How complaints and notifications are handled

The Physiotherapists Registration Board of NSW and the Health Care Complaints Commission (HCCC) are both available to receive complaints from any person about the professional conduct of a registered physiotherapist, and to assist people in this process.

Consultation with HCCC
Irrespective of which organisation receives a complaint, the Physiotherapists Registration 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 Physiotherapists Registration Board has a Complaints Screening Committee which consists of at least three members of the Board and which consults with representative(s) of the HCCC in assessing complaints.
A range of options depending on the nature of the case is available to the Board after consultation with the Health Care Complaints Commission. The Board may:

Deal with matter directly, as in a Board Inquiry,
Refer the matter to the Commission for investigation,
Refer to an Impaired Registrants Panel,
Refer to the Health Conciliation Registry for conciliation, if all parties agree,
Refer the matter to another body
Dismiss the complaint,
Refer to the Physiotherapy Standards Advisory Committee, or
Refer to a Tribunal.

A decision to discipline a physiotherapist maybe made by the Board or the Tribunal following a hearing at which the grounds of the complaint are proven.  Protective orders which may be imposed by the Board or the Tribunal range from a caution to deregistration.  Other options include directing that conditions be placed on practice, imposition of a fine or referral of the physiotherapist for medical or psychiatric treatment or counselling.

Complaints may be dismissed
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 will be taken in these circumstances.

Referred for Investigation
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.

Physiotherapists Standards Advisory Committee
If the HCCC decides not to investigate a complaint the Board may refer it to the Physiotherapy Standards Advisory Committee. This small committee sits independently of the Board to investigate and advise on professional standards. The role of this committee is to settle complaints by consent of the parties and/or make recommendations to the Board on further action to be taken.

Direct resolution
The matter may be referred to the physiotherapist concerned for direct resolution with the complainant.

Conciliation
Some complaints may be considered appropriate for conciliation between the parties, and if both the physiotherapist and the complainant agree, the matter may be referred to the Health Conciliation Registry.

Counselling
In some instances, a matter is not considered sufficiently serious to warrant investigation, but the physiotherapist may be directed to attend counselling.

Adverse comment
The HCCC uses peer reviewers to provide advice concerning the conduct complained of. In cases where a peer reviewer makes adverse comments relating to the physiotherapist's conduct, insufficient to warrant a disciplinary inquiry, the HCCC may write to the physiotherapist concerned and advise him or her of the peer reviewer's adverse comments.

Impairment
If it considered that a physiotherapist's inappropriate conduct arises from a health concern and that the physiotherapist 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 Impaired Registrants Panels are empowered to oversee health matters and impairment processes for the Board.  These Panels develop rehabilitative programs tailored to the needs of the particular physiotherapist and meet with the physiotherapist at regular intervals to discuss their progress.

While complaints may be related to health matters, it is not necessary to lodge a complaint. A person may notify the Physiotherapists Registration Board of a physiotherapist who is suspected of suffering from an impairment.

The Board is empowered under section 38 of the Act (link to section 38) to require a physiotherapist, subject of a complaint or notification, to undergo an independent medical examination (at the Board’s expense), where it feels it is appropriate to do so. Failure to attend a medical examination may be considered as evidence of insufficient physical or mental capacity to practise physiotherapy and in turn grounds for a disciplinary complaint.

Board Inquiries
A Board inquiry will be conducted at a Board meeting to deal with a  complaint of unsatisfactory professional conduct where appropriate.

Physiotherapists Tribunal
The Physiotherapists Tribunal makes its findings independently of the Board and operates in a more formal manner similar to Court proceedings. The Tribunal will hear the more serious matters of professional misconduct.

A decision to discipline a physiotherapist is made by the Tribunal.  Protective orders which may be imposed by the Tribunal range from a caution to deregistration.  Other options include directing that conditions be placed on practice, imposition of a fine or referral of the physiotherapist for medical or psychiatric treatment or counselling.

Both the Board and the HCCC are both required under legislation to make the names of de-registered and cancelled practitioners, as well as relevant Tribunal and court decisions publicly available.

Physiotherapist notified
The physiotherapist 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 physiotherapist. 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 physiotherapist.

Urgent Action to protect life or physical or mental health
Generally no conditions or suspension are imposed on a physiotherapist's registration until the matter has been investigated and a formal inquiry held, in accordance 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 55 of the Physiotherapists Act 2001 provides that the Board may suspend registration 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 of the suspended period requires the approval of the Chairperson of the Physiotherapists Tribunal.

After investigation by HCCC
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 Physiotherapists Registration Board (represented by its Complaints Screening 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 physiotherapist 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 professional misconduct the complaints are referred to the Physiotherapists Tribunal.

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Last Updated:April 2008