When would I make a complaint to an ombudsman?
If the formal complaints procedure does not resolve your complaint about your health or social care, this can be very frustrating and sometimes upsetting. However, there are other actions you can take. One of these is asking the relevant ombudsman to investigate your complaint.
What is an ombudsman?
An ombudsman is an official appointed to investigate someone's complaint against a company or organisation, especially a public authority. The ombudsman is independent of the NHS, providers of care, local authorities and the government.
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Ombudsmen do not have any power to enforce their recommendations, but their recommendations are almost always followed.
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When will an ombudsman take on a case?
An ombudsman does not have to take on a case. Generally, they won’t investigate your complaint if:
- you have not been through the formal complaints procedure first with the care provider, NHS or local authority
- you make your complaint outside of 12 months from the date of the event(s), unless there is a special reason for the delay
- your complaint is already the subject of legal proceedings (or sometimes when it could become the subject of legal proceedings)
Which ombudsman should I complain to?
The ombudsman you complain to will depend on where you are and what you are complaining about:
Parliamentary and Health Service Ombudsman (England)
The Health Service Ombudsman is part of the Parliamentary and Health Service Ombudsman. The Ombudsman makes final decisions about complaints that have not been resolved by the NHS in England.
If you make a complaint to the Health Services Ombudsman and it upholds your complaint, it can make recommendations to the NHS to put things right. This could include asking it to:
- make an apology
- acknowledge its mistakes
- make a payment.
It can also ask the organisation to show how it will prevent this happening again so that other people don’t have to go through the same situation.
If the complaint also concerns social care then the Local Government and Social Care Ombudsman will jointly review the case.
You can’t apply to the Health Service Ombudsman if your care was private, unless it was funded by the NHS.
Local Government and Social Care Ombudsman (England)
The Local Government and Social Care Ombudsman makes final decisions about complaints that have not been resolved by a local authority in England about adult social care.
The Ombudsman can investigate complaints that:
- the council has not provided a service which it has a duty to provide
- there has been a failure in providing a service
- there has been maladministration connected with action taken by or on its behalf.
If the Ombudsman does uphold your complaint, then they can request the council to put things right. This could include asking it to:
- make an apology
- provide a service you should have had
- make a decision that it should have done before
- improve their procedures
- make a payment.
If the complaint also concerns health care then the Health Service Ombudsman will jointly review the case. You can still complain to the Local Government and Social Care Ombudsman about social care, even if the care was private.
Public Services Ombudsman (Wales)
The Public Services Ombudsman investigates all complaints about public services in Wales, including those made against the NHS, the local authority and independent care providers.
When you submit a complaint, the Public Services Ombudsman aims to:
- let you know whether it is able to investigate your complaint within six weeks
- check if there are any quick actions it could ask the organisation to make to resolve the situation.
If the Ombudsman does uphold your complaint, then they can request the council to put things right. This could include asking it to:
- make an apology
- improve their procedures
- make a payment.
What can I do if this hasn't resolved my complaint?
If you feel like your complaint has not been dealt with by the ombudsman, you have some some other options. You can:
This information was published in May 2017. We will revise it in 2019.
