Investigation process

There are three main stages involved in the investigation of complaints

This process is different for an FOI review

FOI review process

Our investigation process

  1. Step 1
    Complaint issue confirmation and information collection

    Find out more about the first steps in the investigation process.

  2. Step 2
    Analysis and review

    Learn more about how information is analysed and evaluated.

  3. Step 3
    Proposed decision and outcome

    Find out more about the outcomes available following an investigation.

Step 1

Complaint issue confirmation and information collection

Our office aims to achieve quick and meaningful resolution of complaints. This means complaints often do not need to proceed to an investigation but may be resolved through other methods, such as by making preliminary inquiries or transferring the complaint to the Australian Health Practitioner Regulation Agency (Ahpra), an accreditation authority or a specialist medical college for a response.

Investigations can take about:

  • six months for standard complaints
  • twelve months for more complex complaints.

It is important to keep these timeframes in mind because our investigators need time to thoroughly look at the issues identified for investigation.

Once we decide that a complaint should be investigated, an investigator will be assigned to manage the complaint.

The investigator will first contact the complainant to discuss the ‘complaint issues’. This is an essential part of the investigation process because we often receive complaints that are complicated and raise multiple concerns, some of which we cannot consider.

After carefully assessing the complaint, the investigator will provide the complainant with a letter explaining the specific issues that have been identified for investigation. The investigator will also provide Ahpra, the accreditation authority or the specialist medical college with written notice of the concerns raised in the complaint and explain the decision to investigate the matter.

The investigator will then collect the information needed to analyse the investigation issues.

This generally involves:

  • requesting more information from the complainant (such as letters or other correspondence)
  • requesting information from Ahpra, the accreditation authority or the specialist medical college (such as relevant documentation, investigation reports, meeting notes or correspondence).

The investigator will provide the complainant with an update every six weeks on the progress of the investigation (unless this is not practical or appropriate).

Step 2

Analysis and review

Once the investigator has the necessary information, they will consider all the information to develop their findings on the investigation issues.

Our investigations usually consider two types of information.

Information related to the complaint

This may include:

  • documentation
  • correspondence or conversations between the complainant and the organisation
  • reports or records of decisions.

Relevant laws, procedures and policies

This may include:

  • legislation such as the Health Practitioner Regulation National Law which sets out Ahpra, the National Boards, accreditation authorities and specialist medical colleges' responsibilities
  • relevant policies and procedures.

The investigator will analyse this information to consider whether the matter was handled:

  • fairly and reasonably
  • in line with the relevant law and applicable policies and procedures.

Some complaints to the Commissioner (but not the Ombudsman) will also be analysed to determine options for the best way to resolve the issues raised and consider whether compensation should be awarded.

Step 3

Proposed decision and outcome

The investigator will come to a decision about the outcome of the complaint following careful consideration of all available information.

If multiple investigation issues have been identified, the investigator may make different decisions about each issue raised.

The investigator will present their proposed decision to the complainant, who will have two weeks to provide a response. This is an opportunity for the complainant to provide new information about their complaint or ask any questions about the proposed findings.

Complaints to the Ombudsman

For complaints made to the Ombudsman, the investigator will provide the complainant with a detailed explanation of the decision on the investigation issues.

The investigator or the Ombudsman may:

  • provide (or suggest that Ahpra, a National Board, an accreditation authority or a specialist medical college provides) a better explanation of the decision or action being complained about
  • speed up the processing of a delayed matter
  • suggest that an apology be offered
  • suggest that a process or policy be reviewed or changed
  • suggest that a decision be reconsidered
  • decide that the handling of the matter was reasonable and take no further action.

The Ombudsman does not have the power to force Ahpra, National Boards, accreditation authorities or specialist medical colleges to change a decision they have made.

However, when appropriate, the Ombudsman can make formal comments or suggestions for improvement to Ahpra, the National Boards, accreditation authorities and specialist medical colleges.

Complaints to the Commissioner

For complaints made to the Commissioner, the investigator will provide the complainant with a detailed explanation of their final decision.

The investigator or Commissioner can decide:

  • what action should be taken to resolve the complaint
  • whether compensation should be awarded for any loss or damage suffered due to a breach of privacy
  • that the handling of personal information was reasonable and take no further action.

Review of the complaint assessment or outcome

Our office offers an internal review of decisions made by staff.

Find out more about review of our decisions

Withdrawing a complaint

Complaints can be withdrawn at any stage. We will take no further action in relation to withdrawn complaints except to advise the organisation being complained about that it has been withdrawn or if, in exceptional circumstances, we need to take action to prevent a serious risk of harm.

Find out more

  • Complaint process

    Complaint process

    Find out more about the main steps involved in our handling of complaints made to the Ombudsman and the Commissioner.

  • Complaints we assist with

    Complaints we assist with

    Our office assists with complaints about how Ahpra, the National Boards, accreditation authorities and specialist medical colleges handle matters. 

  • Commissioner complaints

    Commissioner complaints

    The Commissioner can assist with complaints about how Ahpra, the National Boards or accreditation authorities and specialist medical colleges, have collected, used or disclosed personal information.

  • Ombudsman complaints

    Ombudsman complaints

    The Ombudsman can assist with complaints about how Ahpra and the National Boards have handled notification or registration matters, personal information and FOI requests. We also can also assist with concerns about accreditation authorities and specialist medical colleges.

  • Other health complaints

    Other health complaints

    Sometimes it can be difficult to know where to make a health-related complaint. Find out more about how to make sure you're in the right place.

Can’t find what you’re looking for? Give us a call on 1300 795 265