Step 1 - What do you want to complain about?
Before you start, it is important to be clear for yourself what it is you want to complain about. This can be any aspect of the NHS care and services that you have received, but might include:

• treatment or care
• the attitude of staff
• poor communication
• waiting times
• lack of information
• failure to diagnose a condition.

Here are some “real-life” examples of recent complaints:

• an emergency ambulance took over an hour to arrive
• a patient was given incorrect information about a medical procedure and suffered pain as a result
• a GP refused to do a home visit
• an elderly patient frequently had to wait a long time for routine transport home from hospital appointments
• a patient felt that a nurse had treated him without respect.

Useful tip: write down now what you want to complain about as simply and clearly as you can so that you can refer back to it later.

Step 2 - What do you want to achieve?
Think about what you want to achieve. Your complaint is more likely to be dealt with smoothly if you can be specific and realistic.

Most people who complain to the NHS can expect:

• to be taken seriously
• an explanation of what happened
• an apology if appropriate
• changes to be made, so that the same thing will not happen to anyone else
• better communication between NHS staff and patients.

The NHS Complaints Procedure cannot be used for the following:

• financial compensation - this is usually possible only through legal action. You need to speak to a solicitor who specialises in medical or clinical negligence
• disciplinary action against any NHS staff member - however, this could happen under a separate procedure as a result of an investigation into your complaint
• private healthcare complaints – even as an NHS patient, you may receive service or treatment not funded by the NHS. If your complaint is about a private service you will need to use the complaints procedure that the private healthcare service operates
• NHS Foundation Trusts complaints - these Trusts have their own process for handling complaints at the first stage of a complaint. However, they do fall under the authority of the Healthcare Commission and the Health Service Ombudsman so the latter stages (2 and 3) of the NHS Complaints Procedure do apply
• care home and nursing home complaints - unless the service or treatment you are complaining about is funded by the NHS.

Step 3 - How should you go ahead?
Once you have got things clear in your mind, you need to decide how best to go about making a complaint. Many complaints are caused by misunderstandings that can quickly be put right once you explain the problem. You do not necessarily have to make a formal complaint to have your concerns addressed.

Are you in the middle of treatment or care? If so, you can speak to a member of staff responsible for the service you are unhappy about. This is often the quickest way to put things right and stop them getting worse. If you do not want to speak to a staff member yourself, or you have tried and have not got what you wanted, then a service called PALS (Patient Advice and Liaison Service) may be able to help you. PALS provides information, advice and support to patients, families and their carers and can help you raise your concerns informally. See the PALS section to find out how to contact PALS.

Making a formal complaint using the NHS Complaints Procedure may be the best route to follow if:

• what happened caused you distress or harm
• no investigation has yet taken place
• you have complained directly to staff but, in your view, their response was inadequate, unreasonable or incomplete
• what happened raises serious questions about standards of care
• you are uncertain about what happened and this could only be clarified by obtaining health records or clinical notes.

Making a complaint using the NHS Complaints Procedure may not be the best route to follow at this stage if:

• staff have listened to your complaint and you have already been offered a range of options to resolve what went wrong (for example, a meeting or second opinion about your treatment)
• staff have listened to your complaint and acted to put right any harm or damage you suffered
• staff have shown you how they have learned any lessons and reviewed their procedures and practice as a result of what happened to you.

To sum up:

• think about whether you have a complaint to make
• can you resolve the problem informally?
• think about the “pros and cons” of making a complaint which are most important to you
• what are the downsides?
• who else will be affected, and how?
• what information do you need to have or to get before you can decide whether to make a complaint?

Useful tip: You may find it useful to obtain a copy of the health records concerned (see the section called Access to Medical Records)