Part 4: Responding to complaints
Complaints are responded to promptly and handled objectively, fairly and in confidence. Remedies are provided where appropriate.
Office of the Ombudsman's guidelines
4.1
In this Part, we discuss:
- knowing how well response standards are met;
- whether complainants are satisfied with outcomes;
- how complaint response standards are better known than the Code;
- how frontline staff could be better equipped for dealing with complaints; and
- dealing consistently with complainants who behave unreasonably.
Summary
4.2
Most complainants told us that ACC's interactions with them were professional and they were informed about the next steps in the process.
4.3
ACC staff showed a good awareness of service standards for some steps in the complaints process. ACC does not systematically monitor or report achievement against all service standards, so it cannot say whether the response standards are routinely met. ACC says that this discourages staff from focusing too much on timeliness rather than quality.
4.4
ACC does not gauge whether people think the complaints system is effective. Only about one in five complainants we surveyed said they are satisfied overall with ACC's complaint process. Staff are supposed to check whether complainants are satisfied with the outcome of their complaint, but there is little assurance that all staff are doing this consistently.
4.5
Frontline staff told us they generally felt equipped to deal with complaints, but not by ACC. Most did not feel that ACC gave them the skills, knowledge, and tools to deal with complaints. Many rely on peer advice and guidance when dealing with complaints.
4.6
The Ombudsman has produced guidance to help public entities with managing complainants who behave in challenging ways but ACC does not use this guidance nor does it have a consistent method to manage such complainants. Staff told us that such complainants take up a disproportionate amount of staff time, but no data on the problem is collected.
Service standards are known but not systematically monitored and reported
ACC aims to provide a high standard of customer service and meet reasonable expectations. Most people told us that ACC staff were professional and kept them informed about next steps. There are service standards for some steps in the complaints process and most staff knew them. However, achievement against all the response standards is not monitored or reported systematically.
4.7
People who have made a complaint need to know how long ACC will take to deal with their complaint and, if there are delays, when to expect a response. It is better to give complainants a realistic time frame for dealing with their complaint rather than making unrealistic promises.
4.8
ACC aims to provide a high standard of customer service and meet people's reasonable expectations. About 60% of the complainants we surveyed agreed that the contact they had with ACC was conducted in a professional manner. About the same proportion agreed that the contact they had with ACC was easy to understand. More than two-thirds say they were informed about the next steps in the complaint process.
4.9
ACC has set service standards for some steps in the complaints process. In local offices, the standards for acknowledging a dissatisfied person are the same as for general inquiries (for example, one working day for telephone messages and two working days for email messages). Local offices have to resolve a complaint referred by CSS within four days unless the complainant agrees to an extension.
4.10
CSS has a standard time frame of five working days, and a maximum of 10 working days to resolve a complaint, after which transfer to OCI is considered.
4.11
The Code does not impose a specific time frame to resolve complaints, but OCI tries to meet the time frame set in their acknowledgement letter. This is usually between four and six weeks, unless otherwise agreed with the complainant. There are no set standards for interim progress reports, but staff say they try to keep the person informed of any delays. For OCI staff, timeliness is captured using an OCI quality and customer engagement assessment tool, although there are no specific performance indicators for this aspect of service.
4.12
There are also time frames:
- for responding to Ministerial letters and correspondence from the Office of the Ombudsman, the Office of the Privacy Commissioner, and chief executive; and
- for ACC local offices or business units to put remedies into practice, which should be within seven working days after OCI has issued the decision letter.
Some people told us that the process lacks integrity, independence, and fairness.
4.13
Not all of these time standards are routinely monitored and reported. Therefore, they act as indicative good practice rather than an absolute standard. Staff who handle complaints told us that ACC is trying to de-emphasise meeting response times because in the past staff focused too much on timeliness, which had an adverse effect on response quality.
4.14
However, only about one-third of complainants from our survey agreed that the length of time it took to resolve the issue was reasonable.
4.15
For OCI, our file review showed that practice was mostly consistent with the set process. We found evidence of improvements by sharing interim findings with complainants. All complainants in our sample were sent a findings letter, but only 40% of the relevant business units, such as the local office, got a copy of the letter. ACC told us that there is an expectation that local offices or business units will be notified through the claims management system when a findings letter is sent to a complainant.
4.16
We also found that in about 10% of cases there was no evidence that the relevant business unit, such as the local office, complied with OCI instructions to send an apology letter to the complainant.
4.17
For CSS, our file review showed that the standard of recording was variable, with both good and poor practice. Poor recording presents a risk to ACC's future intentions to improve its analysis of complaints.
