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[Your address]

[Your NHS body]

To [Chief Executive of the NHS Trust or GP Practice Manager]

I write further to my conversation with [name] in which I made an informal complaint about the service that I received from [name of healthcare professional/care provider].

As discussed, I was unhappy with the standard of service received from [name of healthcare professional(s)] involved in my birth care on [date(s)] for the following reasons:

[set out details of the issues that you are complaining about and any consequences that resulted from those issues]

I am not satisfied with the action that was taken by my healthcare professional following the making of the informal complaint, and would now request that this matter be dealt with as a formal complaint in accordance with your internal complaints procedure.

I have included the following documents in support of my complaint:

[list and include photocopies of any supporting documentation that you think may help with the investigation of your complaint]

I look forward to hearing from you within the next 14 days [if it’s important that your complaint is resolved sooner eg because you are without medication as a result of the GP’s actions, then provide details of this]

Yours faithfully,

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