{
  "schemaVersion": "1.0",
  "slug": "nhs-complaints-pals-and-advocacy",
  "url": "https://www.med-easy.co.uk/guides/nhs-complaints-pals-and-advocacy/",
  "title": "NHS complaints and PALS: find the right route and make your concern clear",
  "description": "Plan an NHS complaint, use PALS or advocacy, organise evidence and identify the correct route in England, Scotland, Wales or Northern Ireland.",
  "category": "NHS access",
  "publisher": "Med Easy",
  "language": "en-GB",
  "sourceCheckedAt": "2026-10-20",
  "reviewStatus": "Editorial information; no registered-clinician review is claimed.",
  "scope": "General UK healthcare information. Country-specific rules and provider examples retain the limits stated in the text. Fees are dated examples, not live quotes.",
  "summary": "Start with the organisation responsible for the care and state the action you need. In England, PALS may help resolve a hospital concern informally; a formal complaint follows the provider or commissioner’s procedure. Use the correct UK nation’s process, organise dated evidence and separate an active care need from the investigation.",
  "introduction": "An unresolved appointment problem, a concern about treatment and a request for a formal investigation may need different responses. Start by saying what needs to happen now, then choose the complaints route for the organisation and UK nation involved.",
  "takeaways": [
    "An informal PALS conversation and a registered formal complaint are different steps.",
    "A numbered timeline makes it easier to obtain answers to each concern.",
    "England, Scotland, Wales and Northern Ireland have different complaint systems."
  ],
  "sections": [
    {
      "id": "separate-immediate-care-from-the-complaint",
      "position": 1,
      "title": "Separate immediate care from the complaint",
      "url": "https://www.med-easy.co.uk/guides/nhs-complaints-pals-and-advocacy/#separate-immediate-care-from-the-complaint",
      "text": "If an appointment has vanished, discharge instructions are missing or a promised call has not happened, first identify the action that is still needed. A formal complaint can examine what went wrong, but it is not a substitute for clinical assessment or an urgent service response. Contact the treating team about an active care problem and explain its practical effect. Use the usual urgent-care route if the situation requires it. Write two short lines: “The problem I need resolved today is…” and “The events I want investigated are…”. This stops a lengthy history from burying the immediate request. For example, you might need confirmation of a follow-up booking now while separately asking why earlier letters went to an old address. Ask which team owns each issue and keep the replies together.",
      "links": []
    },
    {
      "id": "use-pals-for-hospital-navigation-in-england",
      "position": 2,
      "title": "Use PALS for hospital navigation in England",
      "url": "https://www.med-easy.co.uk/guides/nhs-complaints-pals-and-advocacy/#use-pals-for-hospital-navigation-in-england",
      "text": "The NHS PALS directory helps locate hospital Patient Advice and Liaison Services in England. PALS can help explain local arrangements and try to resolve concerns informally. It is useful when you are unsure which department to contact, have been passed between teams or need help communicating a concern during a hospital stay. Say whether you want practical assistance, an informal resolution or information about making a formal complaint. Ask what will be recorded, who will receive the concern and when you should expect an update. A conversation with PALS is not necessarily a registered formal complaint. Request confirmation if that distinction matters. PALS is not a national booking team and cannot promise a clinical outcome or appointment date.",
      "links": [
        {
          "label": "NHS PALS directory",
          "url": "https://www.nhs.uk/service-search/other-health-services/patient-advice-and-liaison-services-pals"
        }
      ]
    },
    {
      "id": "identify-the-organisation-responsible-for-the-response",
      "position": 3,
      "title": "Identify the organisation responsible for the response",
      "url": "https://www.med-easy.co.uk/guides/nhs-complaints-pals-and-advocacy/#identify-the-organisation-responsible-for-the-response",
      "text": "NHS England’s complaints guidance explains complaints about NHS services and the role of providers and commissioners. In England, the organisation providing care or the organisation commissioning it may be the appropriate starting point. Ask which route applies before sending the same case to several organisations as if each were a separate appeal body. For care involving several organisations, describe the whole sequence and ask how the response will be coordinated. Separate the factual questions: who made the referral, who accepted it, who sent the appointment and who was expected to communicate the result? Keep appointment identifiers and dates close to the relevant event. The most useful recipient is the team able to investigate the service involved, not simply the organisation with the most familiar name.",
      "links": [
        {
          "label": "NHS England’s complaints guidance",
          "url": "https://www.england.nhs.uk/contact-us/feedback-and-complaints/complaint/"
        }
      ]
    },
    {
      "id": "build-a-short-answerable-complaint",
      "position": 4,
      "title": "Build a short, answerable complaint",
