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Written by: Linda Ware
Reviewed by a Medico-Legal Expert
Last Reviewed:
March 2026
Written by: Linda Ware
Reviewed by a Medico-Legal Expert
Last Reviewed:
March 2026
Healthcare professionals working in the NHS and private practices face the same employment challenges as other employees, however there are added layers of Good Medical Practice, Patient Safety and other regulatory requirements.
Navigating these are often confusing and sometimes anxious times for healthcare workers. MDS has compiled a series of simple guides regarding initial steps that can be taken to address these issues.
Other Medical Defence Organisations will not be able to support you with this kind of matters. MDS is the only medical defence organisation that provides union-grade employment support to its members as part of our services (subject to plan). If you are an MDS member and you plan to file a grievance, please contact us as soon as possible before you attempt any kind of resolution. If you are not with MDS yet, it might not be too late to join, as we can often support our members with issues that took place before you became a MDS member, however these will be classed as pre-existing issues, and assistance will be at discretion.
Today we cover…Grievances (internal procedures).
A grievance is very different from a disciplinary process and from a protected disclosure (whistleblowing).
Disciplinaries are initiated by the employer, and are borne of concerns about an employee’s conduct, performance or behaviour. Whistleblowing is when someone, generally an employee, raises concerns about wrongdoing or malpractice that can affect others.
A grievance is about you and how you are treated at work. It is:
It is important to remember that you can raise a grievance even if the situation is not legally wrong.
Within NHS and in healthcare, the health community most grievances fall under the following categories:
Any concerns should be raised as early as possible to help prevent the matter escalating further.
A grievance generally progresses over a number of stages, depending on the policies adopted by your organisation. If you are feeling aggrieved, then your first action should be to obtain a copy of your employer’s policy relating to raising grievances.
If you are working within the NHS you may also wish to consider using the Freedom to Speak Up framework, which empowers staff to raise concerns without fear of reprisal.
Any grievance procedure should provide a structured and fair way for staff to raise workplace concerns. Whilst the process can feel daunting, it plays a vital role in protecting employees rights and maintaining standards across the organisation.
The first step in most grievance policies, (Informal) Stage 1, is generally to try and reach an informal resolution, before submitting a formal complaint, this might involve:
Hear from our Employment Relations Team Leader, Linda Ware, providing a quick summary on the process and steps to take…
Raising a formal complaint can be stressful, so if the matter can be resolved quickly at this stage, you will avoid the weight and formality of a formal investigation.
Resolution at this stage may include facilitated conversations or mediation. Remember, any such meetings should be done promptly and with the aim to resolve the issues as quickly and as informally as possible.
You would not normally be accompanied by a witness or representative at this type of informal meetings, and there generally are no minutes taken, but it is nonetheless wise to seek advice from your professional body before attending them.
It is also important to consider what resolution or outcome you are seeking. Remember, there are not always clear winners and losers in a negotiation, and often it’s about reaching the outcome you can happily live with.
You should receive a written summary of the outcome of the informal resolution process.
However, if the issue is serious or cannot be resolved informally, then you may have no option to raise a formal grievance.
This is known as (Formal) Stage 2. The format in which you submit your grievance will very much depend on your employer’s policy. Some employers may provide a specific form to fill, others will require for you to write a submission instead.
Whatever way the grievance is submitted, it should be sent to your Line Manager, another appropriate manager or HR if your Line Manager is involved in the issue.
In your formal grievance letter or email, you should provide as much information as possible and cover at least these points:
Once this is submitted, your employer should acknowledge receipt and appoint a case manager. The case manager will be responsible for overseeing the grievance process, whose role will include appointing an investigating officer (IO) and providing them with clear terms of reference. The IO will investigate the matter and provide his findings to the case manager.
Any investigation should be fair, impartial and confidential, and normally the IO will invite you to attend a formal grievance meeting where you can explain your concerns in person. At this meeting you have the grievance meeting, you have the right to be be accompanied by a trade union or similar representative, or a colleague. Depending on the specific policy of your employer, a meeting chair, the investigating officer, an HR representative and witnesses may also be present.rights to be accompanied.
