NHS Practices Send Back Chatbot Complaint Letters

GP surgeries and hospitals in England are asking patients to describe complaints in their own words after a wave of chatbot-written letters. The letters run long, quote rights that may not apply, and hide the incident staff need to investigate. The ask went public on 21 September 2026, on top of a record year for NHS written complaints.

Patients turned to tools such as ChatGPT to sound formal enough to be believed. That lawyer voice is now the reason a letter gets sent back.

Hospitals Now Ask for the Patient’s Own Words

GP leaders have told practices they understand a chatbot can help someone sort their thoughts. They have also said the same tools “make it harder for practices to understand what actually happened,” because they can add “incorrect information, add details that are not true, include laws, rules, or rights that” do not belong in the file.

The Parliamentary and Health Service Ombudsman already wants a complaint in your own words. Its form page warns that AI text can make a case too complicated or drag in legal references that are not relevant, which can slow the review or force a resubmit.

London North West University Healthcare NHS Trust has put the same instruction on its public complaints page. Write the dates. Write how it felt. Check every line before you hit send. And do not ask AI to add legal arguments to make the letter sound more official.

That last line is the tell. People were not using chatbots only to fix spelling. They were using them to borrow a solicitor’s register, because the NHS complaint system has long rewarded a letter that looks like a case.

How a Seven-Page Letter Gets Written in Seconds

A prompt as thin as “complain about a GP being dismissive” can return a full-page letter in under 10 seconds from ChatGPT, according to practice managers who spoke to a Cogora white paper on complaints. The same research found AI was raising both the number of complaints and the time each one takes.

There is a genuine gain buried in that speed. People who freeze at a blank page, or who do not write formal English, can now get a draft. The cost sits on the other side of the desk.

WHAT A CHATBOT LETTER COSTS A PRACTICE

• The clock: A full page can appear in under 10 seconds from a one-line prompt.
• The length: A typical human letter of about three-quarters of a page becomes seven pages or longer once a chatbot has expanded it.
• The follow-up: One GP partner spent three days reviewing and answering a single AI-written complaint.

Lee Bennett, strategic complaints lead at NHS England, said some patients now use AI to write letters and to reply to the replies they get. “This is proving quite a challenge across the NHS and other government bodies. It’s making some of the complaint letters overly complicated, confusing and in some cases inaccurate.”

Complaint Teams Chase Rights That Do Not Exist

Dr Sarah Townley, deputy medical adviser at the indemnity body Medical Protection, told a Birmingham conference on 11 June 2026 that the problem has moved past ordinary complaints into claims. People are filing in their own name, without solicitors, and the packets are huge.

We’re seeing the use of AI in claims, we’re seeing it in litigation. People are bringing claims in their own name, they’re not using solicitors. These letters can be 25 pages long, quoting various legal arguments that maybe don’t even exist because it’s been generated by AI.

Dr Sarah Townley, deputy medical adviser, Medical Protection, at Pulse LIVE Birmingham

Even a weak claim still has to be read. Townley said the workload is “phenomenal” because staff must sift a much larger pile, and length no longer tracks how serious the issue is. “It can be something very simple, but then suddenly that’s now five or six pages long.”

HOW LONG THE LETTERS RUN

Townley said most practices would rather hear the patient “in their own language,” because that is easier to decode. With AI, she said, “you get word soup that’s seven pages long,” then you still have to ring the patient to ask what they are actually worried about. “So you’re kind of doubling that workload.”

James Biggin-Lamming, director of strategy and transformation at London North West, has described a sharper failure. Doctors have received letters that used AI which “hallucinated treatment options patients then feel they have been denied.” The family arrives convinced a real therapy was withheld. The trust then spends time unpicking a treatment that was never on offer, which he said drains teams and “risks diverting time and energy from helping care for people.”

Practices still have to acknowledge a complaint in three working days. A 25-page packet with invented case law does not pause that clock. Staff must open the file, write the acknowledgement, and then spend days finding the one paragraph that describes what happened in the room.

Written Complaints Already Hit 256,777

The chatbot wave did not arrive in a quiet year. NHS England’s official count of NHS written complaints for 2024-25 was 256,777, the highest since the series began in 2014-15.

NHS WRITTEN COMPLAINTS IN ENGLAND

The largest share of new hospital and community complaints by subject was communications, at 17.6%. In general practice the largest share was clinical treatment, at 15.0%; in dental services it was 28.9%.

Healthwatch England has said fewer than one in 10 people who had poor care in the previous year made a formal NHS complaint. The usual reason was a lack of faith that anything would change. A Cogora survey of GPs, published with the same white paper, found 79% said the growing threat of complaints had pushed them toward defensive medicine.

