How does the NHS complaints procedure work?

The organisation complained to must acknowledge your complaint within three working days and agree a response timescale with you.

If you're not satisfied with the outcome, you can escalate your complaint to the Parliamentary and Health Service Ombudsman (PHSO).

A complaint can get you an explanation, an apology and changes to prevent recurrence. This will not get you compensation. If you've been harmed by suboptimal care, that is a separate legal process and you typically have three years to bring a claim.

Most NHS care is good care. But when something goes wrong like a missed diagnosis or a dismissed concern, knowing how the complaints system actually works makes it far easier to get a straight answer, and to know whether you might also have a legal claim.

Why would I make an NHS complaint?

People complain to the NHS for reasons that range from poor communication to serious harm. Common causes for complaint include:

• A delayed or missed diagnosis

• Poor communication between staff, or between staff and patients

• Concerns being dismissed or not investigated

• Being given the wrong medication or treatment

• Rude, dismissive or unprofessional staff conduct

• Administrative errors such as lost referrals, cancelled appointments, missing test result

A complaint isn't just about venting frustration. It's the formal route to an explanation of what happened, an acknowledgement if something went wrong and a commitment to change so the same mistake isn't repeated for someone else. A complaint can also result in an apology being offered - an outcome most people think is very important before there can be any closure.

Who can complain, and within what time limit?

You can complain if you received the care yourself, or on behalf of someone else. This could be a child, or an adult who lacks the capacity to complain themselves.

The general rule is that a complaint should be made within 12 months of the incident or within 12 months of when you first became aware you had grounds to complain. NHS organisations have a discretion to accept complaints after 12 months, particularly where the delay is understandable or unavoidable, for example, while you were still receiving treatment or coming to terms with what happened.

How do I make an NHS Complaint?

If you’re unhappy with the care or service you’ve received from the NHS, you have the right to raise your concerns. The NHS complaints procedure is designed to ensure your voice is heard and that any issues are addressed appropriately.

Step 1: Raise concerns informally

Sometimes, issues can be resolved quickly by speaking directly to the healthcare provider involved, such as a nurse, doctor, or practice manager. You may want to start by explaining your concerns and seeking clarification or an apology. This may resolve matters for you.

Step 2: Submit a formal complaint

If informal discussions don’t resolve the matter or you don't feel able to make an informal complaint, you can make a formal complaint. This can be done in writing, via email, or verbally. Your complaint should be directed to the organisation responsible for the care, such as:

• The Chief Executive of the NHS Trust or hospital where you were treated

• The Practice Manager of your GP practice

• The Practice Manager of your dental practice or pharmacy

• You can also complain to NHS England if your issue relates to primary care services (GPs, dentists, etc.).

• All hospitals have a Patient Advice and Liaison Service (PALS) who are able to offer assistance with complaints.

Step 3: Include key details

When making your complaint, ensure you provide:

• Your full name and contact details

• A clear description of what happened and why you’re dissatisfied

• Relevant dates, locations, and names of individuals involved

• Copies of any supporting documents

You should submit your complaint as soon as possible and certainly within 12 months of the incident or from when you first became aware of the issue.

Step 4: Await a response

The organisation should acknowledge your complaint within 3 working days and will usually contact you to agree a timeframe for a response (usually between 25 and 60 working days). A full written response should be sent to you once the investigation is complete. If your complaint is complicated and needs more time, the NHS should write or call to explain the delay and give you a new date for a response.

Sometimes you may be invited to attend a face-to-face meeting to discuss your complaint. If that is offered always take a friend along with you and ask for the meeting to be recorded.

What can I actually get from an NHS complaint?

A successful complaint can result in:

• A clear explanation of what happened and why

• An apology

• A plan of action: changes to procedures, additional training, or other steps to prevent any repeat

What it won't do is award you compensation. Financial redress for harm caused by negligence is handled separately, through NHS Resolution (for NHS bodies) or the relevant indemnity provider, via a civil claim. This is one of the most common misunderstandings about the process, a complaint and a compensation claim run on entirely different tracks.

What if I'm not satisfied with the response?

If local resolution doesn't resolve things, you can escalate your complaint to the Parliamentary and Health Service Ombudsman (PHSO), the independent body created under the Health Service Commissioners Act 1993. The PHSO will generally only investigate once you've completed the local process, and you normally need to refer your case within 12 months of the final local response. The PHSO can recommend an apology, service changes, or in some cases a discretionary financial remedy, though this is distinct from, and usually smaller than, compensation awarded in a negligence claim.

Do I need a lawyer to complain to the NHS?

Not for the complaint itself, you don't need legal representation to raise concerns or escalate to the PHSO, and there's no charge for using the complaints process.

Where legal advice becomes relevant is if you believe the care fell below an acceptable standard and caused you harm. That's a question of clinical negligence, not just poor service, and it's assessed differently. Did the care fall below the standard a reasonably competent clinician would have provided, and did that failure cause or worsen an injury?

If so, you generally have three years from the date of the negligence or from when you first became aware of it, to bring a claim (under the Limitation Act 1980). Different rules apply for children and for claims following a death. Gathering medical records and expert evidence takes time, so it's worth seeking specialist advice well before the limitation period is close to running out.

A useful rule of thumb is to make the complaint for accountability and explanation. Take legal advice early if you suspect there's also been genuine harm. The two aren't mutually exclusive and pursuing a complaint first can actually strengthen a subsequent claim for compensation by putting facts on record while they're fresh.

How VWV can help with your NHS complaint?

Complaints teams and legal claims sit in different parts of the system, and it isn't always obvious which route is right for your situation. We can:

• Help you draft a letter of complaint

• Review a complaint response you've already received and advise whether it suggests a compensation claim is worth investigating

• Help you understand whether what happened meets the legal test for clinical negligence, before you commit time to a claim

• Advise on evidence and time limits, particularly where a limitation deadline is approaching

• Handle a clinical negligence claim on a no win, no fee basis where the case is suitable, working alongside the NHS complaints process

If you're unsure whether you're dealing with a service failing or something that meets the legal bar for negligence, that's exactly the kind of question worth asking early, before evidence or time limits become a problem.

If you need legal support with an NHS complaint or a possible clinical negligence claim, contact Nicola Bickham on +44 (0)117 314 5330 or David Gazzard on +44 (0)117 992 9285, in our Clinical Negligence team.