How to Write an NHS Complaint Letter UK: A Complete Guide
- James Pite
- 3 days ago
- 8 min read
Every patient in England has the right to complain about any aspect of NHS care. That right is enshrined in the NHS Constitution and backed by regulations that require NHS organisations to acknowledge complaints, investigate them and respond in writing. Despite this, many people never complain. They feel unsure of the process, worry about affecting their care or simply do not know where to start.
This guide explains who to complain to, what to put in your letter, how the process works from first submission to the Parliamentary and Health Service Ombudsman, and what the NHS is required to do at every stage.
What You Can Complain About
An NHS complaint can cover any aspect of NHS treatment or care that you are dissatisfied with. Common grounds include:
Poor clinical care or treatment, including misdiagnosis, delayed diagnosis or inappropriate treatment
Poor communication or failure to keep you informed about your care
Failure to obtain proper consent before a procedure
Rude, dismissive or unprofessional behaviour by NHS staff
Long waiting times that have caused harm or worsening of your condition
Failure to refer you to a specialist when your symptoms warranted it
Errors in medication, dosage or administration
Poor discharge planning that left you without adequate support
Failure to follow national guidelines or the organisation’s own policies
Inadequate care in a GP surgery, hospital, mental health service or any other NHS setting
You can also complain on behalf of someone else if they have given you consent, or if they lack capacity to complain themselves and you are acting in their best interests.
Who to Complain To: Two Routes
Under the NHS Complaint Standards, you have two options. You can complain directly to the NHS organisation that provided your care, such as the hospital trust, GP surgery or mental health service. Or you can complain to the commissioner of those services, which is your local Integrated Care Board for GP surgeries, dentists, opticians and pharmacists, and NHS England for more specialist or national services. You cannot complain to both simultaneously about the same issue.
For most people, complaining directly to the organisation that provided the care is the most effective first step. They have access to the clinical records and the staff involved, and can investigate your complaint more thoroughly than a commissioner can at a distance. If you do not feel comfortable complaining directly to the organisation, the Integrated Care Board route is available.
Tip: Before deciding, check whether the organisation has a Patient Advice and Liaison Service, known as PALS. PALS can help you raise concerns informally and may resolve straightforward matters without a formal complaint being needed. For more serious concerns involving harm, a formal written complaint is usually the right approach from the outset.
The Time Limit for NHS Complaints
You should make your complaint within 12 months of the incident you are complaining about, or within 12 months of becoming aware that something went wrong. This limit can be extended in exceptional circumstances, for example where you were unable to complain sooner due to illness or where the harm only became apparent later. If you are approaching or past the 12-month mark, include a brief explanation of why you were unable to complain sooner in your letter.
What the NHS Must Do When It Receives Your Complaint
Once a formal written complaint is received, the NHS organisation must:
Acknowledge your complaint in writing within three working days
Discuss with you how the complaint will be investigated and agree a timescale for a response
Investigate the complaint thoroughly and impartially
Provide a written response that addresses every point you raised with clear explanations
Tell you about your right to take the complaint to the Parliamentary and Health Service Ombudsman if you are not satisfied
The response timescale should be agreed with you at the outset based on the complexity of your complaint. NHS England’s own policy sets 40 working days as a general target for a full response. If the investigation is likely to take longer, the organisation should explain why and keep you updated throughout.
How to Structure Your NHS Complaint Letter
Address It to the Right Person
Send your letter to the complaints manager or patient experience team of the organisation you are complaining about. For a hospital, you can also address it to the Chief Executive. Do not send it to the clinical team involved in your care as this is likely to delay it being processed formally.
State It Is a Formal Complaint
Use those words in the subject line and opening sentence. This ensures it is logged and processed under the formal complaints procedure rather than treated as general feedback.
Provide Your Details and the Patient’s Details
Include your full name, address, date of birth and NHS number if you have it. If you are complaining on someone else’s behalf, include their details and confirm your relationship to them and that you have their consent, or explain why you are acting without it.
Set Out What Happened in Chronological Order
Describe the events in date order. For each relevant appointment, procedure or contact with the NHS, state the date, what happened, what you were told and what the outcome was. Be specific and factual. Reference documents you are attaching, such as appointment letters, discharge summaries or test results, where they support your account.
State What You Say Went Wrong
After the factual account, state clearly what you believe the NHS organisation or its staff failed to do. This might be a failure to diagnose, a failure to communicate, a failure to follow guidelines or a failure to treat you with dignity and respect. Be specific about which failures you are raising and at what point they occurred.
Describe the Impact
Explain the effect the failure has had on you or the person you are complaining for. Physical harm, worsening of condition, avoidable procedures or treatments, emotional distress, time off work, financial cost. Be honest and specific. The impact informs both the investigation and any remedy the organisation may offer.
State What You Want
Tell the organisation what outcome you are seeking. Most complainants want some or all of the following: a full explanation of what happened and why, acknowledgement that something went wrong, a formal apology, confirmation of what steps have been or will be taken to prevent the same thing happening to others. If you want compensation, you can state that, though financial compensation for clinical harm is generally pursued through a separate negligence process.