So the service is already answering more written complaints than at any point in the official series, while most unhappy patients still never write at all. Into that gap walked a tool that can turn a flash of anger into a seven-page dossier before the kettle boils.

Professor Victoria Tzortziou Brown, president of the Royal College of General Practitioners, said AI “may make it easier for patients to raise concerns and improve accessibility for some,” and that it could also raise the number of complaints made “in the heat of the moment or without full context.” Complaints still need “careful human judgement,” she said, and each one has to be taken on its own facts.

Patients Who Needed Help Putting It in Words

The same polish that burns hours on a complaints desk is, for some patients, the first draft they have ever been able to send. English as an extra language, low literacy, dyslexia, anxiety after a bad appointment, and sheer exhaustion after a long wait all make a blank complaints form feel like another closed door.

Dr Clare Craig, a diagnostic pathologist, put the split in blunt terms on X. There is a difference, she wrote, between AI-written hospital letters, which she called bad, and AI-written patient complaints. “A patient may need help to put their complaint into words and to weigh up their concerns.” She added that she does not think doctors should be dismissive of patients who used AI to fill that gap.

The risk now is the opposite of access. Once staff have waded through enough invented statutes, a fluent letter starts to look like a tell. One GP described a four-page email that arrived two hours after a clinic, then said an admin colleague told him they “get them all the time” and treat the polished ones as nonsense. If that habit spreads, the patient who used a chatbot because they cannot write a formal letter is the one whose file gets skimmed.

Patients can already see the double standard. The NHS is putting AI into notes, letters, reception lines and, in some pilots, app triage. A complaint about care that was itself mediated by software, then rejected because the patient used software to describe it, is a hard circle to defend. The clean reply is not a ban on help. It is a ban on fake law.

The ombudsman already offers a path that does not run through a public chatbot. People who want support but prefer not to use AI can call 0345 015 4033, ask a friend, a relative or an advocate, or request an easy-read form. Those routes keep the facts in a human voice without pasting a medical history into a consumer model that may store it and train on it.

What the Ombudsman Wants From Chatbot Drafts

The ombudsman’s rule is short. Simple language that says what happened will always help more than complicated, formal writing. Do not ask a chatbot to add legal arguments, formal legal language or references to laws to make the complaint sound more “official.” Check that every line matches what you actually lived.

It published that advice in public as early as 9 February 2026.

Thinking of using an AI tool to help you submit your complaint to us? Make sure:

– you keep it simple
– you stick to the facts
– it’s in your own words.

For more advice on using AI visit: https://t.co/3vkquTlrkB pic.twitter.com/KLNRmm1Zaq

— Public Service Ombudsman (@PublicServOmb) February 9, 2026

The same office later posted useful prompts for AI tools that try to keep the model on a leash. The prompts ask for a time order, for facts with no assumptions, for the person’s own voice, and for a rewrite that uses only the information supplied and invents nothing.

PHSO RULES FOR A CHATBOT DRAFT

• The voice: Keep the prompt on your experience and how it made you feel, and keep the result in your own voice.
• The facts: Use only what you typed in; tell the tool not to add or invent new facts.
• The law: Do not ask it to cite statutes or dress the letter as a legal case.
• The privacy: Do not paste names, NHS numbers or medical detail into a consumer chatbot unless you know where that text will sit.

London North West’s page tracks that list almost line for line, which is how national advice becomes a local form. The trust still says AI can help someone organise thoughts. It also says the investigation lives or dies on dates, times and a feeling that belongs to a real person, not a model that has read a thousand templates.

Word Caps Are Already on the Table

Cogora’s white paper floated a complaints system that would cap the word count on the first submission, to deter the long AI letter. Dr Katie Bramall, chair of the BMA’s GP Committee, said a practice website form with a limited number of words could cut through “a lot of the AI word soup and salad.” She also called for a national, central way of handling complaints, because patients still cannot find out when a hospital appointment is, and still bounce off a closed reception line.

A word cap would stop the 25-page filing. It would not stop the invented treatment, and it would not help the patient who needs more than 200 words to describe a year of missed scans. Someone still has to call, and someone still has to read.

Until a national form exists, the instruction from the ombudsman and from trusts such as London North West is the one that fits on a single card. Write what happened, in the order it happened, in the voice of the person it happened to, and leave the statutes off the page.

Disclaimer: This article is news reporting on NHS complaint handling and published advice. It is for information only and is not a guide to any individual case. It does not constitute legal advice on NHS complaints, clinical negligence or consumer rights, and it is not medical advice. Anyone who wants help with a live complaint should contact the provider’s complaints team or PALS, an independent advocate, or a qualified solicitor before they file or threaten legal action. Complaint counts, local forms and ombudsman pages change, and readers should check the live official pages for the current rules.