannot use the NHS complaints procedure to make a complaint. You will need to follow the complaints procedure of the private healthcare service you used.
    • However, you can still use the NHS complaints procedure if the medical care you received was funded by the NHS, but provided by a private service.

    3. Complaints against Care and Nursing Homes:

    • You can only use the NHS complaints procedure if the care or nursing home is funded by the NHS.
    • If the care or nursing home is privately funded, you cannot use the NHS complaints procedure. Care and nursing homes usually have their complaints procedure, so you can make a complaint via that process.

    Deciding What You Want to Achieve

    If you are specific and realistic about with the outcome you expect with your complaint, your issues will likely be handled in a smooth and speedy manner.

    When making a complaint about treatment received at the NHS, you can expect:

    • Your complaint to be investigated and dealt with properly and efficiently
    • To receive support in making your complaint
    • A prompt resolution where possible
    • To know the result of the investigation into your complaint

    In the end, you can expect an explanation of circumstances surrounding your complaint and, if appropriate, an apology. You can also expect to receive assurances that appropriate action will be taken to prevent a repeat of same negligent action to someone else.

    The NHS Complaints Process

    Once you are sure of what you want to achieve with the NHS complaints procedure, it is now time to make a complaint. There are different ways you can make a complaint:

    • Speak to a member of staff directly
      Sometimes a complaint may arise as a result of miscommunication or a misunderstanding, and this can be put right if you explain the issue to the appropriate quarters. If possible, speak to a member of staff who was directly involved in the medical care you received, or to the management, to express your dissatisfaction. This is usually the fastest way to straighten matters, so things don’t get worse.
    • Speak to the Patient Advice and Liaison Service (PALS)
      If you do not feel comfortable speaking with the NHS staff involved in your treatment or you have tried and your issue is still unresolved, then you may receive support from the Patient Advice and Liaison Service (PALS). PALS provides advice and support to patients, families and their carers; they can quickly provide the answers you need.

    Making a Formal Complaint Via the NHS Complaints Procedure

    If you are still unhappy with the outcome after making an informal complaint about the issue, or if the problem cannot be sorted, you can make a complaint using the NHS complaints procedure. The first stage of this process is called local resolution.

    Local Resolution

    Local resolution provides an opportunity for you to explain what you are dissatisfied with and the outcome you expect. It also makes it possible for you and the NHS body to have time to discuss the incident; this process is important because it is designed to resolve your concerns and aid the improvement of local services. This is a time to raise every concern that you are dissatisfied with as you will be unable to raise new issues later.

    You can address your complaint at the local level to:

    • The NHS organization which provides the service, OR
    • The organization that buys or commissions the service. If you were treated by a GP, this is NHS England and in the case of a hospital treatment, this will be a clinical commissioning group. If you received care from another service, you can find out who buys or commissions the service here.

    The Parliamentary Health Service Ombudsman

    If the response to your complaint at the local level is not satisfactory enough, you can make a complaint to the Parliamentary Health Service Ombudsman. The Ombudsman is independent of the government and they exercise powers as set down in law. The service is free and confidential.

    By law, you are expected to submit a complaint to the Ombudsman within a year of when you first became aware of the concern you are making a complaint about. If it is already over one year, the Ombudsman may still help you if there were strong reasons for the delay.

    When Should I Make a Complaint?

    You should make your complaint as early as possible. Complaints should usually be made within one year of the incident that you are complaining about, or as soon as you became aware of the problem. The time limit can be extended if investigation into the complaint is still possible. For instance, if making a complaint earlier would have been difficult because you were suffering a trauma, the time limit may be extended.

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    How Medical Negligence Direct Can Help

    Medical Negligence Direct works with a panel of medical negligence solicitors who are specialists in making medical claims. We can assist you with both stages of the NHS complaints procedure, from crafting an initial draft to supporting you all the way if your complaint gets to the Ombudsman. If you consider making an NHS claim after the complaint, you can count on us to support you in your quest for NHS compensation.

    Contact Us

    If you need advice or support in relation to making a complaint about treatment you received at the NHS, please get in touch with us by calling 0800 644 4240.