      "url": "https://www.med-easy.co.uk/guides/nhs-complaints-pals-and-advocacy/#build-a-short-answerable-complaint",
      "text": "Use a dated sequence followed by numbered concerns. Distinguish what you personally observed from what somebody told you, and say when a date is approximate. Attach the relevant letter, invoice or message rather than sending an entire record without explanation. Remove unrelated information about other people. Ask for a secure route if records contain sensitive material. Then describe the impact and the response you are seeking. That might be a corrected administrative record, an explanation, an apology, clearer communication or evidence of a service change. An outcome request helps focus the investigation without assuming that every requested remedy is available. For example: “Please explain why the referral was returned, confirm whether a replacement is needed and identify who will tell me when it is accepted.” Keep a copy of the submitted version.",
      "links": []
    },
    {
      "id": "ask-for-support-and-agree-how-updates-will-work",
      "position": 5,
      "title": "Ask for support and agree how updates will work",
      "url": "https://www.med-easy.co.uk/guides/nhs-complaints-pals-and-advocacy/#ask-for-support-and-agree-how-updates-will-work",
      "text": "Complaints can be difficult to organise while you are unwell. Ask about accessible communication, an interpreter or an independent complaints advocate. England’s NHS guidance describes free complaints advocacy; the local arrangements matter. If somebody is acting for you, the organisation may need your authority to discuss personal information with them. Agree what they can receive and whether you also want copies. England’s usual NHS complaint limit is 12 months from the event or when it came to your attention, with possible exceptions. Do not assume that identical deadlines apply elsewhere. Ask promptly about the applicable limit, acknowledgement, expected response and update arrangements. Keep a simple log with the date sent, reference number, promised next contact and actual reply. An agreed date is more useful than repeatedly starting the same account with a new person.",
      "links": []
    },
    {
      "id": "use-the-correct-system-in-each-uk-nation",
      "position": 6,
      "title": "Use the correct system in each UK nation",
      "url": "https://www.med-easy.co.uk/guides/nhs-complaints-pals-and-advocacy/#use-the-correct-system-in-each-uk-nation",
      "text": "For Scotland, use NHS inform’s complaints guidance and ask about the Patient Advice and Support Service. The local NHS board or practice can explain its process and the relevant escalation route. Do not treat English PALS arrangements or English complaint deadlines as a UK-wide procedure. In Wales, Listening to People replaced Putting Things Right from 1 April 2026. Use current Welsh guidance rather than an older template. In Northern Ireland, nidirect identifies health and social care complaints routes , including support from the Patient and Client Council. If treatment crossed a border, ask which organisation provided it, how it was funded and which complaint procedure governs that episode.",
      "links": [
        {
          "label": "NHS inform’s complaints guidance",
          "url": "https://www.nhsinform.scot/care-support-and-rights/health-rights/feedback-and-complaints/feedback-complaints-and-your-rights/"
        },
        {
          "label": "Listening to People",
          "url": "https://www.gov.wales/listening-people-nhs-wales-complaints-incidents-and-redress-process"
        },
        {
          "label": "nidirect identifies health and social care complaints routes",
          "url": "https://www.nidirect.gov.uk/articles/how-complain-or-raise-concerns-about-health-services"
        }
      ]
    },
    {
      "id": "read-the-final-response-against-your-original-questions",
      "position": 7,
      "title": "Read the final response against your original questions",
      "url": "https://www.med-easy.co.uk/guides/nhs-complaints-pals-and-advocacy/#read-the-final-response-against-your-original-questions",
      "text": "Make a small table: your numbered concern, the answer given, supporting explanation and anything unresolved. This is easier to assess than deciding whether the overall letter feels satisfactory. If a point is missing or inaccurate, identify it precisely and ask what further information would resolve it. Record any promised action and who will confirm its completion. The final response should explain further options. In England, unresolved NHS complaints may go to the Parliamentary and Health Service Ombudsman after the local process; other nations have their own ombudsmen. A professional regulator or the CQC has a different role from the complaint handler. Reporting a wider concern does not itself secure an individual remedy. Keep active treatment, complaint investigation and any separate advice needs clearly organised.",
      "links": [
        {
          "label": "CQC",
          "url": "https://www.cqc.org.uk/contact-us/how-complain/complain-about-service-or-provider"
        }
      ]
    }
  ],
  "questionsToAsk": [
    "Which team can address the immediate care problem while the complaint is investigated?",
    "Has my concern been registered formally, and what is its reference?",
    "Which numbered questions and supporting documents will the investigation cover?",
    "What communication support or independent advocacy can I use?",
    "When will I receive an update and what review route follows the final response?"
