Complaints can be unpleasant but help improve the quality of care for other people. Complaints usually signal a problem and therefore provide an opportunity to improve.
|Standard – what we’ll be assessing on||Evidence to provide for assessment|
1.3 The practice ensures a patients' right to complain. [Right 10].
Under the Code of Health and Disability Consumers’ Rights all complaints receive a fair, simple, speedy and efficient resolution.
Practices need to use Right 10 of the Code of Health and Disability Services Consumers’ Rights as guidance:
- A provider must acknowledge any complaint in writing within 5 working days (Right 10(6)(a)).
- A provider must make a decision on whether the complaint is justified or not, or whether more time is needed to investigate the complaint, must be made by the provider within 10 working days of giving written acknowledgement of receipt of the complaint (Right 10(7)).
- A provider must inform the consumer (with an explanation) within 10 working days if more time is needed to investigate the complaint, and that more than 20 additional working days will be required.(Right 10(7)(b)(ii)).
- Once a practice determines whether the complaint is justified, the practice must inform the consumer of that decision (with reasons, any proposed actions and any appeal procedure) ‘as soon as practicable’ after making the decision (Right 10(8)).
- A provider must inform a consumer about progress on the complaint at intervals of no more than one month (Right 10(4).
A Complaints Officer (or team) is responsible for explaining and educating the team on the practice’s complaints policy and procedure. They supervise and manage the complaints process. If the complaint involves the Complaints Officer, the practice must appoint an alternative Complaints Officer to be responsible for that specific case. The Complaints Officer’s role description must be in accordance with the practice’s Complaints Policy and processes. An example of a role description can be found here.
A complaints register is a comprehensive record of complaints and how they are managed. The register includes dates and details of the complaint, any actions taken in response to the complaint and outcomes (including reasons and improvements) in chronological order. These reasons and improvements need to be discussed and shared with the complaints officer of the practice team.
Complaints policy and procedure
The complaints policy and procedures must include:
- A process which is consistent with Right 10 of the Code
- Timelines for managing complaints
- A designated Complaints Officer with role description
- Team training/induction descriptions
- Complaints register and process
- How complaints are shared with the team (if appropriate)
- How the practice learns from complaints.
Where a patient is unable to visit the practice in person to make a complaint, for example during a pandemic or other reason, a practice must have a process to ensure patients are able to communicate their complaint in a variety of ways other than in person. For example, by phone, video communication, in writing, by email or text.
Links to resources
Resources from the Health and Disability Commissioner
Health and Disability Commissioner: The Code of Health and Disability Services Consumers’ Rights 1996
Health and Disability Commissioner: Timeframes for Responding to Complaints under Right 10 of the Code (Fact Sheet 3)
Office of the Ombudsman Tari o te Kaitiaki Mana Tangata: Effective complaint handling guide
Health and Disability Commissioner: Learning from complaints leaflet