Example 22

Statements of intent: Examples of reporting practice.

Office of the Health and Disability Commissioner (Te Toihau Hauora, Hauātanga), Statement of Intent 2008/09, pages 17-21

6.1 Output 1 – Complaints Resolution

Value 2008/09 $3,844,438

The Commissioner has various options when a complaint is received to secure a fair, simple, speedy and efficient resolution. He may decide to take no action, for example, where the passage of time makes it impracticable to take any action, or where a complaint is made by someone other than the consumer and the consumer does not wish the matter to proceed.

The other options open to the Commissioner include:

  • gathering additional information and sharing this with the parties concerned, which can often resolve the matter for the complainant
  • writing an educational letter to the relevant party
  • referring the complainant to the provider to work with the complainant to resolve the concerns raised, and asking both the provider and the complainant to report back on the outcome
  • referring the complainant to advocacy for assistance in resolving his or her complaint
  • referring the parties to formal mediation to resolve the complaint
  • referring the complaint for investigation
  • referring the complaint to an agency who is better placed to manage the complaint, for example, the Privacy Commissioner or the Human Rights Commission.

Where complaints are outside jurisdiction, the Commissioner’s approach is always to assist the complainant or enquirer to identify the correct agency, as many callers find it difficult to discern the Commissioner’s role from the name of the office, and often expect the office to be able to deal with any matters related to the broader health and disability sector issues.

HDC responds to enquiries from the public, health and disability service providers, and from a range of other associated bodies and organisations in the health and disability sectors. In responding to enquiries, HDC offers advice and information in order to assist consumers to better understand health and disability services and systems and to participate more fully in their care. The information and advice is provided both verbally and in writing. It can assist people to take their own action in managing concerns they have with a health or disability service provider. Sometimes it simply helps to clarify a matter and no further action on the part of the enquirer is needed.

When someone makes a complaint about a health or disability service, HDC looks for the lessons from the complaint and uses this to encourage improvements to the service in question. Complaints help consumers to have their needs and expectations known and understood. They assist in identifying poor practice and poor systems and allow remedial action to be taken. Complaints help to keep people safe by offering a learning opportunity to all involved, especially the health or disability service provider. Complaints offer insight into the reasons for near misses, preventable injuries, emotional harm and preventable deaths.

Serious complaints that are upheld offer an opportunity not only for learning but also for accountability. An individual or organisation that has seriously breached the Code of Rights may be censured by the Commissioner and face disciplinary action. Very serious cases are referred to the Director of Proceedings for prosecution, and this may result in loss of the right to practise as a registered health professional. This protects the public from providers whose practice is significantly below the acceptable standard and at risk of causing harm.

Where the Commissioner makes recommendations for improvements to services or an individual provider’s practice, he follows up to ensure that action has been taken. Information about the Commissioner’s findings, recommendations, and resulting action, is widely circulated to professional bodies and relevant organisations in order to share the learning from this work.

Output 1 – Complaints Resolution
Outcome

Ministry of Health Outcomes

Trust and security — New Zealanders feel secure that they are protected by the system from substantial financial costs due to ill health, and trust it because it performs to high standards, reflects their needs and provides opportunities for community participation.

System outcomes/Quality — Health and disability support services are clinically sound, culturally competent and well co-ordinated, and ongoing service quality improvement processes are in place.

HDC outcomes that contribute to the MOH outcomes:

Consumers are protected and are able to exercise their right to complain without fear of retribution.
Complaints about health and disability services result in significant improvements in the safety and quality of services.
Output 1 Performance Measures and Standards
Complaints Complaints
6.1.1 Every complaint is addressed promptly and impartially, using the most appropriate option under the HDC Act 1994.
  1. 80% of complaints are closed within six months, and 95% are closed in 12 months, with no files aged over 2 years. Quarterly updates on progress are provided.
  2. Less than one percent of complaints files are reopened after a closed file review1 to determine the fairness and appropriateness of the original decision. Quarterly updates are provided.
  3. A random sample of consumers and providers is surveyed and feedback is sought regarding the timeliness and fairness of HDC complaints’ processes. Reported in the final quarter.
Complaints Complaints
6.1.2 Where quality and safety issues are identified, changes are recommended. Recommendations are followed up to ensure improvements have occurred.
  1. Follow-up of recommendations confirms 100% compliance by providers. Progress is reported in the 3rd quarter.
  2. 10% of group providers (organisations) subject to recommendations from HDC, report systems changes to improve the quality and safety of their service. Reported in the final quarter.
Complaints Resolution Process Complaints Resolution Process
6.1.3 Review the Health and Disability Commissioner Act and Code of Rights as required by the HDC Act 1994.
  1. Review of Act and Code completed with findings and recommendations reported to the Minister of Health by 30 June 2009.

