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This information applies to Wales
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.
You can use this information to complain about NHS services which have been delivered in Wales or which have been commissioned by an NHS institution within Wales but delivered outside Wales. For example, if a patient is sent by a Welsh NHS trust for treatment to an NHS hospital in England this procedure could still be used.
Time limits for making a complain
You should make your complaint as soon as possible after the problem incident. The time limit for a complaint is usually six months from the date of the incident, or six months from the date that you first became aware that there was a problem. In either case the complaint must be made within twelve months of the problem incident.
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. You can make a separate complaint about a refusal to waive a time limit.
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 their 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. All NHS institutions must have a complaints procedure. All local health boards and NHS trusts have a complaints manager. The senior partner in a family health practice will be responsible for the complaints procedure. In most cases the matter will be resolved at this stage.
Second stage - Independent review panels
If your complaint is not resolved through Local Resolution, you should ask for an Independent Review. You make this request to the Independent Review Secretariat, a body that is independent of the NHS. The address of the Secretariat will be given in the letter which informs you of the results of the Local resolution. The request for an independent review must be made within four weeks of receiving this final letter.
Your complaint will be handled by an individual reviewer who can:-
- refer the matter back for further action under Local Resolution if it is felt that a resolution could still be achieved
- refer the matter outside the NHS complaints procedure to a relevant professional body
- 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 independent reviewer decides to take no further action you will be advised of your right to refer the matter to the independent Health Service Ombudsman.
Third stage –The Health Service Ombudsman
If you are unhappy with the outcome of the Independent Review you do not have a right of appeal. However you can refer the matter to the Health Service Ombudsman or seek a judicial review.
For more information about using the Ombudsman, see How to use an ombudsman in Wales.
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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 at www.publiclawproject.org.uk/simpleguide.html.
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Help with your complaint
Community Health Councils (CHCs) are independent organisations which can help you make a complaint about NHS services or your NHS practitioner. For more information about CHCs, go to the website of the Board of Community Health Councils in Wales at www.wales.nhs.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.
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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 an NHS practitioner has been guilty of professional misconduct, it may be possible to complain to the practitioner's professional or regulatory body. Each body has a disciplinary committee that can investigate complaints. If a practitioner is found guilty of professional misconduct they can be prevented from practising in the future.
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