  ],
  "frequentlyAskedQuestions": [
    {
      "question": "Do I have to speak to PALS before making a formal NHS complaint?",
      "answer": "PALS is an informal support option in many English hospitals. Ask the provider for its formal complaints procedure if that is the route you want; do not assume a PALS conversation is a compulsory first stage or a registered complaint.",
      "url": "https://www.med-easy.co.uk/guides/nhs-complaints-pals-and-advocacy/#faq-1"
    },
    {
      "question": "Is the complaints process the same across the UK?",
      "answer": "No. Use the procedure for the nation and organisation involved. Wales introduced Listening to People from 1 April 2026; Scotland and Northern Ireland have their own arrangements and support services.",
      "url": "https://www.med-easy.co.uk/guides/nhs-complaints-pals-and-advocacy/#faq-2"
    },
    {
      "question": "Can a complaint replace the need to contact my clinical team?",
      "answer": "No. An investigation may take time and cannot provide an urgent clinical assessment. Contact the relevant care team about a continuing care problem while keeping the complaint history separate.",
      "url": "https://www.med-easy.co.uk/guides/nhs-complaints-pals-and-advocacy/#faq-3"
    }
  ],
  "appointmentJourney": {
    "before": [
      "Write the immediate action needed separately from the events you want investigated.",
      "Find the official complaints contact for the provider and UK nation involved.",
      "Arrange relevant dates and documents into a concise numbered timeline."
    ],
    "during": [
      "Ask whether the concern is being handled informally or as a formal complaint.",
      "Confirm the questions being investigated and any representative’s authority.",
      "Agree the next update and your preferred accessible communication method."
    ],
    "after": [
      "Compare the final response against each original question.",
      "Record the owner and expected completion of any promised action.",
      "Use the stated escalation route for issues that remain unanswered."
    ]
  },
  "sources": [
    {
      "title": "NHS England: feedback and complaints about NHS services",
      "url": "https://www.england.nhs.uk/contact-us/feedback-and-complaints/complaint/",
      "publisherDomain": "england.nhs.uk",
      "kind": "NHS or public authority"
    },
    {
      "title": "NHS: find patient advice and liaison services",
      "url": "https://www.nhs.uk/service-search/other-health-services/patient-advice-and-liaison-services-pals",
      "publisherDomain": "nhs.uk",
      "kind": "NHS or public authority"
    },
    {
      "title": "NHS inform: feedback, complaints and your rights",
      "url": "https://www.nhsinform.scot/care-support-and-rights/health-rights/feedback-and-complaints/feedback-complaints-and-your-rights/",
      "publisherDomain": "nhsinform.scot",
      "kind": "NHS or public authority"
    },
    {
      "title": "Welsh Government: Listening to People complaints process",
      "url": "https://www.gov.wales/listening-people-nhs-wales-complaints-incidents-and-redress-process",
      "publisherDomain": "gov.wales",
      "kind": "NHS or public authority"
    },
    {
      "title": "nidirect: concerns and complaints about health services",
      "url": "https://www.nidirect.gov.uk/articles/how-complain-or-raise-concerns-about-health-services",
      "publisherDomain": "nidirect.gov.uk",
      "kind": "NHS or public authority"
    },
    {
      "title": "CQC: complaints about a service or provider",
      "url": "https://www.cqc.org.uk/contact-us/how-complain/complain-about-service-or-provider",
      "publisherDomain": "cqc.org.uk",
      "kind": "Regulator"
    }
  ],
  "relatedGuides": [
    "https://www.med-easy.co.uk/guides/nhs-referrals-waiting-lists/",
    "https://www.med-easy.co.uk/guides/accessible-appointments-and-interpreters/",
    "https://www.med-easy.co.uk/guides/uk-healthcare-four-nations/"
  ]
}