//Investigation report summary: Complaint about decision to grant credentialing privileges to a medical practitioner at a HHS October 2016

Investigation report summary: Complaint about decision to grant credentialing privileges to a medical practitioner at a HHS October 2016

12 October 2016

This report outlines the investigation conducted by the Health Ombudsman into a complaint about a Hospital and Health Service (HHS) concerning a decision to grant clinical privileges to a medical practitioner. Concerns were raised about the practitioner’s recency of practice and clinical experience.

The scope of the investigation was to determine whether the appropriate process was undertaken by the HHS credentialing committee in granting the practitioner credentialing.

The investigation concluded that the requirements of the Credentialing and Defining Scope of Clinical Practice for Medical Practitioners and Dentists in Queensland Health Policy 2012 had been met.

While the HHS submitted it had no reason to question the practitioner’s recency of practice, in the Health Ombudsman’s view, the following factors should have been considered as triggers for a more detailed examination:

  • The practitioner’s recency of practice had been raised by the unit directors and a committee member as an issue.
  • The practitioner’s curriculum vitae (CV) stated that their last clinical role finished in November 2013, nine months prior to the credentialing decision. Given that it was a requirement under the policy’s terms of reference that the committee review the applicant’s CV, that review should have prompted further inquiry.
  • There was a lack of clarity about the nature and scope of the referees’ clinical contact with the practitioner, apart from the one week in July 2014.

In the circumstances, and particularly considering the highest level of credentialing (level 6) was being requested, the Health Ombudsman considered a more prudent approach would have been for the credentialing committee to undertake further validation regarding the practitioner’s referees and recency of practice before determining the outcome of their interim and full credentialing application.

Given that the investigation determined that the committee did not deviate from the Queensland Health policy, the Health Ombudsman’s decision in relation to this matter was to take no further action in accordance with section 44(1)(a)(ii) of the Health Ombudsman Act 2013, as he reasonably considered the complaint lacked substance.

Read the report