If you have experienced mistreatment or sub-standard service from the NHS, it is natural to want an explanation. You might not be seeking compensation – although this may be possible through a clinical negligence claim – you might just want an apology, recognition of the poor treatment you have received, or to highlight issues which could harm other patients.
You may be able to achieve these outcomes by submitting a complaint to the NHS.
Writing a letter of complaint is often the crucial first step to making your grievance official. It can also be a useful way of ordering your thoughts and perspective on events, and clearly detailing your experiences.
However, writing an effective complaint letter can be tricky. To properly explain your complaint, it must be clear, accurate, and thorough. So we’ve created this step-by-step guide to help you with constructing a strong NHS complaint letter.
Do I have the right to complain?
Before examining how to write a letter of complaint, it is helpful to look at who has the right to complain.
In general, you have the right to complain about any aspect of any NHS service, whether you have experienced mistreatment, misdiagnosis, poor standards of care, or bad service. Even if there is no doubt in your mind that you have a right to complain, you should be aware of the following points:
- The nature of your complaint. Your complaint must relate to an issue which has already affected you. For example, a medical injury or illness you have suffered for which you hold the NHS responsible.
- Time limits. Complaints should be made within 12 months of the incident in question. If the basis for your complaint only becomes apparent later on, the 12-month time limit will only begin to run from the point at which you became aware of those grounds for complaint. Deadlines can be extended in situations where there is a justifiable reason for the delay; however, it is always advisable to submit your complaint as soon as possible.
- Understanding. There is no minimum age requirement to make a complaint, but it is required that anyone making a complaint must fully understand the nature and implications of what they are doing. This means that young children and people without the mental capacity to understand the process (e.g. people in a coma or suffering from the effects of a severe head injury) should have someone else make the complaint on their behalf.
- Complaining on someone else’s behalf. If complaining on behalf of someone else, such as a family member or a friend for example, you must have their permission to do so. However, there is some flexibility to this rule; especially in respect of people who are unable to understand the situation or who have passed away.
- Duplicate complaints. You cannot make a duplicate complaint if that same issue has already been resolved or investigated.
- Verbal complaints. In a similar way to a duplicate complaint, if you have already made a verbal complaint – and the NHS resolves the issue by the end of the next working day – then you will be prevented from submitting a written complaint about it later.
NHS complaints and clinical negligence claims
Writing a complaint to the NHS and making a clinical negligence claim [link to blog post guide ‘making a clinical negligence claim’ when posted] are two separate courses of action. Complaints are made through internal NHS complaints procedures, whereas a clinical negligence claim is a legal action, relying on the wider ‘laws of the land’. You may take either course separately or pursue both.
If you make a complaint and are dissatisfied with how the NHS has handled it and/or the complaint’s outcome, then it is important to make the NHS aware of this. However, you are not prevented from taking legal action in a clinical negligence claim just because you have made a complaint.
Similarly, you are not legally bound to accept the outcome or findings of a complaint. If the NHS dismisses your complaint, this will not mean you cannot make a clinical negligence claim.
Despite being distinct from each other, there are some areas where complaints and clinical negligence claims overlap – most notably in terms of evidence. Gathering evidence for a complaint may form a good evidential basis for a clinical negligence claim. Also, organising the sequence of events into a clear narrative can help a clinical negligence solicitor to assess the prospects of a potential claim.
Each service provider in the NHS (such as a hospital, GP surgery, pharmacist, dentist etc) has its own complaints procedure. The first step of preparing your complaint is therefore to find the relevant procedure. These should be readily accessible for patients, so requesting a copy from the service provider directly is often the easiest approach.
However, you can submit a complaint to the NHS commissioner of the service instead. NHS England’s website explains more about who this might be in your situation.
In many cases, it may be best to attempt resolution of your issue in person before filing an official complaint. You could achieve the outcome you are looking for much more quickly, especially if you are seeking an apology for how you have been treated. In addition, it demonstrates that you are being reasonable – doing all you can to resolve the matter.
Naturally, however, trying to resolve some complaints in person will be insufficient or inappropriate – for example, where you have suffered lasting harm from medical negligence.
Preparing your written complaint
If you still wish to submit a written complaint, preparation is strongly recommended. Your complaint letter will be much more effective if it is accurate and comprehensive. You should therefore keep safe any relevant papers, such as correspondence, test results, appointment cards etc.
You should also make notes of any verbal discussions you have had regarding the matter. These notes should record:
- When the conversation took place
- The person or people you spoke to
- What was said and by whom
Writing your letter of complaint – a step-by-step guide
This step-by-step guide should help you create an effective letter of complaint.
The information you include is a balancing act; you need to provide all the relevant details so that the NHS can consider and investigate your complaint, but you don’t want your letter to become bogged down in unnecessary detail, doing so might make your complaint difficult to understand.
Essentially, our advice is to stick to the point: state the facts, don’t be abusive, be constructive, and try to be dispassionate in your letter. If you feel yourself getting too emotional when writing, step away from it and continue later. That being said, it is perfectly acceptable to explain how the incident may have affected your work, family, and personal life.
