The NHS complaints procedure is failing to hold services to account, according to a report that calls for sweeping reform.

The report by the Public Law Project, which claims it is the first independent, UK-wide study of the procedure since its introduction three years ago, identifies problems at all stages.

While accepting the principle of local resolution, the report says the procedure 'fails to recognise how difficult it is for complainants to have to confront the very organisation or people that treated them'. The report also says it lacks impartiality and transparency.

The report finds that the next stage of the procedure, independent review, also fails to 'give complainants confidence in (its) independence or effectiveness' as the panels were 'established as a committee of the trust' and 'paid for by the trust'.

None of the complainants who had gone through independent review felt that the NHS had been held properly accountable, it says.

'Complaints have enormous potential to shed light on problems faced by people receiving care in the NHS,' said report author Henrietta Wallace. 'Yet the procedures for monitoring complaints and ensuring that improvements are implemented are woefully inadequate. Far from improving the accountability of the NHS, many feel that the new procedure is letting the NHS evade responsibility for mistakes.'

The report says the Department of Health should produce national standards on local complaint resolution and reform its application in primary care as 'a matter of priority' so people can complain to 'an officer who is independent of the practice concerned'.

It calls for a 'fast track' taking complaints which raise serious questions about competence to higher levels of the procedure, litigation or the professional bodies.

It demands a complete overhaul of the independent review process, calling for the DoH to set up independent regional complaints centres to employ convenors and provide administrative support.

And it says health authorities should monitor complaints in primary care and the Commission for Health Improvement should be given a role in monitoring complaints against trusts.

Patients Association representative Mike Stone, who was involved in producing the report, said he hoped it would 'facilitate better procedure'.

The report also calls for community health councils to be given a statutory role in supporting complainants. Donna Covey, director of the Association of Community Health Councils for England and Wales, said the report supported its experience of the complaints system.

Cause for Complaint? Henrietta Wallace, Public Law Project, Room E608, Birkbeck College, University of London, Malet Street, London WC1E 7HX. Free.