Internal review requests procedure

1.    Application/scope

This procedure is to be read in conjunction with the Office’s complaints management system (CMS) and internal review policy and the service delivery complaints procedure.

The purpose of this procedure is to provide guidance to employees in their handling of internal review requests.

2.    What is an internal review request?

Complaints about the decisions made or actions taken by a Queensland Ombudsman employee (including the Ombudsman) in relation to the assessment or investigation of a complaint about an agency are dealt with by way of an internal review process.

Where a client is dissatisfied with a decision made by an employee concerning the assessment of their complaint about an agency or the investigation of that agency they may request the employee’s action or decision be internally reviewed.

3.    What should a request include?

Requests for an internal review should include:

  • name, address, email and telephone number of the client
  • previous case reference number, if known
  • a concise summary of the reasons for requesting an internal review – why the decision was wrong or why/how the assessment, investigation or decision was deficient
  • any new information that should be considered in reviewing the matter
  • copies of any relevant letters or other documents that have not previously been provided
  • the outcome being sought.

4. How should a request be made?

Requests for an internal review can be made by:

  • email to ombudsman@ombudsman.qld.gov.au with Internal Review Request in the subject
  • mail to Office of the Queensland Ombudsman, GPO Box 3314, Brisbane, Qld 4001
  • telephoning (07) 3005 7000 or 1800 068 908 (outside Brisbane)
  • visiting Level 18, 53 Albert Street, Brisbane.

The Office may request that an internal review request be put in writing.

5.    Time limit

A request for an internal review must be made no later than one year after the client was notified or made aware of the decision or action. Review requests made outside this timeframe will only be reviewed if the Office considers that exceptional circumstances exist.

6.    Who conducts the review?

An internal review will be conducted by an authorised review officer, who will be an employee at a level equal to, or more senior than, the original decision-maker. The authorised review officer will be nominated by the Deputy Ombudsman.

7.    What outcome can be expected?

Reviews of complaints may include, but are not limited to, one or more of the following outcomes:

  • the original decision was correct and the complaint does not merit further investigation
  • the original decision was wrong and should be amended without further investigation
  • the original investigation should be reopened
  • the decision should be better communicated
  • a policy, procedure or practice may be amended
  • records may be amended
  • further assistance to address a service delivery complaint that forms part of the internal review may be provided
  • an apology or some other remedy may be offered.

8.    When is an internal review required?

An internal review is to be undertaken where a client challenges the validity of a decision concerning a substantive issue, for example, on the basis that the investigation was fundamentally/materially inadequate or the assessment of the material was significantly in error.

Requests for internal review should clearly explain why the client believes the complaint handling/investigation process or conclusions were deficient. Where this has not occurred in sufficient detail to understand the complaint, the client may be asked to outline their concern.

9.    When an internal review is not required

In the following situations an internal review is not required:

  1. Client expresses disappointment about the decision, questions the validity of the decision or seeks an explanation or clarification but does not ask for a review

Such an approach by the client may be made on the telephone or in writing. 

The approach should be handled by the original decision-maker or investigator who managed the case in the first instance.

Where the client’s approach has been over the telephone, the employee should decide whether it is necessary to follow-up the discussion with an email or letter to the client confirming the conversation. During this conversation the client is to be verbally advised that they may seek an internal review of the original decision if they remain dissatisfied. A follow-up email or letter should confirm the client’s ability to seek an internal review.

Where the client’s approach has been in writing, the response should also be in writing and include advice that the client may seek an internal review.

Notwithstanding that a written response should be provided, it is preferable that the employee take the opportunity to discuss the case with the client over the telephone.

In the above situation, the case is not reopened in Resolve nor is a new case created. The matter is to be dealt with as correspondence on the closed Resolve case.

  1. Client submits new information concerning a substantive issue

An approach by the client may be made on the telephone or in writing. 

As a threshold question, the original decision-maker will decide whether the new information concerns a substantive issue.

If the new information does not concern a substantive issue, the original decision-maker may decline to undertake any further investigation and must advise the client of this decision. The client is to be advised that they may seek an internal review of the original decision if they remain dissatisfied.

If the original decision-maker decides the case should be further investigated, that employee will advise the client of:

  • the decision to further investigate, and
  • at the appropriate time, the outcome of that investigation.

If the original case has been closed, a new case should be opened in Resolve and ‘Yes’ is selected in the Continuing Issue on the Issues screen if the new matter was opened in the same financial year.

If the result of any further investigation does not justify the decision being changed, that employee must advise the client of that outcome with the employee’s reasons. The client should be advised that they may seek an internal review of the decision if they remain dissatisfied.

