Complaints about care and health services

There can be many reasons why you might want to make a complaint. You want to complain because:

• you're experiencing delays to services or cancellations for no good reason
• you feel that there has been a lack of communication or information
• you're concerned about the quality of the services you're receiving
• you've received poor treatment from staff
• you're worried that the assessments of your health or care needs are not good enough
• you have been refused a care needs assessment
• you have had to wait a long time for equipment or adaptations to be put in place
• you don't think your personal budget is high enough to meet your needs
• your needs have changed while you've been waiting for an assessment and you need help urgently
• you've experienced changes or reductions to your care.

You have a right to complain about poor care. It can be a way to:

• get an apology
• find out what went wrong and why
• make sure it doesn’t happen again – to you or someone else.

If you’re unhappy with an ongoing situation or a particular incident, don’t be afraid to speak out. Organisations need to know if there’s a problem, and they usually prefer to be told so that they can resolve it.

It's a good idea to discuss things informally with the organisation or staff providing your care first. In most cases, having an informal conversation is enough to put things right. 

You can speak with the individual concerned, another member of staff or the manager. If you're not comfortable doing this yourself, you can ask someone else to do this on your behalf, such as a friend or relative.

If you’re not happy with the response or the problem continues, you may want to make a formal complaint. All health and social care services must have a complaints procedure. Ask the service you want to complain to for a copy. It should be available in different formats, such as a leaflet or online.

You – or a friend or relative – can complain by:

• phone
• email
• letter
• using an online form.

You must receive written or verbal acknowledgement of your complaint within three days, which will also tell you:

• what will happen next
• how long the initial investigation will take
• who will contact you
•  how long it will take to respond to your complaint.

When you complain, you should:

• make it clear that you are making a formal complaint
• give a clear, concise account of what happened or went wrong
• include all relevant facts, such as dates, times and names
• explain what you want to happen as a result of your complaint
• attach copies of any relevant letters or documents – keep the originals
• try to stay polite and professional, even if you feel angry or upset
• keep a record of the name and job title of anyone you speak or write to.

If any action is promised or a decision made, ask for written confirmation.

You should make your complaint as soon as possible. If you live in England or Wales, you'll usually have 12 months from the date of the incident, or when you became aware of it, to make your complaint. In Scotland, you should make a complaint within six months of the reason for the complaint (or of you becoming aware of the reason for the complaint).

If you’re considering legal action (see below), you'll have to act more quickly. For example, if you're applying for a judicial review, it must be done within three months. So it’s important to get specialist advice as soon as possible.

If the NHS is taking longer than six months to respond, they must give you a reason for the delay and let you know when they are likely to respond. For social care complaints, you should receive a response within a specific timeframe, depending on where you live:

• England – within 12 weeks unless it's a complex case
• Scotland – within five working days
• Wales – within 10 working days.

Complaints about social care services

Care at home

Try to resolve the issue with the care agency first. If you arranged care privately, ask for a copy of the agency’s complaints procedure.

Care in a care home

If you're unhappy with your care, you – or a friend or relative – should first talk to the home manager or matron of the care home and try to find a way to resolve the complaint. Ask them for a copy of the home’s complaints procedure.

If you arranged or paid for care privately through an agency or organisation, you can make a complaint directly to them. If your care was arranged or paid for by your council, you can make a complaint using the council’s complaints procedure. To find details of your local council, go to Gov.uk.

You can also report your concerns about private home care agencies or care homes to the Care Quality Commission (England only). In Scotland, contact the Care Inspectorate, and in Wales, contact Care Inspectorate Wales.

They don’t investigate individual complaints but can check that the agency or care home is dealing with it. In more serious cases, they may carry out an inspection, or use your evidence if the agency is being inspected at that time.

If you’re concerned about something that is beyond the care home’s control – such as the amount the council is prepared to pay towards the care home’s fees, or the accuracy of the information – you may want to consider applying for a judicial review. 

Complaints about health services

NHS services

If you want to complain about NHS services, you can complain directly to the service. Ask the organisation that provided your care for a copy of their complaints policy and the name of the person you should direct your complaint to.

If you don’t want to approach the healthcare provider directly, you can complain to the commissioner of that service.

