What is the Independent Complaints Advocacy Service (ICAS) and who can use it?

The Independent Complaints Advocacy Service (ICAS) is a free advocacy service available in each region of England. It assists NHS patients and their advocates in drafting and pursuing complaints against NHS providers. The service supports individuals throughout the complaint process, including attending meetings and helping with onward referrals if necessary.

How long does the ICAS complaint process usually take?

The typical timeframe for the ICAS journey is between three and twelve months. This period covers the initial complaint to the local NHS provider and any subsequent referral to the Parliamentary and Health Service Ombudsman (PHSO) if the complainant remains unsatisfied with the local resolution.

What are the main steps in the ICAS complaint journey?

The first stage involves submitting a complaint to the relevant NHS provider, such as a GP practice, trust, or commissioner. This is known as local resolution. An ICAS advocate can attend meetings during this phase to support the patient. If the patient is unsatisfied with the outcome, ICAS supports a referral to the PHSO within twelve months.

What outcomes can result from an ICAS-supported complaint?

Possible outcomes of the process include an apology, financial remedy, service change, or disciplinary referral. If the complaint is resolved at the local level, it may result in service improvement. If referred to the PHSO, the outcome may be a finding of maladministration. ICAS supports patients in seeking these remedies throughout the process.

What happens if I am not satisfied with the local NHS resolution?

If a patient is unsatisfied with the local resolution provided by the NHS provider, ICAS supports a referral to the Parliamentary and Health Service Ombudsman (PHSO). This referral must be made within twelve months of the initial complaint. The PHSO can investigate the case and potentially issue a finding of maladministration.

All Legal Journeys

Health & Social Care

England only

4 stages

3–12 months

Reviewed 2026-05-22

Independent Complaints Advocacy Service journey (NHS)

Using ICAS to support an NHS complaint and onward referral to PHSO.

This page applies in England only — different rules may apply in Wales, Scotland, or Northern Ireland.

Who Uses This Journey

NHS patients and their advocates pursuing complaints with the help of free independent advocacy.

Stage-by-Stage Timeline

Contact ICAS

Free advocacy service in each region; helps draft and pursue the complaint.

Local Resolution (NHS provider)

Complaint to the GP practice, trust, or commissioner. ICAS advocate attends meetings.

PHSO referral

If unsatisfied, ICAS supports referral within 12 months.

Outcome

Apology, financial remedy, service change, or disciplinary referral.

Possible Outcomes

Resolved at local level
PHSO finding of maladministration
Service improvement

Official Sources

NHS Complaints Advocacy

Frequently asked questions

What is the Independent Complaints Advocacy Service (ICAS) and who can use it?: The Independent Complaints Advocacy Service (ICAS) is a free advocacy service available in each region of England. It assists NHS patients and their advocates in drafting and pursuing complaints against NHS providers. The service supports individuals throughout the complaint process, including attending meetings and helping with onward referrals if necessary.
How long does the ICAS complaint process usually take?: The typical timeframe for the ICAS journey is between three and twelve months. This period covers the initial complaint to the local NHS provider and any subsequent referral to the Parliamentary and Health Service Ombudsman (PHSO) if the complainant remains unsatisfied with the local resolution.
What are the main steps in the ICAS complaint journey?: The first stage involves submitting a complaint to the relevant NHS provider, such as a GP practice, trust, or commissioner. This is known as local resolution. An ICAS advocate can attend meetings during this phase to support the patient. If the patient is unsatisfied with the outcome, ICAS supports a referral to the PHSO within twelve months.
What outcomes can result from an ICAS-supported complaint?: Possible outcomes of the process include an apology, financial remedy, service change, or disciplinary referral. If the complaint is resolved at the local level, it may result in service improvement. If referred to the PHSO, the outcome may be a finding of maladministration. ICAS supports patients in seeking these remedies throughout the process.
What happens if I am not satisfied with the local NHS resolution?: If a patient is unsatisfied with the local resolution provided by the NHS provider, ICAS supports a referral to the Parliamentary and Health Service Ombudsman (PHSO). This referral must be made within twelve months of the initial complaint. The PHSO can investigate the case and potentially issue a finding of maladministration.