Claims and complaints: what you need to know

Claims and complaints: what you need to know

Summary:

One of the more stressful things you may experience during your career is receiving a complaint or claim. We have gathered together resources that will assist you during this time. If you have a matter in progress remember you can always reach out to your claims manager or lawyer for ongoing support.

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22 / 07 / 2021
professional conduct

Professional conduct matters

Professional conduct complaints may originate from a patient, a hospital, a colleague or on referral from the coroner. They are managed by a complaints entity such as Ahpra, HCCC (NSW) or OHO (QLD).

Ahpra states that more than 70% of the notifications they receive result in no further action and less than 1% of notifications end with a practitioner’s registration being cancelled.

Video: Ahpra story

Factsheet: Dealing with professional conduct complaints

Podcast: It happened to me – disciplinary matter

Video: Receiving a complaint from AHPRA

Handbook: When patients complain

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Employment issues

You may be asked to attend a meeting with your employer at any time. The meeting might be about your performance, your conduct, a clinical matter you were involved in, or you may be asked to provide information about an incident.

Factsheet: What to do when requested to attend an employment meeting

Video: Meeting with hospital administration

Factsheet: Suspension from practice

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Civil claims

The majority of civil claims, that is claims made for compensation, do not end up in court. The key issues are whether the doctors practice was negligent and if so did any harm occur as a result.

Factsheet: Giving evidence in court

Video: Writing a medico-legal statement as an expert witness

Handbook: The whole truth – responsibilities when providing evidence

Article: Credible medical expert witness: the role

Article: Medical expert witness – tips and traps

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Coronial

The coroner may investigate any unexpected, unnatural or violent death including those related to accident, injury and certain medical or surgical procedures. The process can take several years and less than 5% of these investigations result in an inquest.

Video: Preparing a statement for the coroner

Article: Protecting your interests – when your coronial statement is used against you

Factsheet: Coronial investigations and inquests

Factsheet: How to write a coronial statement

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Direct patient complaint

Patients have every right to complain about issues with their care. These can range from an informal discussion to a more formal process. In our experience they can often be the result of an unmet expectation and poor communication.

Factsheet: Responding to a direct patient complaint

Handbook: When patients complain - the complaint process: what you really need to know