To complain about primary care services such as your GP, a dentist, an optician or a pharmacist, contact the relevant health authority for your country:

England – NHS England

Scotland – the Local Health Board (LHB) – you should only contact them in exceptional circumstances

Wales – the LHB

If you are complaining about secondary services, such as hospital care, mental health services or out-of-hours services, for example, you should contact the local Integrated Care Board (ICB) in England, or the LHB in Scotland and Wales. You must not complain directly to the service and also contact the board – if you do this, the board will likely disregard your complaint.

Private healthcare

If your complaint is about private healthcare that you are funding yourself, you'll need to complain directly to the healthcare provider. Each private healthcare provider should have their own formal complaints procedure. 

If you’re not happy with their response, you can contact the Independent Healthcare Sector Complaints Adjudication Service in England. In Scotland, contact Healthcare Improvement Scotland, a regulatory body for private healthcare services. If you live in Wales, you can share your concerns with the Healthcare Inspectorate Wales, which makes sure that healthcare services are meeting set standards.

If you’re receiving treatment from a private healthcare provider but it is funded by the NHS, you should go through the NHS complaints procedure. 

Complaints about both social care and health services

If you need to complain about both NHS and social services, you only need to make your complaint to one organisation. That organisation must contact the other service to decide who will take overall responsibility for dealing with your complaint.

If you want to complain about an individual care or health professional, you can contact their professional body.

If you’re not happy with the outcome of your complaint to the NHS, a council or a care provider, you can take it further. The next step depends on the type of service and how your care is funded.

Ombudsman

You should approach the relevant Ombudsman within 12 months of the incident happening, or of when you became aware of the problem.

For complaints about NHS services, contact the Ombudsman for your country:

• England – Parliamentary and Health Service Ombudsman (PHSO)
• Scotland – Scottish Public Services Ombudsman (SPSO)
• Wales – Public Services Ombudsman for Wales. (PSO).

You can also contact the services above if you're paying for your care yourself and you're not happy with the care provider's response.

Judicial review

You can apply for a judicial review if you want to challenge the way a decision was made – for example, if you think the law wasn’t correctly applied or the right procedures were not followed. The charity Public Law Project has published a short guide explaining how this process works.

In some cases, applying for a judicial review may be a more effective route than making a formal complaint to the council. However, judicial reviews are expensive and they’re not appropriate in every case. So, you should get legal advice first to see if it would be better to use the complaints procedure instead.

You can’t apply for a judicial review and also complain to the ombudsman, so you have to decide which is the best option in your case.

Other legal action

You might want to consider legal action if you’ve been injured as a result of a mistake made in your care or treatment – known as clinical negligence – or if your human rights have been breached. Visit Action against Medical Accidents for more information about clinical negligence.

You can also take a public authority to court but it can be a long and expensive process. To get advice or find a solicitor, contact Action against Medical Accidents or the Law Society. If you live in England or Wales, contact Civil Legal Advice to find out if you may be able to get help with legal costs. In Scotland, you may be eligible for some legal aid, depending on your circumstances. You will need to find a solicitor that does legal aid work - search at the Scottish Legal Aid Board.

Our guide Staying in control has more information about how to prevent and report abuse.

If you want to talk to someone about the process of making a complaint and what your options are, you can contact our free Helpline to arrange to speak to an adviser.

If your complaint is about the NHS, you can get support from your local patient advice and liaison services (PALS) in England and Wales. If you live in Scotland, your local patient advice and support service (PASS) can help. You could also contact Citizens Advice – find your local branch if you live in England or Wales, or in Scotland.

If you don’t feel confident about making a complaint, you could speak to an independent advocate. An advocate can help you communicate your concerns and may be able to help you resolve problems. For help finding an advocate, contact:

• Healthwatch in England – they also provide information and resources about how to make a complaint
• Scottish Independent Advocacy Alliance in Scotland
• LLAIS in Wales. The Age Cymru HOPE project also offers independent advocacy services to people over the age of 50.

See our factsheet Helping you get your voice heard: Independent advocacy for more information.

If your complaint is about abuse, contact your local authority’s adult social services department or their safeguarding team. Find contact details at the websites below:
•    England – NHS
•    Scotland – mygov.scot 
•    Wales – NHS 111 Wales  – select 'Social Care and Social Services' to find contact details for your local council's social services department.

You can find more information about safeguarding in our guide Staying in control.

For confidential help and advice on reporting abuse, contact Hourglass.