Your Rights as an NHS Patient: Complaints, PALS and the Ombudsman
The NHS Constitution gives patients in England a set of rights — including the right to be treated with dignity and respect, the right to be involved in decisions about your care, the right to accept or refuse treatment, and the right to complain without it affecting your care. This guide explains those rights and the practical route when something goes wrong: raising it at the time, contacting the Patient Advice and Liaison Service (PALS), making a formal complaint, and escalating to the Parliamentary and Health Service Ombudsman. It explains the process only — it gives no legal advice.
Complaining does not affect your care
No NHS service can withdraw or reduce your care because you complained. The NHS Constitution gives you the right to complain about any aspect of NHS care, to have the complaint acknowledged within 3 working days and properly investigated, and to take it to the Parliamentary and Health Service Ombudsman if local resolution does not satisfy you.
What the NHS Constitution guarantees
The NHS Constitution for England sets out what you can expect as a patient. Among its rights are the right to safe and appropriate care; the right to be treated with dignity and respect; the right to be involved in decisions about your care, including the right to accept or refuse treatment; and the right to complain about any aspect of NHS care and have the complaint dealt with properly.
The Constitution also sets out your right to have a complaint acknowledged within 3 working days and properly investigated, to discuss how the complaint is handled and to know the likely timescale, and to take the complaint to the Parliamentary and Health Service Ombudsman — or the Local Government Ombudsman — if you are dissatisfied with the local response. It also gives a right to compensation where you have been harmed by negligent treatment.
Step 1: raise it at the time
If something has gone wrong, the fastest fix is often the simplest: raise it at the time, with the person involved or their manager. Many problems — a misunderstood instruction, a delayed appointment, a brusque manner — can be sorted on the spot, and staff would usually rather know immediately than read about it in a formal complaint weeks later.
If you do not feel able to raise it directly, or the problem is not resolved, the next step is PALS — the Patient Advice and Liaison Service — described below. You do not have to choose between raising it informally and complaining formally: you can do both, and one does not block the other.
PALS: informal help and advice
PALS — the Patient Advice and Liaison Service — offers free, confidential advice at almost every NHS hospital. It is the first point of contact for concerns, questions, and informal resolution. PALS can answer questions about your care, liaise with staff on your behalf, and explain the complaints procedure.
PALS is informal: it does not investigate formal complaints, and it does not take sides. Its job is to help you understand what happened and what your options are, and to sort out problems quickly where it can. If you are in hospital and something is worrying you, ask any member of staff for the PALS office — or look for the PALS contact details on the hospital’s website.
Step 2: making a formal complaint
A formal complaint is handled through a two-stage procedure. Stage one is local resolution: you complain to the organisation that provided the service, or to its commissioner — your local Integrated Care Board, or NHS England. The organisation must acknowledge your complaint within 3 working days and investigate it properly, and you have the right to discuss how it is handled and to know the likely timescale.
Complaints should normally be made within 12 months of the treatment concerned, though the time limit can be extended depending on the circumstances — for example, if you only recently found out about the problem. Put your complaint in writing if you can, say what happened and when, say what you would like to happen, and keep a copy. If you need help writing it, PALS or a local advocacy service can help.
Step 3: the Ombudsman
If local resolution does not satisfy you, stage two is the Parliamentary and Health Service Ombudsman. The Ombudsman is independent of the NHS, and investigates complaints about NHS services in England. You should normally go to the Ombudsman after the local process has finished, though there are exceptions.
The Ombudsman can recommend that the organisation apologise, take action to put things right, or pay compensation where appropriate. Its decisions are not legally binding in the way a court judgment is, but NHS organisations almost always follow them. Details of how to contact the Ombudsman are on its website and on nhs.uk.
Other routes for particular complaints
Not every complaint goes through the same route. Complaints about the use of the Mental Health Act go to the Care Quality Commission (CQC), which regulates health and social care services. Complaints about individual professionals go to their regulators — for example, the General Medical Council (GMC) for doctors, and the Nursing and Midwifery Council (NMC) for nurses and midwives.
If you are unsure which route applies, PALS can point you in the right direction, or you can check the guidance on nhs.uk. And remember the point this guide started with: complaining does not affect your treatment. No NHS service can withdraw care because a patient complained.
Sources: House of Commons Library, NHS complaints in England (research briefing CBP-10719); NHS Constitution for England; NHS England, complaints guidance.