If you would like to see any sample complaint letters, these are available to download, for free, from our Legal Library. Hopefully, these can provide you with a useful starting point and help you to structure your own letter. However, if you are using a sample letter as a template, always make sure that you replace the details with your own, and that no sample details are left in by mistake!
- Step 1: Gathering your information. Before you start your letter, you need to be fully prepared and have everything to hand. Ensure that you gather together all the relevant details and information that you have, including telephone calls, appointment dates, notes, documents, correspondence, and the names of any medical professionals involved (doctors, dentists, surgeons etc.).
- Step 2: Including your personal details. Your letter should be set out in standard letter format, with your contact details in the top right corner. These should include:
- Your name
- Your address
- Telephone number(s)
- Email address.
- Step 3: Addressing your complaint letter. In the top left corner, you will need to provide the address of the NHS service provider or commissioner against whom you are directing your complaint (see the ‘Complaints procedures’ section above). Remember that the NHS has numerous departments and employees so it will save a lot of time if send your complaint letter to the right place.
Your letter should also be specifically addressed to the right person. This will usually be the person you have been in contact with. If you’ve dealt with more than one person, then just address it to one of them. If you are unsure of the names of the people to whom you have been speaking, we would suggest addressing it to Chief Executive of the hospital in question (you can find out their name from the hospital’s website) or to the Practice Manager if it’s a GP surgery.
- Step 4: Writing your opening paragraph. In the first paragraph of your letter, you should clearly set out your reasons for writing and state that it is an official complaint against the NHS. Here, you should also provide your full name, date of birth, and NHS number (if you know it) so that the NHS can find and access your medical records. If you are making a complaint on someone else’s behalf, make sure you provide their details here instead.
- Step 5: Writing the main body of your complaint letter. The main part of your letter should explain clearly and concisely exactly what your complaint is. Specifically, you need to explain what you believe has gone wrong, what should have been done better and what effect the incident has had on you.
We would recommend setting out your complaint in chronological order, writing about events in the sequence that they occurred. This will make it easier to understand and follow.
When writing anything in your letter, it is always worth questioning whether it is relevant to your complaint. If it isn’t, then you should leave it out. Again, this will help with the clarity of your letter.
- Step 6: Asking specific questions. If you want answers to any specific questions, it can be helpful to list and number them towards the end of your letter. This clearly indicates the issues to which you want the NHS to respond. It also invites them to answer your questions using your numbering, which can help you consider their response.
- Step 7: Concluding your complaint letter. You should conclude your letter by explaining that you have followed the NHS complaints procedure and will be expecting a response within a reasonable period of time.
- Step 8: Adding enclosures. If you have any evidence or documentation in support of your complaint then you should attach copies to your letter. This could include any appointment cards, written notes or correspondence which you believe will support or illustrate your complaint. Always keep the original documents yourself, however, so that this evidence is not lost if your complaint letter goes missing.
If you are sending any enclosed documents, at the end of your letter (after your signature and printed name) you should write ‘Enclosures’ and list all of the documents that you are attaching to your letter. Try to describe each document specifically (i.e. the kind of document it is, any date on it etc.) so that it is clear which document you are referring to. This list can also help you when compiling your letter before posting – like a checklist to ensure all enclosures are included.
- Step 9: Proof-reading. Before sending your complaint letter, it is important to re-read it to ensure everything is accurate and that all relevant information has been included. Again, try to be as detached as possible when re-reading your letter and ask yourself whether your letter:
- makes sense
- sounds reasonable
- is constructive, factual and concise
- makes any unfounded claims or unsupported arguments
- sounds too aggressive or emotional in tone
This cold analysis can be difficult when you are so closely attached to the issues in the complaint. It can be helpful to ask a friend or family member to read your letter, ideally one who does not know all the details of your complaint. Can they understand your letter? Can they analyse it in the detached way described above? If so, what do they think of it?
Finally, good spelling and grammar can make a huge difference to the clarity of your writing. Whilst no one will be marking your complaint letter for these things, you should try to eliminate as many mistakes as possible. A well-written letter will make a much better impression, so ask a friend for help if writing is not your strong suit. All of that said, never let worries over technicalities stop you from sending a complaint letter – making your grievance known and understood are the crucial points!
- Step 10: Sending your letter. Once you are satisfied with your complaint letter, and you are sure the address and intended recipient are correct, you can send it off.
What to expect after you have sent your complaint letter
After your letter has been sent, you should expect acknowledgement of your complaint within three working days. However, besides acknowledging receipt of the letter, there is unfortunately no set time limit for an actual response to your complaint.
If you haven’t heard anything within six months of sending your letter then the NHS service you have sent it to should explain the reason for the delay. Should you be unsatisfied with their explanation, or believe that they are simply fobbing you off, then you can contact the Parliamentary and Health Service Ombudsman.
Alternatively, you could consult a specialist clinical negligence solicitor for further advice, and potentially about making a claim.
How Truth Legal can help
At Truth Legal, our experienced clinical negligence solicitors have helped many people claim compensation for a medical mistake. If you are considering making a clinical negligence claim in addition to your complaint, please feel free to contact us to discuss your situation.