1: All requests for the Commissioner to reconsider his decision result in a closed file review.

6.2 Output 2 — Education

Value 2008/09 $888,505

Through education HDC aims to have providers understand their responsibilities and comply willingly with the requirements of the Health and Disability Commissioner Act 1994, and have consumers know their rights under the Act and feel free from fear to exercise those rights. The Advocacy Service is the primary vehicle for promoting awareness of the Code of Rights to the public, both to consumers and providers of health and disability services. However, the Commissioner’s Office also focuses on several types of promotional and educational initiatives:

  • Presentations at conferences and seminars, both nationally and internationally, on specific areas of interest to provider and consumer audiences. Findings from the Commissioner’s complaints resolution work are used to facilitate a deeper understanding of issues providers and consumers need to be cognisant of, along with suggestions for service improvement. Staff from the Commissioner’s Office often work in a co-facilitation role with advocates and consumers to deliver educational sessions to special interest groups.
  • Customised training working with consumers to help them build support networks in situations where they are likely to need ongoing help to work in partnership with a particular provider or a number of providers. Customised training is also developed and implemented with individual providers and group providers to address their specific needs in relation to better meeting their obligations under the Code, whether it is changes to their practice or their systems.
  • Opinions given by the Commissioner provide information for the public and, in particular, professional bodies on issues for improvement in the delivery of health and disability services. The opinions outline areas for learning around professional accountability and systems failure. Case studies are also available. These can be found on the Commissioner’s website, www.hdc.org.nz.
  • Publications in a range of media are available from the Commissioner’s Office and can be ordered on-line or by post or fax. These publications explain the role of the Health and Disability Commissioner, the processes used in carrying out the Commissioner’s functions, and information about the services offered by the Commissioner’s Office. Many of these publications are available in languages other than English and Māori. There are easy-read versions of the key publications. All information produced is free to the public.
  • Articles written by the Commissioner and members of his senior management team are published regularly in a wide range of health and disability journals, magazines and newsletters.
  • Media interviews and releases are given where there are opportunities for wider learning as a result of HDC findings or where there is a perceived public safety issue.
  • DVD movies are provided for use as training and awareness-raising tools and for providing general information.
Output 2 – Education
Outcome

Ministry of Health Outcomes

Trust and security — New Zealanders feel secure that they are protected by the system from substantial financial costs due to ill health, and trust it because it performs to high standards, reflects their needs and provides opportunities for community participation.

System outcomes/Quality — Health and disability support services are clinically sound, culturally competent and well co-ordinated, and ongoing service quality improvement processes are in place.

Reduced inequalities — we achieve an improvement in the health status of those currently disadvantaged, particularly Māori, Pacific peoples and people with low social economic status.

HDC outcomes that contribute to the MOH outcomes

Consumers are protected and are able to exercise their right to complain without fear of retribution.

Sustainable improvements in safety and quality in the health and disability sectors are achieved through learning from complaints.
Output 2 Performance Measures and Standards
6.2.1 Provide six-monthly Commissioner complaints trend reports to DHBs in September 2008 and March 2009.

6.2.2 Develop two national educational initiatives aimed at strengthening consumer voice and increasing the use of consumer-centred approaches by providers, by 30 June 2009.

6.2.3 Produce a DVD on the Code of Rights in New Zealand Sign Language by 30 June 2009.

6.2.4 Produce and deliver 300,000 units of educational material by 30 June 2009.

6.2.5 Facilitate two consumer seminars by 30 June 2009.

6.2.6 Provide 20 education presentations to health and disability sector organizations by 30 June 2009.

6.2.7 Provide two intensive provider training programmes for providers who may work in isolation or in settings where there is little or no input from consumers of the service.

6.2.8 Provide quality responses to relevant submission documents affecting the rights of health and disability services consumers.
  1. 80% of DHBs report that they find the trend reports useful and describe how they have used the trend information.
  2. Educational initiatives implemented.
  3. DVD produced.
  4. Percentage of new orders rather than repeat orders for educational material increases from 3% to 5% a month.
  5. 80% of participants who respond to the seminar evaluation rate that they were satisfied or very satisfied with the usefulness of the seminar.
  6. 100% of requestors of education presentations rate that the presentations met their expectations.
  7. 80% of participants who respond to an evaluation of the intensive training programme rate that they were satisfied or very satisfied with the content and delivery of the programme.
  8. Provide an annual report on the impact of policy advice given and submissions made by 30 June 2009 with quarterly updates on the percentage of satisfaction with the quality of our policy advice and submissions.
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