What happens when you make a complaint

The assessment process allows us to sensitively gather and analyse detailed information about your complaint from all relevant parties.

This information helps us decide whether, and how best to further deal with a complaint.

The assessment process also helps us identify matters which should be dealt with as a priority.

Our assessment process is generally completed within 22 business days (or 44 business days with an extension granted under specific circumstances prescribed in the Act).

Local resolution is a voluntary process for resolving complaints quickly with minimal intervention by the OHO. As its name suggests, complaints identified for local resolution are resolved between you, the complainant and the health service provider. We provide assistance to help clarify the issues of concern and to identify strategies, outcomes, or agreements which might lead to the resolution of the complaint.

To be suitable for local resolution, you must be the direct recipient of the health service in question, or where complaining on behalf of someone else, demonstrate sufficient interest in the matter. Some examples of sufficient interest may be where you are a parent or legally appointed guardian of the health service consumer, or the health service consumer has given you their authority to represent them in the complaints process.

Our local resolution process is generally completed within 22 business days (or 44 business days with an extension granted under specific circumstances prescribed in the Act).

Some complaints either must (by law) or can be better handled by another organisation.

The Health Ombudsman has powers to refer a matter to the Australian Health Practitioner Regulation Agency (Ahpra), other government entities in Queensland, or another state or an entity of the Commonwealth with functions that include dealing with the matter.

Where a matter relates to the health, conduct, or performance of a registered practitioner, the OHO can (or sometimes must) refer the matter to our co-regulatory partner, Ahpra, as the most appropriate entity. A referral to Ahpra may occur during the Triage stage, or following another relevant action such as assessment. Learn more about this arrangement.

In some cases, we may identify the issues of concern may (or must) be dealt with by another State or Commonwealth entity, and a decision may be made to refer your matter to them to manage. Typical government entities that we refer complaints to include Hospital and Health Services (including Public Health Units), Aged Care Quality and Safety Commission, Queensland Police Service and the Australian Government Department of Human Services (Medicare).

Most referrals to both Ahpra and other government entities occur at the intake and triage stage, however referrals to other entities can also be made following most other relevant actions.

The OHO works with these entities to ensure high quality complaints management processes are delivered including the maintenance of safety and quality in the provision of health services.

We’ll always tell you if we refer your complaint to another body and we’ll share any information we’ve collected about your complaint to save you time and effort.

Conciliation is a voluntary process for resolving complex and/or sensitive complaints including those requiring detailed explanations or confidential resolution. The process is facilitated by skilled conciliators who use their independence and specialist resolution and negotiation skills to assist all parties to be heard, identify issues for discussion and negotiate outcomes between the parties.

Information disclosed during a conciliation process—including details relating to any agreements or negotiations—is confidential and privileged, meaning it cannot be discussed outside of the process or admitted as evidence in a proceeding before a court, tribunal or disciplinary body.

Whether parties agree to undertake conciliation can depend on other actions or processes that may be underway or being considered.

Typically, the referral of a matter for conciliation will occur following the conclusion of another relevant action, such as assessment or investigation.

Unlike assessment and local resolution, there are no set timeframes to complete a conciliation.

In the most serious cases, the Health Ombudsman can take immediate action on individual health service providers who are a serious risk to public health and safety or for reasons of public interest.

Immediate action is an interim measure taken on an urgent basis by way of immediate registration action in relation to a registered health practitioner, or interim prohibition order issued to an unregistered health practitioner (or a registered health practitioner practising in an unregistered capacity).

In taking immediate action the Health Ombudsman can:

• imposes conditions on the practitioner's registration
• suspends the practitioner's registration
• imposes restrictions on the practitioner's practise
• prohibit the practitioner from providing a health service.

Learn more about the Health Ombudsman's immediate action powers.

We conduct formal investigations for the most serious complaints, which fall into one of the two categories: individual health practitioner investigations or systemic investigations.

In relation to individual registered health practitioners, an investigation seeks to determine whether their conduct or performance may constitute professional misconduct, or whether another ground exists to suspend their registration.

Where an investigation establishes that an unregistered practitioner poses a serious risk to persons, the Health Ombudsman may issue a permanent prohibition order against the practitioner.

We undertake systemic investigations to determine if there are issues relating to the operation of a system, process or practice (rather than the individual actions of a person or practitioner) that may impact on the provision or quality of health services.

An investigation involves a much more detailed examination of the matter. We will let you and the health service provider know if we decide to start an investigation.

We abide by procedural fairness ensuring all parties are given fair opportunity to comment and provide information.

Learn more about how the Office of the Health Ombudsman's handles investigations.

The Director of Proceedings is an independent position that has the power to determine if a matter regarding a registered health practitioner is appropriate for referral to the Queensland Civil and Administrative Tribunal (QCAT).

In deciding whether a matter should be referred to QCAT, the Director of Proceedings takes into account factors such as:

• How serious was the practitioner’s conduct and/or performance- would it be found to be professional misconduct or grounds for suspension or cancellation?
• How serious is the risk to public health and safety?
• How likely is it that the allegations could be proved in QCAT?
• What are the likely orders QCAT may make?

If the Director of Proceedings refers the matter to QCAT, the Director of Proceedings prosecutes the matter on behalf of the Health Ombudsman.

If the Director of Proceedings decides not to refer to QCAT, the matter is referred back to the Health Ombudsman with a recommendation to:

• refer the matter to Ahpra
• investigate the complaint further
• take no further action.

The Director of Proceedings can also refer matters back to the Health Ombudsman to obtain ‘stated information’ to assist the Director in his/her decision making.