Your NHS rights

NHS waiting list complaint template

A calm, constructive template you can adapt to contact your hospital's Patient Advice and Liaison Service (PALS). It's designed to get a useful response — not to start a fight.

Last updated 10 May 2026 3 min read Reviewed against publicly available NHS guidance Read our methodology Independent — not medical or legal advice

When to contact PALS

It's reasonable to contact PALS in any of these situations:

You've waited longer than 18 weeks since referral and haven't started treatment.
You've heard nothing from the hospital and don't know where you are on the list.
An appointment has been cancelled or rescheduled multiple times.
Your symptoms have changed and you want this fed back to the team.
You're considering switching providers and want to understand your options.

What PALS actually does

PALS is the informal front door to the trust. Officers can chase booking teams, look up your record, explain processes, and often resolve the underlying issue without anything ever becoming a formal complaint. They are not clinicians and won't change clinical decisions, but they can unblock administrative ones.

Escalation etiquette

Start with PALS. Don't go straight to the chief executive or your MP.
Be specific. Reference dates, names of clinicians, and your NHS number.
Keep it short. Two or three short paragraphs is more effective than two pages.
Stay neutral. Frustration is fair — anger usually slows things down.

The email template

Body

Dear PALS,

I am writing to ask for your help with a long-standing referral. My details are:

Name: [your name]
Date of birth: [DOB]
NHS number: [NHS number]
Referring GP / surgery: [name]
Specialty / consultant: [specialty / consultant if known]
Date of referral: [date]

I have now been waiting X weeks since referral, which is past the NHS 18-week Referral to Treatment standard. I would be grateful if you could:

Confirm where I am on the pathway and the expected next step.
Let me know if there is a short-notice or cancellation list I can join.
Share what options are available to me under NHS patient choice if my wait continues.

For context, my symptoms [have stayed the same / have worsened in the following ways: …]. I am happy to attend at short notice if a slot becomes available.

Thank you for your help.

Kind regards,
[Your name]
[Phone] · [Email]

What to include

Your full name, date of birth and NHS number.
The exact date of referral.
The specialty and, if known, the consultant.
Specific dates of any appointments cancelled or rescheduled.
Any change in symptoms since the referral.
A clear, polite ask — what you'd like PALS to do.

What not to say

Don't threaten legal action up front. It changes nothing and slows replies.
Don't make it personal about individual staff members.
Don't include unrelated complaints — keep this message focused on the wait.
Don't overstate your symptoms. Honest, specific descriptions are far more useful.

Realistic expectations

A good PALS reply will confirm your status on the list, give you a concrete next step, and sometimes flag patient choice options. It usually won't jump you up the list — but it will make you visible to the booking team, which can matter when cancellations happen.

When to escalate to the ICB

If PALS hasn't resolved the issue and the trust's formal complaints process has stalled, you can escalate to your Integrated Care Board (ICB). ICBs are the local NHS bodies responsible for commissioning services, and they have a complaints route for issues their providers haven't resolved.

Beyond the ICB, the Parliamentary and Health Service Ombudsman is the final independent step. It's unusual for a wait-list issue to need to go that far.

Frequently asked questions

Is contacting PALS considered making a complaint?+

No. PALS is deliberately separate from the formal NHS complaints process. It's an informal route designed to resolve concerns quickly. Most patients don't need to escalate beyond PALS.

How long does PALS take to reply?+

Many PALS teams aim to acknowledge contact within a few working days, with a substantive response within 1–2 weeks. Complex queries take longer. Following up politely after 10 working days is reasonable.

Should I copy in the consultant or chief executive?+

Generally no — at least not initially. Going through PALS first usually gets a faster, more practical response. Escalation can come later if needed.

Will complaining hurt my care?+

It shouldn't. NHS staff are trained to separate complaints from clinical care, and the NHS Constitution explicitly protects you from being treated differently for raising concerns. A calm, specific message keeps things professional.

What if PALS doesn't get back to me?+

If you've had no meaningful response after about two weeks, it's reasonable to send one polite follow-up. After that, you can move to the trust's formal complaints process.

See where you stand in 60 seconds

Use our free 18-week calculator to check whether your wait may have passed the NHS Referral to Treatment standard.

Open calculator Wait Assessment Report

Sources

NHSWaitHelper is an independent information platform and is not affiliated with the NHS. We do not provide medical or legal advice. Always speak to your GP, clinician, or a regulated adviser about your individual circumstances.