The complaints process

All parts of the NHS have the same complaints procedure so the steps in making a complaint should be the same throughout.
Each service has to have: a person responsible for dealing with complaints, a written complaints procedure and a leaflet to explain their procedure.

When there is more than one Trust or service involved in your complaint, you should send your complaint to both of the Trusts (for example, a mental health Trust and a primary care Trust) and any service involved (for example, the ambulance service). Once you have made a complaint, it will follow a set path:

1. Local procedures - Local resolution
2. The Healthcare Commission

Local procedures & Local resolution
the first stage in the complaints procedure takes place at a local level, in the service where the events that you want to complain about took place. You can make your complaint directly to the staff concerned in the service or practice. If you would prefer not to talk to them directly, you can send your complaint to the Complaints Manager in the NHS Trust that manages the service or to the Complaints Manager in the GP's local Health Authority.

The NHS rules for complaints make it clear that all complaints must be taken seriously. If there is a problem with your health care, the person you complain to must make sure that your immediate needs are being met. Once they have done that, they should go on to investigate your complaint.

You should receive an acknowledgement of your complaint within 2 working days and a full response within 10 working days if your complaint is about a GP, or 20 working days if it is about a Trust or Health Authority.

The Healthcare Commission
If you are not satisfied with the result of the local investigation, you have two months of receiving a final formal written response from the service or the person you have made a complaint about to contact the Healthcare Commission [www].

The Healthcare Commission will acknowledge your request within two working days. If your complaint does not fall within their criteria or should be handled by another body such as the General Medical Council, they will let you know and advise you of your options. If the Healthcare Commission decides to take up your complaint, a member of the complaints team will be allocated to your case. They will carry out an initial review. They will review the issues your complaint raises, with the help of expert advice if necessary. At the end of the initial review they will write to you and the service or person about whom you are complaining with their decision and any recommendations. You should receive the results of the initial review within 20 working days of your letter being received. If they decide that the complaint requires further investigation, they will tell you.

If the Healthcare Commission decides to investigate your complaint further they will agree the investigation’s terms of reference with you. This should include what aspects they are going to investigate and how they are going to do it. At the end of the investigation you, the organisation, and the service or person you are complaining about will receive a report of their findings. In most cases, it will take no longer than six months for your case to be investigated and recommendations made.

If you are unhappy about the outcome of the investigation, you have the right to request an independent panel to hear your concerns. The panel will consist of three members of the public, who are not connected to the NHS but who have been specially trained to deal with NHS complaints. The panel will hear your complaint and the views of the service or the person you have complained about. They may also make recommendations for resolution or for improving services where appropriate.

Complaints that cannot be resolved by the Healthcare Commission may be referred to the Health Service Ombudsman by the Healthcare Commission or you may refer them yourself.

The Health Ombudsman

If you are not satisfied with how your complaint was handled after local resolution and the Healthcare Commission decides that it has been correctly investigated, or if you are not happy with how this was investigated by the Healthcare Commission, you can take your complaint to the Health Services Ombudsman.

This is a government appointed civil servant with responsibility for overseeing the NHS complaints procedure. There are some complaints that the Ombudsman cannot investigate, for example:

  • If you disagree with a decision but the decision has been taken properly and is one allowed by the law
  • If you have started to take legal action

You should send your complaint to the Health Service Ombudsman within a year of the events you want to complaint about. If there are good reasons why you cannot send it in time, for example, the Independent Review takes longer than it should, the Ombudsman may still consider your complaint.

If the Ombudsman agrees to investigate your complaint, her office will send you a summary of your complaint and a schedule of what they intend to investigate.

The Trusts will send all the documents relevant to your complaint, including your medical notes if they are needed. The Ombudsman will contact you and interview you, as well as the other people involved in the complaint. These interviews are usually informal but the Ombudsman does have the power to search for evidence.

Once the investigation is complete, you will be sent a copy of the Ombudsman's report. The Ombudsman can make suggestions and recommendations, including changing a decision. On occasion they will recommend that the Trust pay damages.
For advice in taking your complaint to the Health Service Ombudsman the Rethink National Advice Service can give you guidance about your case, how and what to write to the Ombudsman and guidance on the process that the Ombudsman will go through.