What we do
Main functions
HaDSCO is established by the Health and Disability Services (Complaints) Act 1995 and also has responsibilities under Part 6 of the Disability Services Act 1993 and Part 19 of the Mental Health Act 2014. The main functions under these Acts are to:
- Deal with complaints by negotiated settlement, conciliation or investigation.
- Review and identify the causes of complaints.
- Provide advice and make recommendations for service improvement.
- Educate the community and service providers about complaint handling.
- Inquire into broader issues of health, disability and mental health care arising from complaints received.
- Work in collaboration with the community and service providers to improve health, disability and mental health services.
- Publish the work of the Office.
- Perform any other function conferred on the Director by the above Acts or another written law.
Code of Conduct for certain health care workers
HaDSCO is responsible for the Code of Conduct for certain health care workers (Code of Conduct) in Western Australia and the Indian Ocean Territories through:
- Receiving complaints.
- Undertaking investigations.
- Issuing prohibition orders when necessary.
For more information about the Code of Conduct, click here.
Key service areas
Service One: Assessment, negotiated settlement, conciliation and investigation of complaints.
Depending on the nature of the complaint and the outcomes sought, HaDSCO will either:
- Encourage the concerns to be raised directly with the service provider in the first instance. For advice on talking with your service provider, click here.
- Direct the individual to our online complaint form or forward them a complaint form to complete.
- Refer the complaint on to a more suitable organisation if HaDSCO is unable to deal with it. For more information on this, see our Customer Service Charter section.
Outcomes can include provision of explanations by service providers, apologies, refunds or waiver of fees, access to services, staff education and training, changes to service processes and procedures, and introduction of new policies.
Role of HaDSCO and the Australian Health Practitioner Regulation Agency
In accordance with the Health Practitioner Regulation National Law (WA) Act 2010, HaDSCO is required to consult with the Australian Health Practitioner Regulation Agency (Ahpra) about complaints relating to registered health practitioners. HaDSCO’s consultation with Ahpra determines which agency should manage the complaint according to the subject matter of the complaint.
Registered health practitioners include Aboriginal and Torres Strait Islander health practitioners, Chinese medicine practitioners, chiropractors, dental practitioners, medical radiation practitioners, medical practitioners, nurses, midwives, occupational therapists, optometrists, osteopaths, paramedics, pharmacists, physiotherapists, podiatrists and psychologists.
Service Two: Education and training in the prevention and resolution of complaints.
HaDSCO provides education and training to a range of stakeholders and communities.
Each year, HaDSCO undertakes a range of ongoing and tailored engagement activities with a variety of stakeholders across Western Australia and the Indian Ocean Territories. The aim is to raise awareness of HaDSCO and ensure HaDSCO's services are available to all.
We also publish de-identified performance data and complaint statistics, in addition to our annual reports.
Background
A parent contacted us to discuss their experience in attempting to access a health care service on behalf of their child.
They suspected that their child demonstrated tonsillitis symptoms, which they explained to the health care provider’s staff. The staff advised that since the symptoms also presented as flu-like, they would have to organise a telehealth appointment as opposed to an in-person consultation.
The parent was concerned with this arrangement as they did not feel that it would allow the health care provider to accurately assess their child’s health. They explained this to the health care provider’s staff who advised that their policy would not allow in-person visits for clients who demonstrate flu-like symptoms.
When they attended the telehealth appointment, they were then informed that they would have to schedule an in-person appointment to receive an accurate assessment. The parent contacted the health care provider’s staff to express their dissatisfaction regarding the process and were advised to locate a different health care provider before being placed on hold indefinitely.
The parent was keen to identify a resolution and contacted HaDSCO to discuss their options.
What did we do?
The HaDSCO Complaints Team contacted the service provider who was willing to engage in the complaint resolution process. An officer from the team then agreed to facilitate a Negotiated Settlement process that allowed the parent to resolve their concerns with the health care provider.
The process allows a HaDSCO team member to encourage and support both parties to reach an agreement though complaints resolution procedures.
The complaint resolution process provided the service provider with an opportunity to review their telehealth process, and customer service.
What was the outcome?
The service provider manager expressed that they were grateful that the situation was bought to their attention, advising it was an opportunity to grow and learn. Although the staff had followed their required protocols, they had not provided the high-quality customer service expected by their management team.
The manager apologised to the parent for their experience and advised that staff would engage in additional customer service training. They also explained their infection control requirements, and why these steps are important protection measures to avoid the spread of infectious diseases.
