Office of the Health Services Commissioner Annual Report 2008

How were the complaints resolved?
The complaints closed in enquiry are those
that were not confirmed in writing. The
resolution of these may be that the caller
felt it was sufficient to tell someone why
they were unhappy and to be heard, however
they may also remain unresolved and the
person may decide to proceed with the
complaint at some time in the future. There
is a one year time limit on complaints but
the Commissioner has the discretionary
power to extend this.
The confirmed cases are resolved either in
the initial assessment process or they are
referred to conciliation. A very small
number are referred for investigation but
this only happens when mediation and
conciliation or referrals to registration
boards are not feasible options. This year
approximately 81% of confirmed cases
were resolved in assessment.
The stages at which complaints were
resolved can be seen in Table 6.
Seriousness
All new complaints are given a
“seriousness” rating which depends upon
the severity of the outcome for the
consumer and the perceived level of risk of
the incident. This rating is allocated initially
Stage of Complaint Process HRA HSCR Total %
Closed in Assessment 64 852 916 81%
Closed in Conciliation 15 205 220 19%
Closed in Investigation 0 2 2 0%
Total Cases Closed 79 1059 1138 100%
Table 6
Resolution Stages
HRA HSCR Total %
0-3 Months 53 489 902 79%
3-6 Months 10 45 55 5%
3-6 Months 7 42 49 4%
9-12 Months 3 36 39 3%
12-18 Months 5 47 52 5%
18-24 Months 1 20 21 2%
24 Over 0 20 20 2%
Total Cases Closed 79 1059 1138 100%
The data in Table 6.1 illustrates the time
taken to resolve and close confirmed cases.
The first three months is, generally, spent
in the assessment stage where
approximately 80% of cases are resolved
and closed. Legislated timelines require
assessment to be completed within three
months.
on the basis of the complaint information
and may be revised and changed during the
course of complaint management as new
information emerges.
Table 6 .1
Time till Resolution
The next stage is usually conciliation (or,
infrequently, investigation). For the cases
not closed in assessment 60% were
completed within twelve months, 30% in two
years and the remainder in more than two
years. This is often due to the complexity of
the issues and the multiple complicated
activities required to reach completion.
Seriousness Rating
1. Low: A phone call, letter or an
explanation should easily resolve the
problem. Included in this rating are
complaints that are frivolous, vexatious,
obviously misconceived or where an
investigation is unwarranted.
2. Medium: Frequently there has been a
misunderstanding; issues involving access
to records, disputes about costs,
discourtesy, diagnostic or treatment errors
or differences of opinion without serious
consequences.
3. High: There may be quality assurance
implications, where changes in practice are
needed to avoid a recurrence or there is a
need for policy development. These also
include complaints associated with
allegations of negligence leading to
personal injury, professional misconduct,
unlawful or unethical acts, lack of informed
consent with serious adverse outcomes.
The seriousness rating of accepted cases
closed in the past year is seen in Table 7.
2007 - 2008
HRA Low Medium High Total %
Access & Correction 22 15 0 37 4%
Collection 2 1 1 4 0%
Data Quality 1 3 0 4 0%
Identifiers 0 1 0 1 0%
Info Available to another HSP 6 1 0 7 1%
Transfer/Closure of HSP 1 0 0 1 0%
Use & Disclosure 7 15 1 23 2%
None 1 1 0 2 0%
Total 40 37 2 79 7%
HSCR Low Medium High Total %
Access 55 34 10 99 9%
Administration 43 13 2 58 5%
Communication 75 55 6 136 12%
Cost 58 26 2 86 8%
Not Specified 3 5 0 8 0%
Rights 42 21 7 70 6%
Treatment 178 328 96 602 53%
Total 454 482 123 1059 93%
Grand Total 494 519 125 1138 100%
43% 46% 11% 100%
Table 7
Seriousness by Issue at Closure
The majority of complaints received (89%)
are rated as “low” or “medium” seriousness
and this is consistent from year to year. The
majority of these complaints can be resolved
by further explanation by the health service
for the complainant.
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Office of the Health Services Commissioner | Annual Report 2008