How do I complain about NHS care?

The NHS complaints process is designed to produce explanation, apology and change. It does not award compensation, which is a separate legal route with different time limits and a different standard of proof. Being clear at the outset about which of those you actually want saves months, because a complaint pursued in the hope of compensation usually ends in disappointment.

Step by step

1. Decide what outcome you want.An explanation, an apology, a change in practice, or your care being put right. If what you want is financial compensation for harm, that is a clinical negligence claim through a solicitor, with a three-year limitation period. The two can run in parallel but they are different processes.
2. Try the informal route first if it is appropriate.PALS — the Patient Advice and Liaison Service — exists in hospitals to resolve concerns quickly and informally. Many issues are settled there in days. It is not the formal complaints route and does not stop the clock.
3. Complain to the right body.Either the organisation that provided the care — the trust, the GP practice, the pharmacy, the dental practice — or the commissioner of that service. You can choose, but not both. For primary care in England the commissioner route runs through NHS England.
4. Note the time limit.Twelve months from the event, or from when you became aware of it. Complaints outside the limit can be accepted at the organisation's discretion where there is a good reason and it is still possible to investigate fairly.
5. Use the free advocacy service.NHS Complaints Advocacy is independent of the NHS, free, and available to anyone. Advocates help write the complaint, attend meetings and keep the process moving. It is one of the most under-used entitlements in the system.
6. Write it as a chronology with specific questions.Dates, what happened, who was involved, and a numbered list of questions you want answered. A numbered list is much harder to respond to incompletely than a narrative, and it makes an inadequate response obvious.
7. Request the records if you need them.You have a right of access to your own health records under data protection law, normally free and within one month. For someone who has died, access is under the Access to Health Records Act 1990 and is limited to the personal representative and certain others.
8. Expect an acknowledgement and a response.Acknowledgement within a few working days, and a response within a timescale agreed with you. If it slips, chase in writing and ask for a revised date.
9. Escalate to the Ombudsman.The Parliamentary and Health Service Ombudsman considers complaints about NHS care in England once the local process is complete. It is free, independent, and it can recommend remedies including financial redress in limited circumstances. Scotland, Wales and Northern Ireland have their own public services ombudsmen.
10. Use the regulators for serious professional concerns.The GMC, NMC, GDC and GOC regulate individual professionals, and the Care Quality Commission regulates services in England. They do not resolve individual complaints, but serious concerns about safety should reach them as well.

Questions people ask