Receiving a response

Once the investigation is finished and any meetings have been held the Complaints Manager should send you a letter containing:

A summary of your complaint
What the investigation found and any actions to be taken as a result
What to do if you are still unhappy with the answers given

Depending on the investigation the letter may contain:

An apology, if relevant
What actions will be taken and when, as a result of your complaint
Who is responsible for making this happen
What steps have been taken to prevent the same thing happening to other people

The letter should be:

Balanced, factual and impartial
Clear and easy to understand

What do I do if I’m not happy with the response?

You can go back to them in writing, quoting the complaint reference number and telling them the part(s) that you are not happy with or don’t understand.

You can’t ask any new questions unless the response has raised issues that you weren’t previously aware of. Any further issues you have must only relate to the issues and questions in the original complaint.

You can ask for a further response to be in writing or, if there hasn’t already been one, ask for a meeting, called a Local Resolution Meeting.

What if I’m still not happy with the response?

The steps so far are called Local Resolution and this must be finished before you can take the matter further.

When Local Resolution is considered by the NHS organisation to have ended you will be given the option of taking your complaint to the Parliamentary and Health Service Ombudsman (PHSO).

For complaints about the use of the Mental Health Act, you have the option of going to the Care Quality Commission (CQC).

Parliamentary and Health Services Ombudsman (PHSO)

If you’re not happy with the way your complaint has been dealt with by the NHS, you have the right to take your complaint to the Parliamentary and Health Service Ombudsman (PHSO).

The PHSO is independent of the NHS, local authorities and government. Their services are free and confidential.

When can I take my complaint to the PHSO?

You should submit a complaint no later than one year from the date of the events you are complaining about (or from when you first became aware of the matter).

The PHSO can extend this time, for example, if the Local Resolution process took longer than a year.

Does the PHSO investigate all cases that are sent to them?

The PHSO will look at every complaint that comes to them but they do not (and are not required to) investigate all the complaints referred to them.

They will not normally investigate your case unless you have already tried to resolve the problem using Local Resolution.

The PHSO can refer you back to the Local Resolution stage of the NHS Complaints Procedure if they think you have come to the Ombudsman too soon, or if they feel that the NHS organisation involved has not done all it can to resolve your issues locally.

The PHSO will not usually investigate a complaint where you do not agree with the outcome of your complaint and you cannot offer any evidence as to why you think it’s wrong or unsatisfactory, or they decide:

there is no evidence to suggest that the NHS organisation acted wrongly
the NHS organisation has done all they reasonably could do to put things right
there would not be a worthwhile outcome from an investigation (for example, if the outcome you want is not possible through this process)

How do they decide whether to investigate a case?

The PHSO will consider whether your case meets their criteria for investigation.

They may ask to see clinical records and other papers involved in your complaint.

The PHSO may decide:

not to investigate the case and take no further action (for example, if they think that the NHS has done all it can to resolve your complaint locally).
not to investigate the case but may ask the NHS organisation to take action which they think would resolve your complaint more quickly without the need for a PHSO investigation. This is called an ‘intervention’.
to carry out an in-depth investigation resulting in a detailed report about the case. This investigation will be very thorough and can take some time. They aim to complete 90% of investigations within 12 months.

If the PHSO agree to investigate my complaint, what happens then?

After they have completed their investigation, the PHSO will write a detailed report.

If the complaint is upheld (this means they support your complaint) they can make recommendations to the NHS to put things right.

What can I do if I am not happy with the PHSO’s decision?

You can raise your concerns about the decision with the person who assessed your complaint. If you remain unhappy you can ask that the decision is reviewed by a different team (although just disagreeing with the decision is not enough for a review to be completed). They will provide you with a form which explains the criteria for a review. This should be done within a month of the decision. Unless you have new information the PHSO will only consider a review once.

The PHSO’s decision about your complaint is final.

This includes their decision whether or not to investigate your complaint and their decision whether or not to uphold your complaint following an investigation.