The Health Committee has published its report on complaints and litigation in the NHS in England and its key findings are:

  • the Government should carry out a full review of the system without delay;
  • the role of the Health Service Ombudsman needs a complete overhaul if it is to provide an effective appeals process for the complaints system;
  • the NHS has no national protocol for the classification and reporting of complaints, and reporting by foundation trusts remains voluntary;
  • the Government’s recent consultation on information strategy in the context of the Health and Social Care Bill did not mention procedures for handling complaints;
  • it remains unclear how patients’ complaints about services delivered by primary care will be handled following passage of the Health & Social Care Bill; and
  • NHS culture is too often defensive and the service remains to be persuaded to adopt a more open culture.  

The Health Committee – Sixth Report: Complaints and Litigation dated 28 June 2011 can be found here.  


The 59-page report contains 56 conclusions and recommendations including eight on advice and advocacy services, including that patient advice and liaison services (PALS) are crucial, as the first line of contact for many complainants and as teams that can resolve complaints, sometimes on the spot. The Government needs to explore how PALS can have a highly visible presence in hospital receptions and GP surgeries and be well signposted throughout larger NHS buildings.

In considering the future of PALS, the committee has had to balance its core role ie the speedy resolution of complaints, with the independence that some witnesses have called for. On balance, the committee finds that PALS should remain a part of the workforce of the organisation being complained about. This “insider” position offers PALS the opportunity to access and influence clinicians and managers that may otherwise be more difficult to achieve.

The committee does not seek to set a minimum grade for PALS officers in the NHS, but does recommend that the Government commissions a framework that sets out the capabilities required to deliver patient advice and liaison roles. This framework should then be used to support, train and develop PALS officers, as well as to ascertain their current skills and benchmark grades across similar organisations.

The committee finds that one single point of access for the entire local resolution of a complaint is valuable and that integration of complaints and advice teams can provide this. The committee finds that Local Involvement Networks (soon to become Local Healthwatch organisations), as the local voice of patients, should drive forward the improvement of patient advice and complaints services and feed into the commissioning process.