Complaint Form

HOW TO COMPLAIN

In the first instance please discuss your complaint with the staff member concerned. Where the issue cannot be resolved at this stage, please contact the Deputy Practice Manager/ Practice Manager who will try to resolve the issue and offer you further advice on the complaints procedure. If your problem cannot be resolved at this stage and you wish to make a formal complaint please let us knows as soon as possible, ideally within a matter of days. This will enable the practice to get a clear picture of the circumstances surrounding the complaint.

If it is not possible to raise your complaint immediately, please let us have details of your complaint within the following timescales:

  •     Within 6 months of the incident that caused the problem

OR

  •     Within 6 months of discovering that you have a problem, provided this is within 12 months

The practice will acknowledge your complaint within two working days and aim to have looked into your complaint within ten working days of the date you raised it with us. At this stage you should be offered an explanation or a meeting with the person(s) involved. When the practice looks into your complaint it aims to:

  • Ascertain the full circumstances of the complaint
  • Make arrangements for you to discuss the problem with those concerned, if you would like this
  • Make sure you receive an apology, where this is appropriate
  • Identify what the practice can do to make sure the problem does not happen again

Patient Complaint Form

    Patient Third Party Consent

      IF YOU ARE COMPLAINING ON BEHALF OF A PATIENT OR YOUR COMPLAINT OR ENQUIRY INVOLVES THE MEDICAL CARE OF A PATIENT THEN THE CONSENT OF THE PATIENT WILL BE REQUIRED. PLEASE OBTAIN THE PATIENT’S SIGNED CONSENT BELOW.


      I fully consent to my Doctor releasing information to, and discussing my care and medical records with the person named above in relation to this complaint, and I wish this person to complain on my behalf.


      This authority is for an indefinite periodThis authority is for a limited period only