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The office of the Health and Community Services Complaints Commissioner, HCSCC, helps people - service users, carers and service providers - to resolve complaints about health and community services in South Australia, when a direct approach to the service provider is unreasonable, or has not worked.

HCSCC also provides information, education and advice to service users and service providers about the HCSCC Charter of Health and Community Services Rights.

HCSCC recognises that there are people who are more difficult to engage with than others because they face significant barriers to participation. This Buzz focuses on people from culturally and linguistically diverse backgrounds and people living in regional South Australia.

Culturally & Linguistically Diverse (CALD) Many refugees face language barriers, are suffering trauma or find it difficult to settle here. People from CALD backgrounds may also experience:

racism and discrimination lack of access to interpreters being given limited information being given written information in

a language they don't understand concerns for their privacy fear of consequences if they

speak up and make a complaint.

Many factors determine our health and wellbeing such as housing, education, employment, spirituality and social connections. For many

Learning to be inclusiveLearning to be inclusiveLearning to be inclusive people from CALD backgrounds these factors contribute to their exclusion and inequities. It is important for services to be responsive to the diverse needs of people from CALD backgrounds to improve their access to services, experience of services and outcomes from services.

Rural & Remote HCSCC also acknowledges barriers for people living in rural and remote South Australia who experience

difficulties accessing quality services locally

geographical isolation from services with costly travel and accommodation expenses

concerns about continuity of care and communication between services

limited access to appropriately qualified service providers

limited choice of service providers.

HCSCC understands that everyone is different and that every special needs group includes people with unique experiences and circumstances - one size doesn’t fit all.

HCSCC is committed to engaging in diverse ways to ensure everyone can learn about their rights and knows how to get help to speak up if they have concerns. HCSCC can offer a guest speaker, provide tailored HCSCC resources, work in partnership with organisations and networks and provide tailored workshops.

If you can help us to engage with groups of people with special needs, please contact HCSCC’s Enquiry Service on P 08 8226 8666; 1800 232 007 free call from a country SA landline or by email.

HOW TO CONTACT HCSCC

Web www.hcscc.sa.gov.au

Telephone Enquiry Service

Mon—Fri 9am—5pm P 8226 8666

SA country callers 1800 232 007

TTY users 133 677 (metro)

1800 555 677 (country)

Speak & Listen users 1300 555 727 (metro)

1800 555 727 (country)

Mail PO Box 199

Rundle Mall SA 5000

Administration & Reception only

Mon—Fri 9am—5pm P 8226 8652 F 8226 8620

hcscchcscchcsccbuzzbuzzbuzz Buzz

ARTICLE INDEX

New HCSCC resources...p2 Links to multicultural resources & supports…...p3 Buzz BITS - Ideas, Tips and Stories: HCSCC Charter Champions Network....p4-5 Helpful links for people living in country SA……...p6 Some case studies…...p7-8

HCSCC has released two new complaint handling guides. They are available for download from our website.

Making complaints about health or community services as a carer

Use the links below to open this brochure in PDF or RTF.

PDF RTF

Disability service complaints

Use the links below to open this brochure in PDF or RTF.

PDF RTF

HCSCC Advance Care Planning booklet Advance care planning lets people know what is important to you, even if you become too sick to speak for yourself. HCSCC has developed a booklet about advance care planning to help people:

think about what it means talk to their family and the other people most

likely to be involved in making decisions for them if they become very ill

talk with their doctor about their wishes for their future medical treatment.

Knowing about your rights can help you and your family to think about and plan for your future medical care, and to get help if your decisions are not respected.

The aim of advance care planning is to ensure your voice is heard so that people know what is important to you, even when you are unable to speak for yourself.

HCSCC Advance Care Planning booklet: Use the links below to open the booklet in either PDF or RTF format.

PDF RTF

To order multiple copies of HCSCC publications please complete our Product Order form.

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HCSCC has been busy with a range of initiatives to inform, educate and advise service users and service providers about the HCSCC Charter since it came into effect in June 2011 including:

promoting the HCSCC Charter and the Charter Champions Network in all external presentations and workshops

including a one page summary about the HCSCC Charter with letters in response to complaints

drawing service providers attention to specific elements of the HCSCC Charter for educational purposes

sending a quarterly HCSCC Charter Champion Network e-bulletin to all registered Champions

contributing articles to a wide range of external publications promoting awareness of the HCSCC Charter

widely promoting 2 new HCSCC brochures - one to help carers make a complaint, the other to help people make a complaint about a disability service

providing HCSCC Charter resources as conference satchel inserts

jointly releasing a media release and SA government email with other SA statutory rights protection agencies to raise awareness about Human Rights Week in December 2011

uploading 15 new HCSCC Charter alignment slides to the HCSCC website

briefing the Minister for Health and Ageing, other Ministers and MPs about HCSCC Charter initiatives

developing an HCSCC Advance Care Planning booklet to help people know their rights and consider their future medical treatment wishes

designing 2 promotional products - a magnifier business card and a lens cloth - specifically for people over 65 years of age

liaising with SA Health and Ageing about the implementation of the HCSCC Charter across public health services

Implementing the HCSCC Charter - what have we been doing?

