Experiences of St George’s Hospital PALS (Patient Advice and Liaison Service)
What we did
Mixed to negative feedback we have received over the last two years from patients/users of PALS led us to research if this was a unique issue to Wandsworth and St George’s Hospital or something prevalent at a larger scale.
As a result, we decided to create a project focused on understanding why people are facing barriers to utilising PALS. We want this project to help improve the user experience of PALS as well as provide important insights and reflections for PALS staff.
Between October 2025 and March 2026, we conducted discussions with Wandsworth residents about their knowledge, understanding and, if relevant, experience of using PALS. In this period, we heard from 201 residents about PALS through a combination of outreach events and online surveys.
What we found
Varied knowledge and understanding of PALS (Patient Advice and Liaison Service)
From our outreach it was clear that many residents did not know about PALS and even fewer felt confident in explaining what its purpose was. Those who were familiar with PALS often equated it with a service for making complaints about the NHS, far fewer were aware of its various other functions including:
- listening to questions, comments and concerns raised by users
- providing support and information to resolve issues
Issues with access and communication
Respondents to our survey indicated a range of issues with accessing PALS both at St George’s and other hospitals.
For those who were able to access PALS, satisfaction with the resulting communication was varied. The main reason for respondents stating that communication was bad with PALS was due to delays in getting updates or response to emails or voicemails sent.
Varied user satisfaction with PALS
While some respondents were satisfied with the outcome of their enquiry with PALS the majority were dissatisfied. Respondents highlighted a range of reasons they were not satisfied.
Several respondents highlighted the issue that using PALS did not lead to any positive change. They stated that PALS seemed to lack the authority to ensure hospital departments followed up and responded to the enquiry.
Several respondents to our survey also noted that the stressful and time consuming nature of their enquiry with PALS had led them to feel it had not been worth their while following the outcome.
What users want from PALS
28 respondents put forward suggestions that they felt would improve the user experience of PALS. A majority (15 out of 28) of the respondents to this question highlighted that improved communication and responsiveness from PALS to a user’s enquiry, both at the start of their journey and throughout, would help improve the experience.
Respondents also mentioned the need for clearer information around PALS, a more sympathetic and listening attitude of staff, and an expansion of their powers to influence real change as other ways to improve the user experience.
Our recommendations
Healthwatch Wandsworth has put forward four key recommendations that could have a positive impact on the user experience of PALS at St George’s as well as addressing the capacity of the PALS team. The full justification for these recommendations and their potential impact can be found in the full report.
1. Improved clarity and information around PALS
- As has already been developed at St George’s Hospital, we would recommend that a clear separation of PALS and Complaints continues to be pursued.
- We would recommend that clear information is provided around the role of PALS and what it can and can’t do, what the timescales associated with an enquiry are, and what outcomes a user can expect.
- We would also recommend that patients are informed of when they should utilise the service and when they should contact the Complaints team directly.
- We would also recommend that St George’s Hospital works to further promote and advertise PALS as a service, with more information provided online, as well as in leaflets and signage in outpatient areas.
- Information and contacting PALS should also adhere to the Accessible Information Standard to ensure disabled people and people with impairments or sensory loss can access the service and receive the communication support they need.
2. Embed a learning culture within PALS
- We would recommend appropriate data collection is embedded into the PALS enquiry process by staff. This should include demographic data to highlight potential disparities or themes that different groups are reporting.
- We would also recommend that PALS collect data on what outcome the user is looking for from their enquiry.
- We would recommend that once an enquiry has been resolved, there should be a standardised and consistent approach to ensure that the user can provide feedback on the service.
- We would recommend that this data and feedback should be reported publicly alongside Complaints in an annual report that is acknowledged and reflected on by the Trust.
3. Improve consistency in the way hospital departments can be contacted
- We would recommend that all departments within St George’s Hospital are contactable in at least one non-digital way. Ideally this should consist of a phoneline that, even if not always staffed, would allow patients to leave messages.
- Ideally there would be consistency between all departments in the way they can be contacted, however, we acknowledge that this may not be feasible for every department.
- We would also recommend that departments provide information on approximately how long it will take them to respond.
- Departments could also indicate when the patient may be better placed to contact PALS or Complaints directly.
4. Ensure patients are aware of statutory advocacy services
- We would recommend that St George’s Hospital ensure there is relevant signposting to Rethink Advocacy (for Wandsworth and Richmond residents) and the relevant advocacy organisations for residents of other boroughs.
- This could be achieved by providing information about advocacy services on leaflets and webpages related to NHS PALS and Complaints.
- We would also recommend that St George’s Hospital work together with Rethink Advocacy, and other relevant advocacy organisations, to ensure that feedback and thematic data on all PALS enquiries and complaints is shared to highlight room for improvement.
St George's University Hospitals NHS Foundation Trust (SGH) Response:
We appreciate the time staff at St George’s took to read our report and present us with their action plan for the coming year for PALS. Their action plan to the four key recommendations made can be read in Section 4. of the full report below.
We also heard from Rethink Advocacy who in response to our report stated, “We are keen to work closely with St George’s to increase independent advocacy awareness and will always support people who want to contact PALS.”
Looking forward:
Healthwatch Wandsworth looks forward to following up with relevant stakeholders over the next 12 months to understand how the user experience of PALS at St George’s Hospital has progressed.
