When we go to an NHS hospital for treatment, and we’re not happy with the service that we receive, most people would probably have a reasonable idea about how to complain. A quick search on the web will bring up the NHS Complaints Procedure. The first step is of course to start informally with the doctor and hospital that is treating you, or to seek the assistance of your GP. If that doesn’t work, then every NHS provider has a formal complaints procedure. If that doesn’t work then you can go the organisation that commissioned, planned or paid for your treatment. This is usually NHS England or your local Clinical Commissioning Groups (CCG).
But when you’re undergoing treatment in a private hospital it’s less straightforward.
The first step is the hospital. Each private hospital has a Chief Executive Officer, Executive Director or Hospital Director. He/she is responsible for everything that goes on in the hospital. Each private hospital and private hospital group has a complaints procedure. Here’s an example - the Spire Healthcare complaints policy.
If you can’t resolve the issue locally, then your next step is likely to be the Medical Director for the hospital, or for the private hospital groups, the Group Medical Director.
Taking it to the next level - the Independent Sector Complaints Adjudication Service
The Independent Sector Complaints Adjudication Service (ISCAS) provides independent adjudication on complaints about their members. You can view their list of members here.
ISCAS is a voluntary scheme and covers the vast majority of independent healthcare providers. Their complaints code is laid out as follows:
- Stage 1 – Local Resolution
Stage 1 is usually dealt with by the Hospital Manager of the Hospital or Clinic (even if it is about a doctor).
- Stage 2 – Complaint Review
Stage 2 is usually dealt with by the Chief Executive or Managing Director of the Hospital Group or by a non-executive director/trustee who has not been involved at Stage 1 and is removed from the hospital/clinic in the case of an individual hospital.
- Stage 3 – ISCAS Independent External Adjudication
Stage 3 is conducted by an ISCAS Independent Adjudicator.
You have to go through stages 1 and 2 BEFORE you go to the ISCAS Independent External Adjudication. You cannot short circuit the process.
Making a complaint to ISCAS
You are asked to sign a ‘Statement of Understanding and Consent’, which means that you agree to thereby agreeing to the parameters of their process. You will need to set out in writing the reasons for your complaint:
- What aspects of your complaint still remain unresolved (after you have been through Stages 1 and 2).
- What outcome you are seeking from making a formal complaint to ISCAS.
You should check what the powers of ISCAS are and what they can and cannot do. Note that if you are an NHS funded patient who has been treated in a private hospital, you must use the NHS Complaints Procedure. The same applies if you are a private patient being treated in a private patient unit within an NHS hospital.
And you cannot complain about:
- Alleged clinical negligence and causality. For this, you need to go to a solicitor.
- A doctor, nurse or other healthcare professional. For this, you go to their professional association or the organisation that regulates their profession.
- Treatment that was received over six months previously (or if it has been longer than six months before you discovered that there was something to complain about.)
You do not have to pay for the complaints process.
There is no appeal if ISCAS rules against your complaint. But you are still able to take legal action at any point.
Other relevant organisations
As with the NHS, there are organisations which represent the interests of patients. For the private sector, there is the Private Patients Forum. The Private Patients’ Forum is there to inform, support and empower patients and all users and potential users of the UK independent private healthcare sector. Its main objective is to help everyone get the best from private healthcare. You can ask a question of them in the Private Patients Forum area of this site.
The Care Quality Commission is also interested I hearing what patients think. Private hospitals began to be inspected under the CQC’s new inspection approach in September 2014. This new regulatory approach for the private healthcare sector signals the first time that these providers will be awarded ratings (from April 2015).
There is also an Association of Independent Healthcare Organisations (AIHO). It is the trade association for independent healthcare providers across the United Kingdom. It represents over 200 private hospitals that provide services to insured, self-paying and NHS-funded patients.
The last resort
It may be the time to call in the lawyers, if there is an issue of medical negligence. Here’s a couple who specialise: