Everyone in the UK will need some kind of NHS service or treatment at some point in their life, and we all hope that the hospital care we receive meets the highest standards of quality. For many people, the treatment they receive will meet or exceed these expectations, but mistakes are always possible. If you have been affected by problems in hospital care or another NHS service, it can help to make a complaint.

This has two benefits: the first is that feedback and complaints can be used by a hospital, or the NHS as a whole, to prevent similar mistakes and problems from arising in the future. Beyond this, a complaint letter could serve as evidence if you ever decide to pursue financial compensation for the harm you experienced.

There are several branches of NHS care beyond medical treatment, and there can be significant repercussions for mistakes in any of these areas. Here, the experienced medical negligence solicitors at JMW outline what the NHS complaints process involves, how to tell if you are entitled to compensation, and how a complaint can back up your case.

What Is the NHS Complaints Procedure?

If you wish to complain about your local hospital, following the correct complaints process is the best way to get the outcome you want, whether that is a written response acknowledging wrongdoing, or a sense that the hospital responsible is taking action. This may be different depending on the specific NHS hospital you wish to make a complaint about, and the nature of your concerns, but a general overview of the NHS complaints procedure is as follows:

• Step 1: Contact the hospital directly via its Patient Advice and Liaison Service (PALS) and review the relevant complaints procedure.
• Step 2: Submit a formal written complaint with all necessary details and evidence.
• Step 3: Await the hospital’s response (which you should expect within 12 weeks).
• Step 4: If you are unsatisfied, consider escalating your complaint to the Parliamentary and Health Service Ombudsman or the Care Quality Commission (CQC).
• Step 5: Seek legal advice to determine whether you are owed compensation.

This process may differ depending on a hospital's complaints process, and will not necessarily apply if you wish to make a complaint about a private healthcare service provider. In the below section, we have provided more detail about each of these steps to help you determine your next steps when making a complaint.

How Do You Make a Complaint Against a Hospital?

Your first step should be to contact the hospital directly. Most hospitals have a complaints manager or a Patient Advice and Liaison Service (PALS). This team is there to listen to your concerns, offer advice, and try to resolve issues informally, without the need to make a formal complaint. If you decide to move ahead, a PALS team can also help you to find (and follow) the hospital's complaints procedure. Every NHS hospital is required to have a written complaints procedure, which can often be found on the hospital’s website or the NHS website. Alternatively, you can ask at the hospital's reception or the PALS team. Familiarising yourself with this procedure can help you to understand what to expect and how your complaint will be managed based on the specific hospital involved.

The next step will usually be to write and submit a formal complaint to the hospital. This should provide a clear explanation of what happened, including dates, times, names of staff (if known), and a detailed description of the incident. Attach copies of any relevant documents or records that support your complaint, and provide your contact details so that the hospital's complaints team can respond. Sending your letter by recorded post or email will create evidence of when you sent it and a back-up of the message. It is important to keep copies of all correspondence for your records, and to support a potential future compensation claim.

Depending on the nature of your complaint, a hospital should usually acknowledge your complaint promptly and provide a timeframe for a full response. In most cases, you can expect a complete reply within 12 weeks. This response should detail any actions the NHS plans to take and explain the outcome of any investigation into the NHS service that fell short of your expectations.

If you are not satisfied with the hospital’s response or if you do not receive a reply within the stated timeframe, you can take further steps, such as escalating the complaint. The Parliamentary and Health Service Ombudsman can investigate complaints that have not been resolved satisfactorily through the hospital’s internal process.

For complaints that relate to concerns about the quality or safety of care, you might consider contacting the Care Quality Commission. Although the CQC is primarily a regulatory body and not a complaints resolution service, it can inspect and monitor hospitals' compliance with the required standards. Local health authorities or advocacy groups can also provide impartial advice and may offer support during the complaint process and, in cases where you have suffered harm due to a care provider's negligence, consult a solicitor who specialises in hospital negligence claims.

If you were treated by a private hospital, please consult our guide on the complaints process for private hospitals.

When Can You Claim Compensation for Hospital Care?

Following the steps listed above should make sure your complaint is handled properly and that you have a clear record of your concerns. This can support you if you believe you may be entitled to compensation, especially if the NHS service provider acknowledges their responsibility for any harm you experienced. A compensation claim can be important, as the money you will receive paves the way for your recovery. Overcoming an injury or illness caused by poor-quality hospital care can be expensive, cause you to miss work, and take a long time. Compensation will pay you back for these losses and any pain or suffering that was caused by the negligent NHS service.

The only way to know for certain whether you are able to make a claim is to speak to a solicitor, but you are generally entitled to seek compensation if you have suffered harm or loss due to negligence or substandard care provided by a doctor or other hospital staff. To succeed in a compensation claim, you must typically prove that the following applied to your case:

• You were owed a duty of care by the person responsible. For hospitals, healthcare providers, and other areas of the NHS, this duty of care is implied by the patient/hospital relationship. A duty of care means that the hospital or medical professionals responsible for your case owed you a duty to provide a certain standard of care.
• The duty of care was breached, meaning that the care provided fell below what is reasonably expected. This could include errors in diagnosis, treatment mistakes, surgical errors, or delays that are not in line with accepted medical standards.
• There is a clear link between the breach of duty and the injury or harm you suffered. In other words, the negligence must have directly caused your injury.

There are many circumstances in which you may be entitled to compensation, alongside making a formal complaint. For example, you might be able to make a claim if:

• You suffered an avoidable injury, whether due to a treatment error or misdiagnosis that directly resulted in additional harm.
• There was a delay in treatment and this worsened your condition or led to further complications.
• A mistake in a procedure or treatment deviated from the recognised standards of care and this led to an injury.
• Decisions made by healthcare professionals did not follow accepted guidelines and this caused you harm.

You should note that dissatisfaction with the quality of service alone is not sufficient grounds for a compensation claim unless you can prove you were injured or experienced financial losses. There is a time limit of three years from the date of your negligent treatment in which you must start the claims process.

Given the complexity of the legal process around medical negligence, you should consult an experienced solicitor who specialises in clinical negligence cases. JMW's experts can help you to assess whether your case meets the necessary criteria and guide you through the process.