How to Give Feedback or Make a Complaint About A&E Care

Your feedback matters

Whether your experience in A&E was excellent, mixed or poor, the NHS wants to hear about it. Positive feedback reinforces good practice and boosts staff morale. Constructive criticism identifies problems and drives improvement. Formal complaints trigger investigations that can prevent the same thing happening to someone else.

Many people feel reluctant to complain about NHS care — they worry about being labelled a troublemaker, about affecting their future treatment, or about adding to the burden on already-stretched staff. But the NHS Constitution explicitly guarantees your right to complain without any impact on your care, and the complaints system exists precisely because the NHS recognises that it does not always get things right.

This guide covers every route for feedback, from an informal word to a formal investigation by the Parliamentary Ombudsman.

During your visit — raising concerns in real time

The most effective time to address a concern is while you are still in the department. Problems are freshest, staff are present, and many issues can be resolved immediately.

Speak to your clinician

If your concern is about your own treatment — you disagree with a decision, feel your pain is not being managed, or want a different approach — raise it directly with the treating clinician. You can:

• Ask for an explanation of why a particular decision was made
• Request a second opinion from a colleague
• Decline a treatment and ask about alternatives (see our patient rights guide)

Speak to the nurse in charge

If your concern is about the department rather than your individual treatment — long waits without updates, cleanliness, noise, staff behaviour, or another patient's distress — ask to speak to the nurse in charge (sometimes called the senior nurse, charge nurse, or shift coordinator). They have the authority to address operational issues and can escalate clinical concerns.

Ask for PALS

Most hospitals have a Patient Advice and Liaison Service (PALS) office on site. During working hours, you can visit in person. PALS staff are trained to listen, investigate and resolve concerns informally. They are not part of the clinical team, which gives them an independent perspective.

After your visit — informal feedback

The Friends and Family Test

Most hospitals will text or email you a survey after your visit, asking whether you would recommend the service. This is the NHS Friends and Family Test. It is a quick way to register satisfaction or dissatisfaction, and the aggregated results are published and used by hospital management to track performance. However, it is not a complaints mechanism — it does not trigger an investigation or a personalised response.

Direct contact with PALS

If your concern is significant but you do not want to make a formal complaint, contact PALS by phone, email or letter. PALS can:

• Acknowledge your experience and apologise on behalf of the trust
• Investigate what happened by speaking to staff and reviewing records
• Provide an explanation for decisions or delays
• Arrange a meeting with a senior clinician if you want to discuss your care in more detail
• Suggest changes to prevent the same issue recurring

PALS aims to resolve concerns quickly and informally. Many people find this route satisfactory and go no further. There is no time limit for contacting PALS, but earlier is better — staff recollections and records are clearest soon after the event.

Formal complaints

If PALS cannot resolve your concern, or if the issue is serious enough to warrant a formal investigation, you can make a formal complaint.

Who can complain?

You can complain about your own care. You can also complain on behalf of someone else — a child, a deceased relative, a person who lacks capacity — if you are acting with their consent or in their best interests. Advocacy services can help you draft and submit a complaint if you need support.

Time limits

The NHS complaints procedure requires that complaints are made within 12 months of the event, or within 12 months of becoming aware of the issue. Trusts have discretion to extend this if there are good reasons for the delay.

How to complain

Write to the hospital's complaints department. Your letter or email should include:

• Your full name, date of birth and contact details
• The date and time of your A&E visit
• The department and hospital
• A clear, factual description of what happened — chronological order is most effective
• What you want as an outcome — an apology, an explanation, reassurance that changes have been made, or a specific remedy

You do not need to use legal language or prove negligence. A clear, honest account of your experience is sufficient.

What happens next

• The trust must acknowledge your complaint within three working days
• They will investigate by reviewing clinical records, interviewing staff, and gathering evidence
• They must provide a written response within a timeframe agreed with you (typically 25–60 working days depending on complexity)
• The response should address each point you raised, explain what happened, acknowledge any failures, and describe any actions being taken

If you are not satisfied with the response

If the trust's response does not resolve your complaint, you can:

• Ask for a local resolution meeting — a face-to-face meeting with senior staff to discuss the findings
• Escalate to the Parliamentary and Health Service Ombudsman (PHSO) — the independent body that reviews NHS complaints in England. The Ombudsman can investigate further and make binding recommendations. In Scotland, the equivalent is the Scottish Public Services Ombudsman; in Wales, the Public Services Ombudsman for Wales; in Northern Ireland, the Northern Ireland Public Services Ombudsman.

Legal action

Formal complaints and legal claims are separate processes. Making a complaint does not prevent you from pursuing legal action, and pursuing legal action does not prevent you from complaining. If you believe you have suffered harm as a result of negligent care, consult a solicitor who specialises in clinical negligence. Many offer free initial consultations.

What complaints cannot do

The complaints process can deliver explanations, apologies, policy changes and occasionally financial remedies. It cannot:

• Discipline individual staff members (this is a separate HR process)
• Change a clinical outcome that has already occurred
• Guarantee that the same thing will never happen again (though it can reduce the likelihood)
• Provide compensation equivalent to a legal settlement

Tips for effective feedback

Be specific

"The care was terrible" is hard to investigate. "At 11:30 pm on 15 March, I asked for pain relief and was told I would have to wait. No one returned for over two hours, during which my pain escalated" is actionable.

Separate emotion from facts

It is entirely valid to feel angry, upset or let down. Acknowledge those feelings, but lead with the facts. A factual, chronological account is more effective than an emotional one — not because emotions do not matter, but because investigators need specifics to identify what went wrong.

State what you want

Be explicit about the outcome you are seeking. "I want to understand why my mother was left on a trolley for eight hours" is a clear ask. "I want something done about this" is not.

Keep copies of everything

Save copies of your complaint letter, the trust's response, any correspondence, and your A&E records (which you can request — see our patient rights guide).

Positive feedback

If your experience was good, the NHS wants to hear that too. Positive feedback can be given through:

• The Friends and Family Test
• A thank-you card or email to the department
• Naming individual staff members who provided exceptional care
• The trust's social media channels
• NHS Choices (the review section of the NHS website)

Staff in A&E work under extraordinary pressure, and a genuine thank-you from a patient can make a significant difference to morale.

Learning from complaints — how the system improves

NHS trusts are required to analyse complaint themes and demonstrate how they have changed practice in response. When you make a complaint, you are contributing to system improvement, not just seeking personal redress. Serious incidents trigger formal Root Cause Analysis investigations, and the findings feed into departmental training, staffing changes, protocol updates and equipment procurement. If the trust's response to your complaint mentions specific actions they have taken, this is not empty reassurance — trusts are audited on whether they follow through.

Bottom line

You have the right to raise concerns or make complaints about NHS care without any impact on your treatment. Start with PALS for informal resolution; escalate to a formal complaint if needed; and go to the Parliamentary Ombudsman if the trust's response is inadequate. Be specific, factual and clear about what outcome you want. And if your care was excellent, say so — it matters more than you might think. For context on what you should expect during an A&E visit, our step-by-step guide and patient rights guide set the standard against which to measure your experience. You can find contact details for every trust's PALS team via our hospital directory.