Hospital and clinic complaints

Hospital complaints often contain several different failures: clinical care, nursing care, medication, communication, discharge planning, records, appointments and complaint handling. A single narrative can make those issues disappear into one general answer.

Use PALS for immediate practical help where appropriate, but state clearly when you want a formal complaint, a documented investigation and a final response.

Key points

PALS contact is not automatically a formal complaint.
Complain to the NHS trust/provider or the commissioner, normally the ICB, but not both for the same complaint.
Ask who will lead where a GP, hospital, ambulance or community service is also involved.
Separate clinical findings from administrative and complaint-handling failures.
PHSO is the final external complaint route for eligible unresolved NHS hospital complaints.

Immediate or formal

PALS, ward resolution or formal complaint?

Need	Route
A current ward, appointment or communication problem needs practical action	Staff, service manager or PALS
A documented investigation and final response are required	Formal trust complaint
You do not feel able to complain directly to the trust	Commissioner complaint through the ICB
The final NHS response does not resolve the complaint	PHSO where eligible

Scope

Break the hospital complaint into answerable issues

Number each issue and identify the relevant period, team and evidence. If the complaint concerns a clinical decision, ask what information was considered, what alternatives were considered, which guidance or accepted practice was relevant and why the conclusion was reached.

Assessment and diagnosis.
Medication and monitoring.
Nursing care, observations and escalation.
Consent and communication.
Surgery, procedure or follow-up.
Discharge planning and handover.
Appointments, referrals and administrative tracking.
Records, duty of candour and complaint handling.

Cross-organisational care

Do not let the complaint fall between services

Where care crossed a GP, ambulance service, hospital and community team, identify the full pathway. Ask the organisations to coordinate, name the lead body and answer the handover questions. A complaint should not be fragmented so thoroughly that nobody investigates the central failure.

Evidence

Build a record that another clinician can follow

Admission, outpatient, operation and discharge dates.
Letters, test results, medication records and care plans.
Names or roles of staff where known.
Contemporaneous patient or family notes.
PALS contacts, formal complaint scope and updates.
Evidence of the practical and health impact.

Parallel routes

Regulation, safeguarding and legal advice

CQC information can inform regulation of the service but does not replace the individual complaint. Serious concerns about a doctor may reach the GMC threshold. Concerns about nurses, midwives or allied professionals may belong with their own regulator. A possible clinical-negligence claim has different legal tests and limitation rules.

Prepare the complaint

Turn what happened into issues that can be investigated

A useful hospital and clinic complaint is not simply a long account of a distressing experience. It gives the investigating body a controlled set of questions, the evidence needed to answer them and the outcome requested for each one. This helps prevent the response from dealing only with the easiest point.

Start with a short summary stating who received care, the service and location, the period involved, the main alleged failings and the effect on the patient. Follow it with a numbered issue list. Keep the chronology and evidence bundle separate so that the complaint remains readable.

Define the scope. Identify the provider, service, location, clinicians or teams and the dates covered. Say expressly if other treatment is outside the complaint.
State each issue. Use one numbered heading for each disputed act, omission or decision. Separate clinical care, communication, access, records and complaint handling.
Give the factual basis. Link each issue to a dated entry, letter, message, witness account or other record. Where something is an inference, label it as such.
Ask an answerable question. Ask what happened, what standard or process applied, why a decision was made and what evidence supports the conclusion.
Request a proportionate outcome. This may include an explanation, correction, apology, review, practical action, learning or a referral to another route.
Keep urgent care separate. A complaint does not arrange treatment or manage immediate risk. Use the clinical or emergency route needed now while preserving the complaint record.

Evidence

Build a compact health complaint bundle

Medical files can become large very quickly. Sending every record without an index can conceal the important evidence. Keep the original records intact, then create a smaller working bundle containing the material necessary to decide the numbered issues.

Bundle item	What to record	Why it matters
One-page case summary	Service, period, central issues, impact and requested outcomes	Lets the investigator understand the case before opening attachments
Chronology	Date, event, person or team, source and significance	Shows sequence, delay, escalation and handovers
Issue schedule	Issue, evidence, respondent position, unanswered point and remedy	Stops distinct allegations being merged or overlooked
Key clinical records	Relevant notes, results, referrals, prescriptions, discharge or care plans	Provides the contemporary record while keeping the bundle proportionate
Communications	Letters, portal messages, call notes and appointment information	Tests what each party was told and when
Impact evidence	Further care, expense, time, symptoms and practical consequences	Connects the failing to the injustice or remedy claimed

If a record appears inaccurate, quote the exact entry and explain whether you seek correction of inaccurate personal data, the addition of a patient statement, or an investigation into the underlying care. A difference of clinical opinion is not always a factual data error.

