NHS Wales introduces new procedure to deal with patient complaints

In April 2026, a significant change came into force across NHS Wales. The new Listening to People guidance replaces the long-standing Putting Things Right framework, setting out how patient concerns, complaints, and medical negligence claims are handled.

NHS Wales state this new approach aims to create a more transparent, responsive, and compassionate system. But what does it actually mean in practice?

Amy Howells, medical negligence associate based in Cardiff, explains NHS Wales's new Listening to People guidance and offers practical advice for patients raising concerns or pursuing a medical negligence claim.

A more human approach to complaints

At the heart of the new system is a simple principle: patients should feel heard, respected, and involved.

Rather than treating complaints as purely administrative processes, NHS bodies are now required to prioritise early, meaningful engagement. This includes a stronger focus on:

• Empathy and communication
• Understanding the patient’s experience
• Resolving concerns as quickly as possible

The ‘listening discussion’: a key change

One of the most important developments is the introduction of a mandatory ‘listening discussion'.

Patients raising concerns must now be offered an early conversation by phone, video, or in person to:

• Explain what happened in their own words
• Clarify what outcomes they are seeking
• Agree how the concern will be handled

A common theme of concern from patients is that issues in care are not acknowledged or rectified. The patient voice is critical in identifying gaps in healthcare. When issues within an organisation are identified, it offers an opportunity to make changes and improve future experiences. 

The key objectives of the Listening to People guidance are welcomed and we look forward to seeing the changes in dealing with concerns in practice. 

Early resolution within ten days

The new framework introduces a ten-working-day early resolution window.

During this period, NHS organisations are expected to:

• Address straightforward concerns quickly
• Provide explanations or apologies where appropriate
• Avoid unnecessary escalation

While this may benefit patients with minor issues, more serious cases, particularly those involving injury or long-term harm, will still require formal investigation.

From a legal perspective, this stage can be crucial. Early responses may contain admissions or inconsistencies that later become important in litigation.

Investigations and outcomes

Where concerns cannot be resolved quickly, a formal investigation will follow.

Patients should receive:

• A clear explanation of what happened
• Findings on whether care fell below acceptable standards
• Details of any learning or changes implemented
• A sincere apology where failings are identified
  

The emphasis is on plain communication, making outcomes more accessible to patients and their families.

Redress: compensation without court proceedings

Under the new guidance, NHS Wales can offer:

• Compensation of up to £50,000
• Treatment or care
• Access to independent legal advice
  

This allows some cases to be resolved without formal court proceedings, potentially reducing delay and legal costs.

However, it is important to recognise that not all cases will be suitable for redress, offers may not always reflect the full value of a claim and independent legal advice is recommended before accepting any offer of settlement. 

Patients who have a case that is not suitable for redress can still bring a claim but a different process applies. 

Conclusion 

The Listening to People guidance represents a cultural as well as procedural shift. 

The previous system which the new guidance sets to replace was often disappointing. In our experience it failed to seek input from patients and their families, and often the most serious concerns were overlooked during investigations.

Under the previous system we also saw that investigations carried out by the health boards did not identify any failings in care, yet when we obtained independent medical evidence, failings in care were identified. This is one of the limitations of a review that is not independent.

We hope this new system will place patients at the centre of the process and provide a more meaningful outcome.

We note that while the new framework aims to resolve concerns in ten days, we consider that many concerns will not fall within this category and many will require additional investigation. No timeframe has been set out for these cases and so patients may be left waiting for extended periods of time for a response.

Our advice would be that patients who have concerns regarding their care should always seek independent legal advice. There may be cases that are suitable for this process and on some occasions, lawyers may advise awaiting the outcome of this process, but there will be cases that are not suitable for this process and waiting for the outcome will cause unnecessary delay.

The investigation process can take some time so we recommend approaching a lawyer to get advice as early as possible so that you can be sure your individual case is being handled in the appropriate way.

Patients with a concern can also speak to Llais (a national, independent statutory body) or the Parliamentary and Health Service Ombudsman.

How Leigh Day can help

If you have questions or concerns about the care you or a loved one has received, our Cardiff-based medical negligence team is here to help. We combine legal excellence with genuine compassion, and over the years we have supported many families in securing answers, accountability, and the compensation they deserve. Please contact us for a free, confidential, no-obligation consultation.