AHPRA early complaint closures on the rise

The proportion of notifications closed within three months has almost double in the last financial year.

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Complaints about healthcare practitioners have hit their lowest point since the pandemic began, as AHPRA reported a promising decrease in notification timelines.

According to AHPRA’s 2022-23 annual report, released last week, the proportion of notifications that were closed within three months increased from around 30% in 2022 to more than 50% in 2023.

AHPRA credits this achievement to several structural changes it made to complaint handling.

For instance, instead of having one team to assess notifications and one team to investigate those same notifications, each complaint is now assigned a single case manager for its whole life cycle.

“Our approach to strengthening practice champions non-adversarial, personal engagement between notification staff, our clinical advisors and the practitioners who are the subject of a notification,” AHPRA said.

“We use case discussions with greater frequency to prevent drawn-out written processes, which practitioners have reported were overly bureaucratic.”

One of the areas it claims to have already made a change in is how it handles complaints relating to impaired practitioners.

“Practitioners with impairments can be some of the most vulnerable individuals we engage with,” the report read.

“A lengthy investigation is generally not required where an impaired practitioner has shown good insight into their impairment.

“Where there is evidence of an impairment, and it is well managed by a practitioner and their treating team, National Boards generally do not need to act.”

Earlier this year, AHPRA-commissioned research identified 20 instances over the last four years where practitioners involved in a regulatory process seriously self-harmed or died by suicide.

This research was only mentioned briefly in the annual report, with the regulator reiterating a “commitment to learn” from the incidents and to improve how it responds to them.

“As a regulator, our primary focus is protection of the public,” the annual report said.

“We believe we can and should hold a concurrent concern for the wellbeing of practitioners.

“A more humane and compassionate approach to regulation will ultimately benefit patients and families as well as practitioners.”

A particularly intriguing aspect to the research was that none of the 20 practitioners who either self-harmed or died by suicide were being investigated for a complaint related to their clinical performance.

Instead, the notifications they were being investigated for were related to either professional conduct or concern that they had a health impairment.

Most of the practitioners who died by suicide had pre-existing mental health conditions or a history of substance misuse, according to the report.

Around 5600 notifications made to AHPRA in the last financial year were about a doctor, representing just under 60% of the total.

Of these, 43% were about clinical care, 15% were about communication, 12.9% were about medications, 6% were about documentation and just 3.4% were about behaviour, a pattern that stands in stark contrast to the practitioners who self-harmed or died.

There were 305 mandatory notifications made against doctors, around half of which flagged a health impairment.

Another 30% were about breach of professional standards.

Two-thirds of all the notifications made against doctors were closed without further action.