When things go wrong or you have concerns about treatment you, a friend or family member received, you may consider making a complaint. Complaints can help highlight to healthcare providers ways to improve their services, which is integral to good governance and quality management.

For privately funded healthcare (self-paying or through insurance), there is no “standard” complaint procedure.

If you want to make a complaint following care you have received, or on behalf of someone else, you will need to ask for a copy of the complaint’s procedure.

If you have reason to make a complaint about Private GP Healthcare, please follow the process set out below: –

Stage 1: Complaint raised directly to us.

In the first instance it would be nice to have an informal discussion to see if we can resolve the issue. This could be with either the business owner or the Practice manager. If you prefer you can of course send a more formal letter of complaint.

The Patient Guide, sets out what to include in a complaint letter and the timescales for acknowledgement, investigation, and a full response.

A formal complaint should be made within six months of the incident. The Independent Health Provider (IHP) may be willing to investigate complaints after this time where there is a realistic opportunity of conducting a fair and effective investigation and there is good reason for a delay in making the complaint.

Stage 2: Internal review of complaint by someone who was not involved at Stage 1 (Manager/Business owner)

If you wish to escalate your complaint to stage 2, you should do so in writing, within 6 months of the final response at Stage 1.

IHPs are expected to have arrangements in place to conduct an objective review of the complaint and how it was handled at Stage 1. The appointed individual reviews all the relevant documents. They may interview staff and set up a meeting with the complainant as part of their investigations. Again, the Patient Guide sets out what to expect at this stage and the expected timescales for a full, written response.

Stage 3: ISCAS Independent Adjudication

If, having gone through Stages 1 and 2 and there has not been a satisfactory resolution you have the right to refer the matter to an independent external adjudicator through ISCAS. This must be done within 6 months of receiving the final response at stage 2; after 6 months you may not have access to the adjudication service. You will not need to pay for this process.

An Independent Adjudicator will have to decide to uphold or not uphold each aspect of the complaint. They will not consider any new issues, although they can consider issues with how the complaint was handled at stages 1 or 2. The adjudicator has the discretion to award a goodwill payment (limit of £5,000) and may highlight points of learning for the IHP and advise the organisation to share with you details of what it has learnt from the complaint. The adjudicator’s decision is final and there is no appeal stage.

The adjudicator cannot order for the IHP to pay compensation to you, provide a refund or pay the cost of revision surgeries, if required.

If you remain dissatisfied:

The Parliamentary and Health Services Ombudsman cannot investigate complaints about privately funded healthcare services.

However, you can raise a complaint to the Care Quality Commission (“CQC”) or the equivalent bodies in Scotland, Northern Ireland, and Wales. The CQC is the independent regulator of health and adult social care in England. They inspect both NHS organisations and independent providers. The CQC will take note of your complaint and may use it as part of their inspection process. However, they will not actively deal with a complaint.

If the issue is about an individual health professional’s fitness to practice, you can make a complaint to the relevant professional regulating body:
The General Medical Council (for Doctors)