How to make a complaint

Who can make a complaint?

Any person can make a complaint, including:

  • the person who experienced the problem.
  • a parent or guardian of the person or child concerned.
  • a relative, friend or representative chosen by the person concerned for the purpose of making the complaint.
  • a health service provider or other concerned person.

If a complaint is made on behalf of the person who experienced the problem, written authority from that person will assist the Commission to process the complaint. Written authority is also desirable where the Commission requires access to the medical records of the person who experienced the problem. Signed authority from the person who experienced the problem is not required if they are under the age of 18 or deceased.

What and who can be complained about?

A complaint to the Commission may be about any health service provider in NSW. This includes:

  • practitioners such as doctors, nurses, dentists, pharmacists, psychologists, chiropractors, podiatrists and others, regarding the clinical care and treatment of a patient, or their professional conduct, and
  • health service organisations such as public or private hospitals, clinics, medical centres, day surgery centres, the Ambulance Service and others, affecting the clinical care or treatment of a patient.
  • health practitioners who currently do not require registration to practise in NSW, such as naturopaths, psychotherapists, dieticians, massage therapists and others.

How can I resolve concerns about my health care?

It is a good idea to first discuss the complaint with the health service provider to see whether they can work with you to resolve the complaint. There are some tips for resolving your concerns directly with the health service provider.

If they do not respond to your complaint, or you are not satisfied with their actions, contact the Commission to discuss your complaint. A complaint that relates to the immediate health or safety of a person should be made without delay. Complaints about sexual or physical assault should be made to the police.

How do I lodge a complaint?

A complaint must be in writing. You can lodge a complaint online, or download a complaint form. Alternatively you can write a letter and send it to the Commission via mail, email or fax.

Can the Commission assist me to write a complaint?

Complaints to the Commission must be in writing and we recommend that you contact the Commission's Inquiry Service on (02) 9219 7444 or Toll Free on 1800 043 159 to discuss your concerns. Staff can help you put your complaint in writing, if you require assistance. The Commission uses interpreting services to assist people whose first language is not English. To contact the Telephone Interpreter Service call 13 14 50 and ask to be put through to the Commission on (02)9219 7444 or Toll Free on 1800 043 159.

What do I need to include in my complaint?

A written complaint should include:

  • Who was involved?
  • What happened and when?
  • What are you concerned about?
  • Have you done anything else to address this matter?
  • What do you want to happen now?

Extra information and copies of other relevant documents should be attached to your written complaint. It will also assist the Commission to have the consent of the person who received the treatment to access their health records.

Using the Commission's complaint form to lodge a complaint can assist in including all relevant information that is needed.

What does the Commission do when my complaint is received?

Once the Commission receives a complaint, it will be allocated to an Assessment Officer. The Commission usually notifies the health service provider that a complaint has been made about them and provides a copy of your complaint. In some instances the Commission may request a copy of the patient's medical records.

The Commission has internal medical and nursing advisers who can provide clinical advice. When the Commission has sufficient information it makes a decision, known as an assessment decision, about the best way to manage the complaint.

In some instances the Commission can decide not to notify the health service provider of the details of the complaint. This is done only where the notification would put the health or safety of a person at risk, prejudice an investigation, place a person at risk of intimidation or affect the employment of the provider. If you believe that any of these may apply to your complaint, clearly explain why in your written complaint.

The Commission has 60 days to assess your complaint. For complaints about registered health practitioners, such as doctors or nurses, the Commission must consult with the relevant health professional council in NSW before making a final decision. All parties involved will be notified of the final decision in writing within 14 days.

What decisions can the Commission make?

  • Refer the complaint to the Commission's Resolution Service.
  • Refer the complaint to the relevant professional Council for their management. This can lead to the Council disciplining, counselling or re-educating the practitioner involved.
  • Refer the complaint for formal investigation where it raises a serious issue of public health and safety or may result in disciplinary proceedings.
  • Take no further action regarding the complaint.
  • Refer the complaint to a more appropriate agency (for example the Office of Aged Care Quality and Compliance).
  • Refer the complaint to the relevant public health organisation to resolve the complaint directly with you. This is called local resolution.

People who made the complaint can request a review of the Commission's assessment decisionwithin 28 days of being notified of the decision. A review must include any new or additional information that may alter the initial assessment decision.

Is there anything else I need to know?

Anyone making a complaint has the right to make a complaint free from harassment or intimidation. The Act provides penalties for any person trying to intimidate a complainant or witness.

Anyone making a complaint to the Commission must act in good faith. There are penalties for any person providing false information to the Commission. In addition, the Commission:

  • has the discretion not to deal with complaints where the incident occurred more than five years ago.
  • has no power to award damages or determine compensation and it cannot direct a health service provider to take specific action to resolve a complaint.
  • cannot compel a health service provider to provide you with a refund or to alter their fees.
  • cannot enforce a health service provider to provide you with treatment.
  • cannot enforce a health service provider to alter a medico-legal document if you are unhappy with the content.
  • cannot deal with matters that occurred outside of NSW.
  • acts to protect the public health and safety. It does not represent individual interests.

Where else can I lodge a complaint?

If you have any questions, please call the Commission's Inquiry Service toll free on 1800 043 159 or 9219 7444.

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