This guide will help you understand:
- the different types of support available to people who make a complaint about their (or another person’s) NHS care and treatment, including:
- an independent NHS Complaints Advocacy service
- specialist independent advice and support services
- the aims of these different services and when and how to signpost people to them
- the value of involving an advocate or specialist advice service and how they can help people who are faced with difficult decisions – particularly where there are other processes that may be an alternative to, or run in parallel with, a complaint.
Read this guide alongside the Model Complaint Handling Procedure. You can find guides on related topics on our website.
Step 1 What standards and regulations cover NHS complaints?
- The Complaints Standards set out expectations to help you deliver good complaint handling in your organisation.
- The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 set out what the law says you must do.
- Other relevant guidance includes Care Quality Commission guidance of duty of candour and NHS England’s Serious Incident Framework.
What the Complaint Standards say
Positively welcoming complaints
Organisations make sure people know how to access advice and support to make a complaint, including giving details of appropriate independent complaints advocacy and advice providers, any Patient Advice and Liaison Service (PALs), and other support networks.
Organisations make sure staff are able to identify when issues raised in a complaint are likely to be addressed (or are being addressed) via another route, so a co-ordinated approach can be taken. Other possible routes include inquest processes, a local disciplinary process, legal claims or referrals to regulators. Staff know when and how to seek guidance and support from colleagues and are able to provide people with information on where they can get support.
What the Local Authority Social Services and National Health Service Complaint (England) Regulations 2009 (regulation 3) say
Your organisation ‘must make arrangements … for the handling and consideration of complaints.’ The arrangements must ensure that: … ‘complainants are treated with respect and courtesy’ … that they receive ‘so far as is reasonably practical – assistance to enable them to understand the procedure … or advice on where they may obtain such assistance’.
What other guidance says
Duty of candour
The Care Quality Commission’s guidance on the duty of candour says that organisations should give people going through the procedure information about ‘available impartial advocacy and support services, their local Healthwatch and other relevant support groups, for example Cruse Bereavement Services and Action against Medical Accidents (AvMA).’
Serious incident investigations
NHS England’s Serious Incident Framework recommends that organisations should make patients or families involved in investigations aware of sources of independent advice and advocacy, including the national charity Action against Medical Accidents (AvMA).
Step 2 How to do it
This section sets out two different types of advocacy available to your service users or their families or representatives:
- the NHS Complaints Advocacy Service
- specialist independent advice and support.
NHS Complaints Advocacy
NHS Complaints Advocacy is a free, independent, impartial service funded by local authorities. It is designed to guide anyone wanting to complain about their (or another person’s) NHS care and treatment through the process of complaining to the appropriate NHS organisation.
Everyone in your organisation who has a public-facing role needs to be aware of who your local independent NHS Complaints Advocacy provider is. That way, they can quickly signpost anyone who wants to make a complaint to help and support, if they need it. If you’re not sure who your provider is, check with your local authority or Healthwatch.
They can also help you understand what their service offers, as services can vary from area to area. This will help you:
- the NHS Complaints Advocacy Service
- specialist independent advice and support.
- Try to establish a relationship with your local NHS Complaints Advocacy Service team. It is a valuable source of information about the needs of your service users and the local population.
- make sure you provide correct information about the advocacy service to anyone wanting to make a complaint
- refer people who want to make a complaint for advocacy support directly, where appropriate
- secure early resolution of complaints by making sure people making a complaint are guided through the process and fully understand their options
- help people who want to make a complaint to access advocacy rapidly, so they are supported as early in the process as possible.
- shape local arrangements for advocacy, including working with commissioners.
Tips: share details
Share the advocacy service’s contact details in posters and information leaflets about your own complaints service.
Also share leaflets about the service, or links to the service, in your letters. This makes it clear that the service is independent and separate from your organisation.
NHS Complaints Advocacy providers can also signpost and cross-refer to other helpful advocacy and specialist support services.
Step 3 Case study 1
What was the complaint about?
Josephine* died in hospital because of a nosebleed, which caused choking. Her daughter, made a complaint because she felt that her mother’s treatment had been inappropriate.
Shelley was not informed about advocacy until she received the response to her complaint. Information about advocacy was provided at the end of the letter, and incorrectly signposted her to the previous service provider. The complaint response letter did not answer all the points Shelley had raised, and she and the family felt ongoing distress about the way Josephine had died.