This guide is maintained as a current resource for July 2026 and covers only the laws of England and Wales. Information is for general guidance, not legal advice. Consult a qualified solicitor for advice specific to your situation.
Comprehensive UK guide to filing a complaint against a health service provider in England and Wales. Learn how to complain about NHS or private healthcare, pathways for escalation, time limits, the role of the Ombudsman and practical steps to ensure your concerns are addressed.
Patients and service users have legal rights when they receive care from health service providers in England and Wales, whether that care is delivered under the National Health Service (NHS) or by a private provider. A complaint is a formal expression of dissatisfaction about the standard of care, treatment, conduct, communication or service received. Understanding how to file a complaint, what processes are available, the time limits, and what outcomes you can realistically expect helps ensure your concerns are considered appropriately. This article explains the steps involved in making a complaint, escalation routes, potential outcomes, and common questions, without offering personalised legal advice.
1. Types of Health Service Providers and Applicable Complaint Routes
Health services may be provided by:
- NHS organisations (such as hospitals, GP surgeries, dentists, opticians and community services);
- Private healthcare providers (including private hospitals, clinics and independent practitioners).
The complaint process depends on whether the service was NHS‑funded or privately funded. For NHS services, there are statutory complaints procedures and independent oversight by the Parliamentary and Health Service Ombudsman (PHSO). For private health services, contractual and internal complaints procedures apply, often including Independent Sector Complaints Adjudication Service (ISCAS) where the provider is registered.
2. Your Rights When Complaining About NHS Care
If the care was provided or funded by the NHS, you have the right to:
- Have your complaint acknowledged promptly and investigated fairly;
- Be kept informed about how your complaint will be handled and the expected timescales;
- Receive a clear and comprehensive response explaining the outcome of the investigation;
- Take your complaint to the Parliamentary and Health Service Ombudsman if you are not satisfied with the local outcome;
- Seek compensation through legal channels if harm resulted from negligent treatment.
The NHS Constitution and statutory guidance require organisations to deal with complaints efficiently, to learn from complaints and to ensure complainants are treated respectfully throughout the process.
3. Making a Complaint About NHS Services
a. Local Resolution
The first step is usually to complain directly to the service provider (for example, your GP practice, local hospital or community care provider). All NHS services must have a complaints procedure and a designated complaints department. You can find information about this procedure on the provider's website, at reception, or by asking staff.
Before submitting a formal complaint, you may choose to speak to a staff member involved in your care or to the Patient Advice and Liaison Service (PALS), which can provide information and support.
Your complaint should be clear, concise and factual, outlining what happened, when it happened, your concerns and the outcome you are seeking. Provide supporting documents, dates, names and any relevant correspondence. Respond promptly if the organisation requests further information.
b. Complaints Process and Timescales
Providers typically:
- Acknowledge your complaint promptly (often within a few days);
- Investigate and respond in writing;
- Inform you of progress and any delays in complex cases.
Keep copies of all correspondence. Complaints should generally be made within 12 months of the event complained about or from when you first became aware of the issue.
4. Escalating an NHS Complaint to the Ombudsman
If you are not satisfied with the response from the NHS provider, or if your complaint has not been resolved after six months, you may escalate it to the Parliamentary and Health Service Ombudsman (PHSO) in England. The Ombudsman is an independent public body that reviews complaints about NHS services that have not been resolved locally.
The Ombudsman will assess whether the complaint is within its remit and whether the NHS organisation followed proper procedures. It may make recommendations, including remedial action and, in some cases, redress or compensation where appropriate.
For complaints in Wales, similar oversight is provided by the Public Services Ombudsman for Wales.
5. Making a Complaint About Private Healthcare
a. Provider's Internal Complaints Procedure
Private healthcare providers are generally required to have an internal complaints procedure. The process may differ between providers because there is no single statutory scheme equivalent to the NHS complaints system. You should submit your complaint in writing to the provider's complaints department, clinic manager or designated contact.
Provide a clear explanation of your concerns, supporting documentation and what remedy or resolution you seek. The provider should investigate and reply within a reasonable timeframe. Documentation confirming response deadlines is often part of the provider's own policy.
b. Independent Sector Complaints Adjudication Service (ISCAS)
Many independent healthcare providers in England are members of ISCAS. If your complaint has not been satisfactorily resolved through the provider's internal process, you may refer it to ISCAS for external adjudication. You must usually do this within six months of receiving the final internal response. ISCAS adjudication is free of charge to patients and can result in findings and recommendations, including goodwill payments up to a set limit (for example, up to £5,000).
If a private provider is not registered with ISCAS, there may be no formal external review process available through ISCAS. In those cases you may consider other regulatory or legal routes.
6. Other Routes and Legal Options
a. Regulatory Bodies
You can raise concerns with regulatory organisations such as the Care Quality Commission (CQC) in England, which monitors safety and quality standards. Complaints to CQC do not replace the provider's complaint process but may inform inspections and enforcement activity.
b. Judicial Review
In limited circumstances, if you believe a public body has acted unlawfully in a way that affects you, you may seek a judicial review in the High Court. This is a complex legal procedure and typically requires legal advice.
c. Compensation Claims
Healthcare complaint procedures are distinct from clinical negligence or compensation claims. If negligent treatment caused harm, you may consider a clinical negligence claim in the civil courts or through qualified legal representation, but this is separate from the complaints process.
7. Practical Tips for Making a Complaint
- Start early and keep to published time limits.
- Keep a written record of your complaint, responses and key dates.
- Be specific about facts and the outcome you seek.
- Maintain copies of all correspondence, medical records and relevant documentation.
- Consider seeking support from advocacy services such as ICAS or equivalent local organisations for NHS complaints.
Key Takeaways
Filing a complaint against a health service provider in England and Wales begins with identifying the appropriate complaints route, whether that is the NHS complaints procedure or a private provider's internal process. For NHS services, there are rights to acknowledgement, investigation and escalation to the Parliamentary and Health Service Ombudsman if local resolution is unsatisfactory. Private healthcare complaints are first addressed internally and may be referred for external adjudication through ISCAS if the provider subscribes. Other options include raising concerns with regulators, pursuing judicial review in exceptional cases, or considering civil claims for harm caused by negligent treatment. Understanding these steps and adhering to procedural requirements helps ensure your concerns are addressed fairly and effectively.
