Complaints and advocacy
If your care is going wrong and the ordinary conversations have not fixed it, you can complain and get help doing it.
If your diabetes care is going wrong and the ordinary conversations have not fixed it, you have the right to complain and to get help doing it. It is not being difficult; it is a normal part of a system that is supposed to answer to the people it treats.
- You are entitled to raise concerns and complain about NHS care, and doing so does not affect your treatment.
- Start informally: most problems are fixed by raising them directly before any formal process.
- PALS, the Patient Advice and Liaison Service, exists to help sort problems in England, often quickly.
- There is a formal NHS complaints process, and free independent advocates to help you use it.
- Clinical decisions stay clinical; this is about how you are treated and whether you are getting the care you should.
That you are allowed to, and it is safe to
People hold back from complaining about health care for a specific fear: that it will sour the relationship or affect the treatment they get. It is worth stating plainly that you are entitled to raise concerns, that the NHS has formal processes precisely because feedback is expected, and that complaining should never affect the care you receive. If it ever did, that would itself be a serious problem worth escalating.
It also helps to separate the two things this can be about. One is how you have been treated: being dismissed, spoken to badly, left without care you should have had, or unable to access something you are entitled to. The other, rarer and more serious, is a clinical concern about a decision or an error. Both are legitimate, and knowing which one you are raising helps you aim it at the right place.
And it is worth keeping the goal in view. Most people who complain are not after a fight; they want something fixed, an acknowledgement, or a change so it does not happen to someone else. Holding onto what you actually want from it keeps the process focused and usually makes it more likely to work.
Raising it directly, and PALS
The great majority of problems are resolved without any formal complaint at all, by raising them directly and early. Telling the person involved, or asking to speak to a manager or the person in charge of the service, often sorts it, because a lot of what goes wrong is a misunderstanding, an oversight, or one individual rather than the whole team. Putting it in a short, calm email creates a record and is easier than a confrontation.
If that does not work, or you would rather not go to the service directly, the Patient Advice and Liaison Service, known as PALS, is the next step in England. PALS is there to help patients sort out problems and answer questions, often informally and quickly, and they can take up an issue on your behalf without it becoming a formal complaint. Similar arrangements exist across the UK under different names, and hospitals will point you to theirs.
Keeping notes helps at every stage: what happened, when, who was involved, and what was said. A dated record turns “I feel I have been let down” into something specific that can actually be looked into, and it is far easier to write down as you go than to reconstruct later.
The complaints process, and getting help with it
If informal routes have not worked, there is a formal NHS complaints process, and you have the right to use it. You can complain to the service that provided the care, or to the body that commissioned it, usually within a time limit of around twelve months from the event or from when you became aware of it. The response should explain what happened, what has been found, and what will change. If you are not satisfied with the outcome, complaints can be escalated further, ultimately to the relevant ombudsman.
You do not have to do this alone, and this is the part people most often do not know: there are free, independent NHS complaints advocacy services whose whole job is to help you make a complaint, understand your options, write letters, and even attend meetings with you. They are independent of the NHS, they are free, and using one is a normal thing to do rather than an escalation in itself. Charities such as Diabetes UK can also advise and sometimes advocate, particularly where the issue is about access to care or technology you should be able to get.
Two things to hold onto. A complaint about how you were treated does not put your future care at risk, and a good service will handle it professionally. And if the issue is that you cannot get treatment or technology you believe you are entitled to, that is often better framed as an access and rights question, with the relevant guidance and an advocate behind you, than as a personal grievance. The clinical judgement stays with the clinicians; whether the right process and access have been followed is a fair thing to hold them to.
What shapes how you approach it
Whether it is one person or the whole service decides how far you need to go: a single clinician is often solved by asking to see someone else, while a service-wide problem may need the formal route. A clinical concern is more serious and worth advice on before raising. And access to technology or treatment you are entitled to is a common, winnable kind of issue, especially with an advocate or a charity behind you.
How it goes
Examples, not instructions or doses.
A calm note to the service manager sorting a problem before any formal process. Most complaints resolve exactly here.
An issue handed to PALS and sorted informally on your behalf. Often quicker than a formal complaint and less draining.
An independent NHS complaints advocate helping write the letter and attend the meeting. Free, normal, and you do not do it alone.