Full Worked Example
[Your name]
[Your address]
[Your email and telephone]
[Date]
The Complaints Manager
[NHS Trust or GP surgery name]
[Address]
Subject: Formal Complaint – [Your name], DOB [date], NHS number [number]
Dear Sir or Madam,
I am writing to make a formal complaint about the care I received at [name of hospital, ward or GP surgery] on [date or between dates]. I will set out what happened, what I believe went wrong and what I am asking the organisation to do.
What happened
On [date] I attended [location] with [describe your symptoms or reason for attendance]. I was seen by [describe the clinician or member of staff if known]. I was told [describe what you were told]. [Describe any tests, treatment or procedures that took place or did not take place].
On [date] I [describe what happened next: returned to the department / received a letter / had a follow-up appointment]. At this point [describe what happened]. [Continue the chronological account, covering each relevant contact or event].
On [date] I [describe how the situation became clear or worsened, or how you came to understand that something had gone wrong].
What I believe went wrong
I believe the following failures occurred. First, [describe the specific failure clearly, e.g. the test results from my appointment on [date] were not reviewed and no follow-up was arranged, despite the results showing an abnormal reading]. Second, [describe any further failure]. Third, [any additional grounds].
Impact
As a result of these failures, [describe what happened to you: my condition was not diagnosed until [date], by which time it had progressed to a more serious stage / I underwent [a procedure] that would not have been necessary if [the failure] had not occurred / I have experienced significant anxiety and distress as a result of the way I was treated].
What I am asking for
I am asking the organisation to: provide me with a full explanation of the clinical decisions made and the reasons the failure occurred; acknowledge that the standard of care I received fell below what I should have expected; provide me with a written apology if fault is found; and explain what steps have been or will be taken to prevent the same failure occurring to other patients.
I would like to receive a response within the timescale agreed with me at acknowledgement. I am happy to provide any further information or documentation that may assist the investigation.
Yours sincerely,
[Your name]
[Signature]
[Attachments if applicable]
If the Response Does Not Resolve Your Complaint
Once you have received the organisation’s final written response, if you remain dissatisfied you can take your complaint to the Parliamentary and Health Service Ombudsman. The Ombudsman is independent of the NHS, its service is free and it investigates whether NHS organisations have handled complaints properly and whether the care provided was of an acceptable standard. You must normally bring your complaint to the Ombudsman within 12 months of receiving the final NHS response.
The Ombudsman can uphold your complaint in full or in part, recommend that the NHS organisation apologises, provides remedial treatment, changes its practices or pays you a financial remedy. Where a complaint is upheld, the NHS is expected to comply with the Ombudsman’s recommendations.
Note: The Ombudsman currently has a waiting time of up to six months before it can begin looking at NHS complaints. Do not delay submitting your complaint once you have the final response.
Complaints About GP Surgeries
Complaints about GP surgeries follow the same basic process: complain directly to the practice manager in the first instance, or to your local Integrated Care Board if you prefer not to complain directly. If you are unsatisfied with the response, escalate to the Parliamentary and Health Service Ombudsman. Full guidance is available from NHS England on feedback and complaints, including how to identify your local Integrated Care Board and how to submit complaints to NHS England for specialised services.
Complaints About Private Healthcare Delivered on NHS Contracts
If you received care from a private provider that was funded by the NHS, for example through an NHS-funded independent hospital or diagnostic service, the same NHS complaints process applies. The provider must have a complaints procedure that meets the NHS Complaint Standards and must offer you the right to escalate to the Ombudsman.
Getting Help With Your Complaint
Free help with NHS complaints is available from NHS complaints advocacy services in your area, which can help you write your letter, understand the responses you receive and prepare for any meetings with the organisation. Find your local advocacy service through your Integrated Care Board or Citizens Advice. For complaints that may also give rise to a clinical negligence claim, specialist charities such as AvMA (Action against Medical Accidents) provide free advice and can help you understand whether your situation warrants legal advice.
If you want help drafting an NHS complaint letter that is clearly structured, addresses the right points and gives the organisation everything it needs to investigate effectively, the team at LetterLab can help you get it right before you send it.
Checklist: Before You Send Your Complaint Letter
Does the subject line and opening sentence state this is a formal complaint?
Is the letter addressed to the complaints manager or patient experience team, not the clinical team?
Have you included your full name, date of birth and NHS number?
Is the background set out in chronological order with specific dates?
Have you clearly identified what you say went wrong and at which point?
Have you described the impact on your health, wellbeing or daily life specifically?
Have you stated what outcome you are seeking?
Have you attached any supporting documents and listed them at the end of the letter?
Are you sending it by email with read receipt or recorded post so you have proof of delivery?
Have you kept a copy and noted the date you sent it?
The Key Takeaway: Write It Formally, Address Every Point, Follow It Through
An NHS complaint letter is not just an expression of dissatisfaction. It is the document that opens a formal legal process, triggers specific obligations on the NHS organisation and creates the record that the Parliamentary and Health Service Ombudsman will need if you escalate. Getting it right from the start matters for every stage that follows.
Write it clearly, with specific dates and specific failings. Describe what happened to you as a result. Say what you want. Then give the organisation a fair chance to respond. If they do not respond properly, the Ombudsman is there. If the harm is serious, legal advice may also be appropriate. But it all starts with the letter.
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