If you are unhappy with the service or treatment you, your family member or someone you care for had received from the NHS, you may want to make medical complaints about doctors or make an NHS staff complaints. This article provides you with information on how to complain about the NHS, how to complain about a GP surgery using the NHS complaints procedure, who to complain to about doctors regarding – NHS misdiagnosis, and so on.
Complaints About NHS
As written in the NHS constitution, you have the right to make a complaint about any aspect of dissatisfactory NHS care, treatment or service.
The NHS encourages feedback because it is used to improve NHS services. If you wish to share your views and experiences, good or bad, simply speak to a member of staff of the NHS.
If you’re unhappy with any NHS service whatsoever, it’s often advisable to discuss your concerns early on with the provider of the service, as they may be able to sort the issue out quickly.
Most problems can be dealt with at this stage, but in some cases you may feel more comfortable speaking to someone who is not directly involved in your care.
Before you proceed to making a complaint about GP (NHS), you should be sure that you are first of all, eligible to make such a complaint.
Who can complain against the NHS?
It is your right to complain about any aspect of the NHS as long as you:
- Receive or have received services from the body concerned
- Are someone who is affected, or likely to be affected, by the action, omission or decision of the body you wish to complain about.
- You can complain on behalf of someone else.
This can only be made possible if the person who has grounds to complain:
- Has died
- Is a child
- Can’t make the complaint themselves as a result of any physical or mental incapacity
- Has given you their consent to act on their behalf.
What about children and young people
If you are a parent, with a child under the age of sixteen, you can make an anonymous complaint to social services. This is possible if the NHS thinks the child cannot make the complaint themselves.
However, you can still complain about GP practice, even though the NHS thinks the child can make the complaint themselves. This is possible as long as the child has given you the permission to make a formal complaint or a GP report on their behalf. In this case, the NHS might demand that the child fills a ‘Permission to act on my behalf’ form.
Before you make a complaint
If you are making a complaint about a GP, the first step is usually to talk to the person concerned, or ask to see the person in charge prior to seeking compensation via complaints. For example, if you are not happy with hospital treatment, try to talk to the person in charge of the ward before complaining to the hospital complaints commission (if need be).
If you wish to complain about a doctor’s surgery, ask to speak to the practice manager. Any member of staff should be able to tell you how to contact the right person to talk to, or in the case of hospital complaints, you can find out from the Patient Advice and Liaison Service (PALS). The switchboard or the website of the organisation could also tell you the right person to complain to.
You should keep a note of:
- The dates and times when you talk to them
- The names of the people present
- What was discussed, their response and what they say will happen next.
If you’re not happy after this discussion, you can go ahead and ask to see the manager of the organisation. Again, the staff should be able to tell you who the manager is and how to contact them. Or in the case of a hospital, you can ask PALS (while making your PALS complaints). Keeping a record of this meeting is vital.
Local resolution
If you’re still unhappy after talking informally about the problem, or if the complaint is something that can’t be sorted out straight away, you can make an NHS formal complaint under the NHS complaints procedure. The first stage is known as local resolution.
You can address your complaint either to:
- The body which provides the service
- Or the body which buys or commissions the service.
In the case of hospital treatment, this is a clinical commissioning group or you address it to the office of the health complaints commissioner and in the case of GP services, this is NHS England. If it’s another service, you can find out who commissions it and make the necessary complaints to the appropriate body.
If you’re complaining to the service provider, you should address your complaint to their Chief Executive or the complaints manager. You might also want to send a copy to the body which commissions the service so they are aware of what problem you may have.
If you do not feel comfortable talking directly with the service provider, you may prefer to address your complaint to whoever commissions the service.
You can decide to make your complaint in person, in writing or by email. However, it’s best to make it in writing and you can get help writing your letter, especially using the NHS complaint letter template.
Whichever method you use, make sure you make it clear that you are now starting the complaints procedure. You should give full details of the problem, including the name of any staff members who are involved. Before you make your complaint, make a note of the relevant events, including dates, times, names and conversations.
Also include all other necessary details. It can take a while to sort out a complaint and keeping a note of everything will help you remember the details, as well as serve as evidence.
Ensure that your explanations are as short and clear as possible. Focus on the main issues, and do away with irrelevant details. Don’t be afraid to say what has upset you, but avoid aggressive or derogatory language. If you can, talk through what you want to say with someone else first, or ask them to read what you’ve written before you proceed to send it.
