Everyone has a right to complain if they are not happy with the standard of a care service they receive from the NHS or your Health and Social Care Trust (HSCT).

A complaint to the NHS could be about being refused a referral to a diagnostician by your GP, or being refused assessment by NHS diagnosticians. A complaint to your Health and Social Care Trust (HSCT) could be about not getting an assessment or, in your view, the right care services for your child.

If you have been waiting a long time for a service or feel that an incorrect decision has been made about your child’s care, then you can make this known to the NHS or your HSCT. The organisation will investigate and attempt to put things right

There are several ways of trying to resolve problems and there is also help available. Here we will tell you a bit about some of the complaints procedures you can use.

If you’re happy with the HSCT but have a problem with the service you’re receiving, such as having a home help visit, should complain to the person who manages that service as well as to the HSCT. If your child is attending a residential service such as a children’s home then the organisation that runs the home will have a complaints procedure that you’re entitled to see. If you feel your complaint isn’t being listened to, then whoever is responsible for managing your care package from within the HSCT should also be informed.

Complaints procedure

Each HSCT will have its own complaints procedure. You should ask your social worker or someone at the HSCT to send you a copy of this. All complaints procedures are slightly different.

The complaints procedure for services that children receive from HSCT is a single stage process. This process is detailed in the Health and Social Care Directions (Northern Ireland) 2009 and the Directions to the Health and Social Care Board on Procedures for FPS Complaints (Northern Ireland) 2009 (the Directions).

To make a complaint you need to let someone at your HSCT know that there is something wrong. You can make either a verbal or a written complaint to them, although it is advisable to put the complaint in writing or keep a note of your complaint if you use the telephone. A complaint can be made to any officer at the HSCT and they should try and sort out the problem.

Upon receiving your complaint, your HSCT must send you an acknowledgement within two working days. If you have complained orally they should send you a written account of your complaint for you to sign and return. You should get a response to your complaint within 20 working days.

Occasionally a mediation meeting between you, the manager concerned and the complaints manager is offered. This meeting is an opportunity to talk about the complaint and resolve it in person. However, you do not have to go to the meeting and if you do, you do not have to agree to anything. If you decide to go to the meeting, you can usually take an advocate with you for support. There is more information about advocates further on.

What if I am not happy with the response to my complaint?

If you have attempted to resolve an issue through the complaints process but have not had a satisfactory resolution, you have two options – the Northern Ireland Ombudsman or judicial review.

Is there anything else I should know?

Keep copies of all the letters you send to the complaints manager and only ever send copies of important supporting documents. Try not to send the original documents.

Northern Ireland Ombudsman (NIO)

The Northern Ireland Ombudsman is a free, independent organisation that investigates complaints against local authorities and NHS trusts by looking into maladministration that has caused injustice. Maladministration is where the correct procedures and considerations in setting up a service, delivering a service or making decisions have not been kept to. This would have resulted in injustice to the person who needed help.

Examples of maladministration include unreasonable delay, unfairness, failure to follow procedure and poor methods of making decisions. If you are approaching the ombudsman, your complaint must be made within 12 months of the incident occurring. In most cases, the ombudsman will only investigate your complaint after you have followed the complaints procedure but not had a satisfactory response. You can also contact the NIO on the basis of a delayed response. The ombudsman has wide investigative powers and can look at all social care and NHS documents. After the investigation, they can also make policy recommendations and arrange for compensation to be made to the complainant.

You can contact an ombudsman by using an application form (ask for a copy from the ombudsman’s office). You should also send copies of any relevant paperwork connected to your complaint.

Judicial review

Judicial review is where the courts apply the law to actions and decisions made by public bodies, and determine whether they are acting lawfully or not. A public body would be acting unlawfully if its decisions are illegal, irrational or unfair. Judicial review is the only way to resolve care-related issues in court. Judicial review can look into whether the correct procedure has been followed to reach a decision. It can then change a decision if it decides that it was wrong. However, judicial review cannot be used simply to appeal against a decision. A case appropriate for judicial review has to be brought to court within three months of:

  • the event that you are complaining about happening
  • a decision being made about your complaint.
Therefore, as soon as it is decided that judicial review is the suitable way of resolving an issue, apply for the review through a solicitor.

Does the judicial review process have a cost?

The general rule of legal costs is that the side that loses the claim must pay both their own and the winning side’s costs. The charges will depend on how far the case has progressed. A ‘letter before action’ from a solicitor can sometimes encourage the public body to put matters right. This could save money and time. If you are considering judicial review, you may be eligible for legal aid. Legal aid is funding from the Government to help people access the courts and resolve disputes. Legal aid helps with the costs of legal advice and representation. Eligibility will depend on the type of problem, your income and capital (savings, properties etc), and whether there is a possibility of you winning the case.

European Court of Human Rights

The Human Rights Act 1998 makes it unlawful for public bodies to act in such a way as to violate a person’s ‘convention rights’.  Convention rights include:

Article 2: the right to life
Article 6: the right to a fair hearing and
Article 8: the right to respect private life, family and home life.

The person making the complaint must allege a violation of at least one of the principal Articles of the Convention of Human Rights 1950.

A complaint can only be made to this court once you have gone through all other complaint procedures, and the complaint must be made within six months of the final decision made by the last and highest domestic court or authority.

If you think an NHS or HSCT decision has breached your child’s rights under the Human Rights Act you should seek specialist legal advice.

Help with the complaints process

Going through the complaints process can be quite stressful and difficult, but there are people that can help.

Advocates

If you are about to make a complaint, advocates can help you explore the options you have. For example, they can advise you on whether it would be best to go through the complaints procedure or whether the situation is too serious and urgent – in which case judicial review may be the best option. Advocates can also help you write letters, contact third parties on your behalf for information, and accompany you to meetings to support you. Advocates are on your side - they work on your behalf and their aim is to achieve whatever it is that you want to achieve. They make sure that your voice is heard and that your opinions are taken seriously.

The Patient and Client Council (PCC)

The PCC aims to provide an independent voice for patients on health and social care issues by representing the interests of the public and engaging with health and social care organisations. It promotes involvement of patients in the delivery of health and social care and provides assistance to individuals making or intending to make a complaint.

Model template letter

We have a model template letter for making a complaint.

Where to go for further advice

Citizens Advice Northern Ireland
Website: www.adviceguide.org.uk/nireland

General Medical Council
Tel: 0161 923 6602
Email: gmc@gmc-uk.org
Web: www.gmc-uk.org 

The Patient and Client Council
Website: www.patientclientcouncil.hscni.net
Email: info.pcc@hscni.net
Freephone: 0800 917 0222

Northern Ireland Ombudsman
The Ombudsman
Freepost BEL 1478
Belfast BT1 6BR
Tel: 02890 233821
Website:www.ni-ombudsman.org.uk
Email : ombudsman@ni-ombudsman.org.uk