Factors that may warrant an investigation

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.