You should also say what outcome you would like, for example, an explanation or apology or a change in treatment or even compensation. If you complain in writing, keep a copy of everything you have written, and make a note of when you sent the letter. If you need to enclose other documents, only send copies and keep the originals with you. You might want to send your letter by recorded delivery to make sure it gets delivered.
If you make a complaint verbally (for instance, complaint against ambulance service), it’s a good idea to make notes beforehand of what you want to say as it’s easy to get distracted if you’re angry. Also if it’s possible, take notes of what they say to you when you report your complaints.
However, the organisation you are complaining about must make a written record of your complaint and provide you with a copy of this record unless the complaint is resolved to your satisfaction by the end of the next working day after you made the complaint. Go through this record carefully, to make sure it is in line with what you wanted to say.
If you’re complaining on someone else’s behalf, you will usually need their consent, so get them to also sign the letter if they can, or enclose an authorization for you to act on their behalf. If you’re complaining on behalf of a patient who has died, you’ll need to prove that you’re the next of kin or that you have got the permission of the next of kin to make the complaint.
How and when should they acknowledge your complaint?
The organization must acknowledge your complaint no later than three working days from when they got it. They can do this either in writing or verbally.
When your complaint is acknowledged, they must offer to discuss with you, at an agreed time:
- How the complaint will be handled, and
- Likely timescales.
- If you don’t accept the offer of a discussion, they must still tell you in writing when the investigation is likely to be completed and when you should get their response.
There are no limits on how long they can take to deal with your complaint but it has to be within a reasonable time. The timescale will depend on factors like:
- How many staff they need to speak to
- How easy it is for them to get access to your medical records
- If other organisations are involved.
If you feel that the delay is unreasonable, you can go to the Parliamentary and Health Service Ombudsman, although they don’t usually investigate until local resolution has finished. After six months, if the organisation is yet to send you a response, they have to write to you to explain the reason for the delay.
NHS Complaint Procedure
The NHS complaint procedure for GPs allows you to make your concerns and complaints known to the NHS.
While making a legal complaint about GP to the NHS, you need to provide as much information as possible to allow the NHS to investigate your complaint. While adhering to the complaint process, ensure that you provide the following:
- Your name and a valid email or home address for reply
- A phone number in case we need to contact you for additional information
- The name, location, and postal address (if you know it) of the service you want to complain about
- A clear description of what you want to complain about and when this happened
- Any relevant correspondence
Ensure that you do not post removable media while making NHS GP complaints to NHS England, for example CDs, DVDs, SD cards and memory sticks. Due to security restrictions, the NHS are not able to access information that is sent this way.
Any removable media will be returned to you, or securely destroyed if you do not have your details secured with the NHS.
NHS England will acknowledge all complaints not more than the three working days after the day you raise a complaint or after the complaint is received by them.
Your complaint will be investigated as soon as possible and you will receive the findings of the investigation along with an apology. You will also receive an explanation of any lessons learned during the process or changes that may occur as a result of the findings of the investigation.
The amount of time this will take will depend on what your complaint is about and its complexity. A simple and easy-to-resolve complaint usually takes significantly less time to fix. On the other hand, a much more complex complaint will require a longer time to resolve. Communication with you is paramount as you need to be kept updated throughout the process.
When you can’t use the complaints procedure?
You can’t use the official complaints procedure if:
- You made a complaint verbally and it was sorted out to your satisfaction by the end of the next working day
- You’re an employee of the NHS body and want to complain about an employment issue
- Your complaint has already been looked at under the NHS complaints procedure
- Your complaint has been, or is being investigated, by the Parliamentary and Health Service Ombudsman.
Time limits
You should make your complaint as soon as possible. Complaints should normally be made within 12 months of the date of the event that you’re complaining about, or as soon as you found out about the concern.
The time limit can sometimes be extended. This happens only if it’s still possible to investigate the complaint. For example, the time limit could be extended if it would have been very difficult for you to complain earlier, because you were undergoing trauma due to the issue.
How do I give feedback or make a complaint about an NHS service?
Most NHS treatment and care goes well but sometimes things can go wrong. If you are unhappy with your care or the service you have received, it is important to let the NHS know so we can improve. There are two ways to tell the NHS what you think:
- Give feedback
- Make a complaint
Giving feedback
Feedback helps the NHS improve the quality of your care.
