How to Complain About NHS Treatment

The Patient Advice and Liaison Service (PALS) is available at every NHS trust in England. PALS staff are independent of clinical teams and can:

• Listen to your concerns and explain your options
• Help resolve problems informally and quickly, often within days
• Liaise with clinical staff and management on your behalf
• Signpost you to other support organisations

PALS is the right first step for most concerns. It is faster than a formal complaint and preserves the option of going through the formal route if needed. Find your local PALS team at nhs.uk or by calling the hospital's main switchboard. If the matter is very serious (for example, a patient safety incident or clinical negligence), you may prefer to go straight to a formal complaint or seek legal advice.

To make a formal NHS complaint:

1. Decide who to complain to: Complain to the provider (e.g., GP practice, NHS trust, pharmacy) or to the commissioner (your local Integrated Care Board for GP and community services). Not both at once — you can switch later if needed.
2. Submit your complaint in writing (email or letter). Include: your full name and date of birth, the dates of the treatment or incidents, a clear description of what happened, what outcome you want, and your contact details.
3. Deadlines: You must complain within 12 months of the incident or of becoming aware of the problem. The provider can extend this if there is a good reason the complaint was not made sooner.
4. Response timescales: Acknowledgement within 3 working days; full written response within 25 working days. If more time is needed, they must tell you.

If you are not satisfied with the NHS organisation's final response, you can refer your complaint to the Parliamentary and Health Service Ombudsman (PHSO). The PHSO:

• Investigates complaints about NHS England and UK government departments
• Is free to use and independent of the NHS
• Can recommend apologies, explanations, changes to practice, and financial compensation

Before the PHSO can investigate, you must have received a final response from the NHS organisation (or have waited long enough without one). The PHSO will assess your complaint and decide whether to investigate — not all complaints proceed to a full investigation. You can contact the PHSO online, by phone (0345 015 4033), or by post.

A complaint and a clinical negligence claim are different processes with different purposes:

• A complaint seeks an explanation, an apology, and improvements to services. It does not result in financial compensation.
• A clinical negligence claim is a legal action (usually through a solicitor) seeking financial compensation for harm caused by substandard care. It is subject to a three-year limitation period.

You can pursue both simultaneously, but be aware that anything you say in a complaint could potentially be relevant to legal proceedings. If you are considering a negligence claim, seek specialist legal advice from a solicitor with experience in clinical negligence. AvMA (Action against Medical Accidents) provides a specialist helpline and can refer you to accredited solicitors.

The complaints process can feel daunting, but free support is available at every stage.

Independent NHS Complaints Advocacy

Under the Local Government and Public Involvement in Health Act 2007, local authorities in England must commission Independent NHS Complaints Advocacy services for their residents. These services — provided by organisations such as POhWER and VoiceAbility — are entirely free and available to any patient who wants help making or pursuing an NHS complaint. Advocates can help you:

• Understand your rights under the NHS Constitution and NHS Complaints Regulations 2009
• Draft a clear, focussed complaint letter
• Attend local resolution meetings with you
• Challenge an unsatisfactory response
• Prepare a referral to the PHSO

Find your local NHS Complaints Advocacy service through your local authority's website or by searching at pohwer.net or voiceability.org.

Integrated Care System Complaints Routes

Since July 2022, Integrated Care Boards (ICBs) commission NHS services including GP and community care. If you are complaining about a service commissioned by the ICB rather than provided by an NHS trust, you should address your complaint to the ICB. The ICB must comply with the same NHS Complaints Regulations as providers — acknowledgement within three working days, full written response within 25 working days.

ICBs also have a PALS service and, in some areas, a dedicated complaint resolution team that can facilitate meetings between you, the provider, and ICB commissioners — a useful route when the failure involves commissioning decisions (e.g., a treatment was not funded, or access was inadequate).

What the PHSO Can and Cannot Do

The PHSO operates under the Health Service Commissioners Act 1993. It can investigate where the NHS has failed to act in accordance with its own procedures, policies, and the NHS Constitution, and where that failure has caused you injustice or hardship. It cannot award compensation in the same way a court can, but it can recommend financial payments (typically £100 to £10,000, sometimes more for serious cases) and can require the NHS to provide apologies, correct records, and change practices. Organisations must comply with PHSO recommendations — refusal is extremely rare and triggers a Special Report to Parliament.