An independent review into the complexity of the system regulating health practitioners has proposed a new single point of entry for patients making a complaint in each state or territory.
The potential overhaul of the complaints pathway has been detailed in the final phase of the probe into “unproductive and unnecessary complexity” within the National Registration and Accreditation Scheme (NRAS).
Optometry Australia (OA) has been involved during a two-part consultation phase, and noted a low level of confidence in complaints handling, inconsistency and delay in notification/complaints decision-making.
“Encouragingly, recommendations moving forwards would seem to support a more efficient complaints and investigation process, which is critical to relieving distress experienced by practitioners subject to lengthy investigation time frames,” OA chief clinical offer Mr Luke Arundel said.
“Optometry Australia appreciates the difficulty in identifying a simple solution in our complex regulatory landscape, but strongly supports the imperative for reform in this area.”
The final report by Ms Sue Dawson outlined four areas for reform, with one of those being the implementation of a unified national approach to health complaints. She also urged an immediate focus on improved management of high-risk matters with the National Scheme.
Currently, she said the Australian Health Practitioner Regulation Agency (Ahpra) manages more serious complaints about “registered” practitioners. If less serious, but still requiring action, it must be raised again elsewhere, frustrating consumers who often carry the burden of locating the appropriate authority.
“Professions also confirm a deeply unsatisfactory experience … highlighting the protracted and stressful processes on matters that often could be easily addressed or dismissed at an earlier stage,” Dawson’s paper said.
“This is significant, noting that well over 85% of notifications to Ahpra ultimately result in no jurisdiction to consider the matter or no further action required by Ahpra.”
It was also concerning and confusing for complainants and practitioners that Ahpra didn’t have powers allowing a notification to be dealt with by conciliation, mediation or other less formal restorative means.
“This deficiency affects complainants seeking closure in a way that acknowledges their experiences when the matter may not warrant disciplinary action,” Dawson said.
“It is equally concerning for practitioners, who feel too frequently confronted with the prospect of a disciplinary-oriented process, even when this is not proportionate or appropriate … and they would be very willing to apologise or engage in alternative resolution processes.”
Under a unified national health complaints system, complaints about registered – and even non-registered/self-regulated practitioners like orthoptists – could be lodged through a single Health Complaints Entity (HCE) in each state and territory. From there, the HCE would triage complaints, seeking to resolve matters not warranting disciplinary action. Serious allegations would be referred to Ahpra.
In its round one submission, OA said it would “tentatively support” this approach.
“As it may potentially improve the patient complaints experience – and if it allows Ahpra to focus on only the 25% of complaints received which do require more concerted regulatory attention, this may assist with desperately needed improvements to Ahpra’s notifications processing timeframes,” the body said.
Meanwhile, Dawson’s review noted a lacking national health workforce strategy and acknowledgement of an “inextricable link” between workforce supply, service access goals and the protective purpose of the National Scheme.
“We had noted the potential benefits of aligning regulatory functions and broader workforce strategy when considering regulation of clinical scope,” Arundel said, “and that it seemed apparent many entities within the scheme see their remit and responsibility as relating singularly to public safety without consideration of workforce strategy or health service access.
“Optometry Australia strongly supports re-alignment to the broader remit envisioned on the statutory objectives.”
More reading
Ombudsman reviewing Ahpra’s ‘vexatious complaints’ framework
Complaints against Australian optometrists hit a five-year high
Key findings from new Optometry Australia-backed workforce projections report
