Complain to your practice: If you are dissatisfied with the treatment or services you have received from your GP practice you should complain first to the practice concerned (local resolution). Wherever possible you should tell someone close to the complaint (e.g. your GP, a nurse or a receptionist). Your complaint may be made orally or in writing and you should receive an acknowledgment within two working days and a response within ten working days, or be kept informed about progress of the investigation. If you would prefer to talk to someone not involved in your treatment then you can contact the complaints manager in the practice. All family doctors operate their own practice-based complaints system. Every practice should have a written complaints procedure, which gives you the name of the person responsible for investigating complaints.

If your are unable to resolve your complaint with your GP or practice, you should refer your complaint to your Primary Care Trust (PCTs- England& Scotland) Community Heatlh Council (CHCs - Wales) or Health and Social Services Trust (HSS Trusts - Northern Ireland).

PCTs, CHCs and HSSTs are local health organisations responsible for managing health services in your local area. They work with local authorities and other agencies that provide health and social care locally to make sure the community's needs are being met.

Find your local PCT/CHC/HSS Trust here

Conciliation: Conciliation is most often used, if both sides agree to this step, to help with complaints about 'primary care' services. Primary care trusts (PCT/CHCs/HSSTrusts) are required to provide conciliation services for these. However, your NHS trust or PCT/CHC/HSSTrust may also offer you this service if you make a complaint to them.

If you are not satisfied with the response from your PCT/CHC/HSST then you can turn to the Independent Review.

The Independent Review: Together with an independent lay person, the convener considers whether any other local resolution action might resolve your problem. If not, then the convener will decide whether there should be an Independent Review of your complaint by a special panel. The convener will only convene a panel if he or she thinks that a panel investigation is likely to resolve the problems you have identified. Either way, you will be told of the convener's decision in writing, usually within four weeks of you requesting a panel investigation. If a panel is to be set up, you will be told what matters they will investigate.

Who will investigate? The panel is made up of three members: the convener, an independent lay person acting as chair and one other person. It examines fully the concerns referred to it by the convener, talking to everyone involved and getting any specialist advice (such as independent clinical assessments) it needs. The panel writes a report giving the results of its investigations, together with its conclusions and any appropriate comments or suggestions. You will be given a copy of the report, and the chief executive will write to tell you of any action being taken as a result of the panel's recommendations.

Compensation & Disciplinary procedures: The panel has no power to discipline anyone, award compensation or even to recommend such action. Disciplinary action may be taken after a complaint has been made but this is considered separately under a different procedure (see step 3 below).

Complain to the Health Service Ombudsman: If you are not satisfied with the convener's decision or are not satisfied with the Review Panel's investigation you can ask the Ombudsman to investigate. The Health Service Ombudsman (also known as the Commissioner) is completely independent of both the NHS and the Government. He/she has been given wide powers by Parliament to investigate complaints about services provided within the NHS.  There is no appeal against the Ombudsman's decision.

What sort of complaints will the Ombudsman investigate? Complaints relating to, for example, failure to respond to an out of hours call, failure to explain decisions or provide information could be dealt with by the above procedure. There are a number of things The Ombudsman can not investigate. These include: complaints about private treatment; complaints about local authority social services; events requiring investigation by a professional disciplinary body; events about which you are already taking legal action. For more information on complaining to The Health Service Ombudsman see the links below.

What about other complaints?

Complaints about the conduct or behaviour of doctors: Complaints relating to the attitude or behaviour of a doctor should be made to the General Medical Council (GMC) The GMC has powers to discipline all registered medical practitioners, whether in the NHS or private sector. It considers complaints about serious failures of care, violent or indecent behaviour, dishonesty, etc.

Complaints about the conduct of nurses, midwives or health visitors: Complaints relating to their attitude or behaviour are made to the United Kingdom Nursing Midwifery Council (NMC). The NMC will investigate allegations of professional misconduct or unfitness to practice for reasons of ill health. Complaints should be sent in writing to the Professional Conduct Department Manager giving details of the name of the nurse, midwife or health visitor, the dates of the alleged incident or pattern of behaviour and an outline of the misconduct. There is no time limit for making a complaint to the NMC. You can call the NMC's advice service (see link to their website below) to have an informal chat before you decide whether to make a complaint.

Complaints about the conduct of other health related professionals: Complaints relating to the attitude or behaviour of paramedics/health professionals including physiotherapists, occupational therapists, speech & language therapists, dietitians, radiographers, chiropodists and other therapists, but NOT doctors, nurses, dentists, opticians or pharmacists or reidential homes, should be made to the Health Professions Council (HPC). The HPC's Investigating Committee will check a complaint or allegation to determine if there is a case and the nature of the case. If so, it then goes to either the Conduct and Competence Committee or the Health Committee.

Court: Failing all else you can still go to court to resolve your dispute. Details of small claims court and other procedures are given in the Legal Section of this site. You can also contact the Community Legal Service (justask.org.uk) that gives access to free advice. Otherwise your local Citizens' Advice Bureau will give you advice and will sometimes organise free legal representation for you.