Demand for our service has increased significantly. Over the last year, we’ve seen a 31% rise in complaints progressing to further investigation. We carefully consider every complaint we receive, but we do not investigate every case in detail. We make impartial, evidence-based judgements about whether further investigation is justified.
To manage this rise in demand, we need to look carefully at our processes to make sure we focus our time and resources on the most serious issues. We also look at where we can provide the best value and make the biggest improvements to public services.
We make choices about which complaints we take forward based on what happened and on whether investigating the complaint could lead to a wider public benefit.
The criteria we use and how we weight these may change over time. We review and update our approach regularly to reflect our priorities and the volume and nature of complaints we receive. Any changes to the criteria will be applied both to new complaints and to complaints already in the queue for allocation to a caseworker, in order to decide if we should investigate.
The information on this page is intended to help you understand our approach. When submitting your complaint, please describe your experience in your own words and stick to what actually happened. If you are using AI tools such as ChatGPT to help you submit your complaint, our guidance on prompts will help make sure you do this. Framing complaints in a way that genuinely reflects your own experience will help us to investigate effectively.
What we think about
We look at your complaint and think about:
- severity of injustice (how much the issue affected the person involved). We look at what the person making a complaint said in order to understand how serious the impact was.
- access to our service (how we make sure everyone can access our service). We look at the following things:
- Does the person complaining need extra support to use our service?
- Does the issue they are complaining about mainly affect those who share the same particular protected characteristic (like age, ethnicity, sex or religion)?
- Has the person complaining said that events happened because of the impact of a protected characteristic?
- wider public impact (how we can have the biggest possible impact). We look at whether there has been significant public interest in the issue or if it has been a matter of public debate:
- Has there been wider engagement on the complaint? For example, has another organisation looked at a related part of the complaint? Or has it been discussed in Parliament?
- Has there been recent media attention about the organisation and the issue in the complaint?
- potential systemic issues that could be affecting lots of people, for example:
- NHS organisations in a particular area not applying a national policy or patient entitlement (such as which services they make available, how care is coordinated or how options are communicated to patients)
- long delays or poor communication from a government department that will likely apply to others needing the same service
- an NHS organisation or government department having a policy or process in place which is flawed or unfair (such as unreasonably limiting access or not having sufficient oversight).
How this information is used
We consider all this information, as well as our priorities and capacity at the time. The system is flexible – our senior leaders review it every six months and may adjust the criteria to change the volume and types of cases we accept. This helps us manage demand while focusing our work where it can make the greatest difference. Reviews can take place earlier if we have significant changes in demand or capacity.
We keep data from all cases, whether we investigate them or not, so that every complaint can make a difference. We use the data to spot trends and see when service failings might be affecting lots of people.