Tips for complaint handlers working for the NHS in England, UK government departments and other public organisations.
We're currently testing the NHS Complaint Standards, model procedure and guidance with organisations taking part in the pilot. For more information see NHS Complaint Standards.
Step 1 Responding to the initial complaint
The best and most cost effective scenario is to deal with issues and concerns as they arise. If you receive a formal complaint then getting the investigation right first time helps you reach the right outcome in the right way. It can also help you identify any learning as quickly as possible.
My expectations for raising concerns and complaints (PDF 9MB) describes the expectations patients and service users have for good complaint handling.
People tell us that when they make a complaint they want:
- a real opportunity to be heard and to input into the process before decisions are made
- to see how decisions are made by following a clear, understandable and transparent process
- complaints handlers to be sensitive and impartial, and make decisions based on objective information and appropriate criteria.
Make sure you:
- Listen carefully. Confirm the complainant’s concerns and the issues to be investigated.
- Ask the complainant what they want to achieve. Can it be resolved straight away?
- If appropriate, manage expectations and explain what is possible.
- Explain how long the process is likely to take. Be open and realistic.
- Agree how to keep the complainant updated and involved, and how often.
- Explain what will happen next.
Step 2 Sharing your investigation plan
Be clear and transparent throughout your investigation and explain the investigation process at the start. This should include:
- what evidence you will consider
- who you will speak to
- who will give advice/independent opinion
- how you will decide if the care or service provided was right or not
- who will be involved in decision-making.
Throughout the investigation remember to:
- Make sure you meet the requirements of any regulations such as NHS complaints regulations and local policies and procedures.
- Follow the Ombudsman’s principles of good complaint handling and principles for remedy.
- Keep good records. Your complaint file should be well structured and contain all the evidence you have considered to reach your decision. It should include:
- all complaint correspondence
- notes of relevant telephone conversations and meetings
- any relevant internal and external emails
- any statements taken from staff or witnesses
- copies of all relevant clinical records
- copies of any relevant local policies and guidance
- any internal specialist or clinical advice, or scrutiny provided during the investigation
- documentation about any action you have taken as a result of the complaint.
Step 3 Making and sharing your decision
When we look at a complaint we consider the response your organisation has already given. Before you send your final response to the complainant, make sure it is as good a response as you would like to receive yourself.
Your response should:
Be clear and compassionate
- Clearly set out the issues the complainant raised and what they want to achieve by complaining.
- Use language that is empathetic and that the complainant can understand.
- Set out how you have investigated the complaint and what evidence you considered, for example interviews with relevant staff, departmental and clinical records.
- If the complaint is about the standard of NHS care and treatment given, include a clinical opinion from a suitable clinician who is not directly involved in the case.
Explain whether or not something went wrong
- what happened, with reference to the evidence
- what should have happened, quoting relevant regulations, standards, policies or published guidance, and if they were met
- if there is a difference between what happened and what should have happened, explain what this is and the impact it has had.
Be clear about your decision and any action you will take
Give your view about the care or service provided and clear reasons for each of your decisions.
If you found something went wrong, include:
- a suitable apology (see the Scottish Public Services Ombudsman's guidance on how to make an apology [PDF 98.3KB] and NHS Resolution's guidance on saying sorry)
- an offer to put things right (including financial redress where appropriate)
- explanations of what lessons have been learnt
- details of how the organisation will put matters right for other service users.
Where possible, offer to involve the complainant in the changes that take place as a result of their complaint.
Promise to keep them updated on the action you take.
Tell people about us
In case the complainant is not satisfied, you must tell them about our service.
You can include the wording below in your final response letter:
If you’re not happy with how we’ve dealt with your complaint and would like to take the matter further, you can contact the Parliamentary and Health Service Ombudsman. The Ombudsman makes final decisions on complaints that have not been resolved by the NHS, government departments and some other public organisations. Their service is free for everyone. To take a complaint to the Ombudsman, visit www.ombudsman.org.uk or call 0345 015 4033.
- Download our Powerpoint presentations on good local complaint handling:
- Good complaint handling for NHS organisations (PPTX 937KB)
- Good complaint handling for government departments and agencies (PPTX 897KB)
- Understanding the Ombudsman’s Clinical Standard (presentation for GPs) (PPTX 961KB)
- Download our presentation about the work and role of the PHSO (PDF 2.3KB)
- Principles of good complaint handling
- Designing good together: transforming hospital complaint handling (PDF 14MB)
- Clinical Standard (PDF 52KB)
- My Expectations (PDF 9MB)
- Principles for remedy
- Financial remedy guidance
You may also be interested in:
- our work on improving the quality of investigations when things go wrong
- our guidance on the roles of the Parliamentary and Health Service Ombudsman and NHS Resolution, and how our services overlap and interact
- our report: An opportunity to improve general practice complaint handling across England: a thematic review.