Complaint Form

Complaints Procedure

The named individual responsible for complaints within the practice is Mrs. Agnieszka Wierzbicka, Practice Manager.
All complaints should be made in writing to the Practice Manager at the practice address or can be done online via the online form (below) on this website.
If an individual has indicated an inability to put their complaint in writing either due to language difficulties or because they find writing/typing difficult or impossible, they should be advised they can relay the detail of their complaint to a member of staff who will submit the basic detail to the practice manager for investigation. The practice would encourage patients who are able to put their complaint in writing themselves to do so to ensure all information is correctly presented, interpreted and recorded.
Although there are no longer statutory timescales for resolving complaints, all complaints will normally be acknowledged within 3 working days of receipt. The individual dealing with the complaint will send written confirmation to the complainant advising them a full investigation is underway and that they will respond at the earliest opportunity.
The individual investigating the complaint may request further information or an appointment with the complainant if this is deemed appropriate or necessary.
The complaint will then be fully investigated and a further response will be made to the complainant in writing at the earliest opportunity.
Advocacy for All is now delivering a service to residents of LB Sutton on behalf of Healthwatch Sutton for advice and support on any complaints about health and social care.
Their contact details are:
Tel: 0345 310 1812 between the hours of 9.00am to 5.00pm Monday to Friday Email: suttonnhscomplaints@advocacyforall.org.uk
Whilst the complaint should be dealt with by the practice, and patients may wish to seek advice and support from Advocacy for All, patients who have a comment or complaint which cannot be resolved locally, can contact NHS England using the details below.
NHS England
PO Box 16738
Redditch B97 9PT
Tel: 0300 311 22 33
Email: england.contactus@nhs.net
If the practice is unable to resolve a complaint there is a second stage of the complaints process called Independent Review. From 01.04.09 the Parliamentary and Health Service Ombudsman will be responsible for this. They can be contacted as follows:
The Parliamentary & Health Service Ombudsman, Millbank Tower, Millbank, London SW1P 4QP
Phone: 0345 015 4033
Email: phso.enquiries@ombudsman.org.uk
Website: www.ombudsman.org.uk
If a complaint is about another organisation and/or service not directly managed or provided by the Practice it is likely the complaint will be referred to them for response. The complainant will be notified directly of any instance where their complaint has been passed to another organisation to respond.
Patients who have a comment or complaint about a primary care services or secondary care service should contact the provider directly or commissioner of the service: this is the organisation that paid for the service or care you received, for example Integrated Care Board.
Contact South West London Integrated Care Board (SWL ICB) instead of NHS England. There is also a separate complaints procedure for SWL ICB. Their contact details are:
NHS South West London
3rd Floor
120 The Broadway
Wimbledon
London
SM19 1RH
Tel: 0800 026 6082
Email: contactus@swlondon.nhs.uk
Website: www.southwestlondon.icb.nhs.uk

Alternatively contact PALS (the Patient Advice and Liaison Service):

St Helier Hospital
Tel: 020 8296 2508 Monday to Friday, 10.00am to 4.00pm

Epsom Hospital
Tel: 01372 735243 Monday to Friday, 10.00am to 4.00pm
Email: est-tr.PALS@nhs.net

Textphone (via Text Relay):
08001 020 8296 2508

Text message:
07975 232021 (deaf, hard of hearing and hearing impaired only)

If your complaint is about the premises then it should be referred to the Building Manager in the first instance.

Complaint Form

First name

Surname

Date of Birth (DD.MM.YYYY)

Email address

Telephone number

Reason for complaint

Patient Third-Party Consent

Patient's Name

Telephone Number

Address

Enquirer / Complainant Name

Telephone Number

Address

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.

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 only, and I wish this person to complain on my behalf.

This authority is for:

Where a limited period applies, this authority is valid until

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