Health - In N. Ireland

This information applies to England and Northern Ireland

Making a complaint about the NHS

You have the right to make a complaint about any aspect of NHS treatment using the NHS complaints procedure. To use the procedure you must usually be a patient or a former patient of the practitioner or institution concerned, although it is possible to complain on behalf of someone else. If you want to complain on behalf of another person, the hospital or practice must agree that you are a suitable representative.

There are NHS complaints procedures for all parts of the UK. This information covers the procedures for England and Northern Ireland but refers to the NHS organisations in England. NHS organisations in Northern Ireland have different names. In Northern Ireland, the NHS is called Health and Personal Social Services (HPSS). The work of the Primary Care Trust or NHS Trust is done by Health and Social Services Boards and the Central Services Agency. The Department of Health is the Department of Health, Social Services and Public Safety and functions of The Independent Complaints Advocacy Services (ICAS) are carried out by health and social services councils.

Time limits for making a complaint

You should make your complaint as soon as possible after the matter you are complaining about occurred. The time limit for complaints is usually six months from the date this occurred, or six months from the date that you first became aware of it.

There is discretion to waive 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.

Financial compensation

It is not possible to get any financial compensation through the NHS complaints procedure. If you are seeking financial compensation you will need to take separate legal action (see under heading Taking legal action about your NHS complaint).

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The NHS complaints procedure

First stage - Local Resolution

If you want to make a complaint about any aspect of NHS treatment you have received or been refused, go to the practice, hospital or trust concerned and ask for a copy of the complaints procedure. This is the same for GPs, opticians, dentists, hospitals, and any other care given by the NHS.

In all cases the first stage of the procedure is to make a complaint to the practitioner concerned. This first stage is called Local Resolution. A large health centre may have a member of staff designated as complaints manager. A smaller practice will probably not have such a person, 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.

If your complaint is about primary care services, the complaints manager can arrange for an independent conciliator or mediator to be brought in to help resolve the complaint. A conciliator or mediator might also be available to help resolve complaints about other types of NHS services.

Second stage - Independent review

If your complaint is not resolved through Local Resolution, you should refer it on for an independent review.

In England, independent reviews are carried out by the Healthcare Commission. To contact the Commission, telephone their helpline on: 0845 601 3012, or visit their website at: www.healthcarecommission.org.uk.

In Northern Ireland, independent reviews are carried out by health boards.

At an independent review, the person carrying out the review may:-

• refer the matter back to the practice, hospital or trust, for further action under Local Resolution if it is felt that a resolution could still be achieved
• set up an independent review panel which will investigate the complaint
• take no further action if it is felt that everything which could be done has been done.

If the person carrying out the review decides to take no further action you will be advised of your right to refer the matter to the independent Health Service Ombudsman, or the Northern Ireland Ombudsman.

Third stage referral to an Ombudsman

If you are unhappy with the decision of the person carrying out the independent review or the outcome of the review panel you do not have a right of appeal. However you can refer the matter to the Health Service Ombudsman, or the Northern Ireland Ombudsman or seek a judicial review.

For more information about using the Ombudsman, in England, see How to use an ombudsman in England or in Northern Ireland, see How to use an ombudsman in Northern Ireland.

Judicial review

It may be possible to challenge the final decision on your complaint by seeking 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.

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Help with your complaint in England

The Independent Complaints Advocacy Service (ICAS)

The Independent Complaints Advocacy Service (ICAS) is a free, confidential and independent service which can help you make a formal complaint about your NHS experience. You can contact your local ICAS office direct, or through NHS managers at hospitals and GP practices, NHS Direct, and the Patient Advice and Liaison Service (PALS). Contact numbers for local ICAS offices are:-

The Patient Advice and Liaison Service (PALS)

You may find it helpful to seek advice from a local Patient Advice and Liaison Service (PALS). Although PALS staff will not be able to take up a formal complaint on your behalf, they can give general advice on complaints procedures and may be able to help you resolve a less serious complaint by informal negotiation. If you are still dissatisfied, you may then wish to make a formal complaint using the NHS complaints procedure.

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.

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Help with your complaint in Northern Ireland

Health and social services councils in Northern Ireland are independent organisations which can help you make a complaint about your NHS practitioner.

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.

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Taking legal action about your NHS complaint

If you are considering taking legal action about your NHS complaint, you will need to consult a solicitor.

You should be aware that these actions are costly and complex. All family practitioners are insured and legal action will usually be contested by an insurance company. Where the legal action is about the actions of an NHS employee of a trust or Primary Care Trust, the NHS institution will be responsible for deciding whether to contest the action.

If you have been injured because of negligence by the NHS and you want to consider taking legal action, see Personal injuries.

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Complaints about professional misconduct

If you think that a NHS practitioner has been guilty of professional misconduct, you may be able to write to their professional or regulatory body to make a complaint. 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 complaints procedure. However, if an investigation has already started under the NHS complaints procedure, the professional body may decide to wait for the outcome of this before deciding what action it should take.

To find out more about the appropriate professional body, you can look at a leaflet produced jointly by all of the regulatory bodies including the General Medical Council. The leaflet outlines which regulatory body is responsible for monitoring each profession and what regulation means. It also provides contact details for all of the organisations. The leaflet has been produced in 12 languages and a large print version of the English version is also available. To download a copy of the leaflet, go to the website of the General Medical Council at www.gmc-uk.org.

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Discrimination

Organisations and people providing NHS treatment are not allowed to discriminate against you because of your race, sex, disability, religion or belief, or sexuality. Also, your local NHS Trust might have an equality policy which says it will not discriminate against you for other reasons, for example, if you have HIV or if you are a transsexual.

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.

If you think that a doctor, dentist, nurse or other NHS health care professional 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, go to the website of the Equality and Human Rights Commission at: www.equalityhumanrights.com.

For more information about discrimination see:

• Taking action about race discrimination
• Discrimination because of religion or belief
• Taking action about sex discrimination
• Discrimination because of sexuality
• Disability discrimination.

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