Explains how to ask a question or make a complaint about Monitor's integrated care licence condition.
If the purpose of your complaint is to resolve your individual concerns about your care, you should complain to your relevant NHS provider as part of the NHS complaints procedure.
The purpose of the process set out below is to consider the behaviour of a provider under the integrated care licence condition and cannot provide resolution for individual cases.
The integrated care licence condition
The NHS provider licence is Monitor’s main tool for regulating providers of NHS services.
The integrated care licence condition is designed to prevent NHS providers from standing in the way of care being delivered in an integrated way.
Anyone can contact Monitor for informal advice, or to make a formal complaint about a provider’s behaviour with regard to integrated care in the NHS.
Complaints can be made by an individual, healthcare provider, commissioner, patient group or representative body.
You can contact Monitor to raise your concerns if you think that a licensed healthcare provider may have breached or is going to breach the integrated care condition of the NHS provider licence.
Examples of actions and behaviours that could reasonably be regarded as against the interests of patients and service users and in breach of the integrated care licence condition are:
- not working constructively with other health and care bodies or signposting complimentary services
- not facilitating effective handovers, service transitions or sharing of health and care records
- not supporting multidisciplinary team working and effective care planning
The list above is not intended to be an exhaustive list of behaviours or actions that could breach the licence condition.
If you are unsure about whether our powers under the NHS provider licence are engaged in relation to integrated care then please get in touch.
Commissioning integrated care: questions about procurement, patient choice or competition
If you have a specific question on commissioning (purchasing of healthcare services) in relation to integrated care, particularly around procurement, patient choice or competition, then please read this guidance.
Get advice before making a complaint
Monitor encourages any person wishing to make a formal complaint in relation to the integrated care licence condition to get in touch first to discuss the complaint. To do so, please email: firstname.lastname@example.org
You should consider contacting Monitor for informal advice if:
- you have a question about the integrated care licence condition and how it is likely to apply in particular circumstances
- you are thinking of making a formal complaint to Monitor about a potential breach of the integrated care licence condition
- you wish to discuss whether to request informal advice
Make a complaint
Anyone may contact Monitor to raise their concerns. A complaint may be made by an individual, a healthcare provider, a commissioner, a patient group, or a representative body.
If you choose to make a formal complaint, Monitor needs certain information to decide whether to investigate the complaint. After speaking to us, you may need to send the following details:
- name, address, telephone number and email address of the organisation or person who is making the complaint
- name and job title of anyone authorised to represent the organisation or person making the complaint
- contact details of the organisations or people the complaint is against
- a statement of how the relevant rules have been broken and any supporting evidence
- an explanation of how your business has been affected and/or how people who use healthcare services have been adversely affected
- a description of the services involved
- an outline of the relationship between you and the organisations or people the complaint is against
- a timeline of relevant events
Cooperation and Competition Directorate
3rd Floor Wellington House
133-155 Waterloo Road
Telephone: Luke Dealtry on 020 3747 0228
Keeping you updated
Within 3 working days of receiving your complaint, Monitor will be in touch to acknowledge receipt and outline next steps.
Monitor decides whether to investigate complaints on a case by case basis, following the principles outlined in its ‘enforcement guidance’.
Monitor publishes an indicative timetable as each case begins: this provides further details on the expected process and indicative timescales. If Monitor thinks the timescale will change significantly during an investigation, it will advise the relevant parties and explain why.
Taking action following a licence breach
Monitor’s powers include, but are not limited to, requiring a licensed provider to:
- take steps to ensure that the breach in question does not continue or recur
- take action to restore the situation to what it would have been were the breach not occurring or had not occurred
- pay a financial penalty
Monitor may revoke a provider’s licence if the provider has failed to comply with the licence condition. Monitor does not expect to consider revoking a licence often and will only do so where it is the appropriate remedy for a breach.