How to raise a concern about GP services

Most concerns about GP services are resolved quickly once the practice knows about them. Sometimes, though, that first conversation isn't enough - and patients are left unsure who to contact next, what timescales to expect, and what the formal routes actually involve.

This guide walks through how the NHS complaints process works for GP services in England: when to raise a concern, who to contact at each stage, and the bodies involved if things aren't resolved at practice level.

You can raise a concern about any aspect of your GP practice - clinical care, communication, the appointment system, staff conduct, prescriptions, record-keeping, or how a complaint has been handled. There is no minimum threshold; if something doesn't feel right, you are entitled to ask about it.

Common reasons people raise concerns include:

Raising a concern early often makes it easier to resolve. Many practices welcome feedback as a way to improve services - and a clear, factual account of what happened is usually more useful than waiting until the situation has escalated.

For most concerns, the first step is the GP practice itself. Every practice in England is required to have a complaints procedure, and most have a designated complaints lead - usually the practice manager.

You can raise the concern informally first (a conversation or short email) or make a formal complaint in writing. A formal written complaint triggers a structured process: the practice must acknowledge it within 3 working days and provide a substantive response in line with NHS complaints regulations.

It helps to include:

Most concerns are resolved at this stage. If the practice's response addresses your concern, the matter ends here. If it doesn't, you can escalate.

If a concern isn't resolved at practice level, NHS complaints in England follow a three-stage pathway:

If you've received a response from the practice and remain unhappy - or if you'd prefer not to raise the complaint directly with the practice - you can complain to NHS England instead. You don't usually need to go through the practice first, although doing so often leads to quicker resolution.

NHS England's customer contact centre accepts complaints by phone, post, or online. You'll need to include:

NHS England aims to acknowledge complaints within 3 working days. Investigations vary in length depending on complexity - some are resolved within weeks, others take several months. You should be kept informed of progress.

If you remain unhappy after NHS England's response, the final stage is the Parliamentary and Health Service Ombudsman (PHSO). The PHSO is independent of the NHS and reviews complaints where local resolution has not produced an acceptable outcome.

The PHSO will normally only investigate after local resolution has been completed - meaning you've usually had a response from both the practice and NHS England (or one of them, with a clear reason why the other route wasn't appropriate). Complaints to the PHSO should be made within 12 months of the original event or 12 months of when you became aware of it, though this can be extended at the PHSO's discretion.

The PHSO can recommend remedies such as apologies, explanations, and changes to practice - but it does not award financial compensation in the way a court can.

Several NHS bodies are sometimes mentioned in relation to complaints. It's worth understanding what each one does - and where they fit in the GP complaints pathway.

PALS is a free, confidential service - but it sits primarily within NHS hospital trusts, not GP practices. PALS teams help patients resolve concerns about hospital care and can signpost to the right complaints route. For concerns specifically about a GP practice, PALS is not usually the main route, although they may be able to point you to your local complaints contact.

ICBs commission NHS services in their region but do not typically handle GP complaints directly. They may be involved if a complaint raises wider commissioning issues, but the formal complaints route for individual GP service concerns runs through the practice and NHS England rather than the ICB.

NHS England currently handles formal complaints about primary care services in England, including GP, dental, optometry, and pharmacy services. This is the body to escalate to when a complaint hasn't been resolved at practice level.

The PHSO is independent of the NHS and provides the final, independent review of NHS complaints in England. It is not a first port of call - it expects local resolution to have been completed first.

The NHS complaints process has a standard time limit. Acting promptly gives the practice and NHS England the best chance of investigating fully - witnesses' memories fade, and some records become harder to retrieve over time.

A complaint can be raised by:

Where the complaint is brought by someone other than the patient, the practice or NHS England will normally need written consent from the patient before sharing detailed clinical information. If the patient lacks capacity, the rules are slightly different and an advocate can help navigate them.

NHS Complaints Advocacy is a free, independent service available to anyone making a complaint about NHS services in England. Advocates are not part of the NHS - they work for charities or independent organisations and can support you through any stage of the complaints process.

An advocate can help you:

Advocacy is delivered regionally - POhWER, VoiceAbility, and SEAP each cover different parts of England. You can find the right provider for your area through your local authority website or the NHS website.

The complaints process is designed to investigate, explain, and where appropriate improve services. Typical outcomes include:

The process does not award financial compensation. If you believe you have experienced harm as a result of clinical negligence, that is a separate legal matter and you may need to seek independent legal advice.

Most complaints are resolved without escalating beyond the practice or NHS England stage. Independent advocacy support can make the process less daunting at any stage.

This article summarises publicly available information from:

Sources referenced include: