Please do not fill in this form. Due to a technical problem we may not receive your completed form. Instead please use the contact details on our complaints webpage. Apologies for any inconvenience.
For more information on the complaints process and the options available to you please see making a complaint.
In order for us to process your complaint, it would be helpful to include the following:
- full personal and contact details such as date of birth, postal addresses and patient hospital number
- a full description of your concerns. Please specify dates, locations and name(s) of staff involved where possible. If you are raising more than one concern, it helps to number each of the different points you are making. This helps us to make sure we answer all of your concerns.
- if you are complaining on behalf of someone else, we may need to obtain the patient’s authorisation confirming that they have given permission for us to provide you with details of their care. A form will be sent to you to complete.