Complaining about the NHS: PALS first, then the ICB, and a year for the ombudsman

A complaint about hospital or GP care in Britain almost always follows the same route, and it does not start with the ombudsman. Two steps sit between the patient and the final stage, each with its own deadline. Here is the order.

Where do you go first?

To PALS, the Patient Advice and Liaison Service. It sits within local hospitals and provides, in the NHS's words, "confidential advice, support and information on health-related matters". Patients, their families and their carers can all use it.

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What does PALS actually do?

It helps sort out problems and questions arising from NHS care, explains how to complain and where to get independent help, and points to support groups outside the NHS. One detail worth knowing: PALS also gathers what it hears in order to change how services run.

How do you find your PALS?

Through the service search on the NHS website, by asking at your GP practice or the hospital, or by calling NHS 111.

What if PALS does not resolve it?

Make a formal complaint, and here there are two possible recipients. The first is the organisation that provided the care: GP, dentist, hospital, pharmacy. The second is the body that commissioned it — your local Integrated Care Board (ICB).

The ICB covers primary care — GPs, dentists, opticians, pharmacies — and secondary care: hospitals, mental health services, out-of-hours services, NHS 111 and health visiting.

When does the ombudsman come in?

Only after the organisation has replied. The Parliamentary and Health Service Ombudsman takes a case once the local complaints process has been completed — the step cannot be skipped.

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What is the ombudsman's deadline?

A year: "within a year of when you became aware of the problem". The clock runs from awareness, not from the event. The service advises getting in touch as soon as possible after the organisation's final response.

How does a complaint about a government body differ?

By the go-between. A complaint about a government department or other public body is sent through your MP, who passes it to the ombudsman; the deadline is the same year. For the NHS in England no MP is needed — you go direct.

What is outside the ombudsman's remit?

A fixed list: judges and magistrates, education, local councils, MPs, the police, and private healthcare where it was not NHS funded.

There is a general limit too: a case is usually not taken where the matter could be settled in a court or tribunal. And the powers have edges — the ombudsman cannot overturn a decision an organisation is entitled to make, substitute its own, or force a change of policy or procedure.

How long is the wait?

The waiting times the service states itself run to eight months, both for NHS complaints in England and for complaints about government services. The helpline is 0345 015 4033, open Monday to Thursday 9am to 4pm and Friday 8.30am to 12pm.

The whole route in one line

PALS, then a formal complaint to the provider or the ICB, then the reply, then the ombudsman within a year of becoming aware of the problem. For government bodies, add one link: your MP.