Treatment feedback and complaints

Here we explain more about how to access information about the care provided to a loved one and the options that are available including giving feedback, making a complaint or pursuing a clinical negligence claim.

Giving feedback

If you would like to give feedback about the care a loved one received but don't want to make a formal complaint, you can do this through the Patient Opinion website. The website is an independent not-for-profit enterprise founded by a GP who wanted to find a way to make the wisdom of patients available to the NHS. You can share your story and read about other people's experiences. This feedback is passed onto the NHS who use it to develop and improve services.

You can also comment on GP practices and NHS hospitals through the NHS Choices website. You can rate hospitals and practices on a number of factors and make comments on what you liked about the service, and what you feel could be improved.

You may want to make positive comments on the care and services. This feedback is just as important because they tell organisations which factors are contributing to a good experience for patients.

Making a formal complaint

Stage 1 - Initial discussion/resolution

If you have questions about the care provided to a loved one, the first thing to do is to raise the matter with the organisation involved. You may want to try to discuss the issue informally first by talking to someone involved with the case, e.g. a GP, consultant, practice manager etc.

If informal attempts do not work or you would prefer to talk to someone who was not involved, you can telephone or write to the complaints manager. This is called local resolution and most cases are resolved at this stage.

Complaints should should be made through the NHS complaints procedure, or if private healthcare, through the company's complaints procedure. Social care complaints should be made through your local authority. Ask for a copy of the organisation's complaints procedure which will explain how you should proceed.

You should make your complaint as soon as possible. The time limit for complaints is usually:

12 months from the date of the event that you are complaining about happened, or
12 months from the date that you first became aware of it.

The time limit can sometimes be extended, such as in situations where it would have been difficult for you to complain earlier, for example, when you were grieving or undergoing trauma.

You will normally need to include information about the issue you are complaining about, when and where it happened, who was involved, their position, information about discussions you have had already, any questions you would like answered, what you would like to happen and your contact details. The organisations we have listed in the Help with making a complaint section below can help you with this.

You should receive a response within 25 days through the NHS complaints procedure. If you make a complaint, you should get answers to your questions, an apology if something went wrong and information on what will be done to prevent the situation happening again.

You can't get financial compensation through the NHS complaints procedure. If you want financial compensation, you will need to take separate legal action.

Stage 2 - Referral to Ombudsman

If you are still unhappy with the result, you can ask the the Parliamentary and Health Service Ombudsman (PHSO), who is independent of the NHS and government, to investigate your case. The Ombudsman will not usually look at matters that have not been through the NHS complaints procedure.

In England you need to contact the Health Service Ombudsman, in Northern Ireland the Healthcare Board, in Scotland the Scottish Public Services Ombudsman and in Wales the Public Services Ombudsman.

NB: From 1 April 2009, there will no longer be an independent review undertaken by the Healthcare Commission and anyone who remains dissatisfied will have the right to go straight to the Ombudsmen. The Healthcare Commission ceased to exist on 31 March 2009. The Care Quality Commission (CQC) is the new health and social care regulator for England.

Help with making a complaint

Making an official complaint can be quite daunting and can often come at a time when you are feeling at your most vulnerable or anxious. The following organisations can provide advice and support to help you through this process:

Patient Advice and Liaison Service (PALS)

You may find it helpful to get advice from a local Patient Advice and Liaison Service (PALS) in England. Although PALS staff will not be able to take up a formal complaint on your behalf, they can give general advice on complaints procedures. They may also be able to help you resolve a less serious complaint by informal negotiation.

PALS aims to listen to patients, their relatives, carers and friends, and answer their questions and resolve their concerns as quickly as possible. It also aims to help bring about changes to the way that services are delivered. You can find the details of your local PALS office on their website www.pals.nhs.uk

Independent Complaints Advocacy Service (ICAS)

The Independent Complaints Advocacy Service (ICAS) in England is a free service that can support you if you are making a complaint about the NHS. ICAS are independent of the NHS and will explain the options available and support you to pursue your chosen course of action. For example, they can help you with writing letters and by accompanying you to meetings.

To find the phone number for ICAS in your region, please see our map of ICAS services You can also contact them via PALS.

Citizens Advice Bureau
Your local Citizens Advice Bureau can be a great source of advice and support if you want to complain about the NHS, social services or local authorities. You can find your local Citizens Advice Bureau on its website.

Clinical negligence

Clinical negligence is where compensation is sought for harm or injury resulting from care that is below the usual standards. The harm can be physical or mental and may happen because there is a delay in diagnosis, a delay in treatment, the wrong treatment is provided or the treatment goes wrong.

Before going ahead, we recommend that you think about what you want to achieve, if you would be happy with an apology, if you have the time and energy (claiming for negligence can be very distressing and may take years) and if compensation is likely to be more than your legal costs.

If you do decide to go ahead, you will need to contact a solicitor who specialises in clinical negligence. Usually, claims need to be made within 3 years (unless you have a reason for not doing it within 3 years).

Your solicitor may ask for medical notes, copies of scans/x-rays and may seek the opinion of appropriate medical experts. They will write a letter to the medical establishment involved who will have 3 months to carry out an investigation. The establishment may accept or deny the claim. If they deny the claim, you may need to take legal proceedings which means they will be taken to court, although most claims are settled before they go to trial.

Legal action can be funded in a variety of ways such as through the Legal Services Commission (this is means tested and used to be called Legal Aid), insurance (some household/union membership policies cover legal expenses), ‘No win, no fee' arrangements or by paying for it yourself.

Help with medical negligence

There are a number of organisations that can help give advice and support if you are considering pursuing a medical negligence claim.

Citizens Advice Bureau

If you are considering taking legal action and have not yet been to a solicitor, you may like to seek help from an experienced adviser such as the Citizens Advice Bureau who can provide advice and support about the time limits for taking action, legal costs etc. You can find your local Citizens Advice Bureau on its website.

Law Society

If you want to take legal action over a personal injury you should consult a solicitor who is a member of the Law Society's personal injury accreditation scheme or clinical negligence accreditation scheme, depending on the nature of the injury. The Law Society can give details of solicitors on these accreditation schemes. For Northern Ireland, please visit The Law Society of Northern Ireland.

Action against Medical Accidents (AvMA)
AvMA is an independent charity which can provide information, support and referral to solicitors if you are the victim of a medical accident. They describe a 'medical accident' as where avoidable harm has been caused as a result of treatment or failure to treat appropriately. They also have a panel of independent medical experts.

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