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In 2020, we commissioned an external expert to review our updated complaints approach. Areas specifically reviewed were the visibility, accessibility, responsiveness, restorative approach, independence, confidentiality, accountability, monitoring with a centralised, anonymous data collection with an analysis process, protection for those who make the complaint and prevention of victimisation. For more information, read the report and recommendations (PDF 386.3KB) (PDF 386.3KB).
RACS complaints framework is relevant to our profession, our role and our commitment to building respect and improving patient safety.
There is a clear role for the College, employers and other agencies which have different legal powers. RACS:
- Provides support to people who raise concerns and complaints, and those who are subject to them.
- Focuses on helping build a culture of respect, including in our handling of concerns about bullying, discrimination and sexual harassment.
- Supports the referral of every complaint to the agency best placed to deal effectively with it.
To get to the best outcome quickly and avoid duplicated effort, we make sure that all concerns and complaints are handled by the agency best placed to manage them. We support referrals to external agencies (including employers, health complaints commissions and regulators) which have the legal powers needed to handle these matters effectively.
Usually, RACS has an advisory, feedback and support role, reflecting the vision and purpose of our College. We foster profession-led conversations that are collegial and non-judgemental and aim to encourage self-reflection and behaviour change. Our Executive Director for Surgical Affairs (EDSA) and Surgical Advisors (SAs) are involved when we do handle complaints. RACS Specialist Training Boards are involved when there is an issue with a training post and our Professional Conduct Committee has a role in the most serious cases.
RACS approach is informal and non-judgmental, aimed at supporting individuals and building a culture of respect. It balances our duty of care to our trainees to provide a safe environment, our responsibility to provide a procedurally fair and timely process, our professional commitment to build a culture of respect and our legal and ethical responsibilities as a College.
What we do
Our Feedback and Complaints team talks through all enquiries, concerns and complaints with the person who contacts us. Sometimes, this conversation helps clarify that other agencies are better placed to deal with the issue. We can support this referral.
Sometimes, the person raising the issue wants to make a formal written complaint, but not every inquiry is formalised in this way.
We keep a record of all complaints and feedback raised with us. We are committed to assessing and managing all concerns to ensure they are treated promptly and fairly. Each complaint is unique and is handled individually, based on the information provided. We work with the person raising the issue, to make sure RACS has the information it needs.
If the matter is better handled by another agency with relevant legal powers, we support these referrals. We provide information about where to raise the matter and how to do it. We can support the person raising the issue and the person responding to it.
In some cases, there are also things RACS can do. We can support professionalism through a profession-led conversation. We can work with our Specialty Training Boards through the training post accreditation process when there are concerns about the safety of a training position.
What other agencies do
Many agencies in Australia and Aotearoa New Zealand have a role in managing complaints about surgeons. In general:
- Local health care complaints commissions and the health ombudsman handle patient concerns, often about the outcomes from surgery, surgical fees and requests for compensation.
- Employers (hospitals and health services) handle concerns about discrimination, bullying (egregious and repeated) and sexual harassment.
- Regulators (Ahpra, the Medical Board of Australia and the Medical Council of New Zealand) deal with serious concerns about patient safety and professional performance.
- Police handle crimes.
Within RACS, but outside the complaints and feedback process:
- Our People and Culture team deals with concerns about staff.
- The Reconsideration, Review & Appeal (RRA) process handles appeals of RACS assessment decisions.
- The Professional Conduct Committee handles the most serious matters, when another agency with legislative powers has made a formal adverse finding. There is a clear threshold and natural justice principals for these referrals.
There is a significant body of evidence showing that it is very helpful to provide timely, non-judgemental feedback to a surgeon whose behaviour has caused concern or distress to someone else. Simply letting them know that someone was adversely affected by their behaviour or conduct, without judging it or trying to work out who is right, triggers reflection and positive change. Sometimes, the surgeon was unaware that their behaviour or language had caused distress.
We use this approach when managing some of the enquiries and concerns raised with us. Often, the person who has raised the concern only wants the problem fixed or the behaviour changed. The surgeon who receives the feedback usually reflects on their behaviour, gains new insights, understands the impact it has had and modifies their behaviour.
Our Executive Directors for Surgical Affairs and Surgical Advisors are Fellows of the College and lead this approach. It is consistent with the principles of natural justice and procedural fairness. It is collegial and non-judgemental and aims to encourage self-reflection and behaviour change.
RACS’ values of Service, Integrity, Respect, Compassion and Collaboration guide the standards and behaviours we expect of our Fellows, Trainees and SIMGs. Our Code of Conduct (PDF 4.44MB) sets out the College’s expectations and our Equal Opportunity and Acceptable Workplace Behaviour policy outlines our policy position.
We are committed to assessing and managing your concerns to ensure they are treated promptly and fairly. Each complaint is unique and is addressed individually on the information provided.
We’re committed to excellence in customer service and will do our best to respond in a timely manner. We will keep you informed during the stages of the process.
If you are concerned about a health practitioner who may be putting public safety at risk, you may submit your concerns directly to Ahpra: Ahpra mandatory notifications
Anyone can make a voluntary notification about a health practitioner, but by law, registered health practitioners, employers and education providers must make a mandatory notification in some limited circumstances. Mandatory notifications help to protect the public by ensuring that Ahpra and the National Boards are alerted to any potential risks to the public.
Outcomes from surgery
Some patients are not satisfied with the outcome of their surgery. If you would like to make a complaint about this, we encourage you to contact your local health complaints commission:
- Health Services Commissioner (ACT)
- Health Care Complaints Commission (NSW)
- Health and Community Services Complaints Commissioner (NT)
- Office of the Health Ombudsman (QLD)
- Health and Community Services Complaints Commissioner (SA)
- Health Complaints Commissioner (TAS)
- Health Complaints Commissioner (VIC)
- Health and Disability Services Complaints Office (WA)
Aotearoa New Zealand
Supporting Fellows, Trainees and SIMGs
RACS Support Program is provided by Converge International. It is a free confidential service available for Fellows, Trainees, Specialist International Medical Graduates and their immediate families. Contact the service any time by calling 1300 687 327 in Australia or email firstname.lastname@example.org.
For Aotearoa New Zealand or from overseas call +613 8620 5300 or visit the Converge International website.
Beyond Blue - Australia
Beyond Blue offers 24/7 support services and can be contacted on 1300 224 636 or visit www.beyondblue.org.au.
Lifeline Aotearoa - New Zealand
Lifeline Aotearoa’s helpline and text line provides 24/7, confidential support from qualified counsellors and trained volunteers. Contact 0800 543 354 or visit www.lifeline.org.nz.
2020 external review and recommendations
Privacy (Conduct Matters) Policy
Equal Opportunity and Acceptable Workplace Behaviour Policy
Frequently asked questions (PDF 625.2KB) (PDF 625.2KB)
Discrimination, bullying, and sexual harassment (PDF 1.04MB) (PDF 1.04MB)