Receiving an official complaint about your conduct or competence as a healthcare professional can be an alarming experience—but preparedness is half the battle. Here’s what you should expect if you are on the receiving end of a patient complaint, and how to deal with it quickly and professionally.
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Step 1: The complaint is made
Complaints can be sent to a number of different bodies: The Medical Council, The Health & Disability Commissioner (HDC), coroners, or even an employer name a few. The vast majority of the time, complaints will be sent to the HDC, so we will focus on this process here.
You can receive a complaint either in writing or verbally. If it is the latter, you will usually receive a transcript of the complaint. If it is the former, you will receive a copy of the email or letter.
Complaints can be made either by the patient themselves, or a representative i.e. a guardian, parent, spouse, etc.
The most important thing to do as early as possible is to contact your insurer. Ideally, you would actually get in touch with your insurer before the official complaint comes in—if you have had an experience that you think may result in a complaint, we encourage you to get in touch with us straight away. Even at these early stages, medicolegal support can be extremely helpful.
Once you have received your copy of the complaint, remember to stay calm. It’s never a pleasant experience having a complaint laid against you, but the next few stages are made far easier with a cool head and a careful process.
Step 2: Investigating the complaint personally
Once you understand the nature of the complaint, you will need to formulate a response to your patient. It is imperative that this response is carefully constructed, and that requires information.
As such, you should gather all pertinent data for this complaint, including patient records. What you want to do here is to refresh your memory of the incident if necessary and check to see if the complaint is valid. Did you make a mistake? How? When? Where? Why? Why not?
Step 3: Responding to the complaint
Your response to the complaint can decide whether or not the HDC officially investigates you themselves. They are relying on you to provide the baseline context of your side of the exchange, and as such you should write a response that is equal parts sympathetic and authoritative—and remember that this response will be read by more than just the complainant themselves. Send this to your medicolegal advisors before you send it anywhere else. They will help you to construct a reasonable response that truly puts your perspective forward.
Begin by directly addressing the issue that has been identified, and explain in detail what happened and why, and, perhaps most importantly, what steps are being taken to ensure that it does not happen again. If you find yourself or your facility to be at fault, this is the stage at which you should apologise. Answer any questions in the complaint itself, ensure you have a clear chronological account of what happened, and remember that your medical indemnity provider can assist you here with legal advice on the content of your response.
Step 4: HDC investigation
If the HDC does decide to investigate further, they will ask you and potentially your organisation for additional information such as clinical notes, internal reports, policies and procedures, hospital records, eye-witness accounts, and so on.
After this fact-gathering, the HDC may seek advice from an expert in the field on what went wrong, and what should have been done instead.
If the HDC does not decide to investigate further, they will notify you of their decision at this stage.
Step 5: Provisional opinion
Once the HDC has performed its investigation, it will provide you with a provisional opinion, which is the initial decision that it will make about whether there has or has not been a breach of the Code of Rights.
You will be sent a letter that outlines this decision, and the reasons behind it.
If you receive an unfavourable outcome, you get the opportunity to respond and correct any factual errors. The medicolegal advice offered by your insurance provider is useful throughout this process.
Make sure you speak to your medicolegal advisors if you receive an unfavourable provisional opinion.
Step 6: Final report
The decision from the HDC cannot be argued once it has been made in the final report. This report will lay out in detail as to whether there has been a breach of the Code of Rights, to what extent, why, where and how, and usually the next steps and recommendations as a result of this decision.
This may include further education for you and/or your team, changes in processes, adjustments to training, and in extreme cases, fines or censure.
Once this has been finalised, this is the last stage of the complaint process. It’s all over! But remember, if at any point you are confused about what you need to do next, get in touch with your medicolegal advisors and clarify. Your advisors will be talking to you at every stage regardless, but don’t be afraid to speak up yourself. The complaints process can be long and arduous; make sure you know what you need to do to hurry it along and get a better outcome.
For more advice on the complaints process, download our free ebook available below.
