New Standards for General Health Providers in Victoria

The Health Complaints Act 2016 (VIC)

You may be aware that a new Health Complaints Act 2016 (VIC) commenced across the state of Victoria on 1^st February 2017, however you might not realise that it introduces new clauses which may directly impact Pilates instructors.

The new Act includes the following new provisions:

• A broader definition of what constitutes a ‘health service’
• A mandatory code of conduct for non-registered health providers (i.e. not with AHPRA)
• The ability for anyone to make a complaint (including 3^rd parties)
• New complaint handling standards
• Greater investigative powers
• Provisions for better data sharing with AHPRA, DHHS and Safer Care Victoria

The significance to PAA members is that, within its broader definition of ‘health service’, the new Act now covers non-registered health providers, also known as general health service providers. This category covers many types of practitioner in including alternative therapists, which is the umbrella label that Pilates sits under with Australian health funds.

As a result of the legislation a new department, the Health Complaints Commission (HCC) has been created to handle complaints about health services provided by any organisation or person in Victoria, including both registered and non-registered providers.

Their role of the HCC is to:

• resolve complaints about health services provided, or the handling of health information, in Victoria
• investigate providers who pose a serious risk to the health, safety or welfare of the public
• contribute to quality improvement in Victoria’s health system through monitoring and data reviews
• provide an accessible and free alternative to legal proceedings
• remain independent and impartial

Complaint handling standards for providers

Complaints are inevitable in any service oriented industry and, though they may be uncomfortable, they are not inherently ‘bad’. In fact, they can be an important part of quality improvement, giving your clients a voice.

The HCC website lists examples of the type of complaints that they manage:

• access to services
• quality and safety
• care and attention
• respect, dignity and consideration
• communication about treatment, options and costs
• the level of involvement in healthcare decisions
• access, privacy and confidentiality of personal health information
• complaint handling by the health service provider.

Wherever possible, handling complaints yourself directly with the complainant is the quickest and easiest way to resolve issues and can create opportunities to restore confidence in your business. Feedback about your services can also improve quality and safety, preventing minor issues from escalating into major problems.

All health service providers in Victoria must now meet the minimum standards for complaint handling as laid out in Schedule 1 of the Health Complaints Act 2016 (Vic). In summary, a health service must:

• Promptly acknowledge complaints and make appropriate attempts to resolve them
• Provide information on how to make a complaint to health service consumers in an accessible and understandable form
• Inform those who have made a complaint of the complaint’s progress and its outcome
• Keep personal information collected in the course of a complaint in a confidential manner
• Keep a record of all complaints, including any action taken in managing them.

The HCC recommend that all providers create a policy on how they deal with complaints, and make sure they are clear on whether that policy meets the legislated standards.

Who can make a complaint to the HCC?

Anyone can lodge a complaint with the Office of the Health Complaints Commissioner, including health service consumers and their friends and family members, health service staff and volunteers, concerned community members and professional organisations. Complaints can also be made anonymously.

Complaints can be made about any health service provided in Victoria. They can also be made about anyone who holds health records, including schools, gyms and other non-health service providers, about how they handle their clients’ information.

What will happen if a complaint is made against me to the HCC?

The first step when a complaint is made to the HCC is for them to decide whether their office should deal with the complaint or if another agency is more appropriate.

They will then confirm that the person making the complaint has tried to resolve the issue directly with the service provider. Whilst some people may have a good reason why they cannot contact the service provider, this is often the quickest and easiest way to resolve an issue and the HCC are legally required to recommend this happens before dealing with it themselves.

If the complainant and the service provider cannot resolve things directly and the complaint is appropriate for the HCC to deal with then they may take further action, applying the least formal process appropriate for the complaint.

