The latest annual report by the Health and Disability Commissioner highlights significant opportunities and challenges, including on-going increases in the number of complaints received, more complex issues being raised in complaints, and the need to respond to changes in the health and disability system.
Health and Disability Commissioner Morag McDowell says, “The Code of Consumers’ rights continues to set the benchmark for consumer-centred care in Aotearoa New Zealand and HDC remains committed to advocating for a health and disability system that amplifies consumer voice and places people at the centre.”
During 2022/23, HDC received 3,353 complaints, up 36 percent on pre-COVID-19 numbers. Despite these pressures, HDC succeeded in closing 6,028 complaints – 16 percent more complaints than the previous year.
“In a constrained environment with limited resources, we have continued to work on finding efficiencies and focusing on people-centred and early resolution where possible.”
In 2022/23 HDC introduced fast-track processes and clinical navigator roles to assist people in understanding their care and the clinical information provided. HDC also re-configured the triage process to focus on early resolution and equity. With a focus on becoming a culturally safe organisation, there has also been ongoing success in bringing a te ao Māori approach to complaints resolution to benefit both whānau and providers.
This year 35 percent of complaints that were closed were referred for direct resolution between the parties, often with the assistance of the Advocacy Service.
“The Advocacy Service plays a vital role in working with people to resolve their concerns as early as possible. HDC also funds the Advocacy Service to promote the Code through community-level educational initiatives,” said Ms McDowell.
The Advocacy service carried out 3,351 networking visits with community groups and provider organisations across the motu in 2022/23, with a focus on priority communities.
HDC also developed and released three online learning modules in November 2022 providing education for providers to increase their understanding of the Code. The modules were accessed by 3,332 providers by the end of June 2023.
An animated video on the Code, which was designed in consultation with consumers, was launched in September 2023. This represented an important opportunity to lift the general public’s awareness and understanding of their rights under the Code.
Under the HDC Act, a formal investigation is taken where an action is, or appears to be, in breach of the Code. “Investigations tend to focus on more serious departures from acceptable standards, professional boundaries, and public safety. They may also address wider systems or equity matters.”
In 2022/23 HDC completed 156 investigations, the highest number in more than 10 years.
HDC uses findings from complaints to influence quality improvements in the health and disability sector.
“In 2022/23 HDC undertook a Commissioner-initiated investigation into cancer care delays in the Southern region after concerns were raised with our Office,” Ms Morag McDowell said.
The findings were widely reported and represented an important opportunity for HDC to speak to the system and contribute to broader systemic change.
Through the making and monitoring of recommendations, HDC also holds the system to account to ensure that learning and change occur. HDC made 592 quality improvement recommendations in relation to individual complaints in 2022/23 with a compliance rate at around 96%.
HDC also continued to proactively seek opportunities to share insights from complaints with other agencies and work collectively to address consumer rights issues. For example, in 2022/23 HDC raised issues and worked with other agencies in relation to the safety of surgical mesh, inconsistencies in informed consent processes, quality of maternity care and the impacts on patients of current delays in planned and emergency care.