Recommendation 134

Commissioning patients’ advocates and support services

Consideration should be given to whether commissioners should be given responsibility for commissioning patients’ advocates and support services for complaints against providers.

The Health and Social Care Act 2012 gave responsibility for commissioning NHS complaints advocacy to individual local authorities; the local authorities took responsibility from April 2013. Local authorities are best able to determine the needs of their local populations.

The review of the handling of NHS complaints has recommended that ‘the independent NHS Complaints Advocacy Service should be re-branded, better resourced and publicised. It should also be developed to embrace greater independence and support to those who complain. Funding should be protected and the service attached to local Healthwatch organisations.’

The Department of Health recognises that the current arrangements for the commissioning of complaints advocacy services are new. The Department of Health will begin an evaluation of the current arrangements for commissioning NHS advocacy services in 2014.


It is recognised that complainants may need assistance to make a complaint and Local Authorities commission advocacy services to provide this support. However, in order to give the public a better understanding of what to expect when receiving this support, Healthwatch England has developed a set of national standards for complaints advocacy services, generated from workshops and interviews with people who use advocacy services.