How To Complain About Medical Negligence

Before making a complaint, you might find it useful to talk to the Patient Advice and Liaison Service (PALS) at your local hospital. Your local PALS can tell you about the complaints process and what to expect. They can even help you resolve your issue informally.

To make a formal complaint about care you’ve received at an NHS dental practice, GP surgery or hospital, the following process applies:

1. Complaint: You make a verbal or written complaint to the surgery or hospital’s complaints department. If you’re complaining on behalf of someone else, include their written consent if possible.
2. Acknowledgement: You should expect an acknowledgement of your complaint, and the offer of a discussion to explain the process.
3. Initial Discussion: If you accept the offer of this discussion, you should find out roughly how long your complaint will take to investigate. There are no set time limits for answering your complaint.
4. Investigation: Your complaint is investigated. If you don’t hear anything within six months, they should tell you why the investigation has been delayed.
5. Response: When the investigation has been completed, you’ll get a written response from the surgery or hospital. Where they’ve found evidence of substandard care, you’ll get an apology. They should also tell you about the steps that’ll be taken to make sure the same thing doesn’t happen to someone else.
6. Appeal: If you’re unhappy with the response to your complaint, the response will also include information about how you can appeal.

If you’re not happy with the NHS Trust’s final response to your complaint, you can take your complaint to the Parliamentary & Health Service Ombudsman.

The Ombudsman won’t automatically investigate your complaint. They’ll let you know whether or not they will investigate.

The Ombudsman won’t normally look at a complaint that’s more than one year from when the incident negligence happened. However, if there’s good reason why your complaint has taken so long (for example if the hospital took a long time to respond to your complaint), then they may still look at it.

If your complaint is about privately-funded healthcare, you should complain to the healthcare provider first. You should ask for a copy of the healthcare provider’s complaints procedure so that you know what to expect, and that you can make your complaint in the correct way. As a starting point you can download our free private healthcare complaint template letter.

If you’re not happy to the response to your complaint from the healthcare provider, then you might be able to take your complaintto the Independent Sector Complaints Adjudication Service (ISCAS). Most private healthcare providers are signed up to ISCAS – you can find out if your provider is signed up on the ISCAS website.

Making a complaint about a private healthcare provider will also notify the Care Quality Commission (CQC). The CQC is the independent regulator of both NHS and private health and social care in England. They inspect private healthcare providers and may use your complaint as part of their inspection process.

Making a medical complaint and a compensation claim are two different things.

You don’t need to have been injured by the medical care you’ve received to make a complaint. To make a medical negligence claim however, we need to be able to prove that you‘ve suffered an injury because of the negligence.

It may well be the case that you’ve received negligent care, but have fortunately not been harmed as a result. In that situation you can’t make a compensation claim, but you could make a medical complaint.

There is some overlap between the two processes. Both will involve an investigation into what went wrong. You may get an apology for the care you received. And in both instances it gives the healthcare provider an opportunity to learn from what happened, and put in place measures to stop it happening again.

No. The rules that govern NHS complaints allow compensation claims to run side by side.

You don’t have to mention the fact that you’re also making a medical negligence compensation claim.

The outcome of your medical complaint will not necessarily be the same as the outcome of your medical negligence claim. This is because the two processes are independent of each other.

If you’re offered compensation as part of a complaint, you should get legal advice. It may be that the compensation amount offered is lower than what you’re entitled to.

You don’t have to make a complaint as well as a medical negligence claim if you don’t want to. The fact that you haven’t also complained will have no bearing on your claim.

If you’re concerned about medical treatment you’ve received from an NHS healthcare provider in Wales, you can make a complaint through the ‘Putting Things Right’ system. This is a complaints procedure in Wales which is available to those who have concerns about NHS funded treatment in Wales.

Through ‘Putting Things Right’, your concerns should either be investigated, or you should receive an apology or information on how the services will be improved. Some key things to consider if you want to follow this procedure are:

• To engage with this process, you should make a complaint to the Health Board’s concerns team. You can find the concerns team’s contact details on each Health Board’s website.
• If your concern is about the care you received from a GP, dentist or pharmacist, you can raise a complaint directly with the healthcare provider, or to the appropriate Health Board. If you complain directly to the Health Board, they may refer the complaint to the healthcare provider to investigate, if they think it’s appropriate.
• You can raise your complaint verbally or in writing. If you need help making a complaint, your local community health council (CHC) should be able to assist, free of charge.
• You should raise your complaint within 12 months of the event, or sooner if possible. If you have valid reasons for making a complaint more than 12 months after the incident, the Health Board will decide whether to investigate.
• Once you’ve raised your complaint, you should receive an acknowledgement within two working days.
• You should receive a response to your complaint within 30 days of the date you made it. However it can sometimes take longer for the Health Board to consider your complaint. If the Health Board cannot respond within 30 days, they should give you an explanation for the delay and keep you up to date with your complaint’s progress.
• After completing their investigations, the Health Board may offer you an apology, offer you information about on how they’re improving their services or offer to investigate your claim under the NHS Redress Scheme.
• If the Health Board believes you’ve received care which fell below a reasonable standard of care, and that you’ve suffered an injury because of this, they should investigate your complaint. This is investigated under the NHS Redress Scheme, an internal complaints procedure within Welsh Health Boards.
• The Health Board will investigate claims under the value of £25,000. You’ll need to contact a solicitor to help you with the claim. The Health Board should meet the cost of your legal fees. An investigation under this scheme can result in you receiving a compensation settlement. If the Health Board believes you’ve been harmed but the value of your claim is more than £25,000, they should advise you to contact an independent solicitor.
• If you’re unhappy with the outcome of the Health Board’s investigation, you can submit a complaint to the Public Services Ombudsman. They can review and potentially investigate the Health Board’s decision to identify issues with the care you received. They can also ask the Health Board to re-consider their response.