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PALS and the NHS Complaints Procedure in Wales: What Patients Need to Know

Posted on in Personal Injury and Medical Negligence

If you're unhappy with NHS care in Wales, it isn't always obvious where to turn. Since 1 April 2026, NHS complaints in Wales have been handled under a new process called Listening to People, which replaced Putting Things Right.

This guide explains how the Patient Advice and Liaison Service (PALS) works in Wales, how the new process runs, the timescales you can expect, and when it may be worth speaking to a medical negligence solicitor. It's written for patients and families across South Wales, including Merthyr Tydfil, Pontyclun, Nelson and Cardiff.

What is PALS and does it exist in Wales?

PALS stands for Patient Advice and Liaison Service. It's an informal, confidential service that helps patients, families and carers with questions and problems about their care, often by liaising with staff on your behalf.

PALS isn't the same as making a formal complaint, and not every Welsh health board uses the PALS name. In NHS Wales, a formal complaint is called a concern.

PALS in your local health board

Which team you contact depends on where you were treated:

If PALS can't help, or you want your concern formally investigated, the next step is Listening to People.

The Listening to People process (from 1 April 2026)

Step 1: Raising a concern and the listening discussion

You can raise a concern in writing, by email, by phone or in person with any member of staff at the organisation involved. If you raise it verbally, the organisation must write it down and give you a copy. Additionally, a concern needs to be raised within 12 months of the alleged negligent treatment, or 12 months from the date on which the Claimant knew the treatment was potentially negligent.

The Welsh Government's Listening to People guidance for patients sets out what to expect at each stage.

The organisation must acknowledge your concern within five working days and offer you a listening discussion, face to face, by phone or by video. It's your chance to explain what happened and what you'd like to come out of it. You can bring someone with you and use Welsh, English or another language.

Step 2: Stage 1 early resolution

If you agree and it's appropriate, the organisation will try to resolve your concern quickly by checking the facts, putting things right where possible and apologising where things have gone wrong. This must be completed within 10 working days of acknowledgement. If it works, the organisation must confirm in writing that your concern is closed. If it doesn't, your concern moves to Stage 2.

A concern resolved at this stage won't be considered for financial compensation. If you believe your care has caused you harm, you may want to take advice before agreeing to early resolution.

Step 3: Stage 2 investigation and redress

Stage 2 is a more detailed investigation, used when early resolution hasn't worked or isn't suitable. You should be given a named contact and an estimate of how long it will take. Where harm is alleged, a Welsh NHS body must assess whether the care fell below the expected standard and caused the harm. If so, it must consider NHS redress, which can include further treatment, an apology and compensation of up to £50,000, with legal advice funded by the NHS body.

The NHS Wales complaints procedure timescales at Stage 2 are:

  • Standard response: Normally within 30 working days of your concern being received, and within six months at most
  • Where redress is being considered: A redress decision within 120 working days, down from 12 months under the previous rules

Any time spent on early resolution counts within these timescales. You'll receive a written response covering each issue you raised, with an offer of a meeting to discuss it.

Concerns raised before 1 April 2026 (Putting Things Right)

Concerns raised up to and including 31 March 2026 are still handled under Putting Things Right, the procedure in place since 2011. For these concerns, the redress limit stays at £25,000 and a redress decision is due within 12 months. If you're unsure which process covers your concern, the team handling it should be able to tell you.

Who to raise a concern with

It is important to note that raising a concern will not necessarily result in compensation being recovered. Whilst Listening to People can result in compensation being recovered, it is important to understand the financial limits of the Redress process set out below.

GP, dentist, pharmacy or optician

If you want to complain about a GP in Wales, or about a dentist, pharmacy or optician, raise it with the practice first, or ask your health board to look into it instead. These practices must investigate and respond, but they can't always offer NHS redress, so compensation would usually need a clinical negligence claim.

Hospital, community or mental health services

These concerns go to the health board's concerns team, or to the trust's concerns team if an NHS trust provided your care. Both can consider redress where harm is found.

NHS 111, ambulance or out-of-hours services

The Welsh Ambulance Services University NHS Trust runs the ambulance service and NHS 111 Wales, so concerns about either go to its Listening to People team. For out-of-hours GP care, contact the health board for the area where you were seen.

