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How does it work? of Complaints about NHS services

To resolve your complaint locally

Wherever possible, you should tell someone close to the cause of your problem about your complaint - a doctor, nurse, receptionist, or practice manager, for example. In many cases, it should be possible to sort out the problem straight away.

If you don’t want to talk to someone who has been involved with your care, you can write to or telephone a complaints manager. All NHS trusts and primary care trusts (PCTs) have a complaints manager who can advise you. GPs, dentists, opticians and pharmacies should also have someone who oversees their complaints procedure. If you are not sure who to contact, get in touch with your local PCT.

You can ask the Patient Advice and Liaison Services (PALs) office at the hospital trust or PCT for information and help on using their complaints procedure. Alternatively, you can telephone NHS Direct on 0845 4647 for information on how to complain.

Trusts and PTCs will normally respond to a complaint within 20 working days. Family health service providers - GPs, dentists, pharmacists or opticians - should reply within 10 working days.

Conciliation to resolve complaints

Conciliation is a way of dealing with complaints that helps to avoid difficult disagreements. A neutral conciliator aims to come up with a satisfactory conclusion for both parties.

Either you or the organisation you are complaining about can ask for conciliation, but both must agree to the conciliation taking place.

Conciliation is most often used to help with complaints about primary care services - for instance GPs. Primary care trusts (PCTs) are required to provide conciliation services for these. However, your NHS trust or PCT may also offer you this service if you make a complaint to them.

Independent review of complaints

If attempts at resolving complaints locally are unsuccessful, you have the right to have your case reviewed by the Healthcare Commission. If you are eligible for this, you need to fill in a complaints form. These are available from local trusts, independent complaints advocacy services, online or can be sent by post. Alternatively, you can write or email your request to the Healthcare Commission with a copy of the report that was given at the end of local resolution.

Contact the Healthcare Commission complaints helpline on 0845 601 3012 if you:

• would like someone to complete the form with you over the phone,
• would like to receive the information in another language or format,
• have any queries.

Your case is not suitable for review if it is outside the Healthcare Commission’s legal authority, if you have not yet made a complaint to the local service, or if you are not eligible to complain under the NHS complaints procedure. In such cases, you may be advised to contact your local independent complaints advocacy service (ICAS) for help.

Once your complaint has been received, the Healthcare Commission will allocate a complaints manager to your case. They may contact you for further information, or ask for advice from health professionals. Sometimes, the Healthcare Commission will need to see your medical records, in which cases your permission will be requested. A course of action will be recommended within 10 days of the receipt of the complaint. Possible outcomes include:

• No further action. The complaint has already been thoroughly investigated and answered locally
• Referral back to the NHS organisation complained against. Recommendation of further action to resolve the complaint or review the organisation’s procedures.
• Referral to the Health Service Ombudsman.
• Referral to another body, such as the General Medical Council (if the Healthcare Commission does not have the legal authority to resolve the complaint).
• Action by the Healthcare Commission, who will investigate the complaint and, following the investigation, set up a panel if the complainant wants this.

If your complaint is referred back for further action locally and you are still dissatisfied, you can ask the Healthcare Commission to look at the complaint again. The complaint will normally be referred back to the local authority for a second time.

If an investigation is necessary to resolve your complaint, you have the right to request a panel of three members of the public to hear your complaint. The panel will hear evidence from you, the organisation you are complaining against, any witnesses involved, and the Healthcare Commission’s report. Based on their findings, the panel will make recommendations about how to resolve your case, and, when necessary, suggest service improvements.

The Healthcare Commission may refer some complaints directly to the Health Services Ombudsman. This happens when witnesses do not cooperate in the investigation, or the case falls within the jurisdiction of more than one ombudsman. The Health Service Ombudsman has additional powers to require witnesses to cooperate with the procedure. Health Service Ombudsman.

If you are not happy with Healthcare Commission’s decisions, you can appeal to the Health Service Ombudsman, who is independent of the NHS and the Government. The Ombudsman will not usually consider a complaint if you have not tried to resolve the matter through the NHS complaints procedure.Contact the commissioner at: The Health Service Commissioner for England, 11th Floor, Millbank Tower, London SW1P 4QP. Tel: (020) 7217 4051

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