The process at this stage may follow one of several paths:

• Early resolution – least formal and often quickest
• Formal resolution – a formal set of documented steps
• Conciliation – like formal resolution but using private & confidential proceedings which encourage open and frank discussion
• Investigation – formal and detailed examination, often for handling large or highly complex matters
• Immediate action – during investigation there may be a need for an interim order, prohibition order or public warning statement

The outcomes the HCC aim to achieve with the complaint resolution process include:

• Explanations about what happened
• Apologies
• Access to treatment
• Access to records
• Refunds or compensation
• Changes in policy or practise to prevent future problems

A new Code of Conduct

To help minimise the risk of complaints escalating to HCC involvement the Health Complaints Act also contains a compulsory national Code of Conduct which sets standards for non-registered providers. It also applies to registered practitioners operating outside their area of registration, for example a physiotherapist providing reiki therapy.

The code only became Victorian law on 1 February 2017 but has been in action in one form or another around Australia for some years. Any possible breach of this code by a non-registered provider may be grounds for a complaint to, or investigation by, the HCC.

In summary, the Code of Conduct says that general health services:

Must
• Provide safe and ethical healthcare
• Obtain consent for treatment
• Take care to protect consumers from infection
• Minimise harm and act appropriately if something goes wrong
• Report concerns about other practitioners
• Keep appropriate records and comply with privacy laws
• Be covered by insurance
• Display information about the Code of Conduct and making a complaint.

Must not
• Mislead consumers about their products, services or qualifications
• Put consumers at risk due to any physical or mental health problems
• Practice under the influence of drugs or alcohol
• Make false claims about curing serious illnesses such as cancer
• Exploit consumers financially
• Have inappropriate relationships with consumers
• Discourage consumers from seeking other health care or refuse to cooperate with other practitioners if they do.

The Act states that providers must make a copy of the full Code of Conduct easily accessible to clients, as well as information about how to lodge a complaint with the HCC. You should refer to the full text of the Code of Conduct, taken from Schedule 2 of the Health Complaints Act 2016 (Vic), to understand your responsibilities.

What may result from a breach of compliance with the Code of Conduct?

The HCC suggest that compliance with the code shouldn’t mean extra work for those who are already operating safely and ethically, but it does provide grounds for them to investigate and act against providers who are not.

They now have greater powers to consider serious and complex matters and may choose to investigate when:

• Complaint resolution is not suitable or unsuccessful
• The provider fails to participate or supply requested information
• There is a serious and imminent risk of harm

At any time during an investigation they may issue an interim order prohibiting delivery of a service, or part of a service, by that provider. A final prohibition order may then be issued following investigation, if it is necessary to do so. Prohibition orders in force in other states and territories will be also recognised in Victoria.

Following an investigation into a registered or non-registered practitioner, they may also choose to issue a public warning statement to alert people to serious risks to their health, life, safety or welfare.

Resources for health providers

The HCC have provided several very useful resources for health providers including templates for the summary Code of Conduct (A4) and the full Code of Conduct (A3) that you can print and laminate for your studio wall. They will also supply brochures for your clients to read (see links below).

If you are a provider in Victoria the HCC recommend the following text to publish on your website:

If you are not satisfied with our service, please contact us. We take complaints seriously and aim to resolve them quickly and fairly.

If you remain dissatisfied with our response, you may contact the Health Complaints Commissioner (HCC). The HCC responds to complaints about health services and the handling of health information in Victoria. Their service is free, confidential and impartial. To lodge a complaint with the HCC:

• Fill out a complaint form online at hcc.vic.gov.au or
• Phone 1300 582 113 between 9am and 5pm, Monday to Friday to discuss your complaint.

The HCC are also conducting a selection of free seminars for non-registered health professionals explaining the new Health Act, handling complaints, and keeping health records at their offices in Melbourne: https://hcc.vic.gov.au/training-events/events

They are also willing to consider visiting groups of providers in their workplace to conduct these seminars. To discuss tailored training for your organisation, contact Caroline Rose (Engagement Officer) on 03 9032 3130 or caroline.rose@hcc.vic.gov.au

Information materials:

Download a copy of the Code of Conduct: In brief (A4)

(PDF 86.39 KB)

Download a copy of the Code of Conduct: Full text (A3)

(PDF 98.43 KB)

Download ‘Expect safe and ethical healthcare’ poster (A3)

(PDF 336.3 KB)

• Request ‘My health records, my rights’ brochure (DL)
• Request ‘Making a complaint’ brochure (DL)

 

Kerry Haywood
PAA Systems Officer