Background
A carer was visiting a health provider who was managing their relative’s end-of-life care. As the patient’s health deteriorated the service provider had agreed to let the carer know if their family member passed while they were away from the facility.
When the carer visited their relative, they found that their relative had passed which caused them distress as they had not been notified. When they enquired about this, the health care provider was initially unsure how the carer had not been contacted.
The carer contacted us and advised they were distressed and unsatisfied with the explanation from the health care provider.
What did we do?
A HaDSCO case officer considered that a conciliation process may provide a satisfactory outcome for the carer.
The conciliation process involves a face-to-face meeting facilitated by HaDSCO. A Complaints Officer encourages an outcome through informal discussions and encourages the parties to resolve the complaint collectively. The conciliation process assists the parties to identify ways to reach an agreement in a non-legal environment.
The service provider and carer both agreed to meet and discuss the issue, and it resulted in a frank but respectful exchange.
What was the outcome?
As a result of HaDSCO’s role in the conciliation process, the carer was able to further explain to the service provider the distress caused through the communication breakdown.
The service provider’s representative advised that the staff involved were devastated about what had occurred, and the incident would be used as a case study to prevent similar instances from re-occurring, in particular around palliative care requirements and family engagement.
The service provider also agreed that their process had not been observed and acknowledged their role in not informing the carer about information relating to their relative. They apologised unreservedly and committed to exploring ways to ensure the situation would not repeat with other health consumers in their care.
Background
A patient with a Pensioner Card contacted us to explain that they believed they had incurred incorrect fees from a health care provider.
The provider had changed their payment policy to a mixed billing system that included some exceptions, for clients like pensioners and infants. This meant that, while most clients would be subject to a fee for a consultation, certain clients could still access bulk billing.
The patient had accessed a service that they thought would be bulk billed but were informed after the service that they were required to pay the consultation fee.
The health care provider had displayed signage which advised that clients with Pension Cards qualified for bulk billing but, when the patient disputed their fee, the staff advised they were unable to provide a refund.
The patient attempted to discuss their concerns with the provider, but the provider maintained that they had been correctly charged for the service they received.
What did we do?
The HaDSCO Complaints Team reviewed the case and determined that a resolution could be achieved through the Negotiated Settlement process. A team representative liaised between the health care provider and the patient to determine the cause of the miscommunication and supported both parties to reach an agreement.
Our enquiries with the health care provider about their billing arrangements showed that in this case the patient had been incorrectly charged.
What was the outcome?
The health care provider acknowledged that their staff required more policy training, particularly on client payments and bulk billing eligibility. The staff completed their training and felt confident that they now have an improved understanding of the policy.
The provider offered an apology and a refund for the patient who was satisfied that their situation had been resolved.
Background
A person in custody at a correctional facility contacted HaDSCO to advise that they had a health concern which had not been addressed by the Prison Health Service Provider.
Procedures are in place to ensure that health care treatment is available for people in custody, and in this way the system aligns with health care in the wider community.
The person advised that they raised their health concern with medical staff at the Prison Health Centre, but they felt that it was not addressed. They also explained that their health concern was further impacted due to other underlying health concerns they had previously reported.
They described the situation to our Complaints Team who agreed that a negotiated settlement process could provide an explanation for the person in custody.
What did we do?
A HaDSCO case officer worked with the person to engage with the Department of Justice as part of the negotiated settlement process.
The process demonstrated that the Department of Justice team was concerned about the person’s mental health as it may have been preventing them from accessing treatments. The team noted that the person had difficulty attending previously offered appointments and treatments due to an inability to engage with them.
At the time of the complaint, the patient’s medical interventions were impacted by an acute mental health episode.
What was the outcome?
As a result of HaDSCO and the Department of Justice’s collaboration, the person’s medical record was reviewed, and their issues were addressed.
HaDSCO’s engagement led to the person’s health concerns being noted for attention and assessment as soon as their condition allowed for safer treatment options. Medical appointments were booked in anticipation of the person’s recovery with assessments to be conducted as soon as the patient’s mental health could be stabilised.
The result was achieved through the collaborative efforts of HaDSCO with the Department of Justice and reflected the strong working relationship between the agencies.
Background
An advocacy group contacted HaDSCO to advise that they had a client who was concerned about medical treatment they had received. The client was seeking treatment for a range of complex mental health issues and required support from an advocacy group.
Advocacy groups can act on behalf of a client when the person requires extra support to access services, communicate their needs and understand what their role is within their treatment plan.
