What makes a regulatory complaints process worthwhile?

Summary

In his latest blog, hub topic lead Martin Fletcher discusses the factors that contribute to a better and more ‘worthwhile’ experience of a regulatory complaints process. He highlights the importance of regular, clear communication and setting expectations early to reduce anxiety, build trust and help participants understand what the regulator can and cannot do.

Content

Regulatory complaints processes in healthcare are frequently associated with stress and distress.[1] For health practitioners and complainants alike, the experience can feel daunting, uncertain and, at times, never ending.

I was the co-author of recently published research that attempted to identify the factors that contribute to a better and more ‘worthwhile’ experience of a regulatory complaints process when concerns are raised about the performance or competence of a health practitioner.[2] The research drew on both the perspectives of health practitioners and the regulatory staff dealing with these matters within a regulatory organisation.

The concept of a 'worthwhile' process varied between individuals. For complainants, value was often tied to improvements in patient safety or changes in professional practice. For practitioners, it might be about a process that provided opportunities for reflection and professional growth. For regulatory staff, it often lay in ensuring fairness, effectively managing expectations and, ultimately, safeguarding patients and the public.

Not surprisingly, the study highlights the quality of communication as an important factor in shaping experience. Participants consistently emphasised the value of clear, regular, informative and empathetic communication throughout the complaints process. Simple actions—such as early phone contact, regular updates and use of plain language—helped participants feel informed and reassured.

When individuals understand what is happening and what to expect next, their anxiety is reduced, and their trust in the process increases.

Proactive updates of progress play a critical role. Long periods of silence increased anxiety and left individuals feeling 'in limbo'. In contrast, regular and structured updates—even when there is little new information—helps participants understand that their case is progressing and is being taken seriously.

Closely linked to communication was the importance of clarifying expectations from the outset. Many complaints arise with a range of assumptions about possible regulatory outcomes—for example, complainants seeking punitive outcomes beyond the remit of the regulator, or practitioners fearing for the worst in terms of maintenance of their licensure, even when a lower risk concern was being raised. By clearly explaining what the regulatory body can and cannot do, regulatory staff were able to better align expectations of likely outcomes earlier. This clarity appeared to allow practitioners to engage more and focus on the fairness and transparency of the process itself, rather than worrying unduly about unlikely outcomes.

Another key ingredient in creating a positive experience was the ‘human’ element. The study found that participants placed significant value on being treated with respect, dignity and empathy.

Feeling 'heard' was a recurring theme across complainants and practitioners. When people felt that their concerns were genuinely listened to and taken seriously, their perception of the process improved—even if the regulatory outcome wasn’t what they had initially hoped.

The role of regulatory staff is central in delivering this experience. Supportive, approachable and knowledgeable staff can transform the tone of the process. Their ability to actively listen, provide reassurance where appropriate and maintain professionalism built trust and confidence. In many cases, participants reported that positive interactions with staff significantly improved their emotional state during what was inherently a stressful process.

Ultimately, the research demonstrates that positive experiences in regulatory complaints management are not accidental. Rather, they are the result of well-designed, human-centred practices in which regulatory staff work within a culture that supports them to focus on patient safety, but also supports them to provide clear communication, empathy, transparency and consistent engagement.[3]

Through this purposive focus, regulatory organisations can reduce the stress and distress associated with a regulatory process to build trust, support learning, and deliver better patient safety outcomes.

References

1. Biggar S, van der Gaag A, Maher P, et al. ‘Virtually daily grief’—understanding distress in health practitioners involved in a regulatory complaints process: a qualitative study in Australia. International Journal for Quality in Health Care, 2023; 35(4). 

2. Bondu L, Bayyavarapu SB, Evans J, et al. What makes an experience positive in a regulatory complaints management process? A qualitative study. Journal of Medical Regulation, 2025; 111(4): 17–26.

3. Biggar S, Fletcher M, van der Gaag A, Austin Z. Finding space for kindness: public protection and health professional regulation. International Journal for Quality in Health Care, 2022; 34(3).

About the author

Martin Fletcher was the Chief Executive of the Australian Health Practitioner Regulation Agency (Ahpra) for 15 years, finishing his appointment in December 2024. Prior to joining Ahpra, Martin was Chief Executive of the NHS National Patient Safety Agency. From 2004-2007, Martin worked with the World Health Organization (WHO) to establish a global patient safety programme. 

Martin holds a Master of Management degree in public sector management, an Honours degree in behavioural sciences and an undergraduate degree in social studies.

Martin holds an honorary appointment as adjunct Professor with the School of Health and Biomedical Science at RMIT University. He was also a co-Director of the WHO Collaborating Centre for Health Workforce Regulation in the Western Pacific Region hosted by Ahpra.