How Do NHS Complaints Work?

//How Do NHS Complaints Work?

No one ever wants to make a complaint. We would all much prefer things to go smoothly and according to plan, to have no grounds for complaint at all. Nowhere is this more true than with medical mistakes.

Most healthcare in the UK is provided free through the NHS. In England alone, the NHS estimates that it deals with over 1 million people every 36 hours. For the vast majority of its patients, the NHS does a remarkable job in difficult circumstances. The news is filled with reports of underfunding and understaffing, yet the NHS continues to treat and care for huge numbers of people.

But mistakes do happen, and the chance of them happening only increases in situations where staff are overworked and resources are stretched thin.

When medical mistakes happen, serious consequences can arise, and you may feel that something has to be done – perhaps to shed light on the way in which you’ve been treated or to help other patients in future.

In 2017, the NHS received over 208,400 formal written complaints – the equivalent of 571 complaints a day. This is also an increase of more than 10,000 complaints over 2016’s figures.

If you have been affected by a medical mistake, you have a right to complain, and there are clear, established processes for doing so. In this post, we will set out some of the details for how NHS complaints work in general.

Why should I make a complaint?

The prospect of making a complaint may sound daunting at first, and you may feel it is simply easier to do nothing.

However, you may also feel strongly that what has happened to you should not be ignored.

Making a complaint will prompt the NHS to investigate your circumstances, discovering where and how they have gone wrong. It is a way of holding those responsible to account and perhaps seeking recognition, and an apology, for the mistake and how it has affected you.

The only way the NHS will learn from its mistakes is if people report them. By making a complaint, you are identifying and highlighting failures in the system to the NHS service providers, hopefully leading to those failures being put right. This can prevent other people from experiencing the same failures in future.

What is the first step in an NHS complaint?

The first step is to gather information about the complaints procedure for your particular circumstances. All NHS organisations will have clear, written complaints procedures but these vary based on the organisation in question.

Every NHS organisation should supply you with their written complaints procedure on request, so asking them for this is often the easiest way to start your complaint. The procedure will tell you everything you need to know about:

  • How to file your complaint
  • Who will consider it
  • How it will be dealt with
  • The timescales for receiving a response
  • The further steps for any unresolved complaints

NHS England, the organisation which sets the priorities and direction for the NHS in England, provides further general information on the different bodies which handle NHS complaints.

What will usually happen when I complain?

In general, you will have the opportunity to talk through your complaint with representatives of the relevant NHS organisation.

This is known as ‘local resolution’ by NHS England.   The theory behind the process is to attempt to resolve issues quickly, where possible, by speaking directly to the medical professionals or organisation involved.

It may be possible to resolve some complaints at this stage. However, you should never feel obliged, or be pressurised, to accept the information you are given. Whilst you may be satisfied with their response, the NHS organisation may also have its own agenda, and wish to resolve the matter on its own terms. You should keep your own interests, and your objectives for the complaint, in mind and judge for yourself whether the NHS has done enough to resolve the issue.

If you do not believe it is possible to resolve the issues involved in the complaint upon an informal basis (which will certainly be the case where more serious issues are involved) then you should file a formal complaint, following the relevant NHS care provider’s procedure.

nhs complaintsThe Parliamentary and Health Ombudsman

If you are dissatisfied with the result of a formal investigation conducted by the NHS, and you have reached the end of their complaints process, you can contact the Parliamentary and Health Ombudsman to take matters further. The Ombudsman can also be used to escalate complaints where an NHS organisation has not responded to you within the timescales they set out.

The Ombudsman can make final decisions on complaints that have not been resolved by the NHS in England.

How long do I have to make my complaint?

There is a time limit to NHS complaints. Usually, you must make your complaint within 12 months of the incident, or if you only found out at a later date that the incident had occurred, within 12 months of it coming to your attention. It is sometimes possible to extend the time limit. This is normally in circumstances where it would have been difficult to make the complaint earlier. For example, if you were grieving, recovering from treatment, or suffering trauma.

It is important to be aware that the Parliamentary and Health Ombudsman also uses the 12-month time limit when investigating complaints. This means you may be unable to escalate your complaint to the Ombudsman if this period runs out – whether you are already going through an NHS organisation’s procedure or not.

You should keep the 12-month time limit fixed firmly in your mind. If you suspect your complaint might require investigation by the Ombudsman, ensure that you register your complaint with them before the time limit expires.

Can anyone help me to make an NHS complaint?

The Patient Advisory Liaison Service (PALS) is available in most hospitals, and is able to offer advice, assistance, and guidance in making a complaint about your medical care.

Another alternative is to seek advice from your local Citizens Advice (formerly Citizens Advice Bureau), although some offices only have limited resources and staff.

Additionally, the independent NHS Complaints Advocacy Service may be able to assist with your complaint.

Truth Legal, have also produced free resources to help you with an NHS complaint. We have created a step-by-step guide to writing your letter of complaint [link to ‘How to Write a Complaint Letter to the NHS’ blog when posted] and two sample letters of complaint in our Legal Library.

Is there anything else that I should do?

It is a good idea to request a copy of your medical records under the General Data Protection Regulations (you might know these better as the GDPR, the subject of countless emails earlier this year!). Having copies of your medical records can help you to support your complaint.

If you are complaining on behalf of a loved one who has passed away, you can request their records through Primary Care Support England, who hold the GP medical records of people who have died.

Should I also start a clinical negligence claim?

Complaints are separate from clinical negligence claims.

For serious cases, where you have been injured or otherwise harmed because of a medical mistake, you may also wish to make a clinical negligence claim. Submitting a complaint (or otherwise) does not affect your rights to make a claim. In the same way, starting a clinical negligence claim does not prevent you from making a complaint.

Whereas clinical negligence claims are a way to seek financial compensation for your injuries, complaints do not necessarily result in any such award. If your complaint is upheld, there is a chance that you or your family will receive financial compensation, but this is not guaranteed.

Truth Legal can help you if you are thinking about starting a clinical negligence claim. Our highly-experienced clinical negligence solicitors have assisted many clients to recover much-deserved compensation. Please contact us to discuss your situation.

By | 2019-01-10T09:58:51+01:00 January 2nd, 2019|Personal Injury|

About the Author:

Gary Warriner
Gary is a clinical negligence specialist solicitor with 30 years’ experience as an injury lawyer.