Complaints process

Complaining can be stressful, so the aim should always be to try and sort out any problems as quickly and informally as possible. If your complaint is responded to effectively when you first raise your concerns, then it is unlikely that matters will need to be escalated through stages 2 and 3. ISCAS has produced a patients’ guide with input from the Patients Association which explains how to make a complaint about an ISCAS subscriber using the ISCAS Complaints Code of Practice.

See the full Patients’ Guide to the ISCAS Code for more information.

Complaints process - stages
Check what we can do and read below to find out more on each stage.

Before you make a formal complaint, ask the provider for a copy of their complaints procedure. ISCAS subscriber’s procedure should clearly layout the three stage process.

If you do not wish to speak to a member of ‘frontline’ staff, or if you are unhappy with how they have responded, you can take your complaint to someone more senior within the organisation, such as the unit Manager or Hospital Manager.

See the Patients’ Guide to the ISCAS Code for more information on;

  • What to include in your initial letter of complaint
  • Information on keeping written records
  • Preparing for a meeting with the provider
  • Timelines for responses

You should normally make your complaint within six months. The IHP may be willing to investigate complaints after this time where there is a realistic opportunity of conducting a fair and effective investigation, and if you have a good reason why you could not act sooner (for example, if you were unaware of the matter, if you were unwell or grieving).

The full response to your complaint at stage 1 should tell you what to do next if you are not satisfied. If you wish to escalate your complaint to stage 2, you should do so in writing, within 6 months of the final response at stage 1

Normally the complaint review at stage 2 will be conducted by a senior member of staff who has not been involved in the handling of the complaint up to that point and is not involved in the daily operation of the hospital/clinic.

The person conducting the complaint review is expected to send you a full, written response on the outcome of the review within 20 working days. Where the investigation is still in progress, you should receive a letter explaining the reasons for the delay. The aim is to complete the review at stage 2, in most cases within 3 months.

See the Patients’ Guide to the ISCAS Code for more information.

If you are not satisfied with the complaint review at stage 2, you have the right to refer the matter to stage 3 independent external adjudication through ISCAS (for subscribing providers). Please see the providers who are covered. You need to do this within 6 months of receiving the final response at stage 2 and ISCAS aims to complete its adjudications within 3-6 months. The person making a complaint does not pay for the complaints process.

Stage 3 adjudication will not consider ‘new’ issues that have not previously been raised with the provider, with the exception of concerns raised about the way the IHP has handled the complaint, which may not surface until after a response has been made at stage 2. There is no appeal to Stage 3 adjudication and the Independent Adjudicator’s decision is final.

If you wish to escalate your complaint to ISCAS at stage 3, you should do this in writing (the address is given in the contact section). Your letter should include the information in the Patients’ Guide to the ISCAS Code, which also provides more information on prompts to help you think through what you want to achieve, and whether it is achievable under the ISCAS Code.

ISCAS will provide a written acknowledgement to you within 3 working days. It will then write to the provider to advise that you wish to escalate your complaint. The provider will have 10 working days to object, where relevant, for example because the earlier stages of the process have not yet been exhausted.

An Independent Adjudicator will send you a letter to confirm that they have received your complaint. They will then compile a chronology of events, identify the main points (‘key heads’) of your complaint and write to you setting out their understanding of your complaint. The Independent Adjudicator will keep you updated with progress, at a minimum, every 20 working days. The Independent Adjudicator will decide to uphold or not uphold each aspect of your complaint. They have the discretion to award a goodwill payment up to a limit of £5,000, in accordance with the ISCAS Goodwill Payments Guide.

There is no appeal to Stage 3 adjudication and the Independent Adjudicator’s decision is final. However complainants are able to seek legal action at any point during or after the ISCAS complaints process and their statutory rights are not affected. If you are not satisfied with the way ISCAS has managed the stage 3 process you are entitled to make a complaint about ISCAS.