Frequently Asked Questions - Health Providers

A complaint has been made about me. What happens next?

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Where can I go for support when a complaint has been made about me?

We acknowledge that being the subject of a complaint can be a stressful and challenging experience for a health practitioner. If the Commission has contacted you to request a response to a complaint, the following may be of assistance:

  • the complaints manager of your facility or Local Health District
  • your professional indemnity insurer
  • a lawyer or legal representative
  • your professional association
  • another support person

It is also important to seek any support you might need for your health and wellbeing and you can access a list of support services here.

Will I get a copy of the complaint made about me?

The Commission is required to advise you that a complaint has been received about you, the nature of the complaint and who made it. The Commission will usually send you a copy of the complaint and seek a response. In some instances the Commission may decide not to notify a provider of the details of the complaint.

What should I include in a response to the Commission?

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The Commission is asking me to provide sensitive patient information such as medical records. Is this allowed?

The Commission is an exempt body under the Health Records Information and Privacy Act 2002. This means that health service providers are allowed to provide private health information to the Commission if they are satisfied that the Commission needs this information to manage a complaint.

Under Section 21A or 34A of the Health Care Complaints Act, the Commission can require any person to provide information and/or records which it considers relevant for the assessment or investigation of a complaint. If you are concerned about releasing sensitive information to the Commission you can contact the officer who may issue you with a Notice to Produce under the relevant section.

Will you provide my response to the person who made the complaint?

As a health service provider you should give consideration to preparing a response that can be provided to the complainant. In the Commission’s experience, less serious complaints can be successfully resolved with a response from the health service provider that acknowledges the complainant’s concerns and provides a clear explanation for the issues that have been raised.

You can request that your response be used for our assessment purposes only. This means that a copy would not be released to the person who made the complaint without your consent, during the assessment process. However, where appropriate we will outline relevant details from your response to the complainant to help them understand the reasons for our assessment decision.

What are the possible outcomes when the Commission assesses a complaint?

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How long will it take before I’m advised of the outcome?

The Commission aims to assess complaints within 60 days. On some occasions the assessment may take longer, for example we may need to consult with the appropriate Health Professional Council, gather additional information or seek further clinical advice. You can speak to your Assessment Officer for updates during the process.

Will you notify my employer about the complaint?

Your obligations to notify your employer of complaints relating to you should be set out in your employment contract and conditions. The Commission also has the power to notify your current employer if it considers that this is necessary to assess the matter effectively or necessary to protect the public.

If a complaint raises serious risks and is referred for investigation, the Commission will generally notify the relevant employer about the complaint.

If the complaint also relates to the organisation or employer that the health practitioner works for, the Commission will notify them of the complaint. However, the responses to the complaint are treated confidentially and separately.

I’m a registered health practitioner – will you notify AHPRA about the complaint?

In NSW, the Health Care Complaints Commission manages complaints about registered health practitioners in co-regulation with the appropriate Health Professional Councils. For example, if the Commission receives a complaint about a medical practitioner, it will consult with the Medical Council of NSW in determining the appropriate outcome. The councils do share information with the relevant national board and the Australian Health Practitioner Regulation Agency (AHPRA). Any notification made to AHPRA or the Health Professional Councils will also be referred to the Commission as a complaint for assessment. This does not mean that your registration will automatically be affected simply because a complaint has been made about you. Each complaint is carefully assessed to determine an appropriate outcome. You can read more about possible complaint outcomes here.

I’m a registered health practitioner and I’m concerned about another registered health practitioner.

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I’m not the subject of the complaint but the Commission has written to ask me for information about an incident I witnessed that involves a colleague of mine. Do I have to respond?

If the Commission has asked you to provide information, you are encouraged to provide a response. If you choose not to respond, the Commission does have the power to compel you to provide information by issuing a formal Notice to Produce Information per Section 21A or 34A of the Health Care Complaints Act. Penalties may apply if you fail to comply with a formal Notice to Produce Information without a reasonable excuse.

I’m being investigated. What is going to happen?

If a complaint is assessed and the decision made to refer the matter for investigation, the Commission will advise you of this outcome in writing. The Commission may ask you to provide information about the issues that are being investigated. It may also request supporting documentation, such as your records of the matter and your resume.

The Commission aims to finalise its investigations as quickly as possible. The actual length of the investigation depends on the complexity of the case. The investigation officer will update you on the progress of the investigation.

At the end of an investigation of a registered practitioner, the Commission can:

  • refer the matter to the Director of Proceedings to determine whether to prosecute the practitioner before a disciplinary body.
  • refer the matter to the appropriate registration body/council.
  • make comments to the practitioner.
  • terminate the matter and take no further action.
  • refer the complaint to the Director of Public Prosecutions to consider criminal proceedings.

At the end of an investigation of an unregistered practitioner, the Commission can:

  • terminate the matter and take no further action.
  • issue a prohibition order per s41A of the Health Care Complaints Act that will prohibit the health practitioner from providing any or specified health services for a specified period or permanently.
  • place temporary or permanent conditions on the provision of health services by this practitioner.
  • issue a public statement.
  • refer the complaint to the Director of Public Prosecutions to consider criminal proceedings.

At the end of an investigation into a health organisation, the Commission can:

  • terminate the complaint and take no further action.
  • make comments or recommendations aimed at improving health care delivery in the future.
  • refer the matter to another relevant body.

If, at the end of the investigation, the Commission is considering taking any action other than termination of the complaint, you will be advised of the proposed action and invited to make a submission within 28 days of that advice.

Does the Commission run any workshops or presentations about complaints management for health organisations?

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I’m interested in becoming an Expert Reviewer for the Commission.

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Other questions?

If you have additional questions or need more information you can contact the Inquiry Line during business hours, Monday to Friday from 9am – 5pm on 1800 043 159 or submit an online inquiry.

Still need more information

If you would like to speak to someone at the Commission for more information before you lodge a written complaint you can contact the Inquiry Line during business hours, Monday to Friday from 9am – 5pm on 1800 043 159 or submit an online inquiry.

Online inquiry

Ready to lodge your complaint

All complaints must be made in writing and we aim to assess complaints within 60 days. Your complaint will be allocated to an assessment officer and we will write to you to explain the outcome of your complaint.

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Track my complaint

You can track the progress of your complaint online.

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