Factors that may warrant an investigation

HDC may investigate any complaint where the actions of a health or disability provider appears to be in breach of the Code.

Below is a guide to the additional factors we take into consideration when deciding whether or not to investigate a complaint. These factors are in no particular order, and any one or more of these factors may be enough to justify a decision to investigate or not.

This list will be reviewed and updated from time to time.

Please note that this is intended as a guide only. The decision whether or not to investigate ultimately lies with the Commissioner.

the alleged breach is serious
there has been more than a mild departure from accepted clinical practice or there has been several mild departures from accepted clinical practice
the incident caused serious harm
the person or patient is vulnerable
the health or disability service provider abused a position of trust
there are significant public health and safety, systems and/or equity issues that need to be looked at
there is evidence that the health or disability service provider acted dishonestly, maliciously, or recklessly
more or complex evidence needs to be gathered and looked into that is outside the scope of an initial assessment
there are reasonable grounds to suggest that the incident or mistake could be repeated
the health or disability service provider has a significant history of complaints against them
HDC is the only organisation that can investigate the complaint or provide any meaningful regulation of a health or disability service provider who is unregulated
the consumer and/or complainant wishes the complaint to be investigated
any other factors are present that HDC considers are relevant.

HDC may decide not to investigate a complaint if:

the alleged breach is minor and was the result of a single incident
the care provided was appropriate or reasonable, or there is only a mild departure from accepted clinical practice
the incident is unlikely to be repeated
the health or disability service provider has engaged positively in HDC's process and accepted responsibility for any wrongdoing and taken steps to fix the issues
there are other adequate solutions or ways of resolving the complaint that the person making the complaint could use and/or there are other reasonable alternatives to an investigation
the person affected by the incident doesn’t want it to be investigated
HDC considers the complaint can be appropriately dealt with through education or recommendations
a substantial amount of time has passed between when the incident occurred and when the complaint was made
an investigation is likely to have a negative impact on the physical or mental health of a consumer/complainant/witness
the health or disability service provider was suffering from a significant mental or physical health issue at the time of the incident
the health or disability service provider has retired or is no longer practising
the health or disability service provider is junior
the person accepts that the provider has fixed the issue
another agency or organisation is better placed to investigate the issue or has already investigated the issue
there is a dispute or disagreement of facts that can’t be solved by gathering further information
there are other reasons HDC considers are relevant.