The advocacy group advised that the health care provider placed their client on a form of injectable medical treatment, and this form of administration left their client feeling concerned. The client was distressed about the medical treatment as they felt it could cause them further harm, and possibly cause their progress to regress.
The client discussed this with the health care provider, but they did not feel like their concerns were heard. They requested that their medical records reflect their feedback on the medical treatment be taken into account for future treatment plans. The situation could not be resolved so the client with the support of the advocacy group contacted HaDSCO for assistance.
What did we do?
HaDSCO agreed to independently engage in a negotiated settlement process with the advocacy group, their client, and the health care provider.
The Complaints Team identified that the client required an explanation of the health care provider’s medical treatment plan.
What was the outcome?
The advocacy group and the client received an explanation from the health care provider on the rationale for the medical treatment that was provided, and the health service provider apologised for the distress felt by the patient. They were also able to explain the processes they had in place to support patient safety, including updating medical records that helped to inform future health care decisions.
Background
A parent contacted HaDSCO to advise they had recently sought treatment for their infant as they were concerned about medication and a service they received. They were informed at the emergency department of a local hospital that their infant had an infection that required medication.
They collected the medication from a separate health service provider after leaving the hospital and administered the dosage however they reported that their infant’s recovery was unexpectedly slow. After reviewing the medication, the parent discovered that it had expired before it was purchased. They contacted the health care provider who told them that the expiration date may impact the medication’s strength, and if they returned the product, it could be replaced with medication that was still in date.
The parent was unhappy with their experience and was keen to ensure that other people did not experience the same situation. They contacted HaDSCO to enquire about their resolution options.
What did we do?
HaDSCO reviewed the case and decided that a Negotiated Settlement approach could provide both a solution and an opportunity for the supplier to review their processes for dispensing medication.
The Negotiated Settlement option allows us to assist both parties share information and encourage a resolution. The process is confidential, and the material discussed during the process is not admissible in courts or tribunals.
A HaDSCO case officer liaised between the health care provider and the parent so they could discuss the incident and agree to a resolution. The parent was provided an opportunity to detail their concerns, and the health care provider was able to engage and explore how they could improve their protocols.
What was the outcome?
The supplier acknowledged that their processes required changes in order to ensure the situation did not repeat. They implemented new protocols that required staff to monitor medication expiration dates as they unpacked stock and included updated education for staff to reinforce proper dispensing protocols.
Additionally, the health care provider advised that they had invested in a robotic dispensing system to improve stock rotation and minimise expired stock waste.
This led to the complaint being resolved as the parent was satisfied with the outcome and the health care provider improved their service delivery model.
Background
Respectful communication is central to understanding a patient’s goals at all stages of their journey. This is particularly important when end of life choices are available for individuals. These choices can be complex, but they support a patient’s decision to eliminate suffering when their options are exhausted and align with strategies in the Sustainable Health Review.
In July 2021, with the introduction of VAD in Western Australia, HaDSCO became responsible for managing complaints associated with this end-of-life choice. Through our complaints role we contribute to strengthening processes and procedures for individuals who choose to access VAD.
This year as part of an investigation into a complaint relating to VAD, we had an opportunity to highlight some learnings about communication, particularly around how people engage in the VAD process.
We received the complaint from a family member of a patient with a terminal illness. The family member advised that their parent had made several requests for information on accessing VAD and felt that they did not receive adequate responses. They also claimed that the provider delayed responding to requests for information about VAD, which they felt resulted in their parent’s prolonged pain.
What did we do?
A complaints officer investigated the case by reviewing records, interviewing family members, clinicians, and relevant agencies. The officer determined that the period leading up to someone making a first request to access VAD is a very important stage in a patient’s journey and requires clear communication for a thorough understanding of the patient’s wishes, values and preferences when delivering end of life care.
The officer also recognised that the VAD process was relatively new at the time of the patient’s admission and that training is ongoing for this new patient pathway.
During our inquiries, we noted that the provider implemented a service improvement through the development and introduction of a flowchart that outlines the process for referring patients and/or their families to an End-of-Life Care Coordinator for end-of-life or VAD discussions.
What was the outcome?
Our investigation highlighted some important learnings. We made recommendations to strengthen communication with patients and family members, and for service providers to ensure their goals of patient care accurately reflect a patient’s wishes and preferences. We recommended that these goals should be reviewed and updated based on changes to a patient’s medical condition, and that clear and precise written communication and record keeping is kept. We also recommended that the reflective learnings from the investigation be used as a deidentified case study for training purposes.