The IO will also meet with any other person mentioned in your grievance and any appropriate witnesses and write a report for the case manager with their findings.
It is then the case manager’s responsibility to decide if your grievance is upheld or not.
There are normally three possible outcomes from an internal grievance process: the grievance is upheld, partially upheld or not upheld.
And there will also be recommendations for actions needed in each of these scenarios (training, mediation, disciplinary actions, policy changes). You must also receive an explanation of the reasons for the case manager’s decision.
These are sample timescales, and the process might be different depending on what is stated in your employer’s grievance policy.
Your complaint must be submitted within six months of the facts you want to complain about taking place.
Acknowledgment from your line manager/employer: within seven calendar days of receipt of your official grievance. Grievance meeting: ACAS suggests this to take place “without unreasonable delay” and ideally within 5 working days from acknowledgement of your grievance, but local policies will vary.
Investigation to outcome: can vary substantially from days to months, depending on the complexity of the grievance, the need for interviewing witnesses, sourcing and examining evidence. Your local policy might set a time limit for this stage.
If you disagree with the outcome, you have the right to appeal. This is generally known as (Formal) Stage 3, or appeal The grounds on which you can appeal the outcome can be:
Appeals must usually be submitted within a specific timeframe (e.g. 710-14 days) and often addressed to the next-level manager. Make sure you know how long you have to submit by reading your local grievance policy. In this appeal you should explain:
From this point, the timescale is similar to Stage 2.
An acknowledgment should be sent to you within 7 days, and an appeal hearing should be held without unreasonable delay.
The appeal will normally be heard by a different manager not previously involved in the process, and you have the right to bring a companion (a union or other representative, a colleague). Other parties present at the meeting, depending on the local policy are an HR representative, witnesses, the previous hearing manager.
During the meeting, you will have a chance to explain why you are unhappy with the outcome of Stage 2.
After the appeal meeting, you must be told about the outcome in writing. This will tell you if your appeal is upheld, partially upheld or not upheld and must include the reasoning for rejecting your appeal. It might also include whether your employee feels they require further investigations.
If your appeal is not upheld. This will end the internal grievance process.
If you are still not satisfied by the outcome, while the internal appeal process is final, there are other avenues that can be followed outside your organisation, such as external mediation and possibly employment tribunals.
Among the options are contacting Acas, which can provide guidance on workplace conciliation. You must start the early conciliation process with Acas within 3 month minus one day of your appeal outcome.
If you believe your grievance fell within unlawful discrimination, constructive dismissal, or a breach of your employment contract, you can file a claim with the Employment Tribunal.
Before you do any of these, it is better to consult your trade union representative or medical defence organisation to review the strength of your case and to see if there are other options available to you, such as a settlement agreement, for instance.
If you’re not yet covered or are unsure about the level of protection you have, consider joining our medical defence membership that offers expert advice and support in medico-legal matters. Good Samaritan cover is just one of the many benefits of having robust medical defence protection.
For more information email us at [email protected], or to get immediate access to expert advice, contact us today at:
0300 30 32 442
[email protected]
There are timeframes, but no single national standard. These are usually set out in the employer’s grievance policy or the local Trust policy. Depending on the nature of the grievance, the relevant local policy should be referred to in the first instance.
No. Raising a grievance is a protected workplace right, and employees should not be dismissed for doing so.
In most cases, no. You would usually be expected to follow the internal Trust processes first, followed by ACAS Early Conciliation. There are strict time limits, typically 3 months minus 1 day from the submission of ACAS early conciliation.
Timeframes vary depending on complexity. These are the usual timeframes
Yes, you can still raise a grievance after leaving employment, although employers are not always obliged to investigate former employees’ grievances under their internal policies.
In some cases, it may still be helpful to raise concerns formally, particularly if they relate to discrimination, bullying, whistleblowing, pay, or professional conduct issues. You should also be mindful of any Employment Tribunal time limits, as raising a grievance usually does not extend those deadlines.
Yes, you are entitled to be accompanied by a trade union representative or a work colleague at a formal grievance meeting.
