Complaints about NHS or private healthcare

 

If you believe something has gone wrong with the healthcare provided to you or a loved one, it is almost always best to discuss your concerns with the medical staff first. If this doesn’t resolve the matter, the NHS has a formal complaints procedure you can follow. It is free to use and we encourage you to try this before taking matters further.

How AvMA can help

Our self-help guides provide clear and straightforward explanations of the procedure and guide you through making a complaint.

If after reading these guides you require further help, please contact our helpline.

Important information on the impact of COVID-19 on NHS complaints handling

Several of the bodies that handle NHS complaints in England, Scotland and Wales have announced changes to their complaints handling procedures in response to the COVID-19 situation. For further information, please see the sections below on changes in England, Scotland and Wales. We will update this information page when we have further news, including any announcement about the position in Northern Ireland.

If you are considering seeking compensation, you need to be aware that there is a three year period to bring a claim and therefore we would advise that if this is likely to pass before a response from the NHS provider or the Ombudsman can be expected, that you seek advice from AvMA or a solicitor.

England

Stage 1 Local resolution of formal NHS complaint

NHS England and NHS Improvement are supporting a system wide ‘pause’ of the NHS complaints process in England which would allow all health care providers in all sectors to concentrate their efforts on the front-line duties and responsiveness to COVID19.

Can I still make a complaint?

Yes. NHS England say “NHS providers should ensure that patients and the public are still able to raise concerns or make a complaint”. Your right to make a complaint or raise a concern is therefore not paused and the legal duty on the NHS to investigate and respond to complaints remains. What is different is the expectation that these can be dealt with in a timely and efficient manner at this difficult time. AvMA advise you to make a complaint whilst events and details are fresh in your mind – it is usually best to do this as soon as possible after the incident.

What happens if I decide to make a complaint?

The NHS will still need to acknowledge the complaint, log this and also see if there are any immediate issues which need to be dealt with such as issues of patient safety.

How long will I have to wait to hear about the investigation?

The initial pause is for three months and will run until the end of June 2020. Your complaint will remain open and once the pause is lifted, it will be investigated and responded to.

This does not mean that in three months’ time you will get a response, as complex clinical complaints such as medical accidents can often take three months or more to look into. The investigative stage will run from when the pause is lifted.

Please try to have a realistic expectation of how long a complaint will take to be dealt with – this is likely to be a lot longer than normal. We understand this is a stressful time, but unfortunately, these special circumstances mean you will need to be patient. Unfortunately, we will not be able to help speed up the complaints process for you.

Are there any exceptions?

Exceptions to the pause may be:

  • If your complaint can be informally resolved without the need for extensive investigations requiring the input of clinical staff, such as by an apology.
  • You withdraw the complaint.

Does the NHS have to follow this advice?

No. The guidance is not mandatory on the NHS . If your NHS provider has decided that they can operate as usual regarding the management of complaints you may be dealt with as normal, although it is likely again that complaints will take longer to be responded to.

Does the pause apply to my existing complaint which the NHS is already investigating?

Yes, it is likely to impact your complaint. NHS England suggests that the pause applies to complaints already under investigation, saying that “all customers awaiting a response to a complaint will be notified that the investigation is on hold”.

Even if the NHS decide that they can operate the complaints system as normal, the response may take longer than usual.

I have already been waiting six months for a response – will I have to wait for much longer?

If you have already been waiting for a long time for a response (six months or more) your complaint should be reviewed to see if it can be resolved at this stage. If you are therefore told that you will have to wait for longer due to the pause, you can ask for such a review to see if an earlier resolution is possible.

How do I contact anyone at the NHS about my complaint?

If you want to contact the NHS you should usually use email at this time, if you can. You should have been given an email address in the acknowledgement letter.

You should also check that any postal address is currently in use before sending anything in the post as offices may be unmanned. NHS England’s address at present is:

NHS England, PO Box 16738, Redditch, B97 9PT

Stage 2 Independent Review by the Parliamentary and Health Service Ombudsman (PHSO)

Can I raise my concerns to the PHSO now?

From Thursday 15th April 2021 the PHSO announced that it would only look further into the more serious complaints about the NHS. These changes have been made due to a queue of over 2500 complaints waiting to be looked at. For the investigations that the PHSO investigates, the pandemic has affected their ability to provide the information needed for the PHSO to carry out their investigations.

How does the PHSO decide which complaints are serious?

The PHSO will be using their ‘Severity of Injustice Scale’ to determine the seriousness of a complaint. This scale takes into account the overall impact that the event complained of has had on their life. Further details of this scale can be found at: Financial remedy | Parliamentary and Health Service Ombudsman (PHSO).

What is the current waiting time to receive a response?

Currently the PHSO states that it could take several months to receive a response to your complaint.

Is this a temporary or permanent service change?

The PHSO has made this change in response to the pandemic so aims to keep these changes under review and will update their website accordingly.

Scotland

At present there is no recommendation by NHS Scotland that the NHS complaints procedures be ‘paused’. However, the COVID-19 emergency means that responses to complaints are likely to be delayed and this may be by several months.
Please check on the website of the service you are complaining about for details of how to best contact them in the emergency, which will usually be by email.

The Scottish Public Service Ombudsman (SPSO)

You can read information on the changes the SPSO has made to the way that it is handling complaints on its website. There are again likely to be significant delays of many months. The SPSO has also specifically asked people not to send in complaints about delays in complaints responses, such as from the NHS.

Wales

There does not appear to be a recommendation of a pause on complaints by NHS Wales, but there may be significant delays in responses to complaints if these require the involvement of key clinical staff or staff that have been redeployed to help with the crisis.

The Public Service Ombudsman for Wales

The Public Service Ombudsman for Wales also has advice on its current arrangements on its website (appears as pop up window).


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