New HCSCC resources

Page 3 hcsccbuzz www.hcscc.sa.gov.au

Helpful links to services & supports for people from culturally & linguistically diverse (CALD) backgrounds

Federation of Ethnic Communities’ Councils of Australia (FECCA) is a peak, national body representing Australians from culturally and linguistically diverse backgrounds. FECCA’s role is to advocate, lobby and promote issues on behalf of its constituency to government, business and the broader community. Click here to go to FECCA. Two papers released by FECCA include:

New and Emerging Communities Policy 2010: Supporting New and Emerging Communities to Participate in and Contribute to Australian Society, 2010. Click here to go to the policy

Improving health and well-being outcomes for Australians from culturally and linguistically diverse backgrounds (CLDB), 2007. Click here to go to the paper

Health Translations Directory is an initiative of the Victoria Government with links to online multilingual health resources from government departments, peak health bodies, hospitals, community health centres and welfare agencies. Searching is easy and can be done by topic, by language or both. Click here to go to the Health Translations Directory

Multicultural Aged Care (MAC) and the Multicultural Communities Council of SA worked together to develop a guide to help residential aged care facilities and community service providers to access information relevant to providing appropriate care for older people from CALD backgrounds. Click here to go to Working Cross Culturally: A Guide

Multicultural Development Association Inc in Queensland’s Treat Me Fairly project 2005 - a pilot project exploring ways to improve access to complaint processes for culturally and linguistically di-verse people. Click here to go the Final Report of the Complaints on Health & Employment, Equity and Rights (CHEER) Project

Multicultural SA is the agency responsible for advising the SA Government on all matters relating to multicultural and ethnic affairs in South Australia. Multicultural SA includes the South Australian Multicultural and Ethnic Affairs Commission (SAMEAC). Click here to go to Multicultural SA

Multicultural SA has developed a Short guide to working with Interpreters. Find out more about how to work with an interpreter on-site or on the telephone. Click here to go to Working with Interpreters - A short guide

The Multicultural Grants Scheme is administered by Multicultural SA on behalf of the Minister for Multicultural Affairs, Hon Jennifer Rankine MP. Click here to find out more about the Multicultural Grants Scheme

Multicultural Youth SA (MYSA) is a community based not for profit organisation that provides leadership, advocacy and direct support services for multicultural young people in South Australia. Click here to go to Multicultural Youth SA

Shelter SA and the ASHRA Network (Agencies Supporting Housing for Refugees and Asylum Seekers) have developed the ASHRA Multicultural Directory which includes information about a wide range of mainstream and specialist services and supports. Click here to go to the latest edition of the ASHRA Multicultural Directory

South Australian Refugee Health Network (SARHN) is a network for people interested in supporting the health of refugees and asylum seekers. Click here to go to the South Australian Refugee Health Network

The Migrant Resource Centre of South Australia (MRCSA) is an independent, non-government agency supporting the effective settlement and participation of people from refugee and migrant backgrounds, particularly new arrivals. Click here to go to the Migrant Resource Centre of South Australia

The Multicultural Communities Council of SA is a peak organisation that services, empowers and advocates for cultural and linguistically diverse communities in South Australia. Click here to go to the Multicultural Communities Council of SA

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HCSCC Charter Champions Network

Ideas to implement the

HCSCC Charter Some ideas to help you… display HCSCC Charter materials in

each service delivery location write an article for your newsletter

raising awareness about the HCSCC Charter

develop an HCSCC Charter Champions network in your organisation with reps from each area or division

refer to the HCSCC Charter when discussing the rights of service users

have a discussion with your colleagues about how you might implement the HCSCC Charter and draft an Action Plan to track your results

ensure that people responding to complaints are aware of and refer to the HCSCC Charter

promote the HCSCC Charter during events involving service users, their families and carers

track complaints aligned with the HCSCC Charter rights and identify opportunities for improvement

ensure that all new staff receive information about the HCSCC Charter during their induction.

HCSCC Charter Champions play a key role in promoting the HCSCC Charter of Health and Community Services Rights.

