If you practise in New South Wales, a complaint about you does not follow Ahpra's notification process. It is assessed by the Health Care Complaints Commission (HCCC) and considered at the same time by the NSW Council for your profession, such as the Medical Council of NSW, the Nursing and Midwifery Council of NSW or the Pharmacy Council of NSW. Ahpra is told about the complaint, because it manages registration, but the HCCC and the Council agree who will manage it. The HCCC aims to finish its assessment within 60 days. You will be asked to respond in writing, and the Council will look at whether you can reflect on what happened and what you have done so that it does not happen again. Contact your indemnity insurer before you respond.
If a concern has been raised about your practice, Dealing with a Complaint or Investigation Professionally covers how to respond to a complaint, what the regulator looks for in your response, and how to show insight and remediation. It is A$200 (A$140 with Bulk Buy 10) for 2 CPD hours, self-paced, with a dated certificate on completion.
If you practise outside New South Wales, read the Ahpra investigation process explained instead.
Who handles an HCCC complaint: the Health Care Complaints Commission and your Council
New South Wales is a co-regulatory jurisdiction. Two bodies work on a complaint about a registered practitioner, supported by the Health Professional Councils Authority (HPCA):
| Body | What it does with a complaint |
|---|---|
| Health Care Complaints Commission (HCCC) | Assesses every written complaint. It can investigate, and it can prosecute registered practitioners before the NSW Civil and Administrative Tribunal (NCAT) or a Professional Standards Committee. It generally deals with the most serious complaints. |
| The NSW Council for your profession | Considers the complaint alongside the HCCC. Councils do not investigate or prosecute. They manage complaints through conduct, performance and health pathways, and they can suspend or restrict your registration if public safety is at risk. |
| Health Professional Councils Authority (HPCA) | Receives complaints for the Councils, checks each one for immediate risk and tells the Council, the HCCC and Ahpra. |
| Ahpra | Is notified, because it manages national registration. It does not decide how an NSW complaint is managed. |
Because the bodies share information, you may hear from more than one of them about the same complaint.
The HCCC complaint process, step by step
- The complaint is checked for immediate risk. The HPCA looks at each complaint for an immediate risk to public health and safety. If there is one, the Council is told straight away, and it must act if it believes public safety is at risk.
- You are told about the complaint. The HPCA says you will be told about the complaint and its details as soon as possible, unless this would put someone at risk.
- You respond in writing. You are asked for a written response by a deadline, and you may be asked for records. You can send more information at any time.
- The HCCC assesses the complaint. It aims to do this within 60 days. The Council considers the information at the same time, and the two consult.
- The HCCC and the Council agree who manages it. The complaint may be closed, resolved, investigated by the HCCC, or managed by the Council.
- The complaint is managed and decided. The steps depend on the route, described below. Complaints can take quite a few months to manage, and longer if they are complex or investigated.
What the HCCC can decide after assessment
The HCCC lists these possible outcomes of its assessment:
- refer the complaint to the relevant Health Professional Council;
- discontinue the complaint, or discontinue it with comments to you about your practice;
- refer it to another body;
- resolve the complaint, or refer it for assisted resolution or local resolution;
- investigate the complaint.
The HCCC says it investigates only complaints that raise significant concerns about risks to public health and safety, raise a significant question about the standard of care, or would, if substantiated, give grounds for disciplinary action.
An HCCC investigation and prosecution
After an HCCC investigation of a registered practitioner, the HCCC lists these outcomes: referral to its independent Director of Proceedings, referral to your Council for action, comments to you to improve your practice, no further action, or referral to the Director of Public Prosecutions for possible criminal charges.
The Director of Proceedings decides independently whether to prosecute. Under the Health Care Complaints Act, the Director considers the protection of the health and safety of the public (the main consideration), the seriousness of the alleged conduct, the likelihood of proving it, and any submissions you make. A prosecution is filed with NCAT for serious cases, or with a Professional Standards Committee.
- A Professional Standards Committee hears less serious matters for nurses, midwives and medical practitioners. It can reprimand you or impose conditions on your registration, but it cannot suspend or cancel it.
- NCAT hears serious matters. Only NCAT can cancel or suspend your registration after a disciplinary hearing.
NCAT and Professional Standards Committee hearings can be held in public, and their decisions are published: NCAT's on NSW Caselaw and Professional Standards Committees' on AustLII. Council meetings and hearings are not public. Our guide on unsatisfactory professional conduct and professional misconduct explains the NSW terms.
When your Council manages the complaint
A Council classifies the complaint as about your conduct, your performance, your health, or a combination, and each has its own process. The Council can review earlier complaints, request records and seek expert advice. It may ask you for more information, interview you, arrange an assessment of your performance or health, convene a panel, or hold an inquiry at a Council meeting.
- Performance. You may be referred to a Performance Review Panel, directly or after a performance assessment. The panel can close the matter, impose conditions on your registration, require you to complete courses, require a later reassessment or reports on your practice, or recommend a complaint to the HCCC.
- Health. If a Council believes an impairment puts public safety at risk, it can refer you to an Impaired Registrants Panel. The HPCA describes this as "not a disciplinary measure". The meetings are confidential and held in private.
- Conduct. The outcomes the HPCA lists include no further action, conditions on your registration, a caution or reprimand, an interview or a meeting with a panel, and referral to the HCCC.
The HPCA says Councils "don't always take regulatory action", and that when they do, the aim is to protect the public. Conditions can require you to complete courses, counselling or treatment, to have supervision or assessments, or to limit your patient numbers. Ahpra is told about conditions and lists those that are not health-related on the public register. Our guide on conditions on your registration explains how to meet them.
What to do when the letter arrives
- Call your indemnity insurer or medical defence organisation straight away, and before you send anything. Your union or professional association can also help.
- Read every letter in full and note each deadline. If you cannot meet a deadline, contact the officer named in the letter before it passes.
- Keep the records exactly as they are. Do not change existing clinical notes. Send records only as your insurer advises; the HCCC can require relevant records.
- Respond in writing to each issue. The HCCC asks for accurate dates, times and details, a timeline for complex matters, and a response in proportion to the seriousness of the complaint. It also asks you to read your response as the complainant would and to avoid being defensive. Copies are given to the complainant unless you expressly ask the HCCC to use your response for assessment only.
- Show what you have understood and changed. The HCCC asks you to report any changes to your practice or systems that have come from the complaint, and to say whether open disclosure has been made. Councils look at your ability to reflect on what happened and the steps you have taken so that it does not happen again.
- Get support. The HPCA lists services including Doctors' Health NSW, Drs4Drs and the Medical Benevolent Association of NSW-ACT. Nurses and midwives can contact Nurse & Midwife Support.
Where a remediation course fits
A Council considers the steps you have taken since the event. A course on the subject of the complaint, completed before the Council or the HCCC decides, gives you a dated certificate and the material for a written reflection. If a Council or a panel later sets conditions, a course record and a reflection show how you have addressed the concern. Our guides on writing a reflection after a notification, insight and remediation and choosing a remediation course apply in New South Wales too.
The courses that fit are Dealing with a Complaint or Investigation Professionally, Insight for Fitness to Practise, Reflection for Fitness to Practise, and the course on the subject of the complaint. Not ready to choose? The free 15-minute notification course covers the first steps; it uses Ahpra's process, but the first calls, the record and the response apply in New South Wales as well.
Sources and further reading
- HPCA (NSW): A complaint has been made about me
- HPCA (NSW): Complaints – taking a closer look
- HPCA (NSW): Possible outcomes
- HPCA (NSW): Performance Review Panels
- HPCA (NSW): Attending an Impaired Registrants Panel
- HPCA (NSW): Receiving a complaint. Where do you go from here?
- HCCC: A complaint has been made about me
- HCCC: Responding to the Commission
- HCCC: Possible outcomes of a complaint
- HCCC: Prosecuting complaints about registered practitioners
Frequently asked questions
Does Ahpra deal with a complaint about me if I practise in NSW?
No. In New South Wales a complaint about a health practitioner is assessed by the Health Care Complaints Commission and considered at the same time by the NSW Council for your profession. Ahpra is notified, because it manages registration across Australia, but the HCCC and the Council decide how the complaint is managed.
How long does the HCCC take to assess a complaint?
The HCCC aims to complete its assessment within 60 days, which is the statutory period for assessment. The whole matter can take longer: the Health Professional Councils Authority says complaints can take quite a few months to manage, and longer if they are complex or go to the HCCC for investigation.
Will the person who complained see my response?
The HCCC says copies of a provider's response are given to the person who made the complaint. You can expressly ask the HCCC to use your response for assessment purposes only. Speak to your indemnity insurer before you send it.
Can the Council suspend me before the complaint is decided?
Yes. If a Council believes action is needed to protect the public, it can suspend or restrict your registration as an interim measure while the complaint is considered. It may first hold a hearing and ask you to attend.
Who can cancel my registration in NSW?
Only the NSW Civil and Administrative Tribunal (NCAT) can cancel or suspend a practitioner's registration after a disciplinary hearing. A Professional Standards Committee, which hears less serious matters for nurses, midwives and medical practitioners, can reprimand you or impose conditions.
Should I start a remediation course before the complaint is decided?
Councils consider whether you can reflect on what happened and the steps you have taken so that it does not happen again. A course on the subject of the complaint, completed now, gives you dated evidence of those steps for your written response or a later meeting with the Council.
This article is published by Healthcare Ethics Australia for general information. It is not legal advice and does not replace advice from your indemnity insurer, professional association or a lawyer about your own matter.