4.18
Also, in about three quarters of our sample, relevant business units, such as local offices, kept CSS informed of progress with resolving a complaint in accordance with ACC's complaint processes. For the other quarter, CSS staff had to ask local offices for updates on progress.
Complainants are mostly dissatisfied with outcomes
Only about one in five complainants we surveyed were satisfied with how ACC handled their complaint. ACC has improved how OCI interacts with complainants. There is little assurance that all staff are complying with the complaints process and checking whether people are satisfied with the outcome of their complaint. ACC does not know whether complainants think the complaints system is effective.
4.19
We asked people to tell us how satisfied or dissatisfied they were with the overall way ACC handled their complaint. ACC also has some data on overall satisfaction about complaints. Figure 17 combines the two data sets and shows a declining satisfaction and increasing dissatisfaction with how ACC handles complaints.
Figure 17
Percentage of complainants satisfied with the way ACC handled their complaint, 2007 to 2009 and 2014
Source: Data for 2007 to 2009 – telephone surveys (of 178, 215, and 159 people) by the Accident Compensation Corporation. Data for 2014 – telephone survey (of 242 people) by the Office of the Auditor-General.
4.20
For complainants who have had a final decision on their complaint, only 44% thought the overall decision was fair. Similarly, 57% of complainants agreed that the matter was resolved after receiving a final decision on their complaint. Conversely, 40% of complainants do not consider the matter resolved.
4.21
Views about the outcome of a complaint have a strong relationship to perceptions of the process. For example, those who feel their complaint is resolved and the outcome is fair are more likely than others to be satisfied with the process.
4.22
However, for those complainants who had their problem resolved and thought the outcome was fair, only 56% were quite or very satisfied with the process. This suggests there is room to improve perceptions about the process, even among those who were happy with the outcome.
4.23
Figure 18 shows the results from our survey of complainants when we asked them about different aspects of the complaints process. About 60% of surveyed complainants agreed that they were given the opportunity to say all they wanted to say. A lower percentage of claimants responded positively against other aspects of the complaints process.
Figure 18
Complainants' views of the complaints process
| Statement | Percentage of respondents who agree or strongly agree |
|---|---|
| You were given the opportunity to say all that you wanted to say | 63 |
| You had all of your questions about the complaints process answered | 41 |
| The process was conducted in an open and fair manner | 40 |
| You felt your individual circumstances were taken into account | 31 |
| You were kept well informed about the progress of your complaint | 31 |
Source: Office of the Auditor-General.
4.24
These results were reflected in some of the feedback we received from our interviews with complainants. Some people told us that the process lacks integrity, independence, and fairness.
Customer Support Service and satisfaction
Complainants consider that CSS staff members treat them with respect and listen impartially to their concerns. There was praise for their attitude.
4.25
Our interviewees told us that, overall, they are very satisfied with their interactions with CSS. Complainants consider that CSS staff members treat them with respect and listen impartially to their concerns. There was praise for their attitude.
4.26
For the most part, CSS informs the complainant about the options for handling the complaint, what will happen next in the process, and expected time frames. Some complainants feel that the service from CSS surpasses that of ACC's general service delivery.
Office of the Complaints Investigator and satisfaction
4.27
Our interviewees told us that OCI and the review of OCI's decisions are the two parts of the complaints process that they are least satisfied with.
4.28
Some of the interviewees who have gone through the OCI process consider that it is not a thorough investigation. They feel OCI does not adequately consider their side of the complaint, and perceive that OCI lacks independence and impartiality. The fact that OCI investigators do not meet with complainants to hear their complaint appears to cause many of these perceptions – people expect to be interviewed.
4.29
Some interviewees were not aware of their right to have the OCI decision reviewed. We saw examples of decision letters that did explain a person's right to have the decision reviewed. ACC has also told us that a factsheet is provided with every decision explaining the right of review.
4.30
Those interviewees, who are familiar with the review process, feel that it lacks independence. Those complainants who had their OCI decision reviewed believe there are significant problems with the review process. This is because the review is based on the information available in ACC files, which depends on accurate and complete recording.
4.31
Work is under way to address some of these problems. OCI has improved its method for communicating with complainants. Communication between OCI staff and complainants are now more frequent during the course of the complaint. This includes sending the complainant interim findings mid-way through the complaint investigation.
Quality assurance and satisfaction
4.32
In CSS and OCI, quality assurance of complaints is based on the expectation that managers sample two cases for each staff member each month. As part of this, managers are expected to speak with the complainant.
4.33
These sampling exercises are a useful first step but do not always provide robust assurance. Because OCI's caseload is smaller, the sampling will capture a bigger proportion of the team's work than CSS and, therefore, provide greater assurance.
4.34
ACC has no specific method to ensure that frontline staff handle complaints well. The sampling exercise for frontline staff aims to review the standard of case management. This exercise might pick up a small sample of cases that involved a person making a complaint. Some of the local office team managers told us that they did not think that this method provided the needed assurance about how ACC handles complaints at the local office.
4.35
ACC has processes in place to check whether people are happy with how their complaints have been handled. Staff at the local office should confirm with people whether they are happy with outcomes. CSS instructs its staff to telephone the complainant after their complaint has been resolved. OCI has a similar requirement for follow-up.
4.36
However, there is no systematic checking, monitoring, and reporting to demonstrate that in all cases ACC:
- contacted the complainant to gauge how satisfied they were with the outcome; and
- carried out the agreed remedy.
4.37
During our in-depth interviews with complainants, people told us that making a complaint and having it investigated is not worthwhile if ACC can simply ignore OCI's decisions or delay any required changes.
4.38
Without routine assurance, ACC cannot show that staff are consistently following the agreed process, and that it is committed to improving services.
4.39
In 2005, an external consultant found that about two-thirds of complaint case files had evidence of checking whether remedies had been put into effect. Our file review showed that:
- about two-thirds of CSS cases had evidence of complying with the requirement to call the complainant and check that they were satisfied with the outcome; and
- about one-third of OCI cases had evidence that staff had followed up with complainants after the investigation to discuss the outcome and check that they were satisfied.
4.40
About 60% of the complainants we surveyed agreed that ACC explained fully the reasons for the complaint decision. However, only about 50% of complainants agreed that ACC had correctly understood their complaint, and slightly more than one-third agreed that the final decision addressed all aspects of their complaint.
4.41
Until about 2009, ACC used to survey complainants to gauge satisfaction. It no longer does this. Staff told us that this was because it was difficult to separate a complainant's satisfaction with the process from their satisfaction with the outcome.
4.42
Without systematic monitoring of complainants' satisfaction or remedy implementation, ACC does not know whether people think the complaints system is effective. This is a missed opportunity to identify improvements.
Perceived value of making a complaint
4.43
Figure 19 shows that the proportion of complainants who thought it was worthwhile taking up their problem or concern with ACC has reduced since 2007.
Figure 19
Complainants who thought it was worthwhile taking up a complaint about ACC, 2007-2009 and 2014
Source: Data for 2007 to 2009 – telephone surveys (of 178, 215, and 159 people) by the Accident Compensation Corporation. Data for 2014 – telephone survey (of 242 people) by the Office of the Auditor-General.
Complainants sometimes feel this apologising lacks sincerity and credibility, especially if the problem is not actually solved or if the same problem happens again.
4.44
In our survey, about 40% of complainants said that ACC did what it said it would do, and about 30% of complainants thought their complaint had made a difference.
4.45
Our interviewees told us that, when ACC apologises, complainants can sometimes feel this apologising lacks sincerity and credibility, especially if the problem is not actually solved or if the same problem happens again.
4.46
Complainants perceive the complaints process as unworthy when OCI's decisions are ignored. In these instances, complainants view OCI as lacking authority. Complainants then question the value of ACC's complaints service.
Improvements suggested by complainants
4.47
Some complainants who we interviewed had suggestions for improving ACC's complaints process. Most of the suggestions related to perceived service failures of OCI and the process for reviewing OCI's decisions. People suggested ensuring that:
- complainants are better informed about the complaints process;
- ACC effectively communicates with complainants and treats them fairly;
- ACC investigates the complaint properly and acts impartially; and
- remedies are effective and adhered to.
4.48
The interview suggestions are consistent with the findings from our telephone survey of complainants. Figure 20 shows an analysis of the attributes of the complaints process that interviewees assessed as important, and how they perceived that ACC performed against each attribute. For example, the analysis showed "The length of time it took to resolve the issue was reasonable" as more important than other attributes. However, people thought ACC had performed poorly in resolving the issue in a reasonable length of time.
Figure 20
Performance and importance analysis of responses from ACC complainants
Source: Office of the Auditor-General. This graph shows the relative performance and importance of each attribute of complaints handling, based on how people rated them. The position of each attribute is determined by its relationship to each of the other attributes. Attributes that are assessed as important but rated as done poorly are at the top on the left.
Complaint response standards are better known than the Code of ACC Claimants' Rights
4.49
Frontline staff told us that they were aware of the complaints performance standards and could recall them reasonably accurately. This shows that staff are aware of the time limits to adhere to. CSS and OCI staff had a high standard of awareness of their time limits. This should help to ensure that people are given timely responses.
4.50
Because the Code is important, we wanted to know how deep-seated knowledge of the Code's eight rights was among frontline staff. We asked staff to select the eight Code rights from a list of 16 possible answers. Respondents could select as many answers as they wanted up to a maximum of 16.
4.51
Sixteen percent of respondents selected only the correct eight choices. Of the respondents who made between 8 and 12 selections, 41% included the correct eight choices. In our view, ACC could improve frontline staff's familiarity with the Code.
Frontline staff could be better equipped to deal with complaints
In general, ACC's staff feel equipped to deal with complaints. However, there is no ACC-wide training about complaints. ACC's intranet contains detailed complaint policies and procedures but they are not easy to access. Instead, many frontline staff rely on peer advice and guidance. These factors pose a risk to achieving consistent, accurate, and up-to-date practice throughout the organisation.
4.52
Our survey asked staff whether they felt equipped to handle complaints and people dissatisfied with ACC. Figure 21 shows that, although most staff felt equipped to handle complaints and dissatisfied people, many did not think that ACC had equipped them to do so.
Figure 21
Staff's assessment of whether they are equipped to handle complaints and dissatisfied people
| Staff who felt equipped | Staff who felt that ACC had equipped them | |
|---|---|---|
| Skills to handle dissatisfied people | 76% | 47% |
| Skills to handle complaints | 62% | 41% |
Source: Office of the Auditor-General. Note: For the purposes of the survey, we defined "complaint" as an official or formal complaint that involved corporate departments, such as CSS and/or OCI. A dissatisfied person was defined as someone who might lack understanding or be dissatisfied, concerned, unhappy, or frustrated with ACC in some way because of an issue that could be trivial through to serious.
Training for frontline staff could be improved
4.53
Staff working in OCI and CSS roles need a lot of experience of managing cases and handling customers. OCI and CSS prefer to hire experienced staff to fit the role rather than train new people. Therefore, recruiting the right person and then improving their skills with on-the-job and other training is important. The CSS and OCI training regimes reflect this. CSS and OCI staff told us that they were reasonably satisfied with how the training regimes work.
4.54
Frontline staff have no specific or mandatory training in how to handle complaints or the complaints process. Staff receive general customer service training when they first join ACC. Later, they might receive more specialist skills training, such as dealing with difficult customers or negotiation skills. Frontline staff told us that they had all received privacy training but the amount and type of other training they received varied widely.
4.55
We were told by ACC staff that attitudes to training vary between local offices and are sometimes poor. Some longer-serving staff told us that they have not had much training since induction and ACC does poorly in providing refresher courses.
4.56
Figure 22 shows what frontline staff told us about the training they have had to help them handle complaints or dissatisfied people. Most frontline staff receive training at their local office. Delivering training at local offices makes sense, but relying on it too much can be risky. This is because inconsistent attitudes and abilities of local office managers and trainers can have too great an influence on the skills of frontline staff. It is likely that opportunities to embed and reinforce a consistent ACC-wide approach to handling complaints are being missed.
Figure 22
Type of training or help that frontline staff received in the previous 12 months to help with complaints or dissatisfied people
Source: Office of the Auditor-General (2014), survey of ACC staff. Note: Respondents could choose more than one option.
4.57
About two-thirds of frontline staff told us that ACC could provide more training to help them handle dissatisfied people and complaints.
4.58
We were told by ACC staff that they consider team managers to be important in handling complaints at local offices. However, they think that team managers are not well trained in handling complaints.
4.59
In partnership with Auckland University of Technology, ACC is developing a central education hub or "Academy". This offers a comprehensive set of tertiary-level programmes in Case Management and Leadership and Management for staff and managers. Implementation is scheduled for late 2014 and the first 40 staff will complete their studies in 2015.
4.60
However, some ACC staff do not think that the Academy's syllabus includes enough reference to handling complaints. A lack of targeted training is a risk because it could contribute to unnecessary escalation of complaints and/or inconsistent practices.
Peer support is effective but access to information is difficult
4.61
ACC staff have access to information to help them deal with a complaint. The several detailed complaint policies and procedures include:
- guidelines to help staff work within the Code;
- service standards for how staff are expected to work with members of the public and with colleagues; and
- information on the complaints process.
