PALS complaint letter template (NHS, UK)

What PALS actually does

PALS — the Patient Advice and Liaison Service — is the NHS's informal first port of call for concerns about care at an NHS hospital trust in England. Every acute, mental health and community trust has one. It is staffed by NHS employees and reports into the trust's governance team.

PALS is not a regulator and not a complaints body. It can't order anyone to do anything. What it can do is pick up the phone to a ward or clinic, get an explanation, broker an apology, and put the issue in writing — usually within days rather than the months a formal complaint can take. If a fix is straightforward, PALS is usually the fastest route to one.

What PALS can't do: investigate a GP practice (PALS sit inside hospital trusts), award compensation, or override a clinical decision. For those you need a formal complaint or, in serious cases, the Parliamentary and Health Service Ombudsman.

The template (copy-and-paste)

Replace everything in [square brackets] with your own details. Keep the structure — PALS teams read dozens of these a week and the headers help them route your concern quickly.

To: [Trust name] PALS office From: [Your full name], date of birth [DD/MM/YYYY], NHS number [if known] Address: [Your address] Email: [Your email] Phone: [Your phone] Date: [Today's date, e.g. 21 May 2026] Subject: PALS concern — care received on [date] at [ward / clinic / department] Dear PALS team, I am writing to raise a concern about care I received at [trust name] on [date]. I would like this matter handled through PALS in the first instance. 1. What happened On [date] at approximately [time], I attended [ward / clinic / department] for [reason]. The following took place: - [Fact 1, in plain language, with date and time] - [Fact 2] - [Fact 3] 2. Why I'm raising it I am concerned because [the impact on you — e.g. delay in diagnosis, medication missed, symptom not investigated, dignity not respected]. 3. What I would like I would like PALS to: - Provide a written explanation of what happened and why. - [If relevant] Arrange [a follow-up appointment / a corrected referral / a copy of my notes from that visit]. - Confirm what, if anything, the team will do differently. I would like this raised informally with the team in the first instance. If it cannot be resolved through PALS, please let me know how to convert it into a formal complaint under the NHS Complaints Regulations 2009. Please acknowledge this concern in writing within 3 working days and respond in full within 20 working days. If you need anything further from me, contact me on [phone] or [email]. Yours faithfully, [Your name]

How to fill in each field

Trust name. Use the hospital trust the care happened at, not the one nearest you. Look up "[hospital name] PALS" — every trust publishes its PALS contact details.
Subject line. Always include the date and the ward, clinic or department. PALS triage by location.
What happened. Stick to verifiable facts in date and time order. Quote what was said only where you remember it word-for-word. Do not attribute motives ("they didn't care", "they lied") — describe behaviour, not character.
Why I'm raising it. The impact matters as much as the act. Missed diagnosis, pain, lost work, dignity, safety.
What I would like. Be specific. "An apology" is fine. "An explanation" is fine. "A follow-up appointment within 4 weeks" is better.

One thing to avoid: naming individual staff as wrongdoers. Identify who you saw ("the registrar on the ward at 14:00 on 3 May") but don't label them "negligent" or "dishonest" — that's for an investigation, not a complaint letter, and it can give the trust a reason to deflect into HR rather than answer your concern.

How to send it

Send by email if at all possible. It gives you a date-stamped paper trail. Most trusts publish a PALS email along the lines of pals@[trust].nhs.uk. Copy yourself in. Keep the sent message.

If you only have a phone number, follow up the call with an email summarising what you said and asking for written acknowledgement. PALS conversations that aren't in writing tend to evaporate.

What happens next

You should receive an acknowledgement within 3 working days. PALS will then usually contact the ward, clinic or department, get their account, and write back. Simple issues are often resolved in 5 to 10 working days; more complex ones take 20 to 30. If you haven't heard anything after 10 working days, email PALS again with the original message attached.

Possible outcomes: an explanation, an apology, a corrected appointment or referral, a change to a team process. PALS cannot award compensation or strike off a clinician. If those are what you need, you're looking at a formal complaint or a clinical negligence claim.

When to escalate to a formal complaint

Escalate when any of the following are true:

The issue involves potential clinical harm, not just service quality.
PALS's response doesn't address what you actually raised.
You want a documented investigation that the Ombudsman could later review.
PALS has missed its own deadline and isn't engaging.

A formal complaint goes to the trust's complaints team (for hospital care) or the practice manager / ICB (for a GP). It must be acknowledged within 3 working days and answered in writing under the NHS Complaints Regulations 2009. For the full Stage 1 walkthrough, see our NHS complaints guide.

If your concern is about a GP not investigating, referring or following NICE guidance, the more direct route is usually a formal, NICE-cited letter to the practice — not PALS. Finally Seen writes that letter for you for £49, with the relevant guidelines cited and a request for a written response within 28 days added to your medical record.

Frequently asked questions

›What is a PALS complaint?

PALS (Patient Advice and Liaison Service) is an informal NHS resolution service in England that sits inside every hospital trust. A PALS complaint is a written or verbal concern raised with PALS rather than through the formal NHS complaints procedure. PALS aim to resolve issues quickly (often within 5 to 30 working days) without a full investigation.

›Is a PALS complaint the same as a formal NHS complaint?

No. PALS is informal and doesn't trigger a statutory investigation under the NHS Complaints Regulations 2009. A formal complaint goes to the practice manager (for a GP) or the trust's complaints team (for a hospital), must be acknowledged within 3 working days and answered in writing. Use PALS for quick fixes, formal complaint for serious or unresolved issues.

›Can I use PALS to complain about my GP?

Not directly — PALS sit inside hospital trusts, not GP practices. For a GP, complain in writing to the practice manager (Stage 1), or to your Integrated Care Board (ICB) if you don't want the practice to handle it. PALS at a local hospital can still signpost you.

›How long does PALS take to respond?

There is no statutory deadline, but most PALS teams aim to acknowledge within 3 working days and resolve simple issues within 5 to 30 working days. If yours doesn't, escalate to the trust's formal complaints team.

›What happens after a PALS complaint?

PALS will usually contact the ward, clinic or department, get their version, and come back to you with an explanation, apology, or action. If you're not satisfied, you can raise a formal complaint — the PALS process doesn't use up your right to do so.

›Do I need a template?

No, but it helps. PALS get short, emotional messages every day; a structured letter gets a faster, more useful response. Use the template below verbatim — just swap in your facts.