Get help Advice and information leaflets Making a complaint Contents Introduction The three stages of complaints What to include Who to contact for formal complaints Professional bodies What if I am still unhappy? More information Introduction Most people are happy with the health and social care they receive. But sometimes things go wrong. If that happens, you need to know how to complain. This guide sets out your rights and offers advice on how to make a complaint. For NHS funded treatment the NHS Constitution guarantees your right to complain whether treated in NHS or the independent sector. For privately-funded healthcare, whether delivered in the independent sector or NHS, the provider must follow the system regulator requirements on complaints. You should always complain or raise a concern if you are unhappy. Complaints and concerns are important to healthcare providers. They help them learn how to improve. When can I complain? It depends on the type of complaint. Try to submit your NHS complaint as soon as possible. Complaints should be made within 12 months. This time limit can sometimes be extended but only if it still possible to investigate the complaint. Private healthcare providers have different rules. Check how their complaints system works. Can I get help to make a complaint? Yes. You can contact your local HealthWatch team via healthwatch.co.uk or NHS Complaints Advocacy – nhscomplaintsadvocacy.org. What to expect You should: Be treated with respect and politeness Receive help to understand the process or advice on where to get help Receive a suitable reply without unnecessary delay Be told the decision Be told what has been done to improve services as a result. The three stages of complaints Stage 1 – making an informal complaint or raising a concern It is usually best to speak to the people involved first. They may be able to deal with the problem straight away. If your complaint is about a hospital, contact the Patient Advice and Liaison Service (PALS) team. You should find their contact details on your hospital’s website. For further information on who to speak to call our free helpline on 0800 345 7115. Stage 2 – making a formal complaint All healthcare providers have complaints policies. Ask to see a copy and for details of how to complain. Everyone who provides an NHS service in England must have their own complaints procedure. We have template letters you can download and use in making your complaint: For GP complaints; For hospital complaints. Stage 3 – contacting the Ombudsman If you are still unhappy you can contact the Parliamentary Health Service Ombudsman (PHSO). Details of which Ombudsman to contact are on the section below titled ‘Who to contact for formal complaints’. What to include Basic information Patient’s name and date of birth Their NHS number if you have it Where the events took place When they happened, including the date and time if you have them Who was involved If anyone saw what happened. Say what you want to happen Hospitals want to know if their care falls below what you expect. If you just want the hospital to admit this has happened, say so in your complaint. It may mean it is dealt with more quickly. You can also ask for a specific result. This could include staff training, an apology, recognition that your care wasn’t good enough, or a meeting to discuss your concerns. Medical records It can be helpful to get a copy of your medical records. They can provide evidence to back up your complaint. You have a legal right to see your records. See our ‘Seeing medical records’ leaflet or call our free helpline on 0800 345 7115 for more advice. Top tips Keep a note of what happened and when Make letters short, to the point and polite Be clear on the outcomes you expect If your provider asks questions try to respond as quickly as you can Talk to your loved ones, who will be able to help you decide what you want to achieve and help you cope with any distress. Who to contact for formal complaints You can complain to either the service provider or the commissioner of the service. Below is a list of who to contact. Service providers GP surgery – the practice manager. If your complaint is about the manager, tell your GP so someone else knows you are complaining NHS hospitals – the PALS team. You can find their details on your hospital website Private hospitals – the manager of the service often the “Registered Manager” Care homes – the director or manager. If any of the fees are paid by the council or NHS you can also contact them Social services – complaints will be handled by the local council. Follow their complaints procedure and copy in the chief executive and your local councillor. Commissioners Clinical Commissioning Groups organise and fund hospital services in England. Your hospital should give you contact details for its group. NHS England oversees GP, dental, optician and pharmacy services. Visit england.nhs.uk or call 0300 311 2233. For information about complaints in Wales visit wales.nhs.uk. For complaints about NHS services in Scotland visit nhsnss.org. To find out how to make a complaint in Northern Ireland visit nidirect.gov.uk. Other The Care Quality Commission (CQC) inspects hospitals and care homes. It does not handle individual complaints. It is keen to hear concerns from patients and their families. Visit cqc.org.uk or call 03000 616161. The CQC also works with several national charities to gather feedback from people who contact them about their experiences of care through its ‘Tell us about your care partnerships’. Professional bodies The following professional bodies can help if you believe someone is: Putting patient safety at risk Not meeting professional standards. General Medical Council Investigates complaints about doctors for up to five years after the event. It can: Stop or limit a doctor’s license to work in the UK Post a warning on a doctor’s record for up to five years. It cannot: Pay compensation or make a doctor pay a fine Force a doctor to apologise or give you the treatment you want. Address: General Medical Council, Regent’s Place, 350 Euston Road, London, NW1 3JN. Telephone: 0161 923 6602 Website: gmc-uk.org Nursing and Midwifery Council Investigates complaints about nurses and midwives without a time limit. It can: Issue a one-year caution which future employers can see Suspend a nurse or midwife Remove someone from the professional register. Address: 23 Portland Place, London, W1B 1PZ. Telephone: 020 7637 7181 Website: nmc.org.uk Health and Care Professions Council Investigates complaints about a wide range of professionals, including occupational therapists and paramedics. Address: Park House, 184 Kennington Park Road, London, SE11 4BU. Telephone: 0300 500 6184 Website: hcpc-uk.org What if I am still unhappy? If you are unhappy with the final response to your complaint these are the next steps you can take. Complaints about NHS funded healthcare You can complain free of charge to the Parliamentary and Health Service Ombudsman. This should only be done once you have completed the full local complaints procedure. You should contact the Ombudsman as soon as possible after receiving your response. They may not investigate complaints received after more than 12 months. To find out more visit ombudsman.org.uk or call the helpline on 0345 015 4033. For Scotland: https://www.spso.org.uk/spso For Wales: https://www.ombudsman.wales For Northern Ireland: https://nipso.org.uk/nipso/ Complaints about adult social care Contact the Local Government and Social Care Ombudsman. This can only be done once the provider has had a chance to respond to your complaint. To find out more visit lgo.org.uk or call 0300 061 0614. Legal action and compensation You can make an NHS complaint at the same time as taking legal action for compensation. The Ombudsman will not investigate while legal action is taking place. If you are unhappy with an Ombudsman or professional body decision you can ask for a Judicial Review. Remember this will be expensive and you are unlikely to be eligible for legal aid. The Law Society provides a list of lawyers who specialise in medical matters. Call 020 7320 5650 or visit solicitors.lawsociety.org.uk. Complaints about privately funded healthcare You can complain free of charge to the Independent Sector Complaints Adjudication Service (ISCAS) This should only be done once you have completed stage 2 of the complaints process You can only raise with ISCAS if the provider (independent sector or NHS) subscribes to ISCAS To find out more visit https://iscas.cedr.com or contact on 020 7536 6091 or by email: [email protected] More information Action against Medical Accidents – free independent advice and referral to independent solicitors – 0845 123 2352 or avma.org.uk. Healthcare Safety Investigation Branch – investigates a limited number of complaints a year which have the most potential to lead to significant improvements in healthcare – hsib.org.uk. National Reporting and Learning System – a central database of patient safety incident reports – report.nrls.nhs.uk/nrlsreporting. NHS Complaints Advocacy Service – local services to support you through the complaints process – 0300 330 5454. Patient and Client Council – help to complain about any part of health and social care in Northern Ireland – 0800 917 0222 patientclientcouncil.hscni.net. Patients Advice and Support Service – free independent advice on NHS complaints in Scotland – cas.org.uk. Information The NHS Constitution is available to view at gov.uk The Patients Association’s position on the Parliamentary and Health Service Ombudsman can be viewed at: patients-association.org.uk/news/position-statement-phso Sources Source material for the information contained in this leaflet is available on request. Contact the Patients Association helpline The Patients Association offers a free national helpline providing specialist information and advice to help patients make sense of their health and social care. Patients can talk directly to trained advisers in strict confidence about any concerns, questions or general experiences they have regarding the NHS and social care systems. The helpline is open from 9.30 am to 5pm, Monday to Friday, and calls outside these times are returned as soon as possible during opening hours. If you would like to contact the helpline, please call free on 0800 345 7115, or visit the Patients Association helpline page on our website for more information.