[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]