The Care Quality Commission regulates health and adult social-care services in England. Patient information can help it identify risk and decide when and where to inspect or take regulatory action.
CQC is not the ordinary body for securing an individual explanation, apology or award. Keep the provider, commissioner and PHSO complaint route moving where personal resolution is required.
Key points
- CQC regulates services rather than deciding most individual complaints.
- It welcomes information about safety and quality.
- It cannot make a complaint for you or take it forward on your behalf.
- Use the NHS complaint route for personal resolution.
- CQC has a particular route for certain Mental Health Act complaints.
Role
CQC regulates services, not individual complaint outcomes
CQC is the independent regulator of health and adult social care in England. It registers, monitors and assesses services, including GP services, hospitals, clinics, dentists, mental-health services, care homes and home-care providers.
Information from patients can influence regulatory work. CQC does not ordinarily take an individual complaint forward on the person's behalf or award personal redress.
Use CQC
When information may be useful to CQC
- Unsafe or poor-quality care that may affect other people.
- Repeated failures suggesting a wider service pattern.
- Staffing, safeguarding, medicines or governance concerns.
- A provider failing to meet fundamental standards.
- Concerns about use of the Mental Health Act within CQC's specific complaint role.
Keep complaint route
Do not substitute CQC for the provider complaint
If you want a response, investigation, apology, correction or personal remedy, use the provider or commissioner complaint route. If that eligible NHS complaint remains unresolved, consider PHSO. CQC information can run alongside those routes where it is relevant to wider quality or safety.
Evidence
Make the information usable for regulation
- Identify the service, location and dates.
- Describe the event or pattern factually.
- Explain the actual or potential safety impact.
- Identify supporting records and whether the provider has investigated.
- State whether the risk is continuing or affects other people.
- Avoid sending unnecessary confidential information about unrelated people.
Limits
What CQC cannot usually do for the individual
| CQC can | CQC does not ordinarily |
|---|---|
| Use information to plan regulatory activity | Act as the person's complaint representative |
| Inspect and assess registered services | Decide compensation or contractual refunds |
| Take regulatory action where its legal powers and evidence justify it | Replace the provider, ICB or PHSO complaint route |
| Handle certain Mental Health Act complaints | Resolve every disagreement about clinical judgement |
Prepare the referral
Present a regulatory concern, not a second complaint
A referral to the Care Quality Commission (CQC) should explain why the facts engage that regulator's public-protection role. Start with the alleged conduct or service risk, not the length of the local dispute. Identify the evidence, seriousness, repetition and whether the risk may still be current.
Keep requests for a personal explanation, apology, correction or financial remedy within the complaint or legal route that can provide them. The same evidence can be relevant to both routes, but the question for each decision-maker is different.
- Identify the regulated person or service. Give the name, location, registration details and relevant dates where known.
- State the concern concisely. Describe the act, omission, pattern or risk in neutral language and separate direct knowledge from inference.
- Explain regulatory significance. Connect the facts to safety, fitness to practise, service quality or public confidence rather than ordinary dissatisfaction.
- Attach primary evidence. Use records, decisions and correspondence that establish the concern. Index the documents and avoid an unfiltered file dump.
- Disclose related proceedings. Identify provider complaints, employer investigations, ombudsman work, police involvement or litigation where relevant.
- Protect deadlines elsewhere. Do not assume the regulator will preserve a complaint, ombudsman or court time limit.
After submission
Understand triage, evidence and possible closure
A regulator may seek more information, refer an issue locally, open an investigation or close it at an early stage. Closure does not necessarily mean the reported event did not happen. It may mean the information falls outside the remit, does not meet the regulatory threshold, is too historic to investigate fairly or is better handled by another body.
Read the reasons carefully. If material evidence was missed, identify the document and the point it proves. If the reasons show that the concern is an individual complaint rather than a regulatory matter, return to the provider, commissioner, ombudsman, data or legal route instead of resubmitting the same narrative under a different label.
| If you need | Keep using |
|---|---|
| An explanation, apology or correction | Provider or commissioner complaint |
| Independent review of an eligible unresolved NHS complaint | PHSO |
| Action about serious professional or service risk | The relevant regulator |
| Access to records or data-rights enforcement | Provider data route and, where appropriate, ICO |
| Damages for injury or financial loss | Specialist legal advice and the appropriate civil route |
Referral checklist
Check the file before sending
- The correct regulator and regulated person or service have been identified.
- The opening paragraph explains the regulatory concern in plain language.
- Each important fact has a date and a supporting source.
- The file distinguishes direct evidence, reported information and inference.
- The public-protection or service-safety significance is explained without exaggeration.
- Irrelevant personal and third-party information has been removed or redacted.
- Parallel routes, decisions and imminent deadlines are disclosed.
- The submission asks only for action within the regulator's powers.
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.