Hospital Treatment: Your Right To Complain

If you're unhappy with the treatment you've received at a hospital, you have the right to make a complaint. There are several ways to do this, including contacting your insurance provider, your state's medical society or licensing board, or the hospital's management. If you believe your rights have been violated by a hospital emergency department, you can file a complaint under the Emergency Medical Treatment and Labor Act (EMTALA). When filing a complaint, it's important to provide as much detail as possible about the incident, including the name of the hospital or staff member involved, the patient's name, and the date and time of the incident. You can choose to file a complaint anonymously, but providing your contact information will allow investigators to reach out to you and provide a summary of the investigation.

How to complain about NHS treatment

You have the right to make a complaint about any aspect of NHS care, treatment, or service. The NHS encourages feedback because it is used to improve services. If you are unhappy with an NHS service, it is often worthwhile discussing your concerns early on with the provider of the service, as they may be able to resolve the issue quickly. Many service providers have feedback forms available on their premises or websites.

If you wish to make a formal complaint, it is best to do so in writing via a letter or email. This ensures that the full details of your complaint are recorded and can be considered. You can complain about the treatment you received yourself, or you can speak on behalf of others in certain circumstances. This includes complaints on behalf of children, a deceased person, or someone who does not have the capacity to do so themselves. When writing a letter of complaint, include the following:

• Details of all the relevant medical treatment received
• Any steps you have already taken to raise your complaint
• Full details of your concerns and why you are unhappy with your treatment
• What you would like to achieve by lodging a complaint, for example, an apology, answers to your queries, or procedural change

If your complaint is about a mental health service, you should contact the service provider or the commissioner (who pays for the service), which is usually your local ICB. If your complaint is about the use of the Mental Health Act on someone detained in hospital or put on a guardianship or community treatment order, complain to the Care Quality Commission (CQC).

If your complaint is about NHS 24, the Golden Jubilee National Hospital, the Scottish Ambulance Service, or the State Hospital, you can find out who to address your complaint to on the NHS Inform complaints page. You can make a complaint in writing, by phone, by email, in person, or using an online complaints form.

If you are considering taking legal action regarding your complaint, you will need to consult a solicitor. Your local Citizens Advice Bureau can provide a list of local solicitors, but be aware that these actions can be costly and complex.

How to complain about private hospital treatment

If you are unhappy with the treatment you received at a private hospital, there are several steps you can take to make a complaint. Firstly, it is essential to gather all the relevant information and documents related to your medical treatment. This includes details such as the dates and times of your treatment, the names of the doctors and nurses involved, and any specific issues or concerns you have.

The next step is to decide the format of your complaint. Making a formal complaint in writing, either through a letter or email, ensures that a record of your complaint exists and allows you to provide a comprehensive account of your concerns. In your letter or email, be sure to include the details of your medical treatment, the specific issues or incidents that led to your dissatisfaction, and any previous attempts you have made to raise these concerns with the hospital. Additionally, clearly state what you hope to achieve by making this complaint, whether it is an apology, answers to your queries, or procedural changes.

When submitting your complaint, address it to the private hospital's patient services or customer relations department. You can usually find this information on the hospital's website or by contacting their main reception. It is important to remain persistent and follow up on your complaint if you do not receive a timely response.

If you are unsatisfied with the hospital's response or if your concerns are not adequately addressed, you can escalate the matter to external organizations. In the case of private hospitals, you may contact the Care Quality Commission and request an investigation into your complaint. Alternatively, if the hospital is a member of the Association of Independent Healthcare Organizations (AIHO), you can direct your complaint to them. These organizations can provide an impartial review of your case and facilitate a resolution.

In more severe cases of negligence or misconduct, you may seek legal advice and consider filing a claim for compensation. Clinical negligence solicitors can guide you through the process of making a claim and help you secure compensation for any harm or injuries suffered due to substandard medical treatment. Remember, your right to quality care and fair treatment must be upheld, and making a complaint can lead to improvements in hospital procedures and patient experiences.

What to include in a complaint

When making a complaint about hospital treatment, it is important to include as much detail as possible. Here are some key things to consider including when drafting your complaint:

Details of your medical treatment

Provide a comprehensive overview of the medical treatment you received, including any specific procedures, medications, or interventions. This information will help the hospital identify the specific areas of concern and conduct a thorough investigation.

Steps already taken to address the issue

Explain any previous attempts you have made to raise your concerns, such as discussions with staff members or informal complaints. This information will help the hospital understand the chronology of events and identify any breakdowns in communication or resolution processes.