An HCSCC Charter Champion may be a person who:

provides a health or community service, for example: a health professional, care worker, case manager, supervisor or chief executive seeks or uses a health or community service cares for a service user advocates on behalf of a service user or group of service users someone who represents an interest group that wants to bring

the HCSCC Charter to life.

The HCSCC Charter Champions network is growing steadily, with 55 registered Champions across a wide range of service users and health and community service providers.

Neami Charter Champions Network

Neami is a non-government organisation supporting people with serious mental illness. Eight staff from different sites have formed the Neami Charter Champions Network.

Regular meetings occur and an Action Plan has been developed to help track their progress. Cheryl, a Community Rehabilitation & Support Worker says that the team met again in December and despite the busy time of year, staff:

had reviewed examples of a staff resource folder to create an easy to read, comprehensive and

concise Charter resource which will be available at each site

are working with management to make Neami’s complaint process as consumer-friendly as possible - including thinking about ways of supporting consumers to raise complaints with other service providers

discussed ideas about how to ensure that consumers receive information about the Charter as soon as possible in their recovery journey

made a commitment to undertake team activities to heighten staff awareness about the Charter before their next Charter Champions meeting in February.

Well done Neami - keep up the great work!

If you would like to join others in bringing the HCSCC Charter to life please: Click here to learn more about the role of an HCSCC Charter Champion

Click here to register as an HCSCC Charter Champion Completed registration forms can be sent to HCSCC by email, mail or fax.

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The state of rural health Australians who live in rural and remote areas have the same right to quality health care as those living in metropolitan areas. However this is often not the reality, with people living in rural and remote areas having much poorer access to local health services, significantly worse health outcomes and a shorter life expectancy than Australians living in metropolitan areas.

To find out more about rural health from the Rural Doctors Association of Australia please use the links below: Fact sheet - The Health of Australians living in rural and remote communities Fact sheet - The Medical Workforce Shortage in rural and remote communities

In late 2010, the Rural Doctors Workforce Agency (RDWA) was commissioned by Country Health SA to undertake a project to explore some of these issues further. Click here to go to the report Road to Rural General Practice

Country Health SA’s newsletter, In Country Health brings together information and news of interest to health practitioners from rural and remote South Australia. Click here to go to In Country Health - Issue 1 (Dec 2011)

The Queen Elizabeth Hospital (TQEH) and the Central and Northern Transition Care Program are proud champions of the Dignity in Care Program. Launched for the first time in Australia in early 2011 at TQEH and with Maggie Beer as the Dignity Patron, this program aims to change the culture of SA health services by reinforcing the importance of treating patients with Dignity and Respect.

This new SA program, with 800 enthusiastic champions already enlisted is modeled on the UK program launched in 2004 with more than 26000 Dignity Champions.

The Dignity in Care Program focuses on building partnerships and in less than one year, there are already strong partnerships with the HCSCC Charter Champions Network, Volunteers (including the Friends), Alzheimer's Australia SA, Country Health SA, Western Linkages, Mental Health Services, Respecting Patient Choices Program and some major non-government organisations including aged care providers.

The program encourages the use of clinical governance strategies and continued staff education to promote 10 Dignity Principles.

In every community there are groups that are more difficult to engage with than others. Not all individuals in these groups may be hard to reach, but many of these people face barriers to participation.

The Capire Consulting Group has developed a booklet with 100 Ideas for Engaging with Hard to Reach Groups such as bereaved, children, people with a disability, older people, homeless, indigenous, newly arrived, older migrants & young people.

Reaching out to these people can present challenges beyond those we wrestle with every day when engaging with the public.

Click here to open the book 100 Ideas for Engaging Hard to Reach Groups

by the Capire Consulting Group.

Handy tips to be more inclusive

The Program runs over a 2 years cycle with clinical themes such as Delirium and Dementia Management, Nutrition, Falls, End of Life Care, Cultural Diversity and Respecting Patients’

Choices.

The Dignity in Care Program successes are due to staff enthusiasm and also because staff value the strengths of working in close partnership with patients and carers. This multi-disciplinary program builds partnership with key stakeholders including those from volunteer and non-government organisations. It crosses the care continuum.

By enlisting Dignity Champions from all walks of life, a Dignity in Care

message is spread throughout TQEH and within community care settings. From the TQEH hub with the focus on the provision of Dignity in Care, the campaign is spreading across the community including to country regions. For more details about the Dignity in Care program please email dignityincare@health.sa.gov.au.

The Dignity in Care program aligns closely with the HCSCC Charter. Building positive partnerships with patients - a fantastic effort by the Dignity Champions at TQEH.

