Why is this important?
NHS and local authority social services complaints
This information applies to England
- Making a complaint about the NHS or local authority social services
- The NHS and local authority social services complaints procedure
- Judicial review
- Help with your complaint
- Taking legal action about your complaint
- Complaints about professional misconduct
You have the right to make a complaint about any aspect of NHS treatment or the local authority social services. You can do this by using the NHS and local authority social services complaints procedure. To use this procedure, you must usually have received services from the organisation concerned. However, it is also possible to complain on behalf of someone else, for example, a child. If you want to complain on behalf of another person, the organisation must agree that you are a suitable representative.
Time limits for making a complaint
You should make your complaint as soon as possible after the matter you are complaining about happened. The time limit for complaints is usually:
- twelve months from the date this happened, or
- twelve months from the date that you first became aware of it.
They can extend the time limit where it would be unreasonable to expect you to have complained in time, for example, because of grief or trauma. It must, however, still be possible to investigate the complaint.
You can't get any financial compensation through the NHS and local authority social services complaints procedure. If you want financial compensation, you will need to take separate legal action.
First stage - resolution of the complaint at a local level
To complain about any aspect of NHS treatment you've received or have been refused, or services provided by the local authority social services, go to the organisation concerned. Ask for a copy of the complaints procedure. You can do this for any service provided by the NHS, for example, GPs, opticians, dentists, and hospitals, and local authority social services departments.
In all cases, the first stage of the procedure is to make a complaint to the practitioner concerned. A social services department must have a member of staff who deals with complaints. They are called the complaints manager. A large health centre may also have a complaints manager. A smaller practice will probably not have a complaints manager, but all NHS practices have a procedure, and someone who has responsibility for it. In most cases, the matter will be resolved at this stage.
The complaints manager can arrange for an independent conciliator or mediator to be brought in to help resolve the complaint.
Second stage – referral to an ombudsman
If you are unhappy with the decision of the complaints manager at the organisation concerned, you do not have a right of appeal. However, you can refer the matter to the Parliamentary and Health Service Ombudsman if the complaint is about the NHS, or the Local Government Ombudsman if the complaint is about social services.
For more information about using the ombudsman, see How to use an ombudsman in England.
It may be possible to challenge the final decision on your complaint by taking court action called a judicial review. Judicial review is a procedure which allows a court of law to review decisions made by public bodies. You can find out more about judicial review on the Public Law Project's website at: www.publiclawproject.org.uk.
Local HealthWatch is the new ‘consumer champion’ for both health and social care. In some areas, local HealthWatch organisations will just be able to give general advice and support about complaints about the NHS and social care. In other areas, they will be able to act as your advocate when you make a formal complaint.
Representatives from local HealthWatch organisations can request information from health and social care providers, who have a legal duty to respond. Providers of health and social care must reply in writing to reports and recommendations made by local HealthWatch within 20 days but in more complex cases, this time limit is 30 days. Information obtained in this way could help you make a formal complaint.
Representatives from local HealthWatch organisations can also enter and inspect premises, to observe how activities are carried on there. Some premises are excluded, for example, children’s homes. Local HealthWatch organisations don’t have the right to enter and view if this would prevent effective services or compromise the privacy and dignity of anyone there. If you have serious concerns about how health services are being carried out in a local facility, you could contact HealthWatch who, depending on the circumstances, might carry out a visit.
Patient Advice and Liaison Services (PALS) for an NHS hospital complaint
If complaint is about treatment in a NHS hospital, you may find it helpful to get advice from a local Patient Advice and Liaison Service (PALS). Although they can’t to take up formal complaints, PALS staff can give general advice on complaints procedures and may be able to help sort out some less serious complaints by informal negotiation. The hospital's website should have details of how to contact the PALS service. If the problem isn’t sorted out at this level, they may help you to make you a formal complaint using the NHS and local authority social services complaints procedure.
Clinical Commissioning Groups patient liaison teams
In some areas, there is a patient liaison service offered by local Clinical Commissioning Groups (CCGs). They will be able to give general advice and support about complaints about NHS primary services. Local HealthWatch will be able to give you information about where there is a CCG patient liaison service in your area.
