An opportunity to improve

Annex B: When a patient raises feedback, concerns or a complaint

When a patient raises feedback, concerns or a complaint

1. Start by giving the patient the opportunity to raise feedback or discuss the issue with you face to face.

This could help to get things sorted quickly. If you choose to deal with a concern this way, you should aim to resolve it by the end of the following day.

2. If a concern cannot be sorted out by the end of the next day, then it has to be treated as a complaint.

Alternatively, the patient can raise the complaint with NHS England. Around 20% of people choose to complain this way.

3. If the patient is not happy with the final response received from either your practice or NHS England, then they can bring their complaint to the Parliamentary and Health Service Ombudsman.  

You should make this clear in your final response.

Download the leaflet: When a patient raises feedback, concerns or a complaint

Who can help?

Advocacy organisations such as the NHS Complaints Advocacy Service, is a free and independent service that can provide support when making a complaint. A list of organisations can be found here. 

NHS England is the organisation that commissions or pays for the services a practice provides. If an individual doesn’t feel comfortable complaining directly to the practice they can complain to NHS England. NHS England will investigate the complaint and  share the findings of the investigation with the individual and the practice. An appropriate apology and an explanation of what it has learned or changes that will take place as a result of the investigation will also be shared.

Your Patient Participation Group (PPG) acts as a ‘critical friend’ to their practice. Since April 2015 every practice is required to have a PPG. It is made up of patients and practice staff who communicate regularly to consider ways of making a positive contribution to the services and facilities offered by their practice to patients. The PPG should be diverse to ensure that the demographics of the practice population are represented.37 Anyone can join the PPG, but it is not for individuals to voice personal interests, resolve personal issues or to get additional personal medical service.

Parliamentary and Health Service Ombudsman is the second tier of the NHS complaints process. If an individual is unhappy with the response from their practice or NHS England and has completed their complaints process, they can refer it to the Parliamentary and Health Service Ombudsman, who is independent of the NHS and government. The Parliamentary and Health Service Ombudsman looks at every case individually, it will examine the issues that have been raised, and seek clinical advice where necessary, but will also look at how the original complaint was handled locally. 

If the complaint is upheld, the Parliamentary and Health Service Ombudsman can ask the organisation to say sorry, review its procedures, and in some cases, may ask the organisation complained about to make a financial payment to the individual affected. 

Healthwatch England is the national consumer champion for health and social care. It has links to communities across England through 152 local Healthwatch.  Healthwatch listens to concerns, directs individuals to sources of support and uses insight from people’s experiences to drive improvement in the delivery of services both in a local area and across England. In some areas local Healthwatch provides advocacy services directly for complainants, and elsewhere it can signpost to partner organisations that can help people with their complaints.  

Which other organisations have a role?

The Care Quality Commission is the independent regulator of health and adult social care in England. It makes sure health and social care services provide people with safe, effective, compassionate, high-quality care and encourage care services to improve. It will not investigate your complaint individually, but it will use the information you provide to inform its inspections. The Care Quality Commission will consider complaint handling when it inspects practices. 

The General Medical Council helps to protect patients and improve medical education and practice in the UK by setting standards. It can restrict or prevent doctors practising if it identifies serious concerns, but will not provide an apology, an explanation of what happened or why. 

37 The National Association for Patient Participation