NHS complaints • PALS • ICB
Turn a difficult NHS experience into a focused, evidence-based complaint.
A strong complaint is not the longest email. It identifies what happened, what should be answered, what evidence supports the concern and what outcome is being requested.
PALS, informal resolution or formal complaint?
Some issues can be resolved quickly through a provider's Patient Advice and Liaison Service (PALS) or patient-experience team. Others need a formal complaint because there is a disputed decision, repeated failure, unresolved harm/impact or a need for a written investigation and response.
We help parents think about the outcome first rather than automatically escalating everything to the highest possible level.
Build the complaint around the actual decision
Four questions
- What happened?
- What should the organisation specifically address?
- What evidence supports that point?
- What outcome are you asking for?
Keep separate
Protective action, allegation, clinical opinion, commissioning restriction, complaint finding and formal legal finding are not interchangeable concepts. Clear correspondence avoids collapsing them together.
When the response is long but the answer is missing
We can map each question against the response and identify whether it was:
That makes follow-up much more effective than sending the original complaint again with “you haven't listened” added to the top.
When an integrated care board (ICB) / commissioner may matter
If the issue concerns commissioning, patient choice, primary-care commissioning responsibilities or a service-level decision outside the provider's control, the relevant ICB or commissioner may need to answer part of the problem. We help identify that distinction; we do not assume every provider problem belongs with the ICB.
Free statutory/commissioned NHS complaints advocacy may be available locally. In Your Corner should complement that support, not pretend to be the statutory service.
If the problem concerns an NHS Right to Choose referral, first identify whether it is a GP/referrer decision, provider issue, local ICB arrangement or waiting-list problem. See our Right to Choose guide before choosing the complaint route.
Practical parent-advocacy guidance, not legal or clinical advice. Reviewed 18 August 2026 against the official sources linked on this page. See how we write, check and correct guidance.
Official sources / further reading
NHS England complaints policy ↗NHS Constitution for England ↗Process and policy can change. This page was reviewed 18 August 2026. Official sources take priority over this general information.
Questions parents ask
Answers for parents and carers in England. These answers were checked on 27 September 2026; use the linked official source where your next step depends on a legal duty or process.
Who do I complain to about an NHS referral delay?
Start by identifying where the delay occurred: the referring practice, receiving provider or a commissioning decision. Ask for confirmation that the referral was sent, received and accepted. You can complain to the relevant provider or commissioner; the ICB is not automatically an appeal stage after a provider complaint.
Official source: NHS England: complaints about services.
Is contacting PALS the same as making a formal complaint?
Not necessarily. PALS can help resolve concerns informally. If you need a formal investigation and written response, make clear that you are using the organisation’s complaints procedure and ask how it will be handled.
Set out the questions and outcome.
Official source: NHS England: complaints about services.
What if I am still unhappy after the final NHS complaint response?
Check what the final response says about escalation. The Parliamentary and Health Service Ombudsman may consider unresolved NHS complaints after the local process, subject to its remit and time limits. An unfavourable response does not automatically mean there is a further internal appeal.
Check what the response answered.
Official source: PHSO: making a complaint.
Where to take the complaint
For most NHS services, you can complain to the organisation that provided the service or, where applicable, to the body responsible for commissioning it.
The correct route depends on the service and the issue being complained about.
The commissioner should not automatically be treated as a second appeal stage simply because a provider has issued a response.
NHS complaints should normally be raised within the applicable complaints time limit, although late complaints may sometimes still be considered where there is a good reason and a fair investigation remains possible.
- NHS public complaints guidance
- NHS Kent and Medway complaints information
- Parliamentary and Health Service Ombudsman: making a complaint
Need help with an NHS complaint?
IYC may be able to help you understand the complaints process, organise the issues, prepare your evidence and work out the next step.
Independent NHS complaints advocacy is also available. If you would prefer commissioned independent advocacy, or IYC is unable to take your case, check Healthwatch Kent or Healthwatch Medway for local signposting. Both websites currently carry notices about changes to local Healthwatch. If that route is unavailable, use NHS Kent and Medway’s independent complaints advocacy information to identify support in your area.
After a final response
If the local NHS complaints process has finished and you remain dissatisfied, the final response should normally explain whether the complaint can be taken to the Parliamentary and Health Service Ombudsman (PHSO).
PHSO is independent of the NHS and considers unresolved complaints about NHS services in England.