Complain to your Ambulance service: Wherever possible you should tell someone close to the cause of your complaint (e.g. a paramedic or nurse). If you are still dissatisfied with the treatment or services you have received, you should complain to the NHS Ambulance Trust concerned (local resolution).

If your are unable to resolve your complaint with your NHS Ambulance Trust, you should refer your complaint to your Primary Care Trust (PCTs- England& Scotland) Community Heatlh Council (CHCs - Wales) or Health and Social Services Trust (HSS Trusts - Northern Ireland).

PCTs, CHCs and HSSTs are local health organisations responsible for managing health services in your local area. They work with local authorities and other agencies that provide health and social care locally to make sure the community's needs are being met.

Find your local PCT/CHC/HSS Trust here

Conciliation: Conciliation is most often used, if both sides agree to this step, to help with complaints about 'primary care' services. Primary care trusts (PCT/CHCs/HSSTrusts) are required to provide conciliation services for these. However, your NHS trust or PCT/CHC/HSSTrust may also offer you this service if you make a complaint to them.

If you are not satisfied with the response from the PCT/CHC/HSSTrust, you can ask, within 28 days of the written reply to your complaint, for an independent review panel to be set up by a non-executive member, or convener. The convener will ask you to explain in writing exactly why you are still dissatisfied, if you haven't already done so.

The independent review: Together with an independent lay person, the convener considers whether any other local resolution action might resolve your problem. If not, then the convener will decide whether there should be an independent Review of your complaint by a special panel. The convener will only convene a panel if he or she thinks that a panel investigation is likely to resolve the problems you have identified. Either way, you will be told of the convener's decision in writing, usually within four weeks of you requesting a panel investigation. If a panel is to be set up, you will be told what matters they will investigate.

Who will investigate? The panel is made up of three members: the convener, an independent lay person acting as chair and one other person. It examines fully the concerns referred to it by the convener, talking to everyone involved and getting any specialist advice (such as independent clinical assessments) it needs. The panel writes a report giving the results of its investigations, together with its conclusions and any appropriate comments or suggestions. You will be given a copy of the report, and the chief executive will write to tell you of any action being taken as a result of the panel's recommendations.

Compensation & Disciplinary procedures: The panel has no power to discipline anyone, award compensation or even to recommend such action. Disciplinary action may be taken after a complaint has been made but this is considered separately under a different procedure.

The Health Service Ombudsman: If you are not satisfied with the convener's decision or are not satisfied with the Review Panel's investigation you can ask the Ombudsman to investigate. The Health Service Ombudsman (also known as the Commissioner) is completely independent of both the NHS and the Government. He/she has been given wide powers by Parliament to investigate complaints about services provided within the NHS.  There is no appeal against the Ombudsman's decision.

What sort of complaints will the Ombudsman investigate? Complaints relating to, for example, failure to explain decisions or provide information could be dealt with by the above procedure. The Health Service Ombudsman cannot investigate complaints which you could take to court or independent tribunal; personal issues; commercial or contractual matters; properly made decisions that you may not agree with; services in non-NHS hospital or nur sing home; complaints about central or local government.

What about other complaints?

Complaints about the conduct of paramedics and other health related professionals: Complaints relating to the attitude or behaviour of paramedics/health professionals should be made to the Health Professions Council (HPC). The HPC's Investigating Committee will check a complaint or allegation to determine if there is a case and the nature of the case. If so, it then goes to either the Conduct and Competence Committee or the Health Committee.

Court: Failing all else you can still go to court to resolve your dispute. Details of small claims court and other procedures are given in the Legal Section of this site. You can also contact the Community Legal Service (justask.org.uk) that gives access to free advice. Otherwise your local Citizens' Advice Bureau will give you advice and will sometimes organise free legal representation for you.