Recommendation BRIS-36: Establish independent, swift, and thorough complaints handling with advocacy for patients
From Bristol Heart Inquiry — Final Report, published 18 July 2001.
Recommendation
Complaints should be dealt with swiftly and thoroughly, keeping the patient (and carer) informed. There should be a strong independent element, not part of the trust’s management or board, in any body considering serious complaints which require formal investigation. An independent advocacy service should be established to assist patients (and carers).
Government response
No government response to this recommendation is on the record yet.
Delivery
DHSC and NHS England say in progress (27 February 2026)
Please see our responses to Recommendations 20 (PALS) and 28 (patient feedback) for current practice.
The NHS Complaint Standards, model complaint handling procedure and good complaint handling guides set out how organisations providing NHS services should approach complaint handling. They apply to all NHS organisations in England and independent healthcare providers who deliver NHS-funded care.
It is a contractual requirement under the NHS Standard Contract that providers publish, maintain and operate a complaints procedure in compliance with the Fundamental Standards of Care, the NHS Complaint Standards and other law and guidance. Complaints can be referred to the Health Service Ombudsman should the complainant remain unsatisfied with the handling of their complaint by the Provider.
NHS England is currently finalising an oversight and assurance process of Integrated Care Boards (ICB) complaints handling.
The Independent Health Advocacy offers independent support to persons making complaints against the NHS.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented – Ongoing”. Table row: section 6.2 No. 36, PDF page 87-88.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
The Government agreed with this recommendation in part.
In its January 2002 response, the Department of Health said it was reviewing the NHS complaints system, including looking at strengthening the independent review stage. The Department referred to the implementation of Patient Advocacy and Liaison Service, which would be available to assist patients through the complaints process.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 6.2 No. 36, PDF page 84.
Themes and tags
Who has spoken
- DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding