Articles and Case Studies

AHPRA Complaints Process

06 Jan 2012

by Ms Sharon Russell

Receiving a complaint or notification from the Australian Health Practitioner Regulation Agency (AHPRA) can be extremely stressful.
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Unfortunately, many medical practitioners will be the subject of an AHPRA complaint at some stage during their career. Sharon Russell, Claims Manager, outlines AHPRA’s complaints process.

MDA National strongly recommends contacting us immediately upon receiving a complaint or notification from AHPRA or any other regulatory body, so we can assist you to provide an appropriate response.

Under national registration, AHPRA has been tasked to investigate notifications and complaints made against medical practitioners. Anyone can make a complaint to AHPRA, whether it is a patient, their relative, a colleague or employer. Complaints can be made over the telephone, in writing or online.

AHPRA may also request a report from a medical practitioner when their own conduct is not in question. For example, AHPRA may be reviewing hospital systems following receipt of a complaint and ask a practitioner to comment on the appropriateness of existing systems.

Alternatively, practitioners may be asked to comment on the competency of a colleague. Importantly, AHPRA does have the power to compel practitioners to respond, to assist in their investigation of a complaint.

Preliminary assessment phase

All complaints go through a preliminary assessment phase, whereby AHPRA determines if the complaint will be investigated by them or referred to another state based health complaints entity. In NSW the co-regulatory system with the Health Care Complaints Commission (HCCC) was retained, therefore in NSW all complaints made to AHPRA are referred to the HCCC

If AHPRA continues to assess the complaint, the practitioner will be asked to provide a written response. MDA National assists Members in drafting their responses, ensuring all issues of concern are addressed objectively and appropriately. If necessary, an independent expert opinion may be obtained.

Following preliminary assessment, the medical practitioner will be notified of what further action, if any, will be taken. This may include:

  1. taking no further action
  2. investigating the notification
  3. requesting a health assessment or a performance assessment of the practitioner
  4. referring the matter to a health or performance panel hearing
  5. referring the matter to a tribunal hearing
  6. issuing a caution
  7. accepting undertakings
  8. imposing conditions on the practitioner’s registration or
  9. taking immediate action on the practitioner’s (or student’s) registration.

AHPRA frequently decides that no further action will be taken after conducting a preliminary investigation. In 2010/11 no further action was taken in 86% of notifications.1

Investigation

AHPRA will undertake an investigation if, in its opinion, the complaint raises issues of clinical concern or of a disciplinary nature. At this point, the investigating officer may seek additional evidence such as statements from witnesses, further medical records, or phone records. They may also direct the medical practitioner to undergo a performance assessment or an independent health assessment, or refer the practitioner to a health or performance panel or a Tribunal hearing. Following the investigation, a decision may be made to:

  1. issue a caution
  2. accept undertakings
  3. impose conditions
  4. refer all or part of the notification to another body
  5. take no further action.

Tribunal

There can be serious consequences for a practitioner if they are referred to a Tribunal, and they are found guilty of unprofessional conduct and/or professional misconduct.

Generally speaking the Tribunal comprises a District Court judge, two medical practitioners and a lay person, specifically appointed to consider the evidence, and determine if the medical practitioner’s conduct constitutes unprofessional conduct or professional misconduct. The constitution of the Tribunal can vary slightly from state to state.

Following the Tribunal hearing the following actions may be taken:

  1. issue a caution or reprimand
  2. fine registrant
  3. suspend registration
  4. cancel registration or
  5. take no further action.

If an undertaking or registration condition is applied, the practitioner will be subject to ongoing monitoring to ensure compliance.

Review of decisions

If a complainant is not satisfied with AHPRA’s decision, they can write to the Complaints Officer within 30 days of the decision and request a review. The complaint may then be referred to the Chief Executive Officer of AHPRA for internal review. If the complainant remains dissatisfied they can contact the National Health Practitioner Ombudsman, who may also conduct an independent review.

Although AHPRA often determines that no further action should be taken, a complaint may have the potential to result in serious consequences for a medical practitioner. Contacting MDA National immediately when you receive a complaint or notification from APHRA means that we can assist you to ensure the best possible outcome is achieved.

By Sharon Russell
Claims Manager (Solicitor)/Risk Adviser



 
Anaesthesia, Dermatology, Emergency Medicine, General Practice, Intensive Care Medicine, Obstetrics and Gynaecology, Ophthalmology, Pathology, Practice Manager Or Owner, Psychiatry, Radiology, Sports Medicine, Surgery
 

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