NHS complaints and PALS: find the right route and make your concern clear

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.

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.

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.

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.

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.

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.

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.