7 Principles (and Core Values) of the NHS
7 Principles (and core values) of the NHS These are the 7 principles of the NHS, as stated in Englands’ NHS Constitution. It was first written in 2009, and last updated in January 2021. 1.&...

Providing feedback or making a complaint about your medical care is a fundamental right within the NHS. While doctors and nurses strive for excellence, mistakes can happen.
A formal complaint is often the most effective way to receive an apology, understand what went wrong, and (most importantly) ensure the same error doesn’t happen to another patient.
In 2026, the NHS emphasises “Resolution and Learning.” Here is the step-by-step guide to navigating the complaints process effectively.
Before launching a formal written complaint, an informal face-to-face conversation can often resolve misunderstandings quickly.
On a Hospital Ward: Ask to speak with the Registrar (the senior doctor under the consultant) or the Ward Manager/Matron.
In an Outpatient Clinic: Request a conversation with the Consultant in charge of your care.
At a GP Surgery: Ask to speak with the Practice Manager or the Senior Partner (the lead doctor).
Top Tip: If you have an informal meeting, bring a friend or relative for support. Take notes and ask for a summary of the meeting to be added to your medical records.
If an informal chat doesn’t help, your next stop should be PALS. Every hospital has a PALS office, usually located near the main entrance.
What they do: They act as an intermediary between you and the hospital staff. They are excellent at “unsticking” communication issues.
The “Secret” Utility: PALS is often the fastest way to chase missing blood test results, biopsy reports, or delayed X-ray appointments.
Confidentiality: You can speak to PALS anonymously for advice, but for them to investigate a specific incident, you will need to provide your details.
If the issue remains unresolved, you should trigger the Formal Complaints Procedure. By law, every NHS organization must have one.
For Hospital Care
Write to the Chief Executive of the Hospital Trust or the Complaints Department. Be clear about:
What happened (including dates and names).
What you are unhappy about.
What you would like to happen (e.g., an apology, an explanation, or a change in procedure).
For GP, Dental, or Pharmacy Care
You can complain directly to the Practice Manager. If you feel uncomfortable complaining to the surgery directly, you can contact your local Integrated Care Board (ICB).
The ICB is the body responsible for commissioning and overseeing all local health services in your area.
If you have received a final response from the NHS but are still not satisfied, you can escalate the matter to the Parliamentary and Health Service Ombudsman (PHSO).
Timing: You should usually contact the Ombudsman within a year of the incident.
Role: They are independent of the government and the NHS. They investigate “maladministration” and cases where the NHS has failed to put things right.
Cost: This service is completely free.
If your complaint involves medical negligence and has resulted in significant physical or psychological harm, you may consider legal action.
Seek Advice: Contact a solicitor specializing in medical negligence or talk to Citizens Advice.
Mediation: Many legal routes now involve a “mediation” stage to avoid lengthy court battles.
| Stage | Who to Contact | Best For… |
| Stage 1 | Ward Manager / GP Practice Manager | Quick resolutions and apologies. |
| Stage 2 | PALS | Navigating the system and chasing results. |
| Stage 3 | Complaints Dept / ICB | Formal investigation and written response. |
| Stage 4 | Ombudsman | Independent review if the NHS response is poor. |
A Note on “Gentle Persistence”: The NHS is under significant pressure in 2026. While being firm about your rights, staying “politely persistent” often yields the best results. A good doctor or manager will view your complaint as a tool for improvement, not an attack.
7 Principles (and core values) of the NHS These are the 7 principles of the NHS, as stated in Englands’ NHS Constitution. It was first written in 2009, and last updated in January 2021. 1.&...
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