NHS and social care complaints procedure: the PHSO

Complaints can be escalated to the Parliamentary and Health Service Ombudsman if a local resolution is unsuccessful.

  • The NHS and social care complaints procedure applies to all NHS health providers in England, including dental practices.
  • There is a two-stage complaints process; local resolution and the Parliamentary and Health Service Ombudsman (PHSO).
  • The PHSO's Principles of good complaint handling sets out a framework for good complaint handling.

When will the PHSO investigate?

  • Complainants who are not satisfied with the initial response to their complaint can refer it for investigation by the PHSO.
  • The ombudsman can also consider complaints brought by the subject of the complaint; for example, a dentist who is not satisfied with NHS England or a commissioning body's response.
  • Grievances about the administration of the complaints procedure itself can also be considered.

Time frames

A complaint must be referred to the ombudsman within 12 months of the final correspondence when local resolution is completed.

This will usually be 12 months from when the final response letter relating to the original complaint has been received.

Investigating the complaint

  • The ombudsman has discretion as to whether or not to investigate a complaint and considers each case on its merits. If the ombudsman decides not to investigate, their office will write to the complainant explaining the reasons for their decision.
  • Where the complaint meets some basic tests, the ombudsman's office will begin an investigation immediately and inform those involved.
  • If an investigation goes ahead, it is possible, though rare, for a dentist to be interviewed. This might be requested where evidence is unavailable or unclear, for example. A professional 'friend' can accompany a dental professional to an interview. We advise that you seek our advice before the meeting. In some situations, it may be beneficial for a DDU dento-legal adviser to attend with you; in other cases it may be more appropriate to attend alone or with a colleague.
  • The ombudsman has access to all the paperwork generated by local resolution and can order the disclosure of documents and the attendance of witnesses, if necessary.
  • The ombudsman's office may also obtain independent professional advice and is assisted by specialist assessors for anything involving clinical judgement. If an investigation goes ahead, the practical aspects are usually undertaken by the ombudsman's representative, who will interview those involved.
  • A confidential draft report is prepared for the complainant and dental professional to check for accuracy.
  • The final report is sent to all interested parties including the secretary of state, and is published in anonymised form on the ombudsman's website.


  • If the ombudsman's office finds the dental professional to be at fault, it may recommend changes to their work, or that the dental professional apologises or offers the patient financial redress.
  • Although compliance with recommendations cannot be enforced, in practice, dental professionals usually adopt recommendations.

This page was correct at publication on 09/12/2019. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.