The Queen Elizabeth Hospital - Dignity in Care Program

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Links to resources, services & supports for people living in country South Australia

Country Health SA Local Health Network - Patient Journey Initiative

Before you travel for medical care Click here to go to the Before you travel for medical care brochure

Contacts for when you travel Click here to go to the Contacts for when you travel brochure

Patient Assistance Transport Scheme (PATS) Information Booklet Click here to go to the PATS Information Booklet

Patient Assistance Transport Scheme (PATS) Frequently Asked Questions Click here to go to the PATS Frequency Asked Questions

The Patient Journey Storybook developed by Dr Anne Johnson for the Health Consumers Alliance of SA, on behalf of Country Health SA Local Health Network, was launched by the Hon John Hill, Minister for Health and Ageing on 17 November 2011. The Storybook captures the work of the Patient Journey Initiative Steering Committee and the innovative work of health professionals, non-government organisations and community advocates to improve health services for people living in country South Australia. Click here to go to Country Health SA for further information about the Patient Journey Storybook

Carers SA is a statewide organisation that works to promote, assist, empower and enhance the lives of family carers in South Australia. Carers SA provides information about local carer support services. Click here to go to Carers SA

DIRC Disability Directory brings together in one handy document a comprehensive, up-to-date listing of information on disability organisations in South Australia. The directory can be purchased in an electronic or printed format or you can search the online database for free. Click here to search the DIRC Disability Directory online

Health Consumers Alliance of SA Inc. (HCA) is the peak body for health consumers in South Australia. HCA works in partnership to involve consumers in policy development and health care decision making, organises forums on relevant health topics, supports consumers to develop skills in advocacy and representation, and communicates systemic advocacy concerns of consumers to health planners and decision makers. Click here to go to Health Consumers Alliance of SA Inc

Health Consumers of Rural and Remote Australia Inc. (HCRRA) is a not-for-profit organisation involved in sharing information and developing networks with health consumers and consumer organisations throughout rural and remote Australia. Click here to go to Health Consumers of Rural and Remote Australia Inc

Local Government Association of SA maintains a database of local council contact details. Click here to find details about your local council

National Rural Health Alliance Inc is made up of 32 national organisations working collaboratively to improve the health and wellbeing of people in Australia’s rural and remote areas. Click here to go to the National Rural Health Alliance Inc

Rural and Regional Health Australia is an initiative of the Australian Government, Department of Health and Ageing and is aimed at helping people to easily find information about local health and aged care services. Click here to go to Rural and Regional Health Australia

SA Community is a database providing information about a wide range of South Australian community services including services such as health, welfare, housing, education, community participation, legal services, arts and recreation. Click here to go to SA Community

sa.gov.au is an online directory of services provided by the South Australian Government. Category searches can include community services, education & training, emergency & legal services, health & medical services and sports & leisure. Click here to go to sa.gov.au

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An, with her husband, her mother-in-law and their first baby, Bang, went to the GP for a 6 week check up after a Caesarean delivery. An was very upset about the way she and her family were treated by the GP.

HCSCC used the telephone interpreting service to understand what An was upset about and what she thought needed to be done about it. An told HCSCC that the doctor had a poor attitude and manner, had not examined her at all and that he had only done part of the 6 week baby check. An said he had also not made any notes in the baby’s health record book. She said she was also upset because she had been charged high fees for an inadequate check up, a particular concern as the family did not have a Medicare card. An questioned how, as a new migrant,

she could trust a GP again?

HCSCC helped An to complain directly to the GP but this didn’t resolve her concerns. After HCSCC became involved, the GP apologised to An, refunded some of the fees paid and provided her with a referral to another GP for the family’s future care. HCSCC drew the GP’s attention to his obligations under the Code of Conduct for doctors, highlighting the doctor-patient relationship, effective communication and meeting cultural needs.

This shows… Complaints are an opportunity to resolve your concerns.

An Afghani family’s experience in a hospital accident & emergency department - the right to a quality service

Ali took his one year old son to a hospital accident and emergency department (A&E) with worsening croup and a high fever. Ten minutes after his son was given medicine in A&E, the hospital staff realised that they had given him double the correct dose. As a result of the overdose, Ali’s son had to stay in A&E for

5 hours and be closely monitored for side effects from the overdose. Although the hospital offered follow up tests to confirm that his son had not been harmed by the overdose, Ali’s confidence was shaken and he decided to take him to his GP for follow up instead.

Although his son was not harmed, Ali was very concerned that he could have been if the mistake had not been noticed quickly. He wanted to know why the mistake happened. Ali was also worried because he no longer felt

confident to take his son to A&E in future.

