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Making a Claim Against Private Healthcare Professionals in the UK



Nearly all people living in the UK recognise the stature of the NHS and its firm place in healthcare for the masses. However, in recent years the NHS has fallen out of favour for some, given the prolonged wait times, concerns over the quality of care, and cutbacks to the services provided. In light of these grievances, private healthcare in the UK is starting to take on a necessary role in diagnosing and treating patients throughout the region. While many may feel as though private care from a doctor or specialist is guaranteed to be of higher quality than the free services provided by NHS, that is not always the case. There are instances where a claim against a private healthcare professional must be brought because they failed to meet a certain standard of care.

If you feel as though you have a claim against a private healthcare provider, here are the steps you need to take throughout the process.

Stage 1 – Filing a Compliant

As a patient, you have rights when you are receiving healthcare from either private or public hands. This includes the ability to bring up any issues that arise during or after treatment of a health condition. When you are unsatisfied with the treatment you received in a hospital or clinic, the first step is to make a formal complaint so that the matter can be investigated and, ultimately, resolved. This is known as Stage 1 of making a claim against a private healthcare professional.

When making a complaint, it is necessary to begin with your treatment consultant about what you experienced. If the consultant does not offer a sufficient explanation or guidance on what to do next, speaking with your GP is the next best move. When talking with your primary doctor, share the concerns you have regarding your treatment, possible alternatives, the need for follow up services, or receiving a referral for a second opinion. If this does not lead to a positive outcome, it may be necessary to file a complaint with the hospital or clinic directly.

Bringing a complaint against a private hospital or clinic is similar to the process of doing so with the NHS as it falls under the Health and Social Care Act. Each hospital or clinic is required to have a complaints procedure in place that allows you as the patient an opportunity to share your issue and receive some sort of resolution. If this does not bring about the results necessary to correct the problem, a complaint to the Care Quality Commission may be in order. Additionally, sharing your experience with the regulatory body overseeing the healthcare professional, such as the General Medical Council for doctors or the Nursing and Midwifery Council, can be beneficial in the process.

The Next Steps – Review and Resolution

When a complaint is submitted, the hospital or clinic is required to perform an investigation on the matter and then provide a full and detailed response. The provider involved in the complaint may take one or more of the following actions to resolve the complaint after it is investigated:

  • Issue an apology
  • Acknowledge an issue took place
  • Take steps to correct the issue
  • Offer a summary of what was learned and might be changed as a result of the incident
  • Provide a payment or good will offer to resolve the issue

In some cases, these gestures are enough to satisfy a patient who experienced less than ideal treatment or care in the hands of a private doctor. However, there may be a need for further legal action once a formal complaint over a potential medical negligence case is reviewed and resolution is offered. Just like NHS providers, private healthcare professionals must uphold a duty of care for each and every patient they treat. When they are negligent in performing this duty of care, a formal complaint may not be enough to hold them accountable or receive the resolution you need or want. However, it is generally advised that the complaint process above is pursued initially to see what type of resolve is possible without legal intervention.

No matter what treatment or care was provided by a private healthcare professional, or the extent of your complaint, there are a few things to keep in mind along the way. Always take care to maintain a full record of what took place and the responses received during the complaint process. Having detailed notes regarding phone calls with providers, second opinions, in-person conversations, and e-mail communications is key to ensuring you receive the resolution you need. You will also want to maintain information about the reason for your dissatisfaction with treatment or care so that you can easily share this with the individual, institution, or regulatory body reviewing the complaint. Each of these aspects is essential to bringing a claim against a private healthcare provider, regardless of how severe the complaint may be.

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