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How complaints and notifications are dealt with
Irrespective of which organisation receives a complaint, the Nurses and Midwives Board and the Health Care Complaints Commission (HCCC) are required to consult in determining how complaints are to be dealt with. For this purpose the Nurses and Midwives Board has a Conduct Committee which consists of at least two members of the Board and which consults with representative(s) of the HCCC in assessing complaints.
It may be considered that a complaint is frivolous or vexatious and that it should not be pursued. In some cases, the alleged conduct may have occurred quite some time before the complaint was lodged and there may be little chance of obtaining evidence after such a long delay. If both the Board and the HCCC agree, no further action may be taken.
If the available information provides insufficient basis on which to make a decision or if the complaint may indicate a serious concern, then the matter will be referred for an investigation to be undertaken. Investigations are undertaken by the HCCC.
Some complaints may be considered appropriate for conciliation between the parties, and if both the nurse or midwife and the complainant agree, the matter may be referred to the Health Conciliation Registry.
In some instances, a matter is not considered sufficiently serious to warrant investigation, but the nurse or midwife may be directed to attend counselling.
If it considered that a nurse or midwife's inappropriate conduct arises from a health concern and that the nurse or midwife may be responsive to a supportive approach, a medical examination or examination by another health professional may be required and then, depending on the medical or other report, the matter may be referred to an Impairment Panel. The Board’s "Competence to Practise" Committee is delegated to oversee health matters and impairment processes for the Board.
While complaints may be related to health matters, it is not necessary to lodge a complaint. A person may notify the Nurses and Midwives Board of a nurse or midwife who is suspected of suffering from an impairment.
The Board may require a nurse or midwife, subject of a complaint or notification, to undergo a medical examination (at the Board’s expense). Failure to attend a medical examination may be considered as evidence of insufficient physical or mental capacity to practise nursing or midwifery. Section 45(5) makes provisions for examination by a medical practitioner or other health practitioner relating to complaints and section 70GA makes provision in relation to notifications of possible impairments.
The nurse or midwife is notified. If the matter is a complaint, the Health Care Complaints Act provides for the HCCC to give written notice of the complaint to the nurse or midwife. Notification may be delayed if notification would prejudice the investigation or place a client or the complainant at risk. If the matter is an impairment notification to the Board, then the Board notifies the nurse or midwife.
Generally no conditions or suspension is imposed on a nurse or midwife's registration or enrolment until the matter has been investigated and a formal inquiry held, in accord with the provisions of the Act and with the principles of natural justice. However if the Board forms the view that urgent action is necessary to protect the life or physical or mental health of any person, section 48 of the Nurses and Midwives Act 1991 provides that the Board may suspend registration or enrolment or may impose conditions that it considers necessary. This power may be used only where necessary to protect life or health, as noted above. Suspensions may be imposed for a maximum of 8 weeks and any extension requires the approval of the Chairperson of the Nurses and Midwives Tribunal.
As noted above, some matters are referred for investigation by the HCCC. After the HCCC has completed its investigation, the results of the investigation are the subject of further consultation between the HCCC and the Nurses and Midwives Board (represented by its Conduct Committee). With benefit of information available from the investigation, any of the above options may be undertaken if considered appropriate e.g. the matter may be dismissed or referred for conciliation, or the nurse or midwife may be referred for counselling or to an Impairment Panel. Where an investigation concludes that there is substance to the allegation and that the evidence is capable of proving unsatisfactory professional conduct or professional misconduct, the matter is referred to a Professional Standards Committee (less serious matters) or the Nurses and Midwives Tribunal (more serious matters).
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