‘Virtually daily grief’—understanding distress in health practitioners involved in a regulatory complaints process: a qualitative study in Australia

Author:

Biggar Susan1,van der Gaag Anna2ORCID,Maher Pat1,Evans Jacinta1,Bondu Lakshmi1,Kar Ray Manaan3,Phillips Rachel4,Tonkin Anne5,Schofield Catherine6,Ayscough Kym1,Hardy Matthew1,Anderson Sarah1,Saar Eva1,Fletcher Martin1

Affiliation:

1. Australian Health Practitioner Regulation Agency , Melbourne GPO 9958, Victoria 3001, Australia

2. School of Health Sciences, University of Surrey , Guildford, Surrey GU2 7YH, United Kingdom

3. Princess Alexandra Hospital , Brisbane, Queensland, Australia

4. Psychology Board of Australia Melbourne GPO 9958, Victoria 3001, Australia

5. Medical Board of Australia , Melbourne GPO 9958, Victoria 3001, Australia

6. Nursing and Midwifery Board of Australia , Melbourne GPO 9958, Victoria 3001, Australia

Abstract

Abstract Protection of the public is the paramount aim for health practitioner regulation, yet there has been growing concern globally on the association between regulatory complaints processes and practitioner mental health and wellbeing. The objective was to understand the experience, particularly distress, of health practitioners involved in a regulatory complaints process to identify potential strategies to minimise future risk of distress. Semi-structured qualitative interviews were conducted with health practitioners in Australia who had recently been through a regulatory complaints process, together with a retrospective analysis of documentation relating to all identified cases of self-harm or suicide of health practitioners who were involved in such a process over 4 years. Data from interviews and the serious incident analysis found there were elements of the regulatory complaints process contributing to practitioner distress. These included poor communication, extended time to close the investigation, and the management of health-related concerns. The study found external personal circumstances and pre-existing conditions could put the practitioner at greater risk of distress. There were found to be key moments in the process—triggers—where the practitioner was at particular risk of severe distress. Strong support networks, both personal and professional, were found to be protective against distress. Through process improvements and, where appropriate, additional support for practitioners, we hope to further minimise the risk of practitioner distress and harm when involved in a regulatory complaints process. The findings also point to the need for improved partnerships between regulators and key stakeholders, such as legal defence organisations, indemnity providers, employers, and those with lived experience of complaints processes. Together they can improve the support for practitioners facing a complaint and address the stigma, shame, and fear associated with regulatory complaints processes. This project provides further evidence that a more compassionate approach to regulation has the potential to be better for all parties and, ultimately, the wider healthcare system.

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health,Health Policy,General Medicine

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