Who do I complain to about my GP surgery?

By Emma Pickford

GP Surgery

Millions of us require the services of our local GP, but what happens when you are unhappy with the experience, or face a serious issue? In this article Emma Pickford will cover why a complaint may be made, the process and timescales for making a complaint and the potential outcomes that can arise.

Why would you need to make a complaint?

There are a number of reasons why a complaint about your GP Surgery may become justified, such as:

  • If you leave your surgery and feel as though your symptoms or concerns have not been fully listened to or taken into consideration.
  • If you believe you have been treated unfairly.
  • If you have been spoken to rudely or in an unprofessional manner.
  • If you believe that things have been missed, either due to an administrative error or a failure by your GP to properly investigate your symptoms.
  • If you believe that you have suffered unnecessary delays.
  • If you feel that treatment or investigative options are being withheld from you.

For some of us, the idea of making a complaint does not come naturally and there is often the concern that by doing so we could be taking up the surgeries limited time and resources which would be better used in treating or seeing other patients.  However, the NHS’s own website encourages patients to speak up, advising that it can help surgeries reflect on their systems and processes, improve services for all patients and help try and put things right if mistakes have occurred.

What is the process for making a complaint to your GP?

The first, and often quickest step to take, is to speak to your surgery directly.  If the reason for your complaint is fairly straightforward and can be easily rectified, it might be that this is all that is needed to be able to resolve the issue.

Depending on the nature of your complaint, you could speak to:

  • Your individual GP
  • A receptionist
  • The Practice Manager
  • An alternative Healthcare provider at the Surgery, such as a Pharmacist or Nurse Practitioner.

What happens if you are not happy with the response from your GP?

If, after an informal discussion with the surgery you are still not satisfied with how your concern has been dealt with, the next stage would be to take more formal action.  You have two options at this stage, you could:

  1. Make a formal complaint to the surgery, or
  2. Complain to the NHS England Commissioner

Unfortunately, you cannot take both options, and so will need to decide at this stage which is the best one for you.

Making a formal complaint to your GP Surgery

Each GP surgery will have its own procedure for dealing with formal complaints, and so the best first step to take is to either ask for a copy of the complaints procedure or try and locate this yourself on their website.

In most cases your surgery will require complaints to be made in writing, however, if this is not possible for you, they should be able to assist you in submitting the complaint verbally.

When making your complaint be sure to include the following information:

  • What happened and when this was.
  • Which member(s) of the surgery were involved.
  • What impact the incident had on you.
  • Details of what you would like to happen to rectify your complaint.

If you have any documentation that supports your complaint, you should also include a copy of this.

One other important point is to try and make your complaint as quickly as possible after the incident, or from when you first became aware that there has been an issue/error.  This is important as there is a cut off time of 12 months for you to escalate the complaint further if need be.

Tancha Porter successfully secured a £20,000 settlement for her client, acting on behalf of her late father, following negligent treatment at a Care Home.

What happens after a formal complaint has been made?

Once you have submitted your formal complaint to your surgery, they have a number of duties they must fulfil, as well as timeframes in which they should respond.

The surgery should

  • Contact you to acknowledge the complaint within 3 working days
  • Explain how the complaint will be dealt with
  • Provide an estimated time frame for the complaint to be resolved
  • Offer you a call or a meeting to discuss the complaint, if this is appropriate
  • Once fully investigated, provide you with a written response to confirm the outcome.

The investigative process could take several weeks or months depending on the nature and severity of the complaint, and you should wait for their response before trying to escalate the matter further.

Making a formal complaint to the NHS England Commissioner

Since July 2023 the correct procedure for making a complaint to NHS England is to direct the complaint to the Integrated Care Board (ICB) who cover your GP surgery, the surgery should be able to advise you which ICB they fall under, either if you ask in person or by going onto their website.

Once you have located the correct ICB, there will be a specific postal or email address for complaints to be sent to, some ICBs may also have an online portal/form for you to use to make a complaint.  As with a complaint to your surgery, you should include the following information:

  • What happened and when this was.
  • The name of the GP Surgery
  • Which member(s) of the surgery were involved.
  • What affected the incident had on you.
  • Details of what you would like to happen to rectify your complaint.

