Two routes, and they do different jobs

There are two entirely separate things you can do about NHS treatment that went wrong, and confusing them costs people a great deal.

The complaint is an administrative process run by the health board itself, with the Scottish Public Services Ombudsman above it. It is designed to give you an explanation, an apology where one is due, and a change in practice so that the same thing does not happen to somebody else. It is free, it is reasonably quick, and you do not need a solicitor.

The claim is a court action for damages against the health board. It requires expert medical evidence, it takes years rather than months, and it is the only route that produces money.

The two are not alternatives in the sense of one leading to the other. They are parallel tracks with different destinations and different deadlines, and the deadline on the claim is the one that ends your rights for good.

When you have to complain by

The NHS Scotland complaints handling procedure sets the limit plainly. Normally, a complaint must be made within six months of the event complained about, or within six months of finding out that there was reason to complain, but in no case more than twelve months after the event itself. A board may consider a complaint outside those limits where there is good reason, but that is a discretion and it should not be relied upon.

These figures are current as at 15th August 2026 and come from the model complaints handling procedure for NHS Scotland, which the Ombudsman publishes for patients.

Stage one: early resolution

Complaints in NHS Scotland run in two stages. Stage one is early resolution, and it is meant to deal with straightforward matters on the spot or close to it. You can raise it with the staff involved, with a senior member of staff, or with the feedback and complaints officer of the board or practice concerned. It can be done in person, by telephone or in writing.

The board should give its decision at stage one within five working days, unless there are exceptional circumstances. If the matter is complex, or if you are not satisfied with the answer, it moves to stage two. You may also ask for it to go straight to stage two, and where the complaint is serious that is usually the sensible course.

Stage two: investigation

Stage two is a formal investigation. The board must acknowledge the complaint, investigate it, and give you a full response as soon as possible and within twenty working days. Where more time is genuinely needed, the board should tell you why and agree a revised date with you.

The stage two response is the document that matters. It should set out what was found, what the board accepts, what it does not accept, and what it intends to do about it. It is also, in practice, the first written account of the treatment from the board’s own perspective, and it is frequently the document a solicitor reads first.

Free help with the complaint

You do not have to do this alone, and you should not pay anyone to do it for you. The Patient Advice and Support Service provides free, confidential and independent information, advice and support to anyone making a complaint about NHS care in Scotland. It is delivered through Citizens Advice Bureaux across the country and it is entirely separate from the health board. Its advisers will help you frame a complaint, chase it and understand the response.

A complaint may be made by the patient, or by somebody acting on the patient’s behalf with their consent, or, where the patient has died or cannot act, by a relative or other appropriate person.

The Ombudsman, and the two things it cannot do

If you remain dissatisfied once the board has issued its stage two response, the next step is the Scottish Public Services Ombudsman. The Ombudsman is independent of the NHS, investigates, makes findings, and makes recommendations to the board. Boards take those recommendations seriously and they are published.

There are two limits on it, and neither is well advertised.

It cannot award you damages. The Ombudsman’s outcome is findings and recommendations. It is not a court, it does not assess compensation for injury, loss of earnings or care, and no amount of dissatisfaction with your treatment will convert an Ombudsman investigation into money. If what you need is compensation, the Ombudsman is not the route to it and never will be.

It must generally stand back where a court could deal with the matter. Section 7(8) of the Scottish Public Services Ombudsman Act 2002 provides that the Ombudsman must not investigate a matter in respect of which the person aggrieved has or had a remedy by way of proceedings in a court of law, unless satisfied that in the particular circumstances it is not reasonable to expect them to have resorted to it. Where there is a genuine claim available, that provision is engaged.

There is also a hard time limit. Under section 10 of the same Act, the Ombudsman must not consider a complaint made more than twelve months after the day on which the person aggrieved first had notice of the matter complained of, unless satisfied that there are special circumstances. The twelve months run from your notice of the matter, not from the end of the board’s procedure, so a complaint that drifts can run out of time at the Ombudsman while it is still with the board.

The same is true, in its own way, of the professional regulators. A regulator can investigate a doctor, nurse or dentist and can restrict or remove their registration. It cannot order anyone to pay you anything either.

