Our process

Our complaints process is

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  • Free
  • Impartial: We do not advocate for either party.
  • Voluntary: We cannot force participation in complaint resolution.
  • An alternative to legal proceedings: You don't need a lawyer.

Complaint

Provider

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Deciding how to handle complaints

When we receive a complaint, our first question is whether this office, or another agency, is best placed to deal with it.

Next we consider whether the person making the complaint has tried resolving it directly with their provider first. This is often the quickest and easiest way to resolve an issue and we're legally required to recommend this happens before we deal with it. We have tips on how to make complaints and can also provide advice by phone. Some people may have good reasons why they can't contact their service provider.

We have several ways of helping to resolve complaints but will always favour the least formal option appropriate.

Early resolution is the least formal – and often the quickest – way to resolve complaints. In most cases, we discuss the complaint with both parties over the phone to clarify the problem and to identify an acceptable solution. If no resolution is reached through this process, we may be unable to assist you further. However, if we find the complaint is too complex to resolve over the phone, but that it can be resolved, we may attempt a formal resolution. We may also decide to initiate a formal investigation.

The formal resolution process involves a series of documented steps, each leading towards finding an acceptable solution. First, we work with the complainant to write a formal description of the complaint and develop a resolution plan, which may include requests for meetings, medical records, reports or independent opinions. We then send the formal description of the complaint to the health service provider for a response.

Any improvements the provider agrees to make in response to the complaint can be documented and shared with all parties. We may check with the provider later to confirm these improvements have been made. If no resolution is reached we may be unable to assist further. The complaint may also be considered for investigation.

As with formal resolution, the conciliation process involves a series of documented steps with the goal of resolution. However, in the conciliation process, all discussions are privileged and confidential. This means all information or documents obtained in this process cannot be discussed outside the process, and cannot be used in any future legal proceedings. Our role is to enable open and frank discussion of the issues in the complaint. These complaints are typically resolved in less than 12 months, but may take longer.

At any stage we may choose to investigate a complaint. An investigation is a formal and detailed examination, often used in handling large or highly complex matters. We may investigate public and private organisations as well as individual practitioners.

While investigating a general health service provider, we may issue an interim order prohibiting them from delivering all or part of a service. A final prohibition order may then be issued following investigation, if appropriate to do so. General providers are those not regulated under the national scheme by the Australian Health Practitioner Regulation Agency (AHPRA) and are also known as non-registered providers. Following an investigation into a registered or non-registered provider, we may issue a public warning statement to alert people to serious risks to their health, life, safety or welfare.