THE SHORT ANSWER
They serve different purposes and you can do both. A complaint goes to the NHS body or private provider and can lead to an explanation, an apology and changes to practice. A claim is a legal process and is the route to compensation. A complaint does not pause the three year time limit for a claim.
Many people start by making a complaint and then wonder whether they should make a claim as well, or whether doing one rules out the other. It does not.
What a complaint can get you
A complaint goes to the NHS body or the private provider involved. It can lead to an explanation of what happened, an apology, and changes to how things are done so the same thing is less likely to happen to someone else.
What it cannot do is award compensation, if your financial position has changed because of what happened, a complaint will not address that.
For a lot of people, an explanation is genuinely what they want most, and a complaint is the faster route to it.
What a claim can get you
A claim is a legal process, and it is the route to compensation. If it succeeds, compensation reflects both the injury itself and its financial consequences, such as care, lost earnings and the cost of further treatment.
A claim also produces a detailed independent review of your care, because that is what the evidence requires. Many people find that the expert reports answer questions the complaints process never reached.
Can you do both at the same time?
Yes, and the two can work together. The response to a complaint can shed light on what went wrong, and you can also ask for a copy of any investigation report into the incident. That material can be useful if a claim follows.
There is one point to keep in view.
Making a complaint does not pause the three year time limit for a claim. Whichever route you take, keep that date in sight.
Complaints processes can take months. If you are near the end of the three years, it is sensible to take legal advice in parallel rather than waiting for the complaint to conclude first.
How to complain in England
NHS complaints in England should normally be made within twelve months of the event, or of when you became aware of it. You can complain to the provider directly, or to the commissioner of the service.
If you are unhappy with the response, you can take it to the Parliamentary and Health Service Ombudsman, which reviews unresolved NHS complaints.
PALS, the Patient Advice and Liaison Service, can help you raise concerns and understand the process before you make a formal complaint.
How to complain in Wales
Wales has its own process, called Putting Things Right, which deals with concerns about NHS care in a single framework.
If you are not satisfied with the outcome, complaints can go on to the Public Services Ombudsman for Wales.
Llais can support you through the process. Its role is to help you raise your concerns, not to take a side.
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Not sure which route fits what you want?
Tell us what you are hoping to get from this. If a complaint would do it, we will say so. If it would not, we will explain what a claim involves.
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No. You can make a complaint and a claim, and many people do both. A complaint can also produce information that is useful if a claim follows.
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In England, NHS complaints should normally be made within twelve months of the event or of when you became aware of it. Wales has its own process called Putting Things Right.
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No. The three year limit for a claim continues to run while a complaint is ongoing. If the deadline is approaching, it is sensible to take legal advice in parallel rather than waiting for the complaint to finish.