How we deal with complaints

Please note it is taking us longer than usual to look into health complaints. This is because the NHS is still facing increased demand for its services and because we have more cases than usual to work through.  We are sorry it could take up to 18 weeks before we can look at your case. We are working hard to reduce this waiting time and will keep you informed by updating the information on this page.

Here you can find out what happens when we first receive your complaint, how we decide if we can investigate it and what to expect if we do.

To find out more about any of the steps in our process, follow the links below, download our simple guide How we look into complaints (PDF 195KB) or call us on 0345 015 4033. 

You can also find our Service Charter here. It explains the commitments we make to you when you ask us to look into your complaint.

You can give us feedback on our service at any point. Please discuss this with the person handling your complaint or their manager as a starting point. 

If you haven't complained to us yet, have a look at our Making a complaint page where you can find out how to do that and what steps you may need to take first.

Step 1 When we first receive your complaint

What happens?

First we do some initial checks to make sure we can deal with your complaint. This includes checking that:

  • We can look into the organisation and issue you're complaining about
  • You have been through the organisation's own complaints process already

How long does this take?

We aim to complete these checks within five working days.

What can we decide?

If we can deal with your complaint, we'll let you know and refer it on to step two. Around 25% of the complaints that come to us are taken forward to the next step.

If we can't take your complaint forward, we'll give you information about what you can do next. This includes giving advice about how to complain to the organisation you're unhappy with, if you haven't done this already.

To find out more about this step in our process, download our guide: What happens when you first contact us (PDF 298KB).

Step 2 Deciding whether to investigate your complaint

What happens?

We take a closer look at your complaint to decide if we should investigate. We look at several things, including:

  • whether you have been affected personally by what happened
  • whether you complained (to us or an MP) within a year of knowing about the issue
  • whether you have (or had) the option of taking legal action instead
  • whether there are signs that the organisation potentially got things wrong that have had a negative effect on you that hasn't been put right

During this stage, our caseworkers will also check whether dispute resolution might be the right option for your complaint. Dispute resolution is way of resolving issues between two parties based on mediation techniques. Our team independently facilitates meetings between complainants and organisations to help them jointly agree on a complaint resolution.

How long does this take?

We aim to give you our decision within 20 working days of receiving your complaint.

What can we decide?

If we decide we should investigate your complaint, we will let you know what will happen next.

If we decide not to investigate your complaint, we will explain why. We will let you know if there are other options open to you and what these are.

To find out more about this step in our process, download our guide: Deciding whether to investigate (PDF 257KB).

Step 3 Investigating your complaint

What happens?

We'll talk to you about your concerns and what we're going to investigate. We'll tell you how long we think our investigation will take and we'll keep you regularly updated. We'll gather all the information we need, including from you and the organisation you have complained about, before we make our final decision on your complaint.

We might seek advice from clinical professionals at this stage. Find out more about how we use clinical advice to inform our decisions.

How long does this take?

We aim to complete most of our investigations within three to six months. More complex investigations may take longer than this, but we aim to complete 95% within a year.

What can we decide?

If we uphold your complaint it means that we found the organisation got things wrong and you have been negatively affected because of this. It also means things haven't been put right and we can recommend what the organisation should do about this.

Of the complaints we investigate each year, we uphold, in full or in part, around 50%.

To find out more about this step in our process, download our guide: What happens when we investigate (PDF 107KB).