Again, if you have any documentation that supports your complaint you should include a copy of this when making your complaint.

What happens after a formal complaint has been made?

Once you have made your formal complaint, the ICB have a number of duties they must fulfil to you, as well as timeframes in which they should respond.

The ICB should

  • Contact you to acknowledge the complaint within 3 working days.
  • Investigate the compliant as quickly as possible.
  • Keep you up to date during the investigation.
  • Once fully investigated, provide you with a written response to confirm the outcome.
  • Explain that you have the right to take your complaint further if you are not happy with the outcome.

As with complaining directly to your GP, it is worth noting that the investigative process could take several weeks or months depending on the nature and severity of the complaint and, again, it is advisable to wait for their response before trying to escalate the matter further.

What to do if you are still not satisfied with the outcome of the GP/ICB Investigation

In a lot of cases, complaints should be resolved by either the ICB or the Surgery themselves, however, if you are still not happy with the outcome, there is one other final step you can take which is to contact the Parliamentary and Health Service Ombudsman (PHSO), who are completely independent of the NHS.

Before explaining the process, it is important to note that, the PHSO will usually expect you to have complained to you GP surgery or ICB before they will look into a complaint.  In addition, you generally only have 12 months from the time you became aware of the problem you are complaining about to contact the PHSO which is why it is so important to take the initial steps as soon as possible.

If you are outside of the 12 month deadline, the PHSO do have some flexibility and when deciding whether they can accept an out of time complaint will consider factors such as whether the organisation you complained to originally has taken a long time to respond, why you were not able to complain sooner and whether the amount of time that has passed would impact on their ability to carry out an investigation.

One final point to note is that the PHSO will not investigate complaints about delays with an initial complaint response or matters which are likely to resolve themselves in a few weeks or months.  This service is only for serious complaints.

Starting a complaint through the PHSO

The PHSO have an online complaint form which has a handy “Complaint Checker” at the beginning to make sure that you are contacting the correct organisation about your particular complaint.  The link to this is below:

PHSO online complaints form

If your complaint is something serious which the PHSO feels is appropriate for them to investigate, they ask that, when making your complaint, you include the following information:

  • The details of your complaint.
  • When it happened.
  • How it affected you.
  • What you would like done to put things right.
  • Whether you are planning or have already taken legal action.
  • Whether you are complaining for yourself, or on behalf of someone else.

As with the GP and ICB, you should also include any supporting documentation.

What happens after submitting your complaint?

The PHSO will review the complaint and decide whether they should investigate it further and they provide a list of factors they take into account when making this decision on their website.  If they do not believe they can investigate further, the PHSO will tell you this is the case, explain why and advise whether there are any further/different options available to you.

If the PHSO do decide to investigate your complaint they will advise you how long this could take and will keep you regularly updated.  When carrying out the investigation they may contact clinical professionals for advice as well as the surgery you are complaining about.

When the investigation is complete, the PHSO will explain to you whether your complaint should be upheld and, if so, they can make recommendations about what the surgery should do about this, for example:

  • They can ask the surgery to take action to put things right for you (or somebody else affected). This could mean getting the surgery to acknowledge its mistakes, apologise to you, or pay you back if you have been left out of pocket because of what happened.
  • They can ask the surgery to look again at a decision it has made, but only if it is clear that it made mistakes, acted unfairly, or didn’t follow its process when making it.
  • They can ask the surgery to improve its services to avoid the same things happening again. This can include asking that they review their policies or procedures, guidance or standards.

Summary

If you have experienced an issue with your GP Surgery that you would like them to fix, the most important piece of advice is to start the complaints process as soon as possible, this ensures you do not miss the deadline for bringing a complaint, but also means information should be more readily and easily available and any conversations should be fresh in everyone’s mind.

Start with an informal discussion with the relevant member of the surgery, if this does not rectify the issue, you can either make a formal complaint to the surgery or to the Integrated Care Board that covers your surgery.  If, after this investigation has been complete you are still not happy that your complaint has been properly dealt with, the final port of call is making a complaint to the Parliamentary and Health Service Ombudsman.

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