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Health consumers

Investigating a complaint

Investigation is different from assessment; it is a much more detailed examination of a complaint and is often used for larger or more complex cases.

After assessing a complaint, the Office of the Health Ombudsman may decide to investigate a complaint further. We must advise a health service provider when a complaint against them is being investigated, although this may be delayed in instances where serious matters are being investigated and the safety of individuals or the integrity of the investigation could be impacted.

How we investigate

An investigation involves gathering evidence and information to help us identify and analyse the cause/s of an adverse health incident or healthcare issue. As part of an investigation, we may:

  • obtain relevant information, documents, equipment, etc
  • interview anyone we believe has information
  • seek independent clinical opinion.

Our investigations are conducted in a way that ensures all parties are advised of the nature of the investigation and have an opportunity to comment and provide information to ensure procedural fairness obligations are met.

Investigation timeframes

Our objective is to undertake and finalise investigations as quickly as possible. Generally, investigations are completed within one year, however this may be extended due to the nature or complexity of a case. At a minimum, we will provide progress reports every three months to the service provider and complainant, if relevant, outlining the progress achieved since the last update.

All investigations not completed within one year, other than those directed by the Minister for Health with a stated timeframe, will be recorded on a public register available on our website. The complainant, health service provider and/or the individual who received the health service will not be identified in any way.

Only general information will be recorded, such as the:

  • nature of the complaint—so long as this information does not put a person’s health and safety at risk, put someone at risk of harassment or intimidation or prejudice an investigation or inquiry
  • date the investigation began
  • current due date for completing the investigation
  • reason the complaint hasn’t been resolved within one year.

Investigation report

After completing an investigation, we may prepare a report containing information, comments or recommendations relating to the case. This report may be provided to relevant parties, such as the health service provider, the complainant, the Minister for Health and parliamentary committee, the Australian Health Practitioners Regulation Agency or relevant national board, pending the outcome of the investigation.

Depending on the nature of the investigation, we may also make our final report publicly available. Reports containing confidential information identifying a protected person, or regarding complaints that have been referred to the Director of Proceedings, will not be made publicly available.

Report recommendations

If a report recommends a health service provider take certain action(s) to improve service delivery, we may ask the provider to report back to us on the implementation of the action(s). Penalties apply for not complying and we can prepare a supplementary report to the investigation, including the provider’s response.

After an investigation

Once we finalise an investigation, we will decide whether or not to take further action and advise the health service provider and complainant, if there is one, of our decision.