Managing patient complaints and second opinions

Chief Psychiatrist policy

This page includes information about the following Chief Psychiatrist policy.

This policy is mandatory for all authorised mental health services (AMHSs). An authorised doctor, authorised mental health practitioner, AMHS administrator, or other person performing a function or exercising a power under the Mental Health Act 2016 must comply with this policy.

This policy applies if a patient under the Mental Health Act 2016 or someone on the patient's behalf, such as a nominated support person, family, carer or other support person, wishes to make a complaint about any aspect of the patient's treatment or care.

You can also find additional fact sheets, forms, clinical notes and resources that are available for this policy under the relevant subtopics on this page.

Introduction

Complaints and feedback mechanisms allow authorised mental health services (AMHSs) to identify areas for improvement, with the goal being to improve patient outcomes.

Complaints and feedback processes also strengthen the accountability of staff and provide oversight in the administration of AMHSs, which increases patient and public confidence.

Patients or an interested person for a patient have a right to request a second opinion about a patient’s treatment and care if an AMHS has been unable to resolve a complaint.

An interested person includes a nominated support person or another person with a sufficient interest in the patient.

Review of care

A patient or interested person for the patient may raise concerns regarding the patient’s treatment and care with their treating team.

Early engagement by health practitioners with the patient or interested person to understand their views, wishes and preferences and where appropriate review aspects of the patient’s treatment and care is best practice.

Independent Patient Rights Advisers (IPRAs) may assist individuals by facilitating a supported discussion with the treating team when a patient or interested person raises concerns about their treatment and care.

Additionally, the treating team may also engage other health practitioners in care reviews on their own initiative where required, for example, to seek a second opinion about diagnostic, medication or risk management matters.

A review of care initiated in these circumstances may include, for example:

• consultation with other health practitioners
• assessment or reviews of treatment aspects by health practitioners external to the treating team
• specific assessments such as cultural assessments or physical health opinions
• Ryan’s Rule processes where there are concerns related to the patient’s condition getting worse or not improving as expected.

While these early engagement processes may assist with resolving concerns before a complaint is lodged, where requested, a patient or interested person should be supported to make a complaint using the local Hospital and Health Services (HHS) procedures.

Management of complaints

Complaints must be received, acknowledged and assessed in accordance with established HHS procedures or, for a private sector AMHS, in accordance with the hospital’s complaints management procedures.

IPRAs and AMHS staff must provide assistance to patients and their support persons in making a complaint if requested.

Where a patient requires specific help to make a complaint, such as with the assistance of an interpreter, personal guardian, support person or community visitor, every reasonable effort must be made by the AMHS to organise the appropriate support.

Notifying the Chief Psychiatrist

You must tell the Chief Psychiatrist about complaints about certain critical incidents or non-compliance with the Act.

This includes incidents such as:

• a death or an injury that causes permanent harm
• unlawfully detaining or restraining a patient
• giving the wrong medicine to a patient that could have caused serious harm
• events involving the health or safety of a patient or person that is a reputational risk to your health service.

It's mandatory to notify the Chief Psychiatrist about critical incidents or non-compliance under the Act. You must tell the Chief Psychiatrist even if a patient or interested person hasn't complained about it.

Find out how and when to report and view the notifying the Chief Psychiatrist of critical incidents and non-compliance policy.

Second opinions

Section 290 of the Mental Health Act 2016 provides patients and interested persons a right to request a second opinion about a patient’s treatment and care if an AMHS has been unable to resolve a complaint.

The patient, or an interested person for the patient, may request the AMHS administrator to obtain a second opinion from another health practitioner about the patient’s treatment and care.

The AMHS administrator must make arrangements to obtain the second opinion:

• from a health practitioner who is independent of the patient’s treating team, and
• in the way required under the policy.

The patient, or interested person for the patient, must be kept informed of steps taken to arrange a second opinion and the outcome of the second opinion.

Timeframes for obtaining a second opinion will vary on a case-by-case basis (due to factors such as the complexity of the issue requiring a second opinion, AMHS size and availability of clinicians). However good practice is for a second opinion to be obtained within 7 days of the request being made.

View the second opinion flowchart in the Management of complaints and right to a second opinion policy to learn what steps to take to get a second opinion.