How we deal with complaints
Here you can find out what happens when we first receive your complaint, how we decide if we should investigate it and what to expect if we do.
If you haven’t complained to us yet, have a look at our Making a complaint page where you can find out how to do that and what steps you may need to take first.
You can give us feedback on our service at any stage by contacting our Customer Care Team. They can also help you if you think we've made the wrong decision on your complaint and you would like us to review it.
We are currently consulting on a draft Service Charter - promises we make to the people who use our service. You can read more about this here.
When you first contact us: our initial checks
When you first contact us about your complaint, we carry out some initial checks to make sure your complaint is one we can investigate. This includes checking if you have already complained to the organisation you're not happy with. This is because we need to make sure it has had the chance to look into your complaint and respond to your concerns.
Deciding whether to investigate your complaint
After we've done our initial checks on your complaint, the next stage is where we decide whether or not to investigate your complaint. We call this an assessment. We'll look at what the organisation you're unhappy with has done and whether it appears to have not acted properly or fairly or to have given a poor service. We'll also look at what effect this has had on you, and what steps the organisation has already taken to put things right.
What happens if we investigate your complaint
If we decide to investigate your complaint, we'll talk to you at the start about your concerns, what we're going to investigate and how long we think this will take. If our investigation shows the organisation you're complaining about did not act properly or fairly or has given a poor service, we can recommend what action it needs to take. This can include not only putting things right for you, but also taking steps to prevent something similar happening again, to someone else.
Stage 1 – When you first contact us: our initial checks
When you first contact us, we do some initial checks to make sure we can investigate your complaint. These checks are important because there are some things you need to do before we can investigate your complaint and some issues and organisations we can't investigate. There are also some things that we don't have the powers to do, like getting a member of staff struck off their professional register. You can find out more here or call us on 0345 015 4033 to discuss your complaint with us.
These are the checks we do on all the complaints we receive:
- We'll check your complaint is about an organisation and issue that we can investigate.
- We'll check that you have already complained to the organisation you're unhappy with and had a final response. If you haven't done this, have a look at our top tips on making a complaint.
There are some other checks we have to do if your complaint is about a UK government department or another public organisation:
- We'll check that a Member of Parliament has asked us to look into your complaint for you (this doesn't need to happen for complaints about NHS organisations).
- We'll check if your complaint needs to have gone through a separate, independent review before coming to us; this applies to complaints about some of the government departments and public organisations we can investigate, so we'll check if this is the case for your complaint and let you know if there is anything more you need to do before we can look into it.
We will let you know if we need any more information from you to be able to complete these initial checks, and we aim to complete this stage within five working days. Find out about our secure email system for sensitive information.
If our checks show that we can't investigate your complaint or if your complaint is not yet ready for us, we'll explain why and give you information on what other options you might have.
Otherwise we'll look at your complaint in more detail and we'll let you know what will happen next.
Stage 2 - How we decide whether to investigate your complaint
Once we've done our initial checks, we'll look at the information you have given us in more detail to decide if we should investigate or not. If we need to, we'll also ask the organisation you are complaining about for information, to help us decide.
Here's what we look at:
If you're unhappy with how an organisation handled your complaint and you would like us to look into it, we need to know as soon as possible. This is because, by law, we can only investigate complaints that are made to us within a certain time frame.
If your complaint is about the NHS, you must make your complaint to us within one year of when you first became aware of the issues you're complaining about.
If your complaint is about a government department (or another public organisation, but not the NHS) you must make your complaint to an MP within one year of when you first became aware of the issues you're complaining about. The MP needs to pass it on to us on your behalf.
The law does give us flexibility to look at complaints that come to us outside of this time frame if there are good reasons for not being able to bring it to us sooner. If this applies to you, please get in touch with us. There is also more information about timings here.
By law, we cannot investigate a complaint if you have (or had) the option to take legal action to get an answer to your complaint. This could include going to court or going to a tribunal. However, the law gives us flexibility to investigate a complaint if we can see that taking legal action will not achieve what you are looking for, or we don't think it is reasonable to expect you to take legal action.
There is more information about legal action here or call us if you're not sure.
We'll look at whether there are signs that the organisation made a mistake or provided a poor service, what effect that may have had on you, and what the organisation may have done already to put things right.
We aim to give you our decision about whether we'll investigate your complaint within 20 working days.
If we decide not to investigate your complaint, we'll explain how we reached that decision. If there is another organisation that could help with your complaint, we'll put you in touch.
Sometimes we can see that we might be able to get an answer to a complaint without a full investigation. But if we do decide we need to investigate, we'll tell you and the organisation what will happen next.You can also have a look at our short animation to find out how we decide whether to investigate a complaint.
Stage 3 -What happens if we investigate your complaint
When we start our investigation
If we decide to investigate your complaint, we'll let you know and also contact the organisation you are complaining about. At this stage, we ask the organisation if it has any initial comments on the issues you have raised in your complaint.
We will talk you through what's going to happen, so you know what to expect. This includes letting you know in more detail what issues we'll cover in our investigation, and asking you how you would like to be kept updated. If we need any more information from you, we'll ask you for that. We will confirm in writing what we'll be investigating and will also let you know how we plan to carry out our investigation and how long we think it will take.
When our investigation is underway
During our investigation we gather information to find out what happened. We may also need to get advice from an independent expert, such as a medical professional, to help us better understand what happened and why. We will let you know if we need to do that. From the beginning to the end of our investigation, we'll always be open and transparent with you about the information we have and how we are using it to consider your complaint.
We will keep you updated on how our investigation is going. These updates will cover what we have done so far, what information we have gathered, and any thoughts we have on what we have seen so far. We will also let you know when we think we'll finish our investigation.
When we complete our investigation
Towards the end of our investigation, we'll send you and the organisation you complained about our initial report of what we have seen during our investigation. This will include our provisional views on your complaint. We will give you (and the organisation) the opportunity to comment. We will look at any comments you give us to see whether we need to do more work before we finalise our decision on your complaint.
We can decide to fully uphold, partly uphold or not uphold your complaint.
If we fully uphold your complaint, this means that we found the organisation you complained about made mistakes or provided a poor service that has had a negative impact on you, and the organisation has not yet put that right.
Sometimes we may find that the organisation did get some things wrong, but not all the things you complained about, or that the mistakes it made did not affect you negatively. If this is the case, we might partly uphold your complaint and we'll explain clearly why we have decided this.
If we fully or partly uphold your complaint, we can make recommendations to the organisation to put things right. This could mean asking it to acknowledge its mistakes and apologise to you or take other steps to make up for the service it gave you. Sometimes we'll ask an organisation to make a payment to you, for example, to reimburse you if you have been left out of pocket because of its errors or to acknowledge distress it has caused you. We can also ask organisations to take action to prevent the same mistakes happening to someone else and to make services better for everyone.
If we make recommendations, we follow up on them to make sure the organisation implements them.
If we don't uphold your complaint, this means we found the organisation acted correctly in the first place or did make mistakes but has already done what we would expect to put things right for you.
We will make sure we complete your investigation as quickly and thoroughly as possible. In general, we aim to complete most of our investigations within three to six months, although some investigations can take longer depending on the complexity of the issues. We aim to complete 99% of all our investigations within a year.Our short animation also explains what to expect if we investigate your complaint.