4.62
Access to knowledge and information should help staff follow the process and treat complainants well. Being able to access and understand this information easily is important. ACC's intranet is the main source of information for staff. However, many staff told us that they find the intranet difficult to use. Some staff resort to looking on ACC's external website because they think it is easier to use than the intranet. Some staff told us that they often give up before finding what they are looking for.
4.63
We asked frontline staff whether they found information to help them deal with dissatisfied people and complainants easy to access. Including those staff who agreed just a little, less than 50% of staff said that they found the information they needed easy to access.
4.64
Frontline staff told us that they feel supported by colleagues and often ask them for advice and support because this is easy to do. Experienced staff told us that they often build their own informal advice networks.
4.65
Including those staff who agreed just a little, about 90% of frontline staff said they found it easy to get advice and guidance from other staff about dealing with complaints and dissatisfied people.
4.66
The median length of service for ACC staff who completed our survey was between seven and nine years. About one-third had 10 years' service or longer. Many ACC staff have long experience, but their job knowledge of how to handle complaints may not always be up to date because they tell us they do not receive enough training.
4.67
To be effective, staff need training, a supportive network of peers to help them, and easily accessible information. Without all of these, there is a risk that handling of complaints may not be consistent nor based on up to date, accurate, and reliable information.
Complainants who behave unreasonably are dealt with inconsistently
The Ombudsman's guidance on dealing with complainants who behave unreasonably is not widely used. Despite reports that such complainants take up a lot of staff time, there has been no evaluation of the problem by ACC. ACC has no process to manage these complainants consistently, except for those considered to be risky.
4.68
All complainants are unhappy in some way. Some are justified because they have wrongly suffered some disadvantage. Most complainants act reasonably, but others do not. They can be aggressive or abusive to ACC staff. Some are deliberately misleading or dishonest and make wider allegations of corruption or conspiracy. They can have overly frequent or persistent contact with ACC staff.
4.69
The Office of the Ombudsman calls this type of complaint "unreasonable complainant conduct" and thinks that this kind of problem is widespread and increasing throughout the public sector:
… it certainly appears that angry, hostile and abusive behaviour is increasing, and that government employees have become convenient targets for the frustrated and angry.14
4.70
The Office of the Ombudsman has practical guidance to help agencies manage unreasonable complainant conduct.15 The approach has been tested internationally and used extensively. The government services team in ACC told us that they are aware of the guidance and have had some training from the Office of the Ombudsman. We found no evidence of it being used in other parts of ACC.
4.71
The Ombudsman encourages public entities to manage unreasonable complainant conduct systematically and consistently, such as by:
- creating a pool of skilled and trained staff to deal with unreasonable complainant conduct;
- designing a method to identify unreasonable complainant conduct; and
- having a system that directs people to staff who are best able to deal with them.
4.72
ACC's challenge is to deal with unreasonable complainant conduct effectively and efficiently within the Code. ACC has no consistent way of doing this, except for those people who are considered risky.
4.73
ACC staff told us that unreasonable complainant conduct can consume much staff time, sometimes out of all proportion to the number of people involved. This stops staff giving time to other claimants who might need help. Complainants who are considered to behave unreasonably often have a long history with ACC and, over time, the number of their complaints usually increases. They increase ACC staff stress and can be demoralising to deal with. Some ACC staff told us that they see such conduct as offering the prospect of a never-ending complaint because they could not imagine a time when the complaint would be resolved.
4.74
ACC does not routinely collect any good data on unreasonable complainant conduct. This means that ACC does not know how many such complainants it deals with, and accordingly, how many resources it uses in trying to manage them. However, we conservatively estimate that, in 2013, about 5% of all complainants could be considered "unreasonable" and they produced 14% of the complaints lodged with CSS and OCI.
4.75
ACC also has what it terms "risky" claimants – people who are aggressive and/or a threat to staff and others. ACC has a way to identify and manage these people. Not all risky people are complainants who behave unreasonably and not all unreasonable complainant conduct is risky, but some people who rely on ACC's services are considered both risky and unreasonable.
4.76
In our view, if ACC can identify and manage risky people then it should be possible to do the same for unreasonable complainant conduct. This would be more effective and efficient for ACC and for other claimants, and would ensure that complainants get an appropriate and consistent response from ACC.
14: The Ombudsman defines this as any behaviour by a current or former complainant which, because of its nature or frequency, raises substantial health, safety, resource, or equity issues for the parties to a complaint.
15: Office of the Ombudsman (2012), Managing unreasonable complainant conduct – a manual for frontline staff supervisors and senior managers, available at the Office of the Ombudsman's website, www.ombudsman.parliament.nz.