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Thursday, 16 November, 2000, 14:57 GMT
How the NHS deals with complaints

In many instances, it is not appropriate to complain directly to the health regulatory bodies. In these cases, patients or their families can air their grievances through the NHS complaints process.

NHS Complaints Process

Any patient can make a complaint about the care they have received or the way they have been treated by NHS staff and organisations.

Under the existing system, patients or their families are expected to follow set procedures.

In the first instance, patients are advised to complain directly to the NHS staff member they are aggrieved with.

Patients should receive a response within 20 days. If they are not satisfied with their response, they can then complain to the Trust complaints manager or convenor or the manager of a GP practice or, in the case of GPs, the complaints convenor at the local health authority. This must be done within 20 days of the reply from the staff member.

The convenor can have the complaint reinvestigated and decide what action should be taken.

They must inform the patient of what action is being taken, if any, giving specific reasons within 20 days of receiving the complaint.

One of the steps the convenor can take is to establish an independent review panel to hear the case.

This panel is headed by a chairman who is appointed by the NHS Executive regional office.

The panel is appointed within four weeks and is supposed to complete its work within 12 weeks.

If the convenor refuses to appoint an review panel or if the patient is unhappy with the outcome of the panel's investigation they can complain to the health ombudsman.

The complaints process has come in for much criticism in recent years from NHS staff and patients not least because of delays in handling cases.

The government is working on plans to make the process more patient-friendly.

Community Health Councils

Community Health Councils were established in 1974 as part of a policy aimed at giving patients a greater say in how the NHS is run.

They are responsible for providing support to patients who have experienced problems or who have made a complaint concerning the NHS.

They also monitor the provision of service and care to patients throughout the NHS by carrying out studies and investigations.

They act as the patient's voice on consultations on local changes to the NHS, such as a Trust merger, and on government plans to reform the health service.

However, these councils are set to be abolished by 2002 and replaced by the Patient Advocacy and Liaison Service (PALS) under plans put forward by the government in July 2000.

Patient Advocacy and Liaison Service
The PALS was announced by the government in its national plan for the NHS in July 2000 and is expected to come on stream by 2002.

Under the plans, patient advocates will be appointed in every Trust and in other NHS services. They will act as an independent facilitator to handle patient and family concerns and will have direct access to the Trust chief executives, for instance, and will have the power to negotiate immediate solutions to problems.

These advocates will also be expected to guide patients and their families through the complaints process, where necessary.

Health Ombudsman

The Health Service Ombudsman investigates complaints about the NHS and is independent of both the government and the health service itself.

Patients can complain to this office if they believe that their complaint has not been addressed effectively through other channels.

The office can investigate complaints against hospitals or community health services.

The type of complaints it examines include those relating to poor service or failure to provide a service; allegations that staff did not follow proper procedures or were rude; and complaints about the care received from doctors, nurses and other health professionals.

The Ombudsman publishes an annual report detailing the number and type of complaints received and how they were dealt with.

There is no appeal against the ombudsman's decision although individuals can complain about how their case was handled.

Commission for Health Improvement

CHI was set up by the government in 2000 as an inspectorate for the NHS in England and Wales.

Its main functions are:

  • to inspect every hospital, health authority and general practice every four years to ensure they are following national guidelines and maintaining standards
  • to investigate "major system failures" - the Health Secretary can ask CHI to investigate a specific hospital

    Its overriding purpose is to make sure that health care is the safest and best quality it can be and to iron out the variation in standards across the UK.

    It can report serious findings about an individual hospital or GP surgery to the Health Secretary which or the Welsh Assembly who can then decide what further action needs to be taken, such as replacing the management team at that organisation.

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