Complaints & Escalation Policy

1. Purpose

This policy explains how patients, prospective patients, representatives, or members of the public may raise a complaint about any part of the practice, including administrative service, billing, privacy, the patient portal, the AI-assisted screening tool, marketing communications, website content, or clinical/professional matters.

The purpose of this policy is to ensure that complaints are received, recorded, assessed, investigated, responded to, and, where appropriate, used to improve the practice’s services, systems, communication, and patient experience.

2. Urgent medical issues

This complaints process must not be used for emergencies, urgent symptoms, urgent clinical advice, or time-sensitive medical concerns.

For urgent clinical concerns during business hours, please phone the rooms directly.

Complaints submitted by email or through the website may not be monitored continuously and should not be relied on for urgent medical care.

3. Types of complaints we accept

You may submit a complaint about, among other things:

• administrative service, scheduling, communication, or staff interaction;
• billing, invoices, fees, medical-aid claims, or payment-related concerns;
• privacy, personal information, data-protection, or confidentiality concerns;
• patient portal access, uploaded records, X-rays, images, documents, or technical issues;
• AI-assisted screening tool concerns, including unclear, incorrect, delayed, or misunderstood feedback;
• website content, blog content, forms, or technical problems;
• marketing communications, contact preferences, unsubscribe requests, or direct marketing concerns;
• clinical care, treatment, post-operative communication, professional conduct, or patient-safety concerns.

4. How to lodge a complaint

Complaints may be submitted by emailing the Information Officer using the contact details provided on this page.

Please include, where possible:

• your full name and best contact details;
• the patient’s name, if you are complaining on behalf of someone else;
• the date and nature of the issue;
• the names of any staff members involved, if known;
• the part of the practice involved, for example billing, appointments, clinical care, patient portal, AI screening, privacy, marketing, or website content;
• the outcome you are seeking; and
• any supporting documents, such as screenshots, invoices, correspondence, appointment details, portal records, or other relevant information.

If you are unable to submit your complaint by email, please contact the rooms and ask for assistance with lodging your complaint.

5. Complaints submitted by representatives

If a complaint is submitted on behalf of a patient by a family member, caregiver, attorney, employer, broker, medical-scheme representative, or any other third party, the practice may require proof of authority, consent, guardianship, or legal entitlement before discussing patient information or providing a detailed response.

This is necessary to protect patient confidentiality and personal information.

Complaints involving minors, dependants, or patients who cannot act for themselves will be handled in accordance with applicable law, professional duties, and the patient’s best interests.

6. What the practice will do

• acknowledge receipt of your complaint within 2 business days;
• record the complaint and assess its nature, seriousness, and urgency;
• refer the complaint internally to the appropriate person, which may include the treating practitioner, practice manager, billing administrator, Information Officer, technical service provider, or another authorised person;
• investigate the matter, which may include reviewing relevant records, correspondence, billing information, portal activity, clinical notes, staff input, or technical information;
• respond with a substantive written reply within 15 business days, where reasonably possible; and
• where appropriate, identify corrective or preventive steps to reduce the risk of the issue recurring.

Complex matters may take longer than 15 business days. If more time is needed, the practice will inform you and, where possible, provide an updated expected response date.

7. Clinical complaints and patient-safety concerns

Where a complaint involves clinical care, medical advice, treatment, diagnosis, surgery, post-operative care, clinical communication, professional conduct, or a possible patient-safety concern, the complaint will be referred for appropriate clinical review.

The complaints process is not a substitute for a medical consultation, second opinion, emergency care, or urgent medical advice.

The practice may recommend that you book a consultation, obtain urgent care, or seek an independent medical opinion where the complaint raises ongoing clinical concerns.

8. Patient portal and AI-assisted screening complaints

Complaints about the patient portal or AI-assisted screening tool may include concerns about uploaded X-rays, images, documents, technical errors, access problems, incorrect patient information, privacy, security, delayed feedback, unclear wording, or misunderstanding of AI-assisted feedback.