You can give positive or negative feedback by telling the NHS organisation or service about it. For example, you can do this through the Friends and Family Test or you can speak to a member of staff, OE you can contact the NHS directly using the NHS complaints helpline. Other ways to give feedback should be clearly displayed at any of the services you visit.
If you are unhappy with an NHS service, it is worthwhile reporting your concerns early on with the service, as they may be able to sort the issue out quickly. Most problems can be resolved at this stage but, in some cases, you may feel more comfortable speaking to someone not directly involved in your care.
How do I make a complaint against NHS?
When making a complaint, you can choose to complain to any of the following:
- The healthcare provider: This is the organisation where you received the NHS service, for example your hospital, GP surgery, dental surgery, etc.
- The commissioner: This is the organisation that pays for the service or care you have received. This will vary depending on which NHS service you are complaining about.
If you are making a complaint about primary care services such as GPs, dentists, opticians or pharmacy services, contact NHS England.
If you are making a complaint about services such as hospital care, mental health services, out of hours services and community services such as district nursing, contact your local clinical commissioning group (CCG).
If you are making a complaint about public health organisations (those who provide services which prevent disease, promote health and prolong life), do well to contact your local council.
If you wish to give feedback regarding the service you received from NHS 111 or make a complaint, please contact the NHS via our NHS complaints email: england.contactus@nhs.net and tell them the location you called from when contacting NHS 111. This will allow the NHS to identify which local service took the call and provide contact details.
Complaining to the complaints commissioner may be the right option if you are not comfortable complaining directly to your healthcare provider, or if you feel this is not appropriate. Please note that if you have already complained to your healthcare provider, the commissioner will not be able to re-investigate the same concerns. If you are not happy with the outcome of your complaint, you may wish to go to the next stage of the NHS complaints procedure.
Making your complaint
You can complain in writing, by email or by speaking to someone within the organisation. You should make your complaint within 12 months of the incident or within 12 months of the matter coming to your knowledge. This time limit can sometimes, in certain conditions, be extended as long as it is still possible to investigate your complaint.
What can I expect if I complain?
You should:
- Have your complaint acknowledged and properly looked into
- Be kept informed of progress and told the outcome
- Be treated fairly, politely and with respect
- Be reassured that your care and treatment will not be affected as a result of making a complaint
- Be offered the opportunity to discuss the complaint with a complaints manager
- Expect appropriate action to be taken following your complaint
Can I get help to make my complaint?
If you feel you would like help to make your complaint, support is readily available. Some people may decide not to make a complaint because they are put off by the seemingly gruelling process, find it confusing or believe nothing will happen. If you are thinking about making a complaint it is important to know that you have access to NHS complaints advocacy to help you make your complaint and provide support throughout the complaints process.
An NHS Complaints Advocate is independent of the NHS and could help you write a letter, attend a meeting with you or explain to you the options available. This service is free to anyone who is making a complaint about their NHS treatment or care.
The NHS Constitution
The NHS Constitution sets out your rights as a patient, and highlights the commitments the NHS has made to providing you with a high quality service. Organisations providing NHS care must take account of the NHS Constitution when treating you, so you may find it helpful to refer to it if you are considering making a complaint.
Unhappy with the outcome of your complaint?
If you are unhappy with the way your complaint has been dealt with and would like to take the matter further, you can contact the Parliamentary and Health Service Ombudsman (PHSO), an agency which makes final decisions on unresolved complaints about the NHS in England. It is an independent service which is provided for free for everyone to use.
If you wish to take your complaint to the Ombudsman, visit the Parliamentary and Health Service Ombudsman website or call 0345 015 4033.
What Is An Ombudsman?
This is an official who is usually appointed by the government or by parliament but with a considerable degree of independence. In some countries, an inspector general, citizen advocate or other official may have duties similar to those of a national ombudsman and could also be elected by a legislature. Below the national level, an ombudsman may be nominated by a state, local, or municipal government. An unofficial ombudsman may be appointed by, or even work for, a corporation such as a utility supplier, newspaper, NGO, or professional regulatory body.
The common duties of an ombudsman are to investigate complaints and attempt to resolve them, usually through recommendations (binding or not) or mediation. Ombudsmen sometimes also aim to pinpoint systemic issues leading to poor service or breaches of people’s rights.
At the national level, most ombudsmen have a wide directive to deal with the entire public sector, and sometimes also elements of the private sector (for example, contracted service providers). In some cases, there is a more restricted directive, for example with particular sectors of society. More recent developments have included the introduction of a specialized Children’s Ombudsman.