Full details of your concerns and expectations

Clearly articulate your specific grievances and the reasons for your dissatisfaction. Explain the impact the issue has had on you, and outline what you would like to achieve by making the complaint. For example, you may be seeking an apology, answers to your queries, or procedural changes to prevent similar incidents in the future.

Relevant dates, times, and locations

Include specific information about when and where the incident(s) occurred. This helps the hospital identify the relevant staff members on duty at the time and facilitates a more accurate reconstruction of the events.

Supporting evidence and documentation

Provide any relevant medical records, correspondence, or other documentation that supports your complaint. This can include discharge summaries, test results, prescription information, or emails/letters related to your concerns.

Your preferred method of resolution

Consider how you would like the hospital to address your complaint. This could include requesting an apology, seeking disciplinary action, suggesting procedural improvements, or obtaining financial compensation if you have suffered an illness or injury due to negligent treatment.

Remember to keep records of all correspondence related to your complaint, including the names and job titles of individuals you speak to, decisions made, and any deadlines agreed upon.

How to complain about hospital discharge

If you have concerns about being discharged from the hospital, the first step is to speak to your doctor or the hospital discharge planner (often a social worker) about your worries. If you are covered by Medicare or a Medicare-managed care plan, you can file an appeal about your discharge while still in the hospital. You should also receive a form from the hospital titled "An Important Message from Medicare," which explains how to appeal a hospital discharge decision. Appeals are free and usually resolved within two to three days. The hospital cannot discharge you until the appeal is completed.

If you are concerned about the lack of caregiving support you will have at home, you can work with your healthcare provider to determine if there is coverage for a home health worker, home-based nursing care, a rehabilitation facility, or short-term nursing home care. Once you have been given a discharge date, and you and your healthcare provider agree that you should extend your stay, you will need to file an appeal with your insurance provider. The steps for an appeal will vary from hospital to hospital and state to state, but you will ultimately need a healthcare provider to explain why an extended stay is medically necessary.

Review your hospital admission papers, which should include a statement of your rights, discharge information, and how to appeal a discharge. If you are not provided with this information, request it from the hospital's patient advocate. The hospital staff member tasked with appeals is the Quality Improvement Officer (QIO), and the federal government has strict requirements about how QIO handles discharge appeals. You can file an appeal on the day of your discharge and will generally not be financially responsible for additional charges until noon the next day.

If you are a Medicare beneficiary and you question the appropriateness of a proposed discharge, whether it is too soon, or whether necessary post-hospital services have been arranged, you should contact your local QIO and file a complaint. The hospital discharge notice should provide the name, address, and phone number of the relevant QIO, along with instructions on how to file a complaint. Before leaving the hospital, ensure that a post-hospital plan of care and services has been developed, and that your discharge plan identifies the necessary services, including how those services will be provided.

Who to contact about mental health complaints

If you wish to make a complaint about a mental health service, you should either contact the service provider or the commissioner (who pays for the service) and this would usually be your local ICB. If you wish to complain about the use of the Mental Health Act on someone detained in hospital or put on a guardianship or community treatment order, complain to the Care Quality Commission (CQC). You can find out how to complain about the use of the Mental Health Act on the CQC website.

Complaints should usually be made within 12 months of an incident or of it coming to your attention. This time limit can be extended if you have valid reasons for not making the complaint sooner and if it is still possible to complete a fair investigation.

If you are considering taking legal action about your NHS complaint, you will need to consult a solicitor. Your local Citizens Advice Bureau can give you a list of local solicitors and inform you of your rights. You should be aware that these actions can be costly and complex. All family practitioners are insured and legal action will usually be contested by an insurance company.

If you are in a life-threatening situation, call 911 or go to your nearest emergency room. If you are suicidal or in emotional distress, consider using the 988 Suicide & Crisis Lifeline. Call or text 988 or start an online chat to connect with a trained crisis counsellor. The Lifeline provides 24-hour, confidential support to anyone in suicidal crisis or emotional distress. If you are a veteran, consider using the Veterans Crisis Line.

The National Alliance on Mental Illness (NAMI) HelpLine is a free, confidential nationwide service that provides one-on-one emotional support, mental health information, and resources needed to tackle tough challenges. NAMI HelpLine does not provide mental health counselling, advice, personal advocacy, or referrals to individual mental health providers or lawyers.

Frequently asked questions