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When:
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What:
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Complaint received
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1.
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If possible, resolve complaint quickly and easily.
Involve the complaints officer at the earliest opportunity.  If appropriate, discuss the complaint with the complainant in a private space.
It may not be appropriate for the person receiving the complaint to discuss it with the complainant. If possible, alert the complaints officer so they can identify the best way to proceed.
The person receiving the complaint should not discuss it if:
- a more senior staff member needs to talk to the complainant
- the complaint involves clinical care
- complaint is being made on behalf of a patient by someone else – signed consent or Power of Attorney is needed before information can be shared.
If the complaint can't be easily resolved:
- Document the complaint. If complainant is there in person, give them information about the complaints process.
All verbal concerns or complaints that can't be resolved on the spot should be put in writing.
Either:
- ask the complainant to complete the complaints form, or
- complete the form and agree what you've written with the complainant.
- Advise senior leadership.
- Advise Pegasus Health if necessary.
Inform Pegasus Health of complaint if:
- nature of the complaint could compromise your ability to deliver services or meet your obligations
- complaint could discredit the practice, Pegasus Health, Health New Zealand, etc.
- Health and Disability Commissioner could become involved
- complaint involves SAC Level 1 or 2 event.
Add all complaints to the complaints register, even if they are easily resolved.
This should be done by the complaints officer.
Include:
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Within 5 working days of receiving complaint
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2.
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Acknowledge the complaint in writing.
Send a written acknowledgement of the complaint.
Your written acknowledgement should include:
- apology for the difficulties they have experienced
- invitation to discuss the way forward by phone or in person
- explanation of their right to bring a support person, or advocate, to all meetings.
If you haven't already given the complainant information about the complaints process, include this with your acknowledgement.
Consider adding an appropriate alert to Medtech to make team members aware of the need for caution, especially around outstanding fees.
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Within 10 working days of acknowledging complaint
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3.
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Investigate the complaint.
Make a plan before starting your investigation.
Write a plan for your investigation to ensure your process is robust.
Include:
- complainant/patient's name and contact details
- their preferred method of contact
- confirmation of consent to discuss the patient's details, if needed
- details of acknowledgement of complaint – date and what was said
- outcome the complainant is seeking
- list of issues to investigate
- identification of who will investigate, with appropriate consents
- timeframe for response
- any helpful information. e.g. cultural needs, language considerations, or disability.
If the complaint is progressed to HDC, your plan may be submitted as evidence.
Carry out the investigation and establish the facts.
Investigate fully what happened:
- Interview staff involved, or ask them to provide statements.
- Review relevant policies and/or procedures.
- Obtain any relevant information from other sources.
- Interview any other relevant people.
- If appropriate, you may want to have a clinician not involved in the complaint review the clinical management.
Don't rush this step – ensure you establish the facts.
If your investigation identifies that a patient has experienced harm as a result of the care provided, refer to Open Disclosure.
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4.
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Decide if the complaint is justified, or if you need more time to investigate.
Make a decision:
Your decision must be made within 10 working days of acknowledging the complaint.
It doesn't need to be communicated to the complainant within the 10-day timeframe.
Source: HDC: Timeframes for Responding to Complaints under Right 10 of the Code
- whether you accept that the complaint is justified or not, or
- if you need more time to investigate.
If you need more time to investigate, identify whether you need more than an additional 20 working days.
If more time is needed to investigate:
- If you need more than an additional 20 days, inform the complainant of this within the 10 working day timeframe.
- If you don't need more than an additional 20 working days, you don't need to communicate until you have made a decision.
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5.
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If you decide that more than an additional 20 working days is needed, inform the complainant.
Write to the complainant to tell them:
- that you need more time to investigate
- your reasons for needing more time.
- that you'll update them on progress at least once each month.
"Month" refers to a calendar month.
For example, if you update the complainant on 26th July, you need to provide another update by 26th August.
Source: HDC: Timeframes for Responding to Complaints under Right 10 of the Code
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At least monthly, if investigation is ongoing
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6.
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Provide regular progress updates.
If your investigation continues for more than an additional 20 working days, provide a progress update to the complainant at least once each month.
"Month" refers to a calendar month.
For example, if you update the complainant on 26th July, you need to provide another update by 26th August.
Source: HDC: Timeframes for Responding to Complaints under Right 10 of the Code
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"As soon as practicable" after making your decision
(no more than a calendar month since last communication)
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7.
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Communicate the decision.
Write to the complainant to inform them of your decision "as soon as practicable" after making it:
"As soon as practicable" means as soon as it is both possible and practical.
However, it shouldn't be more than one calendar month since your last communication with the complainant.
- Explain your decision and the next steps.
The aim of this communication is to ideally resolve the complaint at this point. Write a careful and measured response.
Include:
- acknowledgement of their distress
- apology, if appropriate
- summary of the main issues
- actions you took to investigate
- a response to each issue raised
- actions you're taking to reduce future risk/lessons learned
- invitation to meet you to discuss and answer questions
If you found the complaint to be not justified, explain why you came to this decision.
Include with your communication:
- details of how to appeal the decision
- copy of Consumer Rights brochure
- information about advocacy services, representation, and support services.
- Arrange a meeting to discuss the decision if the complainant requests it.
At this point, the complaint is resolved unless the complainant decides to take it further.
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