Free NHS complaints advocacy in England

What is NHS complaints advocacy?

NHS complaints advocacy is an independent support service for people who are making, or considering making, a complaint about NHS healthcare in England.

Its purpose is to help someone understand and use the NHS complaints process and to make sure they can communicate their concerns effectively.

The service is free.

NHS England says free help from an NHS complaints advocate is available at any stage of the complaints process. It is therefore possible to ask for advocacy before a complaint has been written, while an investigation is underway or later in the process if additional support becomes useful.

Is NHS complaints advocacy independent?

Yes.

The statutory arrangements are specifically for independent advocacy services.

The Health and Social Care Act 2012 requires local authorities to arrange these services and says that, as far as practicable, their provision should be independent of the person who is being complained about or who is involved in investigating or deciding the complaint.

This is an important distinction from support that may be available within the NHS organisation itself.

Who can use NHS complaints advocacy?

The service is for people who are making, or intend to make, a complaint in relation to NHS health services.

NHS England’s current guidance says the service is free to people making complaints about their NHS treatment or care and should also cover NHS-funded care provided in independent hospitals or services.

A person does not need to have written a formal complaint before contacting an advocate.

What can an NHS complaints advocate help with?

An advocate can help someone navigate the complaints process without taking over the underlying decision about what happened.

Depending on the support needed and the local service, advocacy can include help with:

• understanding the NHS complaints process;
• identifying the main issues that need to be raised;
• organising events and concerns into a clear sequence;
• writing or preparing a complaint letter;
• understanding correspondence from the NHS;
• preparing for meetings;
• attending meetings with the person making the complaint;
• considering what questions remain unanswered; and
• understanding the available next steps within the complaints process.

NHS England specifically identifies help with writing a complaint letter and attending meetings as examples of what an advocate can do.

What can’t an NHS complaints advocate do?

An NHS complaints advocate does not:

• investigate the healthcare itself;
• decide whether the NHS organisation was at fault;
• determine whether there was clinical negligence;
• provide medical advice;
• provide legal advice about a clinical negligence claim;
• guarantee that a complaint will be upheld; or
• make the complaint instead of the person who wishes to complain.

NHS England expressly says an advocate can help write the complaint and attend meetings but cannot make the complaint for the person or give medical or legal advice.

Can an advocate come to meetings with me?

Yes. NHS England identifies attending meetings as one of the ways a complaints advocate can provide support.

That can be useful where someone finds the complaints process difficult to navigate, wants help keeping the discussion focused or wants another person present who understands how the process works.

The advocate’s role is to support the complainant rather than to become the NHS investigator or decide the outcome.

How do I find my local NHS complaints advocacy service?

There is not one national advocacy organisation covering every part of England.

Local authorities arrange NHS complaints advocacy services for their areas, and different organisations can provide the service in different places. The statutory framework allows local arrangements rather than requiring one national provider.

NHS England recommends either:

• searching for ‘NHS complaints advocacy’ in the local area; or
• contacting the local Healthwatch, which can identify who provides the advocacy service locally.

When should I contact an advocate?

There is no need to wait until the complaint has gone wrong.

An advocate can be contacted:

• before the complaint is written;
• while deciding what issues to raise;
• after the complaint has been submitted;
• while an NHS investigation is underway;
• before a complaints meeting; or
• after receiving a response where help understanding the next stage would be useful.

NHS England says it is never too late to ask for advocacy help during the complaints process.

Does using an advocate affect the complaints deadline?

No.

Using NHS complaints advocacy does not create a different time limit for making the underlying complaint.

The ordinary NHS complaints rules still apply. In England, complaints should normally be made within 12 months of the event or, if later, when the matter came to the person’s attention, subject to the rules allowing a late complaint to be considered in appropriate circumstances.

Does advocacy protect a clinical negligence deadline?

No.

NHS complaints advocacy concerns the NHS complaints process. A clinical negligence claim is a separate civil legal process.

Contacting an advocate, making an NHS complaint, attending complaints meetings or waiting for the NHS response does not by itself stop the limitation period for a clinical negligence claim.