How to complain to the ombudsman?
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- Follow GP complaints procedure: Before reporting any complaint to the Health Service (NHS) Ombudsman, you must first follow the usual NHS complaints procedure. You will need to show that you’ve tried to work out your complaint at the local level before the ombudsman is able to look into it.
- Check that you meet the requirements: If you’re not happy with the final response from your GP practice or the NHS in your region, you can refer your complaint to the Health Service Ombudsman. You must have received a final response to your complaint before the ombudsman can go through it. The ombudsman will need a copy of this in the form of writing. If you feel that it is taking too long to receive a final reply, you can call the ombudsman to see if they can help out. The ombudsman will not usually look into your complaint if it happened more than one year ago, or if you first became aware of it more than one year ago, unless there are exceptional circumstances.
- Find the correct Ombudsman: The ombudsman you contact will vary depending on where you live:
- England Parliamentary and Health Service Ombudsman (PHSO)
- Scotland Scottish Public Services Ombudsman (SPSO)
- Wales Public Services Ombudsman for Wales (PSOW)
- Northern Ireland Northern Ireland Ombudsman (NIO)
- Complete a complaint form: You will need to complete a complaint form, but you can call or email the ombudsman to help you with this. NHS Advocacy at your local council can also help you make your complaint.
You should include the following information on the form:
- Your name and address
- The name and address of the GP and surgery you’re complaining about
- Details of what your complaint is about, including exactly what the GP or GP practice did that shouldn’t have happened (or what should have happened but didn’t)
- What you have lost in terms of personal injustice, financial loss, hardship or inconvenience
- What you would like the GP surgery to do to put things right, and details of what you have done so far to try and resolve the complaint
- Include copies of any relevant letters or emails you’ve exchanged with your GP or GP surgery.
If the ombudsman decides that it can legally examine your complaint, they will look at all the facts. They might need to get expert advice or more substantial evidence.
How To Complain About A Medical Receptionist?
You may have experienced poor medical care due to GP negligence or an unfriendly encounter with a member of staff, and as a result, you may have had an unpleasant experience in a medical office. Sometimes, just coping with the experience and trying to move forward without action may not be the best option or decision to take. If you’ve found reason to file a complaint against a medical receptionist, file it with the hospital or health care system affiliated with that specific medical office.
Ensure that you contact the medical office in which the medical receptionist works. Ask to speak with the office manager with an attempt to resolve the problem before taking further action.
Write a letter and address to the hospital which the medical office is a part of. If your medical office is self-sufficient, ensure that you file a complaint with your state’s medical review board.
In the letter, write as much details as you can possibly recall, including the date and time of your visits, the names of staff members involved (or descriptions if you cannot recall names), the purpose of your being at the office, what the problem was and if the medical office tried to resolve the problem. Explain in details, the steps you’ve taken to resolve the problem with the medical receptionist and why you feel they need to take further action.
Also include in your letter, all the things you feel could have been done to prevent your complaint or resolve the situation.
Also make sure you include your phone number or an email address that you access regularly so a representative can contact you easily, if need be.
Making a complaint about mental health service
Everyone has the right to speak up and make a complaint about a mental health service and there are specialist organisations to help you do so.
For public mental health services
To make a complaint about a public mental health service you can:
- Talk directly with your service – every public mental health service must have a process to help you raise your concerns
- Talk with the Mental Health Complaints Commissioner (MHCC).
The MHCC is independent and can:
- Help you raise your concerns directly with the service
- Work with you and the service to help resolve your concerns
- Discuss other options if they aren’t able to help.
- The MHCC can receive complaints about any aspects of the treatment or care delivered by a public mental health service.
Anybody who is genuinely concerned about someone’s experience with a public mental health service can make a complaint. This includes people receiving care, families, loved ones, advocates, mental health workers and friends.
For private mental health services
The Health Complaints Commissioner (HCC) can help you with complaints about private mental health services.
Before you contact the HCC, your first step is to contact the person or the organisation and try to resolve the issue with them. If you find this difficult or are still not happy with the situation, call the HCC. The HCC is independent body and can:
- Help you raise your concerns directly with the service
- Work with you and the service to help resolve your concerns
- Discuss other options if they aren’t able to help.
- The HCC can receive complaints concerning any aspects of the treatment or care delivered by a private mental health service. This includes but not limited to the privacy of and access to health information about you.