Writing

Ask precise questions and realistic outcomes

A complaint is easier to investigate when each allegation is followed by the question that would resolve it. Avoid asking the recipient to prove that the entire service was lawful or safe. Ask for the policy, clinical reasoning, record or decision relevant to the specific event.

Weak formulation	Stronger formulation
You ignored me and broke NHS rules.	Please explain why the concern recorded on 4 May was not assessed until 9 May, identify the process that applied and address the clinical effect of that delay.
The notes are lies.	The entry dated 12 June states that I declined the appointment. I attach the message accepting it. Please investigate the discrepancy and explain how the record will be corrected or annotated.
I want everyone disciplined.	Please investigate the identified conduct, explain the findings and state what proportionate action or learning follows. I understand confidential employment action may not be disclosed.
Pay compensation immediately.	Please address the evidenced financial loss and avoidable impact, state what local remedy is available and explain any separate legal route that must be used.

The outcome must fit the body's powers. A provider can explain and improve its service. PHSO can investigate eligible unresolved complaints and make recommendations. A professional regulator protects the public. A court determines a legal claim and damages.

Response audit

Test whether the final response actually resolves the complaint

A long response is not necessarily a complete one. Audit it against the numbered complaint rather than reacting only to its conclusion. Make a table showing whether each issue was upheld, partly upheld, not upheld or not addressed, together with the evidence and reasons relied on.

Does the response identify the complaint scope and the evidence considered?
Does it answer every numbered issue and distinguish fact from clinical opinion?
Where accounts conflict, does it explain which evidence was preferred and why?
Does it address the impact on the patient, not only whether staff followed a process?
Are apologies, corrections, reviews and service-learning actions specific and measurable?
Does it give the correct next route and explain any applicable time limit?
If the investigation was delayed, were reasons and meaningful updates provided?

If a material issue is missing, identify it by its original number and ask for a focused supplementary response. Do not restart the entire narrative. If local resolution is complete or further correspondence would add nothing, prepare the external referral around the unresolved issues and injustice.

Escalation

Use parallel routes without confusing their jobs

One event may justify more than one route, but that does not turn the bodies into interchangeable appeal stages. Keep a route table showing the question asked of each body, the outcome it can provide, the submission date and the next deadline.

Route	Use it for	Do not expect it to
Provider or commissioner	Investigation, explanation, apology, correction, local remedy and learning	Decide a court claim or professional fitness to practise
PHSO	Eligible unresolved NHS service failure or maladministration causing injustice	Act as an emergency clinical service or replace legal advice
CQC	Information relevant to safety and quality of regulated services	Take most individual complaints forward or award personal compensation
Professional regulator	Serious concerns about fitness to practise and public protection	Resolve routine dissatisfaction, waiting times or ordinary refunds
ICO or data route	Information rights and compliance with data-protection law	Determine whether clinical treatment was negligent
Legal claim	A pleaded cause of action and legally recoverable remedy	Pause merely because a complaint or regulator report is underway

Tell each body about material parallel proceedings and keep the factual chronology consistent. Do not allow a complaint, PHSO referral or regulatory report to obscure a separate statutory, contractual or court deadline.

Practical questions

Common questions before and after sending

Can someone complain for the patient?

Often yes, with the patient’s authority or another lawful basis. The organisation may need consent or evidence of authority and must still protect confidential information. Different considerations can apply where the patient is a child, lacks capacity or has died.

Must the complaint be made on a special form?

Usually the substance matters more than the format. Use the provider’s published route where practical, keep proof of submission and make clear that the message is a formal complaint under the NHS complaints arrangements where that framework applies.

Can a late complaint still be considered?

The ordinary NHS local complaint limit is 12 months from the event or from later awareness. The responsible body has discretion to consider a later complaint where there was good reason for delay and it remains possible to investigate fairly.

Is there a fixed final-response deadline?

The Regulations require timely and efficient handling but do not impose one universal 25, 28 or 60 working-day deadline for every complaint. The organisation should discuss handling and timescales, keep the complainant informed and explain delay.

Should I name individual staff publicly?

Use names where necessary in the confidential complaint and evidence. Public identification can create privacy, fairness and legal risks, particularly while facts remain disputed. Send relevant information to the body able to investigate it.

What if the patient needs care from the same service?

Say that clearly and ask for communication arrangements, reasonable adjustments or a contact who is separate from the disputed events. A complaint should not be allowed to interrupt clinically necessary care, but an alternative provider cannot always be guaranteed.

Official sources

Check the current rules behind this guide

This guide focuses on England. Health complaint structures, regulators and ombudsmen differ elsewhere in the UK. Official contacts, procedures and service responsibilities can change, so check the live source before relying on a deadline or route.