Our case summaries are based on real complaints and highlight some of the outcomes we can achieve. Names and identifying details have been changed to protect privacy.
Case summary 1: Access to medical equipment
The complaint
Chris needed a CPAP machine as part of his care but was having trouble getting access to it. He contacted us for help.
What we did
We assessed the complaint and identified that it may be suitable for early resolution. We contacted the provider to better understand the issue and help reach a quick resolution.
The outcome
The provider confirmed with us that Chris would be able to access the CPAP machine that day. We let Chris know of the outcome and the matter was resolved quickly.
Case summary 2: Refund and change in policy
The complaint
Elena contacted us after a dental practice charged her a $150 non-refundable booking fee and would not provide the treatment item numbers listed in her quote.
What we did
We contacted the dental practice, asked for a response and reviewed its policies and procedures.
The outcome
The practice refunded Elena the $150 booking fee and changed its procedures so patients receive a copy of their treatment plan.
The practitioner also introduced a new policy to make sure patients are clearly informed about any non-refundable booking fees before they are charged.
Case summary 3: Improving follow-up appointment system
The complaint
Mosese contacted us because they had to wait much longer than expected for an appointment after surgery. The appointment was meant to happen six weeks after their operation, but it did not take place until 12 weeks later.
When Mosese was finally seen, it was discovered that there had been a complication from the surgery and they needed another operation. Mosese said the delay caused pain, stress, anxiety and depression.
What we did
The health service provider told us that appointments were fully booked, which is why Mosese was not seen sooner. They accepted that the delay meant the complication was not identified as quickly as it could have been.
The outcome
The health service provider made changes to help prevent this happening again, including:
- keeping appointment times available for patients who need follow-up care after surgery
- making sure patients who need urgent follow-up are given priority
- having a doctor review referrals each week to help patients get appointments at the right time.
Case study 4: Apology and improvements
The complaint
Carly contacted us about the care she received in hospital after the birth of her baby. She felt staff did not respond to her needs quickly enough and was concerned about the cleanliness of the hospital. She was also unhappy with advice provided by a nurse.
What we did
We asked the hospital to respond to the complaint and discussed the concerns about the nurse with the Australian Health Practitioner Regulation Agency (Ahpra) and the Nursing and Midwifery Board of Australia.
The outcome
The hospital acknowledged Carly's concerns and apologised that her experience did not meet her needs. It also reviewed its cleaning practices.
The nurse provided an explanation, reflected on the care provided, and offered Carly a personal apology.
Ahpra and the Nursing and Midwifery Board of Australia reviewed the concerns and found no issues with the nurse's conduct or performance. As there was no evidence to confirm exactly what was said during the conversation, no findings could be made about that part of the complaint.
Case summary 5: Follow up on refund
The complaint
Hans contacted us because they had not received a refund for a prepaid appointment. The health service provider had agreed to refund $100, but several months had passed and the money had not been paid.
What we did
We contacted the provider, explained the concern, and asked for a response.
The outcome
The provider explained they had tried to process the refund, but there had been a problem with the transaction. They then contacted Hans and paid the $100 refund.
Case study 6: Compensation
The complaint
Jarrah contacted us after experiencing a lasting adverse outcome following a healthcare procedure.
What we did
We spoke with the provider and confirmed Jarrah was seeking compensation. The provider agreed to discuss the matter through conciliation, and the complaint was referred to conciliation to help the parties reach an agreement.
The outcome
A conciliator helped Jarrah and the provider discuss the issue and reach an agreement. Jarrah received compensation as part of the resolution.
Case summary 7: Referral to registration board
The complaint
Daniella contacted us about the care she and her son received at a hospital. She said her son was given a medication that was meant for her, and she was given an injection that was meant for her son. After this happened, her son spent six days in intensive care.
What we did
As part of looking into the complaint, we spoke with Ahpra about the concerns raised and whether they should be considered by the relevant Registration Board.
The outcome
After discussing the matter with us, Ahpra agreed to take it on for further review and accepted the referral.
Case summary 8: Rescheduling a booking
The complaint
Priya contacted us after her medical appointment was cancelled because she arrived late. The clinic rescheduled her appointment for four months later, which she felt was unreasonable.
What we did
We spoke with the clinic to better understand what had happened. The clinic explained that patients who arrive late can often still be seen. However, on this occasion, the doctor was only working part of the day and Priya arrived about 35 minutes late for a 30-minute appointment.
The outcome
We raised Priya’s concerns with the clinic and tried to resolve the matter through early resolution. We asked the clinic to consider offering an earlier appointment. Following discussions, the clinic agreed to review the appointment arrangements and work towards an earlier booking for Priya.
Case summary 9: Apology, acknowledgment and improvement
The complaint
Yuki was concerned about the care her child received and felt that her concerns were not listened to when she raised questions about her child's condition and treatment. She was also unhappy with the provider's response to her complaint.
Yuki wanted an apology, a better explanation, and improvements to help prevent similar concerns for other families.
What we did
We provided the complaint and Yuki’s desired outcomes to the provider and invited them to respond.
The outcome
The provider apologised to Yuki, gave a clearer explanation about the care that was provided, and acknowledged that communication could have been better. The provider also advised that feedback had been given to staff to help improve future care and communication.
Case summary 10: Helping a patient access their medical records
The complaint
Killian contacted us after a clinic he had attended permanently closed. Killian was unable to access his medical records. When he contacted the new owner of the clinic, he was told the records were not held by the new clinic and could not be accessed.
What we did
To help resolve the issue, we contacted Ahpra to obtain contact details for the practitioner who had treated Killian at the closed clinic. We then contacted the practitioner, explained the concerns, and asked whether they could assist Killian to access his records.
The outcome
The practitioner advised us that their practice manager would provide information about how the records could be accessed. The practice manager contacted us the same day and provided the relevant details. This information was passed on to Killian, who was then able to access his medical records.
Case summary 11: Advice and explanation
The complaint
Peter complained to us about the management of his cancer treatment following diagnosis.
What we did
We contacted the provider to obtain a response to Peter’s complaint.
We also consulted with the Medical Board of Australia through Ahpra. The Medical Board of Australia determined that the complaint did not raise any issues about the doctor’s performance as a medical practitioner that required any intervention by them.
The outcome
The practitioner provided a full response and an explanation that the treatment given to Peter was in accordance with the current clinical practice guidelines issued by the National Health and Medical Research Council.
Peter was reassured that his treatment was in accordance with the current standard of care for his diagnosis.