Parliamentary and Health Service Ombudsman

The PHSO is one of the most senior ombudsmen in the UK. The NHS side handles complaints about service failure, clinical failure, and administrative failings in NHS England, GP practices, dentists, ambulance services, mental health trusts, and community health services. The Parliamentary side handles complaints about most UK government departments — including DWP, HMRC, Home Office, MoJ — accessed via MP referral. The PHSO investigates around 4,000 cases a year and upholds around 30%. Remedies include apology, compensation (£100-£100,000+ in extreme cases), corrective action, and service change. Reports are laid before Parliament for serious cases.

In practice, the PHSO is the end of the road rather than the start, and most complaints that fail do so on process rather than merit. For NHS matters you must first complain to the provider or the commissioner and receive a final response. For government department matters you cannot approach the Ombudsman directly at all — the complaint must be referred by an MP, which is a genuine statutory filter, not a formality. Either way, the complaint should normally reach the PHSO within twelve months of when you became aware of the problem.

Worked example: a patient's family complains that a delayed diagnosis followed three GP appointments where symptoms were not investigated. The practice responds with an apology but no explanation of what went wrong. The family refers the case to the PHSO, setting out a chronology, the clinical records, and precisely what they want — an explanation, an acknowledgement of the failing, and evidence of changed practice. The PHSO obtains independent clinical advice and applies its Service Model, asking what should have happened and whether the gap between that and what did happen caused injustice. It upholds the complaint, recommends a written apology, a financial remedy for the distress, and an action plan the practice must evidence.

The misconceptions are worth clearing up. The PHSO is not a route to clinical negligence damages — if you are seeking substantial compensation for injury, that is a court claim with its own three-year limitation period, and pursuing the Ombudsman does not pause it. It does not discipline doctors or nurses; that is for the professional regulators. It cannot look at matters where you had a realistic alternative legal remedy, or at complaints about private healthcare unless the care was NHS-funded. And it does not investigate every case: many are resolved or closed after initial assessment.

The PHSO is the NHS and central-government counterpart of the LGSCO for councils and the FOS for financial firms, and you reach it after a final response letter. Read our guides to taking an NHS complaint to the Ombudsman and regulator versus ombudsman.