Part of KO41a NHS hospital and community health services written complaints
Guidelines
General
The KO41a should be completed with information on written complaints received about Hospital and Community Health Services made by, or on behalf of, patients in the relevant reporting period.
A written complaint is one that is made in writing to any member of staff or is originally made orally and subsequently recorded in writing. Once it is recorded, it should be treated as though it was made in writing from the outset.
Complaints, comments and suggestions that do not require investigation should not be included.
The detailed information regarding a complaint, including age and status of the complainant, and the service, subject and professional area of the complaint, only need recording for new complaints received in the relevant reporting period.
Where a new complaint covers several aspects of care or treatment, the complaint should be recorded against each relevant item within the service, subject and profession areas (sections 5, 7 and 8). Totals for these areas can be greater than the number of new complaints.
- Section 1: Organisation details and organisation site details
- Section 2: Summary of overall numbers of complaints
- Section 3: Age of patient
- Section 4: Status of complainant
- Section 5: Service area
- Section 6: Subject area of clinical treatment sub-categories (see below)
- Section 7: Subject area
- Section 8: Profession
Clinical area (section 6): This section is a single subject area item that has been broken down into more detail. Data should be recorded in section 6 if the complaint has a clinical aspect to it, otherwise leave it blank.
If the complaint is transferred to another organisation, the organisation that deals with it should record it and provide details on their own return.
Do not include investigations instigated by outside agencies, for example the Police or Coroners Court.
Brought Forward/Carried Forward: Numbers Brought Forward to the current reporting year should be the same or similar to those Carried Forward from the previous year.
Total Brought Forward – should only be the number of complaints unresolved at the end of the previous year and brought forward into this reporting year. If aggregating the annual return from quarterly reports it should not be the sum of complaints brought forward between each quarter within the year. Detailed information for brought forward complaints (age, status, service, subject and profession) should not be recorded as this information will have been included previously. The detailed breakdown is only for new complaints in the relevant reporting period.
Total Carried Forward – should only be the number of complaints unresolved at the end of this reporting year and carried forward to the next year. If aggregating the annual return from quarterly reports it should not be the sum of complaints carried forward between each quarter within the year.
Upheld complaints
If a complaint is received and substantive evidence is found to support the complaint (or all aspects of the complaints), then the complaint should be recorded as upheld.
Where there is no evidence to support any aspects of a complaint made, the complaint should be recorded as not upheld.
If a complaint is made regarding more than one issue, and one or more of these issues (but not all) are upheld, the complaint should be recorded as partially upheld.
Site level
Complaints should be recorded against the relevant site or hospital to which the complaint relates.
Site level data must be provided for sites with valid Organisation Data Service (ODS) codes. Details on how to obtain these codes are included in section 4 of this guidance. Data should be displayed using one line of data for every site that has received a complaint. Sites that have not received a complaint do not need to be included.
Specific guidelines for ICBs and sub-ICBs
A single overall return from each ICB for the reporting year is required.
ICBs should complete the KO41a return as complaints may be made to them about commissioning issues and any other services they directly provide.
ICBs should not record complaints regarding services provided by NHS trusts even where they conduct the investigation. These complaints should be recorded on the return of the NHS trust concerned.
Complaints regarding GP Out-of-Hours Services (OOH)
Where ICBs directly employ doctors (or others) to provide OOH then these complaints should be recorded by the ICB on the KO41a under the service type 'Other community healthcare services' in Section 5.31.
Where ICBs commission the OOH from an independent provider then these complaints should be recorded on the return of the provider. If the provider does not have a valid ODS code or is otherwise unable to make a return, then these complaints should be recorded by the ICB.
ICB reporting in Section 6 – ICBs are not expected to include any of their complaints in Section 6 Subject Area of Clinical Treatment. Only complete this section if the complaint has a clinical aspect to it, otherwise leave it blank.
Where complaints regarding Continuing Health Care (CHC) or Individual Funding Request (IFR) issues do not fit easily into the available categories for Section 7 then they can be included in [7.69] Other.
Last edited: 4 March 2026 3:00 pm