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Mueller J.1,2, Woltman-Black J.3, Warren J.4
1Chair, Physiotherapy Board of New Zealand, Welington, New Zealand, 2Waipiata Consulting Ltd, Coromandel, New Zealand, 3Chief Executive, Physiotherapy Board of New Zealand, Welington, New Zealand, 4Professional Advisor, Physiotherapy Board of New Zealand, Welington, New Zealand
Background: He aha te mea nui o te ao? He tangata! He tangata! He tangata!
Regulation provides the public and consumers of physiotherapy services assurance that a physiotherapist is suitably qualified and competent to provide safe, quality care that meets appropriate regulatory standards. What happens when things go wrong and a complaint is made against a physiotherapist? How does a regulator ensure their systems and process are fit for purpose to address complaints? A key function of all regulators is to manage the systems and process associated with patient complaints. While the legal framework and legislative mechanisms vary across jurisdictions, common principles such as natural justice, timeliness and proportionality of response remain core to an effective regulatory response from regulatory authorities.
Regulation provides the public and consumers of physiotherapy services assurance that a physiotherapist is suitably qualified and competent to provide safe, quality care that meets appropriate regulatory standards. What happens when things go wrong and a complaint is made against a physiotherapist? How does a regulator ensure their systems and process are fit for purpose to address complaints? A key function of all regulators is to manage the systems and process associated with patient complaints. While the legal framework and legislative mechanisms vary across jurisdictions, common principles such as natural justice, timeliness and proportionality of response remain core to an effective regulatory response from regulatory authorities.
Purpose: In Aotearoa New Zealand, physiotherapy is a regulated profession governed by the Health Practitioners Competence Assurance Act (2003). The purpose of the Act is to “protect the health & safety of the public by providing for mechanisms to ensure that health practitioners are competent and fit to practisetheir professions (s 3(1))”. As the regulatory authority for physiotherapists, one of the core functions of the Physiotherapy Board is the management of complaints against physiotherapists.
Methods: To assist our understanding of how we were managing all complaints, Secretariat staff undertook a continuous quality improvement process to identify opportunities to improve internal systems and processes. An independent audit of our complaints processes was commissioned in 2016.
Results: Although the number of complaints is small, they are increasing at a greater rate than can be expected compared to the professions growth. They have increased from 9 in 2012/13 to a projected 50 for the 2016/17 financial year. There has been a marked shift in complaints from competence to conduct, with the majority of complainants being patients. There are currently 11 formal conduct investigations and 2 disciplinary tribunal cases underway. The independent audit found that conduct cases were well managed with good systems in place. The Board could improve some procedures to protect itself from legal challenge in line with principles of good regulation.
Conclusion(s): The cost to the profession is rising, and we need to consider why physiotherapists are presenting with conduct complaints such as fraud, boundary issues and unprofessional behaviour. The Board considers complaints against physiotherapists an opportunity to learn and continually reflect on and improve both the processes by which we manage complaints, and to use appropriate regulatory levers when working with all physiotherapists. Complaints are costly, time consuming and stressful for the complainant and the physiotherapist, and the recent audit of our processes has provided a number of opportunities for continued improvement.
Implications: It is essential that authorities with responsibility for the management of complaints against physiotherapists are continually reflective of the systems, processes and regulatory levers that are available, evaluate risks, and ensure at all times that the health and safety of the public remains central to all decisions. Every complaint is preventable.
Funding acknowledgements: Not applicable
Topic: Professional issues
Ethics approval: Not applicable
All authors, affiliations and abstracts have been published as submitted.