Complaints Advocacy Services
Local authorities have the responsibility for commissioning independent NHS Complaints Advocacy services. These will replace the former ICAS service which helped people wishing to make a formal complaint about an NHS practitioner or service. In some areas, local HealthWatch will carry out these advocacy services. In other areas, local authorities may group together to commission the service at a regional level.
These advocacy services will also cover social care, not just health services. In some areas, they will include children’s services as well as adult social care.
Although an independent Complaints Advocacy service can help you to make a formal complaint, it cannot investigate complaints itself.
The Care Quality Commission
The Care Quality Commission (CQC) regulates:
- practitioners carrying out primary healthcare, including GPs
- adult and child social care.
Although the CQC does not deal with individual complaints, you can report her/his experience to them. This could result in action being taken against the care provider. There is information about this on the CQC's website at www.cqc.org.uk.
You can also get help to make a complaint about your NHS practitioner from your local Citizens Advice Bureau. To search for details of your nearest CAB, including those that can give advice by e-mail, click on nearest CAB.
You may find it useful to have someone to help you put across your case, for example, if you are a mental health service user, have learning difficulties or English is not your first language. You can contact a local organisation that may be able to provide you with an advocacy service.
You can search online for advocacy groups on the Action for Advocacy website: www.actionforadvocacy.org.uk. You can also contact them on:
Action for Advocacy
The Oasis Centre
75 Westminster Bridge Road
Tel: 020 7921 4395
Fax: 020 7921 4201
If you are considering taking legal action about your complaint, you will need to consult a solicitor.
These actions are usually costly and complex. All NHS bodies and local authority social services are insured and legal action will usually be defended by an insurance company. Where the legal action is about the actions of an NHS employee of a trust or Clinical Commissioning Group (CCG), the NHS institution will be responsible for deciding whether to defend the action. The same applies if the legal action is about the actions of an employee of the local authority, for example, a social worker. It will be for the local authority to decide whether to defend the action and who will ultimately be responsible.
If you've been injured because of negligence by the NHS and you want to consider taking legal action, see Personal injuries.
If you think that a NHS practitioner or social services employee has been guilty of professional misconduct, you may be able to write to their professional or regulatory body to make a complaint.
Examples of professional misconduct include when a practitioner:
- has a sexual relationship with a patient
- claims they are competent to practise and they are not
- claims they have the qualifications to practise and they don't
- visits a patient without their request to do so
- breaks a patient's confidentiality
- puts false information on a patient's medical records.
If the practitioner is found guilty of professional misconduct, they can be prevented from practising in the future.
You may make a complaint to a professional body even if you have also made a complaint under the NHS and local authority social services complaints procedure. However, if an investigation has already started under the complaints procedure, the professional body may decide to wait for the outcome of this before deciding what action it should take.
You can make a complaint about the professional misconduct of a doctor to the General Medical Council (GMC). For more information, go to the GMC website at: www.gmc-uk.org.
To find out which professional body is responsible for regulating other NHS practitioners such as dentists, opticians and psychologists, go the Statutory Regulators Directory on the Professional Standards Authority's website at www.professionalstandards.org.uk.
The NHS and other organisations or people providing health care services are not allowed to discriminate against you because of age, disability, gender reassignment, pregnancy or childbirth, race, religion, sex or sexual orientation.
If you're disabled, a health service provider must make 'reasonable adjustments' to allow you to use their services. If they don't do this, they must be able to show that their failure to do so is justified, otherwise they will be discriminating against you. Examples of making reasonable adjustments include providing information on audiotape as well as in writing, or installing a ramp to allow wheelchair access.
I have hearing difficulties and it is embarrassing when I go to the dentist – I can never hear them when the receptionist calls out my name.
You could ask your dental surgery to keep a record of all their patients with hearing difficulties. Receptionists can then come over and let you know when the dentist is ready to see you, rather than calling out your name. The surgery should agree to this. If they don't agree and they don't have a very good reason, they are probably discriminating against you and you should make a complaint.
If you think that an NHS health-care professional or social services employee is discriminating against you, you can complain about this. Ask to see a copy of the equality policy of the organisation they work for and point out where they are failing to keep to it.
For more information about discrimination in the NHS and local authority social services, go to the website of the Equality and Human Rights Commission at: www.equalityhumanrights.com.
If you have experienced discrimination, you can get help from the EASS discrimination helpline.
For more information about discrimination see our discrimination pages.