Complaining about NHS care in England

How do I complain about NHS care in England?

Anyone providing an NHS service in England must have arrangements for dealing with complaints.

A complaint can be about NHS care, treatment or another aspect of an NHS service. It can concern something that happened, something that was not done, communication, delays, the way a decision was made or another concern about the service received.

Often the simplest first step is to raise the issue directly with the service involved. Some problems can be dealt with quickly without needing a longer formal investigation.

Should I complain to the healthcare provider or the commissioner?

For NHS-funded services, there are generally two possible routes:

• complain directly to the provider that delivered the care; or
• complain to the commissioner responsible for the NHS service.

For example, the provider might be a hospital trust, GP practice or dental practice. The commissioner is the NHS body responsible for arranging and funding the relevant service.

Current NHS England guidance says that for the same complaint you choose between complaining to the provider and complaining to the commissioner; you do not submit the same complaint to both routes at once.

What is an integrated care board?

An integrated care board, usually shortened to ICB, is an NHS organisation responsible for planning and funding most local NHS services in its area.

For complaints made to the commissioner, current NHS England guidance directs people to their local ICB for services including:

• GPs;
• dentists;
• opticians;
• pharmacies;
• ordinary hospital services;
• mental-health services;
• out-of-hours services;
• NHS 111; and
• community services such as district nursing.

When would a complaint still go to NHS England?

NHS England still directly commissions some healthcare services during 2026/27.

Its current patient guidance identifies examples including:

• healthcare in prisons and other health-and-justice settings;
• military healthcare; and
• certain specialised services for rare or complex conditions.

A complaint about one of those services can therefore fall within NHS England’s own complaints arrangements rather than the ordinary local ICB commissioner route.

How can I make the complaint?

Under the NHS complaints regulations, a complaint can be made:

• orally;
• in writing; or
• electronically.

If a formal complaint is made orally, the organisation must make a written record of it and provide a copy to the complainant.

It can help to set out:

• what happened;
• when and where it happened;
• which service or staff were involved, where known;
• how the events affected the patient;
• which questions remain unanswered; and
• what outcome or explanation is being sought.

How long do I have to make an NHS complaint?

The general rule in England is that a complaint should be made within 12 months of:

• the date of the matter complained about; or
• if later, the date when the matter came to the complainant’s attention.

That is not an absolute cutoff.

The complaints regulations allow a late complaint to be considered where the organisation is satisfied that:

• there were good reasons for not complaining within the ordinary period; and
• despite the delay, it is still possible to investigate the complaint effectively and fairly.

What happens after the complaint is received?

The organisation should normally acknowledge a formal complaint no later than three working days after the day it receives it.

At acknowledgement, the complaints regulations require the organisation to offer to discuss:

• how the complaint will be handled; and
• the period within which the investigation and response are expected to be completed.

If the complainant does not want that discussion, the organisation must determine the response period and tell them what it is in writing.

How long should the NHS take to answer?

There is no single fixed deadline that says every NHS complaint must receive its final answer after the same number of days.

The expected response period should be discussed or communicated at the beginning of the process, taking account of the complaint and the investigation required.

During the investigation, the organisation should keep the complainant informed about progress as far as reasonably practicable.

The regulations contain an important six-month safeguard. If the final response has not been sent within six months of receipt, or within a longer period agreed before the six months expires, the organisation must write to explain the delay and then provide its response as soon as reasonably practicable.

What should the final response contain?

Once the investigation is complete, the organisation must send a written response explaining how the complaint was considered and the conclusions reached.

The response should address any remedial action identified and say whether action required because of the complaint has been taken or is proposed.

For NHS complaints, the response must also explain the right to take an unresolved complaint to the Parliamentary and Health Service Ombudsman.

What if my complaint involves more than one NHS organisation?

A complaint can involve several organisations — for example a GP, ambulance service and hospital.

The complaints regulations require relevant organisations to co-operate where a complaint crosses organisational boundaries.

That includes seeking to agree which organisation should lead the handling of the complaint and communication with the complainant, exchanging relevant information and working towards a co-ordinated response.

Can I get independent help with an NHS complaint?

Yes.

Free, independent NHS complaints advocacy is available in England.

An advocate can help someone understand the complaints process, organise what they want to say, prepare a complaint letter and attend meetings.

NHS England’s current guidance says advocacy can be used at any stage of the complaints process.

The provider varies by local area. A local Healthwatch can help identify the NHS complaints advocacy service serving that area.

What is PALS?

PALS stands for Patient Advice and Liaison Service.

PALS is commonly available through hospitals and can provide confidential advice, support and information.

It can be particularly useful where there is a concern that needs addressing while care is still being provided — for example an immediate communication or treatment problem in hospital.

PALS can also explain the NHS complaints procedure and tell someone where independent complaints support is available.

What if I am still unhappy after the NHS has answered?

The Parliamentary and Health Service Ombudsman (PHSO) is the independent final-stage complaints body for unresolved complaints about the NHS in England.

The Ombudsman will usually expect the NHS organisation to have had the opportunity to deal with the complaint first.

A complaint can normally be brought to PHSO after the organisation’s final response where the problem remains unresolved.

PHSO also says that a person can approach it where their NHS complaint has not been dealt with after six months.

Is there a time limit for going to the Ombudsman?

Yes.

For NHS complaints in England, PHSO says the complaint should be brought to it within one year of when the person became aware of the problem being complained about.

The Ombudsman can sometimes make an exception where there is a good reason for delay, but that should not be assumed.

Does making an NHS complaint affect a clinical negligence claim?

A complaint and a clinical negligence claim can arise from the same healthcare, but they serve different purposes.

A complaint can help obtain an explanation, identify what went wrong, record an apology or learning, and produce useful investigation material.

A clinical negligence claim asks separate legal questions about breach of duty, causation and the injury or loss attributable to the negligence.