What anaesthetists need to know about ANZCA’s complaints process

The Australian and New Zealand College of Anaesthetists (ANZCA) subscribes to the Medical Board of Australia’s Code of Conduct and the Medical Council of New Zealand’s Code of Good Practice.

Although the college is not a regulator and cannot award compensation or compel outcomes, it has a process in place to manage complaints against anaesthetists and members of the Faculty of Pain Medicine, which falls under its ambit.

While allegations requiring significant investigation are referred to the relevant regulatory body, the college will manage certain allegations with a view to facilitating agreed outcomes in the interests of maintaining high standards of professional conduct.

It will consider complaints (or notifications) about:

  • Unacceptable professional standards, including poor clinical standards or outcomes.
  • Unacceptable behaviour, such as bullying, discrimination or sexual harassment.
  • Unacceptable behaviour during training and assessment.

It accepts complaints against and concerns from:

  • The community.
  • Patients.
  • Other health professionals.
  • Employers.
  • Tribunals.
  • Regulatory or educational bodies.
  • Staff.

However, the college may decide that a notification is abusive, trivial, misconceived or vexatious and refuse to deal with it any further other than to inform the notifier.

Any doctor who becomes aware of a complaint or notification against them should inform their medical indemnity insurer before they respond.

Tego understands that complaints, claims and litigation can be stressful for anaesthetists and other doctors and has a 24-hour support hotline for clients: 1300 938 991.

Indemnity Insurance

The hotline is staffed by lawyers and aims to help medical indemnity insurance clients get through a claim or complaint quickly and strategically. Click here to learn more about discharging patients

ANZCA says the Medical Board of Australia’s code makes “explicit the standards of ethical and professional conduct expected of doctors by their professional peers and the community”.

The College has also published a Performance Guide for clinicians, which states that anaesthetists are expected to consistently demonstrate the highest standards of medical knowledge, anaesthetic skills and professional behaviour.

It lists four examples each of good and poor behaviour.

Poor behaviour

  • Fails to respond promptly and appropriately to post-anaesthetic issues or concerns about potential complications.
  • Introduces new technology or procedures without adequate prior assessment and consultation.
  • Rushes or cuts corners in order to complete work.
  • Fails to manage workload to avoid working when fatigued.

Good behaviour

  • Ensures appropriate pain management is instituted in a timely manner.
  • Optimises the patient’s condition before anaesthesia, taking into account the impact of comorbidities.
  • Goes through the appropriate processes when learning a new technique, including observation, supervised training, assessment and certification.
  • Modifies clinical practice in response to ageing, impairment or limitation of manual dexterity.

ANZCA has developed a pathway with four levels of intervention:

Level 1 – single unprofessional incident: Informal, advice and assistance offered, point of reflection, non-judgmental. Aims for local resolution before being considered by ANZCA.

Level 2 – apparent pattern – awareness intervention: This is the first stage that involves a formal process, which is often in the form of counselling.

Level 3 – pattern persists – guided intervention by authority. This is the second stage of formal process. Disciplinary intervention considered. Employer involved.

Level 4 – no change and potential for high impact or high risk – disciplinary intervention most likely. Employer shares responsibility for outcomes. Notification to medical regulator is considered.

Note: Very occasionally a single incident may be reckless or egregious enough to warrant a level 4 response.

These are the potential outcomes of a notification:

  • No further action.
  • Informal discussion with a senior fellow as quickly as possible, to inquire about the member’s welfare, the member’s reflections on the matter, and changes to future practice and assistance ANZCA with continuing education.
  • Referral to an individual nominated by ANZCA to assist and support professional practice.
  • Referral to an external organisation.
  • Requirement to sign a deed of undertaking (level 2 conduct).
  • Issue of a reprimand (level 3 conduct).
  • Referral to Regulation 26 professional standards panel (levels 3 or 4 conduct).
  • Referral to ANZCA council for consideration of removal of fellowship or other actions, such as, a report to medical regulatory authority (level 4 conduct).

Click here to read the college’s full Notification and Management of Complaints and Concerns Policy.

This publication is general in nature and is not comprehensive or constitute legal or medical advice. You should seek legal, medical or other professional advice before relying on any content, and practice proper clinical decision making with regard to individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgment or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Tego Insurance Pty Ltd is not responsible to you or anyone else for any loss su­ffered in connection with the use of this information.