What PHSO is and isn't
The Parliamentary and Health Service Ombudsman (PHSO) is the independent body that makes final decisions on complaints about the NHS in England, and about UK government departments. It is created and governed by the Health Service Commissioners Act 1993 and reports to Parliament, not to the NHS.
PHSO is not a court, not a regulator, and not a fast service. It can't strike off a clinician — that's the GMC. It can't award damages for clinical negligence — that's civil litigation. What it can do is independently investigate whether the NHS got it wrong, decide whether that caused you injustice, and recommend a remedy.
Eligibility and the 12-month rule
To bring a case to PHSO, three things normally have to be true:
- You've been through the local NHS complaints process and received a Stage 1 written response, or the body refused to investigate.
- You're within 12 months of the events or within 12 months of becoming aware that something went wrong.
- You're the person affected, or you have written consent from them (or you're acting for someone who lacks capacity / has died).
PHSO can extend the 12-month deadline in exceptional cases — bereavement, late receipt of medical records, ongoing health issues that prevented you from complaining sooner. Explain it briefly in your covering letter.
Your evidence pack
Send a focused pack, not a box file. PHSO assessors read hundreds of cases. The pack that gets accepted has:
- A one-page timeline of events with dates.
- Your original written complaint and the NHS body's Stage 1 response.
- Any further correspondence that followed.
- The specific medical records pages that show what you're complaining about (not the whole file — see our records guide for how to get them).
- A short statement of what outcome you want: apology, service change, financial remedy, learning.
How to submit a complaint
Submit online via the PHSO complaint form at ombudsman.org.uk/making-complaint, by phone, or by post. The free NHS Complaints Advocacy service in your area can help you prepare the pack — it's a statutory free service.
How PHSO decides
PHSO uses a two-stage internal process: assessment (do we look at this?) and, if accepted, investigation. The assessment looks at whether the NHS body had a fair chance to respond locally, whether the issue is one PHSO can decide, and whether there's enough evidence to investigate. Investigation looks at the underlying records, the NHS body's account, and (often) advice from independent clinicians.
The two key tests PHSO applies are "service failure or maladministration" and "injustice". They have to find both.
What PHSO can order
- A written apology with specific findings.
- Financial remedy — usually modest (often £100–£2,500), occasionally higher for severe failures.
- Service changes, training, or process improvements.
- A public report if the case is in the wider public interest.
If your underlying issue is being dismissed by a GP, the lever that often works better than a complaint is a NICE-cited request that has to be answered in writing and added to your medical record. Finally Seen writes that letter for £49.
Frequently asked questions
›Who can complain to PHSO?
Any NHS patient in England (or someone acting on their behalf, with consent) who has already completed the local NHS complaints process and is not satisfied with the response. PHSO also handles complaints about UK government departments.
›What is the 12-month rule?
You normally need to bring a complaint to PHSO within 12 months of the events you're complaining about, or within 12 months of becoming aware of them. PHSO can extend this in exceptional cases, but you have to explain why.
›Do I need to use a solicitor?
No. PHSO is free and designed to be used directly by patients. Independent NHS Complaints Advocacy (provided by your local council) can also help — they're free and trained in the process.
›What can PHSO decide?
PHSO decides whether there was 'service failure' or 'maladministration' and whether it caused 'injustice'. They can recommend apologies, financial remedy (usually modest), service changes, and learning. They can't strike off a clinician — that's the GMC.
›How long does PHSO take?
PHSO publishes target times of around 12 weeks for an assessment decision, with full investigations often taking 6–12 months. Complex cases can take longer.