As this situation involves the consideration of new information and the making of a fresh decision on that basis, the decision-maker’s response should be in writing. Notwithstanding that a written response should be provided, it is preferable that the employee take the opportunity to discuss the case with the client over the telephone.

10.      Undertaking an internal review

A review must be undertaken by an authorised review officer (the reviewer) as nominated by the Deputy Ombudsman.

The purpose of the review is to establish whether the Office’s complaint handling/investigation and decision-making process, in response to the original complaint about an agency, was appropriate and/or the conclusions reached were reasonable.

Where a client has requested an internal review, a new case is opened in Resolve as ‘Review Request by Contact’ file type. Additionally:

  • A written acknowledgement in relation to a review should be issued within seven business days from receipt.
  • Reviews should be completed within three months of receipt of the review request from the client.
  • The reviewer will advise the client in writing of the decision and explain their reason/s for the decision.
  • The reviewer will complete the required fields in Resolve before closing the case.

The reviewer will consider the information provided with the request and material on the original case file. The reviewer may also speak to the employee/s who dealt with the original complaint. The review is not a further investigation of the original complaint but an analysis of the investigation and decision.

A reviewer may, among other things:

  • decide that the original conclusion appears to be incorrect and that a new conclusion should be substituted
  • determine that further investigation should be undertaken, or
  • affirm the original conclusion and close the file.

See section 7 above for a more complete list of the outcomes that may be expected.

If the reviewer decides further investigation is appropriate, they will advise the client of the decision to further investigate and either:

  • conduct or supervise the investigation, or
  • refer the matter to another employee to investigate and make the final decision.

The original decision-maker should not be involved in the further investigation in this situation.

11.    One review only

Unless exceptional circumstances exist, a complaint will be reviewed only once. Where a client seeks a subsequent review, the reviewer should consult the Deputy Ombudsman as to whether a further review should be undertaken.

In appropriate cases, the reviewer, in advising the client of the outcome of the review, may also advise the client that the Office will not consider further submissions and correspondence.

12.    Mixture of internal review request and service delivery complaint

Where a request for an internal review also contains a service delivery complaint, the reviewer should also consider and address the service delivery complaint (see service delivery complaints procedure). The particulars of the service delivery complaint should be formally recorded in the Service Delivery Register maintained by the Executive Coordinator, but should also be recorded on the internal review file in Resolve.

13.    Recordkeeping

A Resolve file type ‘Review Request by Contact’ should be created for both recordkeeping and reporting purposes.

Under the Ombudsman retention and disposal schedule (QDAN 553 v2) review requests, as well as the original complaint case being reviewed, are permanent records (see the Office’s Recordkeeping manual for further information).

14.    Reporting

Internal review requests will be reported in the Office's annual report and review data will be published annually in accordance with the requirements of s.219A of the Public Service Act 2008.

15.    Feedback and monitoring

Reviewers will:

  • advise the original decision-maker that a review request has been received, and
  • report the outcomes of each review to the original decision-maker with appropriate comment aimed at preventing a repetition of any error or unsatisfactory service that may have occurred.

The Deputy Ombudsman will report to the Ombudsman Management Group on a six monthly basis regarding trends in internal reviews and performance. 

 

Reviews of this procedure will be aligned to reviews of the policy.

16.    Definitions

authorised review officer

The person nominated by the Deputy Ombudsman to conduct the internal review:

  • if the original decision-maker is a Principal Investigator or Principal Assessment Officer, the authorised review officer is the supervising Assistant Ombudsman or another Assistant Ombudsman nominated by the Deputy Ombudsman. Additionally the Deputy Ombudsman may also review the decision.
  • if the original decision-maker is an Assessment Officer, a Complaints Officer or an Enquiry Officer, the authorised review officer is the Manager RAPA or a Principal Investigator who is nominated by the Deputy Ombudsman. Additionally, any Assistant Ombudsman may review the decision.
  • if the original decision-maker is an Assistant Ombudsman, the authorised review officer is the Deputy Ombudsman or another Assistant Ombudsman nominated by the Deputy Ombudsman
  • if the original decision-maker is the Deputy Ombudsman, the authorised review officer is the Ombudsman unless the Ombudsman directs otherwise.
reviewer The authorised review officer conducting the internal review
original decision-maker The employee who made the original decision (the subject of the review) finalising the matter in accordance with delegated authority
substantive issue An issue which if substantiated will, or is likely to, result in the original decision being set aside or amended

 

17.    Related documents

Complaints management system (CMS) and internal review policy

Service delivery complaints procedure

Last updated: Friday, 28 September 2018 1:37:07 PM