PALS vs a formal concern under Listening to People

A PALS complaint works best for problems that can be fixed quickly and informally, such as a delayed appointment, a communication problem on a ward or a question about your treatment. It's often the fastest way to get something sorted while you're still receiving care.

A formal concern is the right route if you want a written response, an investigation or compensation. Only a formal concern to a Welsh NHS body can lead to NHS redress. The 12-month time limit for raising a concern still runs while you're talking to PALS.

Independent support: Llais and the Public Services Ombudsman for Wales

Llais is the independent citizen voice body for health and social care in Wales. Its complaints advocacy service is free and confidential, and an advocate can help you write your concern and attend meetings with you. Contact Llais Wales on 029 2023 5558.

If you're still unhappy after the NHS organisation has responded, the Public Services Ombudsman for Wales can independently review how your concern was handled, decide whether the response was reasonable and recommend further action. You'd usually need to contact the Ombudsman within 12 months of becoming aware of the problem.

NHS redress or a medical negligence claim?

NHS redress in Wales can be a quicker, less adversarial route to compensation, but it has limits:

  • A financial cap. Redress can't exceed £50,000, or £25,000 for concerns raised before 1 April 2026
  • Welsh NHS bodies only. It isn't available against GP practices, dentists, pharmacies, opticians or independent providers
  • Accepting is final. Accepting an offer means giving up the right to bring a court claim about the same issue

A medical negligence claim isn't capped and can be brought against any healthcare provider. Our guide to bringing a claim against the NHS explains what a claim involves and how it can be funded.

Medical negligence claims in Wales usually have a three-year time limit from the negligence or from when you became aware of it. This is generally paused while a concern is being considered for redress, but that protection doesn't cover every complaint.

When to speak to a medical negligence solicitor

You don't need a solicitor to raise a concern, but early advice from clinical negligence solicitors in Wales may help if:

  • You or a family member has suffered significant or lasting harm, or a loved one has died
  • The harm happened in primary care, where redress isn't available
  • Your claim may be worth more than £50,000, or you want to check a redress offer
  • You're unhappy with the outcome of an investigation
  • You're getting close to the three-year time limit

Once a legal claim is formally started, the Listening to People investigation is paused and redress is no longer available for that issue.

How JNP Legal can help

Our medical negligence solicitors advise patients and families across South Wales on claims arising from NHS and private healthcare, and can help you weigh up a concern, an investigation response or a redress offer.

We offer free initial appointments at all four offices and, depending on the circumstances, free home visits across Wales and the South West. No win, no fee arrangements are available for qualifying cases, and our medical negligence and personal injury solicitors work as one team.

Frequently asked questions

How long do I have to raise an NHS concern in Wales?

Normally within 12 months of the event, or of realising there was a problem. Later concerns can sometimes be accepted, but rarely after three years. Separate time limits apply to legal claims.

How quickly must the NHS acknowledge my concern?

Within five working days of receiving it, with an offer of a listening discussion.

How much compensation can NHS Wales offer without going to court?

Up to £50,000 through NHS redress for concerns raised from 1 April 2026, or £25,000 before that. Settlements for children or adults who lack capacity still need court approval.

Can I raise a concern and make a medical negligence claim at the same time?

Not in parallel. Once a claim is formally started, the concerns investigation pauses. A solicitor can advise on the right order for you.

Can I raise a concern on behalf of someone else?

Yes, for a child, someone who lacks capacity, someone who has died, or someone who has asked you to act for them. The organisation may need the patient's consent to share details with you.

What if I'm not happy with the health board's response?

Ask your named concerns contact to clarify anything that's unclear, or ask the Public Services Ombudsman for Wales to review it. If you've been harmed, a solicitor can advise on a claim.

Does raising a concern affect my future care?

It shouldn't. Welsh Government guidance states that people won't be treated differently for raising a concern, and Llais can support you if you're worried.

Speak to our medical negligence solicitors

If you're unhappy with NHS care, our team can help you understand your options. Call our Merthyr Tydfil office on 01685 350 421, our Pontyclun office on 01443 584120, our Nelson office on 01443 450 561 or our Cardiff office on 02920 763 211, Monday to Friday, 9am to 5pm.

You can also email law@jnplegal.org, send us an enquiry online or visit our contact page.