Taking an NHS Complaint to the Ombudsman: When the PHSO Is the Right Door — and How to Walk Through It
An eLitigant guide. General information only — not legal advice. Companion piece to our step-by-step guide on completing the PHSO online complaint form.
In short
The Parliamentary and Health Service Ombudsman (PHSO) is the free, independent final step for complaints about the NHS in England — but it looks further only into the more serious complaints it receives. Before the merits are considered, you must hold the organisation’s final response, normally be within twelve months of becoming aware of the problem, and be the right complainant. Plain, dated, document-anchored complaints that ask only for what the Ombudsman can give have the best chance of passing its initial assessment.
Chris prepares your complaint document to a professional standard — from your own facts and your own documents.
The Parliamentary and Health Service Ombudsman (PHSO) is the final, independent step for complaints about the NHS in England. It is free, it is independent of both the NHS and government, and its powers are set out in law. But it is also selective: it now looks further only into the more serious complaints it receives, and a large share of submissions do not pass its initial assessment. This guide is about giving your complaint the best chance of being one that does.
(A note on the name: the PHSO has announced it will become the Public Service Ombudsman. The service is the same — if correspondence arrives under the new name, it is the same body.)
First: is the PHSO the right door at all?
The Ombudsman answers one question: did the organisation get things wrong in a way that caused you injustice which has not been put right? That is different from the questions other bodies answer. A regulator asks whether a provider complied with the regulations. A court asks whether negligence caused compensable harm. The Ombudsman asks about maladministration and service failure — the incident never investigated, the promised account never provided, the complaint answered beside the point, the process that failed the person it existed to serve.
If your real goal is substantial financial compensation for injury, the Ombudsman is usually the wrong door — that is a legal claim, with its own time limits, and the Ombudsman may decline to investigate matters where court action is the appropriate route. If your goal is the truth, an apology, an independent investigation, records you have been refused, or changes so it does not happen again — those are exactly what the Ombudsman can recommend, and saying so plainly strengthens your complaint.
The three gateway conditions
Before the merits are ever considered, three things must be true:
- You have completed the organisation’s own complaints process and hold its final response. If the organisation has declared the matter concluded and will not reopen it, that is completion — and a final letter that itself signposts the Ombudsman answers the point beyond argument.
- You are in time: normally within twelve months of becoming aware of the problem. If the underlying events are older, explain precisely why awareness came late — for example, records or admissions that only surfaced recently. The late emergence of the truth is often itself part of the complaint.
- You are the right complainant: the person affected, someone with their written consent, or — where the person has died — their personal representative, evidenced by the grant of probate or letters of administration.
What the assessors weigh
The Ombudsman’s published criteria for deciding whether to investigate include: whether the organisation may have got things wrong with a continuing, unremedied negative impact; the severity of the injustice; whether legal action was realistically available instead; the wider public interest; and impact on people in vulnerable circumstances. Read your draft against that list before submitting. A complaint that shows a serious, documented failure, a real and continuing injustice, remedies no court can give, and honest disclosure of any parallel processes is answering the assessor’s questions before they are asked.
The five habits of complaints that land
Write in your own words. The Ombudsman says this expressly and warns that formal legal language and over-templated drafting can slow review or trigger a resubmission request. Plain first-person narrative — what happened, when, what it did to you — always outperforms legal costume.
Keep the chronology airtight. Date every event. If there is any gap between the events and your complaint, close it yourself, in one paragraph, before anyone asks.
Let the documents prove the facts. Upload the final response, your complaint correspondence, and the key records. Make every factual claim one the assessor can verify against an enclosure.
Ask only for what the Ombudsman can give. Explanations, apologies, independent investigation, procedural change, and in appropriate cases a payment. If you seek no payment, say so — it removes at a stroke the suggestion that your complaint belongs in court.
Disclose everything else. Any legal claim, any regulator, any other body — named once, plainly, with an explanation of why each asks a different question. Parallel processes are not a problem; undisclosed ones are.
What to expect
You will receive a reference number on submission, an initial update within a stated number of working days, and then a wait — current timescales for NHS complaints run to months, and only a minority of complaints proceed to full investigation. Of those that are investigated, a substantial majority are upheld in whole or in part. The funnel is narrow; the far end favours well-built complaints. Mediation may also be offered as a route to resolution — agreeing to consider it costs nothing and signals reasonableness.
Quick checklist
- Final response in hand (or the organisation’s refusal to engage further, in writing)
- Within twelve months of awareness — or the delay explained by the facts
- Standing evidenced (consent, or grant for a deceased person)
- Own-words narrative, dated throughout
- Outcomes matched to the Ombudsman’s powers
- Legal action and other bodies disclosed
- Documents uploaded; reference number recorded
eLitigant helps litigants in person prepare court and complaint documents to a professional standard.
Related guides: Raising a concern with the CQC about an NHS or care provider · How to make a Financial Ombudsman (FOS) complaint · Housing Ombudsman complaint guide