Complaining does not stop the three-year clock

This is the most important paragraph on this page.

A claim for damages for personal injuries in Scotland must be brought within three years, under section 17 of the Prescription and Limitation (Scotland) Act 1973. Nothing in that Act suspends the three years while a complaint is being investigated, while a duty of candour process is running, while an adverse event review is under way, or while the Ombudsman is considering the case. There is no provision to that effect because none was ever made.

The consequence is blunt. A person who complains at six months, waits for stage two, escalates to the Ombudsman, and receives a decision two years later, has spent most of the available time and may have very little left in which to investigate and raise a court action. Investigating a medical negligence claim properly — records, a breach of duty expert, a causation expert — takes many months on its own.

Section 19A allows a court to permit a late action where it seems equitable. It is a discretion, it is opposed, and it is frequently refused. It is not a plan.

One qualification about saying you intend to sue

The model complaints handling procedure for NHS Scotland does exclude one category from the complaints route: a complaint where the person has already commenced legal proceedings, or has clearly stated an intention to do so rather than pursue the matter through the complaints procedure.

Read that carefully, because it is narrower than it sounds. It bites where somebody has chosen litigation instead of complaining. Taking advice from a solicitor is not the same thing, and asking for your records is not the same thing. If you want the complaint answered as well as the claim investigated, say so in the complaint, and put the complaint in your own name and in your own words.

Duty of candour and adverse event review

Alongside the complaints procedure there are two processes the board may be obliged to run whether or not you complain at all.

The organisational duty of candour arises under Part 2 of the Health (Tobacco, Nicotine etc. and Care) (Scotland) Act 2016, with the procedure set out in the Duty of Candour Procedure (Scotland) Regulations 2018. It is triggered where an unintended or unexpected incident in the provision of care appears to have resulted in one of a defined list of outcomes, including death and severe harm, as determined by a registered health professional who was not involved in the incident. Where it applies, the organisation must notify the person affected, give an account of what is known, offer a written apology if one is wanted, offer a meeting, review what happened, produce a written report, and account for all of it in an annual report.

Separately, NHS boards review adverse events under a national framework published by Healthcare Improvement Scotland in February 2025.

Neither decides whether anyone was negligent, and neither gives you a right to compensation. Both, however, tend to produce a fuller factual account than a complaint response does, and both are worth asking for by name.

If the treatment was private

The NHS complaints procedure and the Ombudsman deal with NHS care. If you were treated privately — in an independent hospital, a cosmetic clinic, a private dental practice — the complaint goes first to the provider under its own procedure, and then to Healthcare Improvement Scotland, which regulates independent healthcare services in Scotland. Healthcare Improvement Scotland asks that a complaint be made within six months from the date the matter came to your notice, and its procedure is modelled on the Ombudsman’s.

A claim arising from private treatment lies against the clinic or the practitioner, not against a health board, and may be a claim in contract as well as in delict. See dental negligence claims, where the NHS and private distinction comes up most often.

Which route are you actually on

It is worth being honest with yourself about what you want, because the two processes reward different things.

If what you want is an explanation, an acknowledgement and a change in practice, the complaints procedure is the right route, it is free, and the Patient Advice and Support Service will help you use it. Most people who go down it get something out of it.

If what you want is compensation — for an injury, for lost earnings, for care you now need — the complaints procedure cannot give you that at any stage, and no amount of persistence will change that. You need advice on a claim, and the clock is running while you decide. What that involves is set out on medical negligence claims in Scotland and, for NHS treatment specifically, on claiming against the NHS in Scotland.

Many people want both. That is entirely legitimate, and it is the most common position of all.

What to do now, in order

Write it down while it is fresh. Dates, names, what was said, who said it. A note made this week is worth far more than a recollection in two years.

Ask for your health records in writing. Do this now, separately from the complaint, because it is the longest lead item.

Put the complaint in early, and ask for stage two if the matter is serious. Six months goes quickly, and the twelve-month backstop is absolute in all but exceptional cases.

Take advice on a claim in parallel, not afterwards. If you are already more than about eighteen months from the treatment, say so at the first contact.