The Care Quality Commission – healthcare
The Care Quality Commission (CQC) is the body which oversees both NHS and private hospitals. They also oversee GP practices, dentists and community health services. They track the performance of health services against national standards and publish the results of their inspections. Standards include:
- You should expect to be respected, involved in your care and support and told what’s happening at every stage of your treatment
- You should expect to be safe when you’re being treated for a health problem
- You should expect to be cared for by staff with the right skills to do their jobs properly.
The CQC don’t examine individual complaints but they do want to hear about people’s experiences of health care – both positive and negative. The manner in which the CQC follows up your comments depends on how serious the concerns are and what else they know about the quality of healthcare at that place. Every information you give the CQC helps them decide when, where and what to inspect.
Reporting concerns to the Care Quality Commission
You can easily report concerns to the CQC by:
- Phoning 03000 61 61 61
- Sending an email to: enquiries@cqc.org.uk
- Using their online form at: www.cqc.org.uk.
Complaining about social care services from the Children’s Services Department
The Children’s Services Department is responsible for a range of social care services to children, young people and their parents or carers including:
- Assessment of children’s and families’ needs
- Family support
- Fostering
- Adoption
- Child protection
- Caring for a child with special needs
- Young offenders
Things to consider before making a complaint
If you have any concerns about a service, please speak to the appropriate staff member as soon as possible. You could also contact their manager to report your dissatisfaction. Most concerns are quickly and successfully rectified this way.
If you are still unhappy, you can make a formal complaint using the complaint process below:
- Do you have parental responsibility? Whilst we can accept complaints from individuals who are considered to have sufficient interest in a child, it may not be possible to deal with your concerns unless the child’s parent, guardian or carer has given their consent for someone to act on their behalf
- Your complaint must be capable of being investigated and relate to the Department’s involvement with a child.
If you are worried about a decision that has been made by the court that relates to a child, you may wish to seek independent legal advice.
Children’s Services are only required to deal with complaints about events that happened within the last year. However, you can contact the Complaints Team for advice if your complaint is outside this timescale.
How to make a formal complaint using the statutory complaints procedure?
Ensure that you put your complaint in writing to the Children’s Services Complaints Team. You have the following options:
- Use our Children’s Services complaints form
- Email childrens.services.complaints@hants.gov.uk
- By post
Children’s Services Complaints Team
Hampshire County Council
Northfields House
Humphries Farm
Hazeley Road
Twyford
Winchester
SO21 1QA
You may prefer to record your complaint on video, DVD, CD or audio tape.
If you are unable to use one of these methods you can make a complaint verbally by calling the Children’s Service contact centre on 0300 555 1384. A member of staff will help to fill in the form on your behalf.
It is the role of the Children’s Services Complaints Team to manage every stage of the statutory complaints process.
What happens after a complaint has been made?
Occasionally, matters raised as complaints are more appropriately dealt with in another way in order to achieve a resolution.
If a complaint or concern raised is going to be managed outside of the complaints process, you will be informed of this in writing.
The Service Department aims to process complaints within three to four working days of receiving them.
They consider any issues raised in line with the statutory complaints guidance ‘Getting the Best from Complaints’ (2006) to decide the best possible means to manage the complaint.
Once the complaint is processed, you will be informed in writing to formally acknowledge the complaint.
If a complaint cannot be accepted within the complaints process, you will be written to, to inform you of this and provide you with the contact details for the Local Government Ombudsman (LGO) to contact, should you disagree with the decision made by the Children’s Services Complaints Team.
How can I complain about the Ombudsman service?
Wondering how to complain about the ombudsman service?
You can lodge a complaint with the ombudsman. If the company fails to respond or you are unhappy with its response. Rather than approaching the ombudsman, you could go straight to the small claims court.
Can I complain against more than one organization?
If your complaint is about more than one NHS organisation, you only need to send a letter to one of the organisations. They should contact the other organisation and work with them to deal with your complaint. The same procedure is used to complain about adult social services arranged, provided or commissioned by the local authority. So if you have a complaint about both a hospital and adult social care services, you can write just the one letter explaining all the problems, and whoever you address the letter to will contact the other organisation.
What powers do the CQC have?
The CQC has the power to:
- Issue a warning notice, asking for improvements within a short period of time
- Limit the services that the organisation can offer
- Restrict admissions to a hospital
- Issue a fixed penalty notice (a sort of fine)
- Prosecute someone carrying out a criminal offence
- Suspend or cancel an organisation’s registration with the CQC.
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