There is provision within the Australian Health Service Safety and Quality Accreditation (AHSSQA Scheme) for health service organisations to appeal the outcome of their accreditation assessment. Health service organisations may appeal to the Australian Commission on Safety and Quality in Healthcare (the Commission) where the process conducted by the accrediting agency has not complied with the AHSSQA Scheme.
An appeal to the Commission can follow an appeal to the accrediting agency or occur without a prior appeal to the accrediting agency.
Criteria for appeal
A health service organisation may only appeal to the Commission where their accrediting agency did not comply with:
- The AHSSQA scheme as set out in the policy
- Commission fact sheets or advisories
- Where there is evidence that:
- A conflict of interest has been identified in breach of the Policy – Approval under the Australian Health Service Safety and Quality Accreditation (AHSSQA) Scheme
- A conflict of interest has been identified in breach of the Policy - Avoiding and managing conflicts of interest under the Australian Health Service Safety and Quality Accreditation Scheme
- The accreditation assessment was not conducted within the time frames as stipulated in the Flow chart of an assessment to NSQHS Standards
- The health service organisation was not afforded due process to appeal the outcome of the accreditation assessment with their accrediting agency.
Appeals to the Commission will not be considered for reasons such as:
- The health service organisation did not allow sufficient time, or comply with the reasonable directions of the accrediting agency to finalise the administration of the assessment prior to the accreditation expiry date
- The health service organisation is transferring between accrediting agencies
- The health service organisation is disputing the ratings awarded at assessment to actions in a set of standards not part of a Commission accreditation scheme.
Process for reviewing health service organisations appeals against the NSQHS Standards accreditation assessment outcome
| Step 1 |
The health service organisation (HSO) receives the final NSQHS Standards accreditation assessment outcome report and wishes to appeal. If the HSO wishes to appeal:
- to the accrediting agency, proceed to Step 2.
- directly to the Australian Commission on Safety and Quality in Health Care (the Commission), skip to Step 5.
|
| Step 2 |
The HSO appeals to the accrediting agency. This must occur within 20 business days of the HSO receiving the final report. |
| Step 3 |
The accrediting agency reviews the appeal from the HSO and provides a determination. This must occur within 20 business days of the accrediting agency receiving the appeal submission. |
| Step 4 |
If the HSO is satisfied with outcome of the appeal, the appeals process ends here. However, if the HSO wishes to further appeal the decision of the accrediting agency, proceed to the next step. |
| Step 5 |
The HSO appeals to the Commission. Where an appeal is made directly to the Commission, it must be within 20 business days of the health service organisation receiving its final assessment report from its accrediting agency. Where an appeal is made following an appeal to its accrediting agency, it must be made within 20 business days of the accrediting agency ruling on its appeal. |
| Step 6 |
The Commission undertakes an initial compliance check of the appeals submission and contacts the accrediting agency and regulator for comment/response. This must occur within 20 business days of the Commission receiving the appeal. |
| Step 7 |
The accrediting agency and the regulator have 20 business days to provide a response. |
| Step 8 |
The Commission reviews the appeal and provides a determination. This must occur within 20 business days of the Commission receiving the accrediting agency and regulator response, or notification of nil response. |
| Step 9 |
The Commission notifies all relevant parties of the appeal outcome within 20 business days of the determination being made, including the HSO, accrediting agency and regulator. The appeals process ends here. |
Submitting an appeal to the Commission
Where an appeal is made directly to the Commission, it must be within 20 business days of the health service organisation receiving its final assessment report from its accrediting agency. Where an appeal is made following an appeal to its accrediting agency, it must be made within 20 business days of the accrediting agency ruling on its appeal.
The Commission will have 80 business days to review the submission, establish an appeals panel and provide the health service organisation with a determination.
All appeals are to be in writing and include executive approval. Incomplete submissions will not be processed. Supporting evidence and documentation should accompany the appeal and include:
- Name, title and contact details of the person (with delegated authority) submitting the appeal
- Health service organisation name and address
- Unique health service facility number (allocated by the Commission)
- Name of accrediting agency
- Accreditation expiry date for the health service organisation
- Assessment date(s) relevant to the appeal
- Reason for submitting an appeal
- Evidence supporting the appeal
On receipt of an appeal the Commission will seek information from the accrediting agency and relevant regulator on the matter.
Appeals should be submitted to the Safety and Quality Advice Centre:
AdviceCentre@safetyandquality.gov.au
