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Health Service Ombudsman Service
How to Complain About the Health Service
This informative article has been contributed by the Health Service Ombudsman Service, explaining how to use their service, if the need arises. (external link will open in a new browser tab or window)
Click these links to go straight to more information on:
Steps in making a complaint
Useful contact details
Ombudsman at work – Case Study
Most patients get good service
Most people are happy with the service they receive from the NHS which, in the majority of cases, provides excellent standards of care. But sadly, when things go wrong they can go badly wrong. The Mid Staffordshire hospitals scandal is a prime example. The outcome is that people who have received poor standards of care end up feeling they have been neglected and mistreated.
Every year around 150,000 people complain about the NHS. Just over 10 per cent of these people (around 16,000) bring their complaint to the Health Service Ombudsman. They come to us when all other efforts have failed to produce the desired outcome. So the cases we see are often from people who are demoralised and frustrated.
Complaining about public services is not easy. Many people, particularly carers and elderly people, often find it hard to complain for a number of reasons. Most people simply don’t know where to start or who to contact. Others assume that the process will be time-consuming, tiring and bureaucratic. (Sadly, it can be.) Many believe that complaining won’t make a difference. And some are afraid to complain for fear of getting a worse service or upsetting someone, like a doctor, who is in a position of authority. It’s all part of the British “mustn’t grumble” culture.
At the Ombudsman Service we know that complaining can and does make a difference. We don’t just investigate individual cases and help people to achieve justice and redress. We also share the learning we take from complaints with service providers – hospitals, GPs and dentists – and with government and regulators to help them improve. There are thousands of examples from our own investigations of where real improvements have been made as a result of someone complaining. (Read the case of Mr. T below)
These are the steps you need to take if you have a complaint
The first step is to complain in writing to the organisation (or individual) you are unhappy about. Complaining to them directly might get the matter resolved quickly and nipped in the bud. Explain why you’re unhappy and how you want them to put things right. You must give the organisation a chance to resolve your complaint and give you their final response. If you are still unhappy, you can then approach us at the Ombudsman Service.
We are the second stage in the NHS complaints system. When a complaint comes to us, our customer service team asks the following questions before they take the case further:
• Does the complaint fall within our remit? For instance, if the complaint is about a local-authority funded service such as a care home we may refer it to the Local Government Ombudsman – an organisation we work closely with.
• Has the complaint been made in writing?
• Was it made within the normal time limit of 12 months? (We still may be able to help if it’s outside this window, but it is important to act swiftly.)
• Has the person complained to the organisation and received a final response?
• Are they still unhappy about this?
First steps towards resolution
Once a complaint has satisfied preliminary checks, we may find that we can get the problem resolved quickly by talking directly to the organisation. In other cases, we investigate further. We’ll look at all the facts. We might need to gather additional evidence and get expert advice as well.
The issues we deal with are wide ranging. They include dealing with entitlement to NHS funding for long term care, poor treatment of the elderly in hospital, removal of patients from GPs’ lists, misdiagnosis of cancer and much more. During 2011-12 we saw an increase in complaints about the NHS failing to acknowledge mistakes in care and an increase in more complaints failures to provide adequate explanations or apologies.
If we find that the organisation has done something wrong that needs to be put right we’ll work with them to get that done. This could mean asking them to acknowledge their mistake, apologise, pay compensation or give an assurance that the same mistake won’t happen again.
Complaining takes courage, stamina and determination. In most cases financial compensation is not what people want. Above all, they want to make sure that the same mistake doesn’t happen to other people.
Information sources and contact details
All NHS funded services have a duty, according to the NHS constitution, to acknowledge and take seriously any complaint made. A complainant has the right to be told how a complaint will be handled, be kept informed of any progress, and have any conclusions explained and confirmed.
Since April 2013 individual local authorities have had a statutory duty to commission independent advocacy services to provide support for people making a complaint about their NHS care or treatment. Arrangements vary between local authority areas. However NHS providers should be able to give the details on how to complain. The relevant council website should also have this information.
Finding out how to complain about NHS funded care can sometimes be difficult, especially as the “new NHS” takes shape. The NHS website has a useful page about complaints (external link will open in a new browser tab or window).
How to contact the Ombudsman
The Health Service Ombudsman is a free and independent service. Its role is to investigate complaints that individuals have been treated unfairly or have received poor service from public services.
Tel: 0345 015 4033
Email: phso.enquires@ombudsman.org.uk
Website: www.ombudsman.org.uk
Ombudsman Service Case Study
A disabled man (Mr T) was left paralysed in all four limbs after he damaged his spine. He also has an uncommon and life threatening condition called autonomic dysreflexia (AD) – a sudden and exaggerated response to stimuli. An episode is a medical emergency and early treatment is crucial.
Whilst out one day Mr T noticed the symptoms of an AD episode. He was taken to a hospital in an ambulance, accompanied by a paramedic. According to Mr T, the paramedic appeared unaware of AD and the importance of early treatment, as was the triage nurse when he arrived in A&E. Mr T described “two hours of unmitigated hell and anxiousness” as he waited to see a doctor.
Mr T complained to the Health Ombudsman Service. He said that the hospital and the paramedics failed to understand and deal with his condition appropriately until he saw a specialist. We swiftly resolved the complaint. The hospital and ambulance trusts involved met Mr T to discuss how to raise awareness of AD. He later told us that someone he knew with a spinal injury had recently been taken to hospital and had been impressed and surprised to be asked if she was susceptible to AD. According to Mr T this was exactly the outcome he wanted.
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Further reading and resources
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