Where appropriate, these complaints may be reviewed from both a technical and clinical-risk perspective.

The AI-assisted screening tool is intended to assist with preliminary screening and communication. It does not replace a consultation, diagnosis, treatment plan, emergency care, or medical opinion from a registered healthcare practitioner.

If you believe you relied on AI-assisted feedback to your detriment, please explain this clearly in your complaint so that the practice can assess the matter appropriately.

9. Privacy, confidentiality, and data-protection complaints

Privacy and data-protection complaints may include concerns about:

• unauthorised access to personal information;
• incorrect personal or medical information;
• disclosure of information to the wrong person;
• security of uploaded records, X-rays, images, or documents;
• direct marketing or communication preferences;
• requests to access, correct, delete, or object to the processing of personal information;
• withdrawal of consent, where applicable;
• failure to respond to a privacy or POPIA-related request.

Privacy complaints will be handled by, or under the direction of, the Information Officer.

Where a complaint suggests a possible data-security incident, unauthorised disclosure, or breach of personal information, the practice will assess the matter and take appropriate steps in accordance with applicable law, including POPIA.

10. Confidentiality

Complaints will be handled confidentially.

Information contained in a complaint will only be shared with people who reasonably need access to the information to assess, investigate, respond to, or resolve the complaint, subject to applicable law, professional obligations, and patient-safety requirements.

The practice may need to share limited information with external service providers, advisers, insurers, hospitals, medical schemes, regulators, or authorities where this is necessary, lawful, and appropriate.

11. Records of complaints

The practice will keep records of complaints received, steps taken, responses provided, and any corrective or preventive action implemented.

These records may be used for quality improvement, staff training, billing review, privacy compliance, portal improvement, patient-safety review, or legal and regulatory purposes.

Complaint records will be retained and protected in accordance with applicable law, professional requirements, and the practice’s privacy and record-retention obligations.

12. Anonymous complaints

You may submit a complaint anonymously.

However, the practice may not be able to investigate fully, request additional information, provide feedback, or resolve the issue properly without your contact details.

Anonymous complaints may still be reviewed for quality improvement, patient-safety, privacy, training, or system-improvement purposes.

13. No retaliation

Lodging a complaint will not affect your access to ordinary care from the practice.

The practice will handle complaints respectfully, fairly, and without retaliation.

Patients and complainants are also expected to communicate respectfully. The practice may take reasonable steps to manage abusive, threatening, discriminatory, defamatory, or repetitive communications.

14. Internal escalation

If you are not satisfied with the practice’s response, you may request an internal escalation or review.

Please reply in writing and explain:

• why you are not satisfied with the response;
• what issue you believe has not been addressed;
• any new information or documents you want the practice to consider; and
• what outcome you are seeking.

The matter will then be reviewed by an appropriate senior or authorised person within the practice, where possible.

15. External escalation

If you remain dissatisfied after the practice has had a reasonable opportunity to respond, you may escalate the matter externally, depending on the nature of the complaint.

Possible external escalation routes include:

• Privacy / data-protection complaints: Information Regulator (South Africa) — inforegulator.org.za.
• Professional-conduct complaints: Health Professions Council of South Africa (HPCSA) — hpcsa.co.za.
• Medical-scheme billing disputes: Council for Medical Schemes — medicalschemes.co.za.
• Hospital service complaints: the relevant hospital’s patient services, complaints, or quality-assurance office.
• Health-establishment service complaints, where applicable: Office of Health Standards Compliance / Health Ombud.

You are not prevented from approaching a regulator, statutory body, court, insurer, medical scheme, hospital, or other appropriate authority where you are legally entitled to do so.

16. Operating entity

17. Related documents

Please also refer to:

• Privacy Notice;
• PAIA Manual;
• Medical Disclaimer;
• Patient Portal Terms of Use;
• Website Terms of Use;
• Contact & Booking.