Your guide to Independent Health Complaints Advocacy
You can use this guide to help you raise a complaint about NHS services anywhere in England.
Making a complaint can feel daunting, but you have the right to be listened to and taken seriously. You don’t have to get everything right – the complaints process is there to help you raise concerns and seek answers or improvements.
The NHS complaints process is:
You can make a complaint yourself, or you can ask for support.
If you need extra help to make an NHS complaint, you have a legal right to free, independent advocacy.
This is called Independent Health Complaints Advocacy (IHCA).
An IHCA advocate can support you to:
IHCA is free, confidential and impartial.
The Advocacy Project does not currently provide free NHS complaints advocacy.
However, we want to make sure you can find the right support.
You can find your local IHCA provider by:
Large national providers include POhWER, The Advocacy People and Voiceability.
This guide is designed to help you decide:
In some circumstances, The Advocacy Project may be able to offer support through our fee-paying advocacy service. This is not a replacement for IHCA, and free statutory advocacy should always be explored first.
You are welcome to contact us if you would like more information.
You can raise concerns about your own NHS care or treatment.
You can also complain on behalf of someone else, including:
The NHS organisation must be satisfied that:
If they decide not to investigate, they must explain why in writing.
If your concern is about care or treatment you are currently receiving, the quickest way to resolve it is often to speak directly to the staff involved.
If this doesn’t feel possible, you can contact the Patient Advice and Liaison Service (PALS) at your local NHS trust. PALS can:
If the issue is not resolved, you can then make a formal NHS complaint.
You should expect the NHS to:
If you are not satisfied with the response, you have right to complain to the Parliamentary and Health Service Ombudsman.
You can complain about services that are provided or funded by the NHS, including:
Other routes may be more appropriate, and we explain these later in this guide.
Before starting a complaint, it can help to take some time to think about:
Being clear about this can make the process feel more manageable and help the NHS respond more effectively.
Your concerns can be about any part of the care, treatment or service you received from the NHS. This might include:
You can also use the NHS complaints process if:
Before raising your complaint, it’s helpful to think about what outcome you are hoping for.
Try to be clear and realistic about this, as it can help your complaint be dealt with more efficiently.
Common outcomes include:
There are some limits to what the NHS complaints process can achieve. It cannot be used to:
Most NHS organisations prefer complaints in writing, but you can raise your concerns in the way that works best for you, including:
If you raise your complaint by phone or in person, the person handling it should make a written record and give you a copy.
If you have advocacy support, an advocate can help you write letters or prepare what you want to say.
Who you contact depends on the NHS service you’re complaining about. If you’re unsure, you can contact the service directly to ask about their complaints process.
This includes hospitals, mental health services, community services and ambulance services.
You can send your complaint to:
You cannot ask both to investigate the same complaint.
You should usually raise your concerns directly with the service or its manager.
You can also complain to NHS England, who will contact the service and investigate your concerns. You cannot ask both NHS England and the service provider to investigate.
You can contact NHS England by:
If you complain to NHS England, you will need to include:
These should be sent to the local Integrated Care Systems (ICS).
You can find details via your local authority, local Healthwatch, or the NHS website.
If you’re unsure who to complain to, you can seek advice from an advocacy service.
Most NHS complaints are dealt with through local resolution. This means the NHS service involved works directly with you to understand and resolve the issue.
This usually involves:
Local resolution gives the service the opportunity to put things right quickly and learn from your experience.
It’s important to raise all your concerns at this stage, as new issues usually cannot be added later.
Some concerns can be resolved quickly. Others may take longer.
In most cases, the NHS will:
How long it takes can depend on factors such as:
Every complaint is different. As part of the process, the NHS may:
You can bring a friend, family member or advocate to meetings. You can also ask for specific staff members to attend or not attend.
At meetings, you should expect:
If you feel uncomfortable or distressed, you can ask for a break or for the meeting to stop and continue at another time.
An advocate can support you to prepare for meetings or attend with you.
Once the investigation is complete, you should receive a written response. This will usually include:
The letter may include:
The response should be clear, factual and easy to understand. Any technical terms should be explained.
If you do not receive a response within the agreed timescale, you can contact the person handling your complaint to ask for an update.
If the response does not address your concerns, it can help to:
Your options include:
If the NHS decides no further action is needed, they must explain this to you in writing.
If you are unhappy with the outcome of local resolution, you have the right to take your complaint to the Parliamentary and Health Service Ombudsman (PHSO).
You can usually only contact the ombudsman after all reasonable efforts have been made to resolve your complaint locally. You should be told in writing when local resolution has ended and that nothing further can be done by the NHS organisation.
By law, complaints should normally be made within one year of:
If more than a year has passed, the ombudsman may still consider your complaint if there were good reasons for the delay.
Website: www.ombudsman.org.uk
Phone: 0345 015 4033
Textphone: 0300 061 4298
Email: phso.enquiries@ombudsman.org.uk
Text ‘call back’ with your name and number to: 07624 813 005
Post: Parliamentary and Health Service Ombudsman, Millbank Tower, Millbank, London SW1P 4QP
When the ombudsman receives your complaint, they will first decide whether they are legally able to investigate it.
In some cases, they may:
The ombudsman will not usually investigate if:
If the ombudsman investigates, they will look closely at what happened. This may involve gathering information from you and the NHS organisation involved. Each case is handled individually, so the process may vary.
Possible outcomes
If the ombudsman finds that the NHS has got things wrong, they may recommend that the NHS organisation:
If the ombudsman decides the NHS acted appropriately, or has already done enough to resolve the complaint, they will explain their decision to you. They will usually share any expert advice they relied on.
The ombudsman’s decision is final, including decisions not to investigate a complaint.
In some circumstances, you may ask for a review of the decision. This does not involve a full reinvestigation, but looks at whether:
If you still disagree, you may be able to challenge the decision through the courts using judicial review.
You may want to see your medical records as part of the complaints process. If you need support with this, we can help explain what to do.
What your records may include
Your rights
Under data protection law, you have the right to see your records unless:
Sometimes only part of a record may be withheld. You can ask whether this has happened.
You need to make a Subject Access Request (SAR). Many GP practices and NHS trusts have a standard form and a dedicated contact for this.
You should usually receive your records within one calendar month.
Complex or multiple requests may take up to three months
Copies are normally free, unless the request is unfounded, excessive, or you ask for additional copies
If anything in your records is unclear or uses technical language, the NHS should explain this to you.
If your records are inaccurate
You can ask for inaccurate information to be corrected.
If your doctor disagrees, you can ask for a note of disagreement to be added to your records. If you remain unhappy, you can contact the Information Commissioner’s Office (ICO).
You can only access another person’s records if:
For children:
If someone lacks capacity, legal advice or court authorisation may be required.
Records of a deceased person can only be accessed by:
People have a statutory right to free NHS complaints advocacy in many areas of the UK. Availability varies by location, and you should be able to find up-to-date local services through the links provided earlier in this guide.
While The Advocacy Project can offer support, we’re not currently funded to provide Independent Health Complaints Advocacy. We can only offer this support through our fee-paying services at present.
