16 DECEMBER 2011: A new report from Queensland’s independent health watchdog shows delays caused by poor coordination of health services are resulting in significant patient harm, according to complainants.
The Health Quality and Complaints Commission (HQCC) analysed all 337 healthcare access complaints received between 1 July 2009 and 30 June 2011.
The report, Why are we waiting? – A spotlight report on access to healthcare in Queensland explores what patients, families and carers have told the HQCC about the problems in accessing healthcare in Queensland.
Chief Executive Officer Cheryl Herbert said the ability to access health services when needed is fundamentally important and the report highlights opportunities for improvement.
“Failure to provide timely access to health services is one of the most significant barriers to quality healthcare, and can increase the risk of adverse outcomes for healthcare consumers, including significant deterioration of health, increased permanent harm or death.
“In the report, we analyse complaint information and provide case studies and excerpts from client complaints to illustrate the problems in accessing healthcare in Queensland,” Adjunct Professor Herbert said.
The top three barriers to accessing healthcare reported in complaints received from consumers, their families and carers were:
1. Delay due to inadequate coordination and management
People who were ‘in’ the health system but who could not access timely care because of process breakdowns or other system failures during their treatment. This issue was associated with the highest level of harm to healthcare consumers, suggesting that priorities for quality improvement in healthcare also need to focus on areas such as best practice referral pathways, triaging practices, protocols for follow-up test results, earlier recognition and management of the deteriorating patient and clinical handover.
2. Waiting/waiting lists
People who had ‘entered’ the health system, but had been placed in a queue or on a waiting list for future care. The second most frequently complained about access issue and was also associated with considerable harm.
3. Withdrawal/refusal to treat
People who had difficulty ‘entering’ the health system, negotiating entry or receiving the health service they were seeking. Most complaints about this barrier were made about the private sector – in particular general practice and specialist private practice.
This may be expected given private sector practitioners can exercise discretion in their choice of clients. However, this cannot be readily said for public hospitals, which were also identified in a considerable proportion of these complaints. This issue was most frequently associated with the areas of general practice, general medicine, emergency care, mental health and dentistry.
Complaints about these three barriers accounted for 93% of healthcare access complaints.
Key statistics from the report
- Access complaints made up an average of 7% of all complaints received in the 2009-2011 financial years.
- Access is not only a concern for healthcare consumers themselves, but for a high proportion of their carers and family members, who made almost a third of all access complaints.
- Public hospitals and general practice are the healthcare settings most frequently identified in access complaints. We recognise that public hospitals and general practices are often people’s first point of contact with the health system when they fall ill or are injured.
- The majority of health services that received access complaints were located in Brisbane and the Gold Coast (59%). The high proportion of complaints about health services in south east Queensland is consistent with the proportion of the Queensland population residing in this area and the concentration of health services in this part of the state.
- The Wide Bay-Burnett, Darling Downs, Sunshine Coast and Far North were the next most frequently reported health service locations.
The HQCC is an independent body dedicated to improving the quality and safety of health services in Queensland.