What if a complaint is made about me as a provider?

If a complaint is made about you, you can learn about and work with our process. You will be able to present your view and can often resolve your complaint without a formal investigation.

It is unsettling to be on the receiving end of a complaint. However, comments and complaints help us learn and improve the quality of services. By discussing them, we can restore trust and mend relationships.

Will I have an opportunity to resolve the issues with the person who complained?

Often, the answer is yes. Around 30% of complaints are resolved this way. Our Commissioner can refer a complaint to you so you can respond directly to the person, or refer the complaint to the Advocacy Service. The Advocacy Service supports the person making the complaint in discussing their concerns directly with you. At this stage, many providers successfully resolve complaints by working with the complainant.

HDC has a report back procedure to check the concerns have been appropriately addressed.

If we refer a complaint to you, however you manage it, you must report back to HDC on the outcome.

The complaint process for the provider

Each complaint is unique. At HDC, we assess every complaint carefully. We are impartial and seek to treat both sides fairly.

This is an overview of our complaints process from the provider’s side:

HDC receives a complaint.
Our Complaints Assessment Team reads and reviews the complaint.
We tell you about the complaint.
There are a range of actions HDC may take, including:

We may ask you to resolve the complaint with the person directly, or with the help of the Advocacy Service. Often the complaint is resolved at this stage, once you report back to HDC on the outcome.
We may decide another agency is better placed to handle the complaint, for example, the Privacy Commissioner or the District Inspector.
When we assess a complaint, we will ask you to tell your side of the story and will request clinical notes. We may seek clinical advice from a peer or expert, too.
We may close the complaint without a formal investigation, if we find that the care was largely appropriate. If this is the case, we will often make recommendations for change or educational comment.
In a small number of cases, HDC will carry out a formal investigation. If this is going to happen to you, we will let you know.

Our Commissioner (or Deputy Commissioner) decides the outcome of the complaint. Before that happens, you will have an opportunity to respond to any adverse comments we make about you and any recommendations. We send you a written explanation of the outcome of the complaint.

HDC’s decisions are usually final. However, they can be reviewed by the Ombudsman or High Court to ensure that everyone has been treated fairly.

Advice to help you handle a complaint well

HDC will usually ask you to provide information to help us assess the complaint. HDC is authorised by law to obtain information, and you won’t be breaching patient confidentiality or privacy by supplying the information we request.

Your professional association can provide advice on responding to complaints. For example, the Medical Protection Society provides advice for doctors.

If you handle complaints sensitively, you are more likely to get positive outcomes, such as:

Achieving low-level resolution
Gaining people's confidence in your practice, sincerity, and intention to do the right thing
People complaining directly to you rather than to HDC

What do people hope to achieve by making a complaint?

We understand that it is unsettling to be the subject of a complaint. Try to consider the position of the person who is complaining. If they are complaining, they are unhappy and under stress. The most common reasons for people complaining are:

the need for an explanation about what happened
wanting to prevent a similar thing happening to someone else
seeking accountability for what went wrong, for example expression of responsibility or apology

For these people, a good resolution may involve:

obtaining answers to questions about the care they received
acknowledging their concerns
review and improvement of a practice or system

Most often, people want an acknowledgement of their experience, an assurance that preventative action has been taken, and an apology for any inadequacies in the care they received.

It's important that providers respond to complaints in a timely way. Your obligations for responding to complaints are outlined in Right 10 of the Code of Health and Disability Services Consumers’ Rights.

Will I need support, such as a lawyer?

This is something you must decide for yourself. It may help to discuss the complaint with peers or colleagues. Your professional body may be able to help or to put you in contact with someone who has been through the HDC process. Some health professionals use lawyers, but many do not.

What if the complaint against me goes to a formal investigation?

We have more information to help you. More details are available on formal investigation of a complaint - information for providers.