Annual Report for the year ended 30 June 2009 - Health and ...

COMPLAINTS RESOLUTION
can be achieved without it, in a more flexible and timely way. Before any decision is made,
considerable information is gathered and carefully assessed, and preliminary expert clinical
advice is sought when needed. Before the complaint is closed, “education letters” are sent to
providers, highlighting any issues and aspects of care needing review. An apology or other
follow-up action is frequently requested.
Section 38 is also used to close complaints when no further action is required because, after
careful assessment, there is no apparent breach of the Code, or because matters are already
being addressed through other appropriate processes or agencies. Occasionally complaints are
closed because so much time has elapsed since the events occurred that it is not really possible
to address the complaint.
Investigations
Proportionately the number of complaints formally investigated remains similar to other
recent years. Formal investigations have increasingly been used for complaints involving
potentially significant breaches of ethical and professional boundaries, and major lapses in
standards of care that have resulted in death or severe disability.
Public safety concerns, the need for accountability, and the potential for the findings to lead
to significant improvement in health and disability services, are also reasons why a complaint
may be formally investigated.
Once again, a significant number of investigations (72 out of 112) have found breaches of
the Code. This confirms that while the number of investigations has dropped in recent years,
this option is being used for the most serious matters. Seventeen investigations resulted in
22 referrals (involving 15 providers) to the Director of Proceedings for disciplinary action to be
considered.
An investigation may be discontinued if it becomes clear that the issues have been identified
and the concerns addressed appropriately, or because expert clinical advice indicates the
care was, in fact, generally reasonable. Last year 32 investigations were discontinued; four
were closed when providers were referred to their registration boards; one was closed after
being referred to the provider for follow-up action; and three were resolved by mediation. All
investigations were concluded within two years, with 64 (57%) completed in 12 months.
Figure 1: Outcome of investigations 2008/09
112 Investigations*
72 Breach Reports
15 Providers referred to DP
*32 discontinued, 3 resolved by mediation, 4 referred to registration board, 1 referred to provider
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