The hospital apologised to Ali for the mistake. They explained that a junior doctor had made a mistake when the medicine was prescribed and that the nurses who prepared the medicine, and gave it to his son, had not followed the correct checking procedure. They also explained that the mistake had been recorded in the incident reporting system and that a medicines safety meeting had reviewed all the factors that had led to the mistake. As a result, the hospital had counselled the staff involved, provided training to other A&E staff to prevent similar mistakes, sped up the appointment of a medicines safety officer and taken other steps to improve medicines safety across the hospital.

Ali told HCSCC that he was pleased that the hospital had apologised and had taken steps to prevent similar mistakes happening again.

This shows… Complaints can help make services safer and better for everyone.

www.hcscc.sa.gov.au

case studies

A Chinese family’s experience with a GP for a 6 week mother and baby health check - the right to respect, the right to information and

the right to a quality service

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HCSCC was contacted by a Disability Advocate with a complaint about a country hospital. The advocate was representing the parents of a teenager, Jill, with severe multiple disabilities.

Jill’s parents were concerned about the standard of care Jill had experienced during a recent stay at the hospital. They felt that Jill’s persistent seizures were not taken seriously. They believed if Jill had not had disabilities she would have been treated differently. Jill had been placed in a children’s ward during her stay instead of a High Dependency Unit (HDU). They were also concerned about high doses of a medication administered to Jill outside of HDU. They felt they had been left to monitor Jill instead of the hospital staff.

Jill’s parents had complained to the hospital but they were dissatisfied with the response. They were concerned that Jill, who would require future admissions to the hospital, would face similar circumstances again.

Jill’s care experience in a country hospital - the right to a quality service

Bob’s transfer to a city hospital - the right to information Josie, her mother Jean and her step father Bob, live in two country towns. Bob has early dementia. Bob was admitted to the local hospital and later transferred to the stroke unit in a city hospital. Josie and Jean rang the city hospital regularly to find out how Bob was going.

Eleven days later, Josie rang the unit and was told that Bob was never admitted. Josie questioned this and the nurse asked another nurse, who confirmed it. Alarmed, Josie drove 40kms to the regional airport thinking that Bob may have been sent home on the plane and was “sitting out there”. Bob wasn’t at the airport.

Josie rang the city hospital again and spoke to Admissions. She was told that Bob had been discharged 3 days before. They also told her that he had been readmitted the next day with a broken nose and discharged the same day. Josie and Jean were now extremely alarmed, worried that Bob was wandering the city streets and in harm's way.

Josie rang the regional police to report Bob as a Missing Person. She also rang Bob’s brother, Kevin, who lived in a country town closer to the city, to let him know. Josie was told later that the police rang the city hospital about Bob’s whereabouts and "got the same answers" as Josie.

The next day Kevin rang the city hospital.

He spoke to a nurse who remembered Bob and said he’d been transferred to the city hospital’s residential unit, where people from the country await upcoming surgery. Kevin rang Josie, who then rang the city hospital to double check. She then rang the police to let them know that Bob had been found.

Josie told HCSCC that the police were extremely cross that so much police time and resources had been wasted because of wrong information.

Josie, Jean and their families were very stressed. Josie estimated that her out of pocket expenses for phone calls and petrol were $60 which she wanted reimbursed. Josie and Jean sought an apology for themselves and the police.

HCSCC asked the city hospital Consumer Advisor to investigate Josie’s complaint and to provide a copy of their response to Josie.

The city hospital had relied on Bob to let his family know where he was and acknowledged that in Bob’s circumstances, staff should have contacted his family to let them know about his discharge. The hospital said they would use Josie’s complaint as a reminder to all staff of the importance of informing families about discharge plans. The hospital apologised to Josie, Jean and the police and reimbursed Josie’s out of pocket expenses.

This shows… It’s okay to complain.

www.hcscc.sa.gov.au

case studies

They were also fearful that Jill might receive less favourable treatment because they had complained. HCSCC organised and facilitated a meeting between Jill’s parents, their advocate and the key hospital staff involved in Jill’s care.

The aim of the meeting was for Jill’s parents to describe their experience, seek a response to their concerns, clarify hospital policy, restore their confidence and plan for Jill’s future admissions.

At the end of the meeting Jill’s parents stated that they felt satisfied their concerns had been addressed. After the meeting the advocate told HCSCC that Jill’s parents felt hopeful that their goal to improve Jill’s future medical care had been achieved.

They also felt that the hospital had been genuine in their acceptance of their responsibilities, without being defensive. The hospital’s apology was accepted by Jill’s parents as genuine.

This shows… Complaints are an opportunity to provide feedback.