Disclosure Log - FOI 24/25-1037
DOCUMENT 1
NDIS Complaints and  
Feedback Framework 
February 2024 
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Disclosure Log - FOI 24/25-1037
Contents  
1.
Context ...................................................................................................................... 3 
1.1 
Background ...........................................................................................................  3 
1.2 
Purpose ................................................................................................................. 3 
1.3 
Scope ....................................................................................................................  3 
2.
Our approach to manage feedback and complaints .................................................. 4 
2.1 
Principles .............................................................................................................. 4 
2.2 
Timeframes ........................................................................................................... 7 
2.3 
Steps to manage enquiries, feedback and complaints ......................................... 7 
3.
Classification of enquiries, feedback, and complaints ............................................... 9 
3.1 
Definitions ........................................................................................................... 10 
3.2 
Complaint levels .................................................................................................. 10 
3.3 
Risk assessments ............................................................................................... 12 
4.
Roles and responsibilities ........................................................................................ 13 
4.1 
National Contact Centre ...................................................................................... 13 
4.2 
Service Delivery Group ....................................................................................... 13 
4.3 
Complaints team ................................................................................................. 14 
4.4 
Managers and leaders ........................................................................................ 14 
4.5 
Partners in the community .................................................................................. 15 
4.6 
Strategic Leadership Team ................................................................................. 16 
5.
Referrals to other organisations .............................................................................. 16 
5.1 
Enquiries, feedback, and complaints about service providers ............................ 16 
5.2 
Serious incidents where abuse, neglect or exploitation is suggested ................. 17 
5.3 
Complaints which are outside of the NDIA’s control ........................................... 17 
5.4 
External review of how we managed an enquiry, feedback or complaint ........... 18 
5.5 
External review of our decisions ......................................................................... 18 
6.
Privacy ..................................................................................................................... 18 
6.1 
Handling of personal information requirements .................................................. 18 
6.2 
Authorised representatives and consent requirements ....................................... 19 
6.3 
Raising complaints and feedback anonymously ................................................. 19 
7.
Continuous improvement ......................................................................................... 19 
8.
Process owner and approver ................................................................................... 20 
9.
Feedback ................................................................................................................. 20 
10.
Version change control ............................................................................................ 20 
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1. Context
1.1 Background 
The National Disability Insurance Agency (NDIA) welcomes enquiries, feedback, and 
complaints. We want to provide an excellent service today and in the future. To 
ensure we do this we have a strong focus on listening to people with disability and 
those important to them. We listen to learn from their experiences, whether they are 
good or bad. Feedback is a critical part of improving the service we provide.  
The NDIA is committed to improving the service we deliver to people with disability 
and their families and carers. All NDIA staff and partners in the community have 
equal responsibility to receive and respond to enquiries, feedback, and complaints. 
This means there is no wrong door for an individual to raise an issue or concern with 
us.  
We value and respect all feedback. We want people to feel safe and supported to 
share their views and experiences with us. Our goal is to understand and resolve 
concerns as quickly as possible. We aim to do this long before they become 
complaints. Simple enquiries, feedback and complaints are often resolved at first 
contact.  
Our Enquiries, Feedback and Complaints policy sets out what this means for people 
who are raising issues and concerns with us.  
This framework guides staff on what this means for us and how we work.  
1.2 Purpose 
The framework aims to: 
 help us resolve each question, issue, or concern as quickly as possible and
as close to the desired outcome the person is seeking as possible. (Please
refer to the definitions for more detail).
 support staff to implement the Enquiries, Feedback and Complaints policy
(the policy).
 establish principles that align with the Participant Service Charter to guide our
approach to enquiries, feedback and complaints.
 define steps and timelines about how we manage feedback and complaints
across NDIA.
1.3 Scope 
The framework is for all people who provide a service or perform a function for, or on 
behalf of, the NDIA. This includes NDIA staff, National Contact Centre (NCC) staff 
and partners in the community.  
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The framework guides our processes for managing feedback and complaints about 
the NDIA’s performance, conduct or processes.  
There are different processes for enquiries that are covered in separate guidance 
material. 
The Participant Service Charter sets out timeframes that apply to our processes in 
this framework. It also establishes timings for other issues and concerns that are not 
covered here. 
People may raise issues and concerns with us that are not covered by this 
framework, including: 
 Issues and concerns about NDIS providers. These are handled by the NDIS
Quality and Safeguards Commission.
 Serious incidents of abuse, neglect or exploitation. These are managed in line
with the Participant Critical Incident framework.
 Concerns raised internally by NDIA staff about unacceptable workplace
behaviour. These are managed in line with the Safe and Respectful
Workplace policy and guidance.
 Protected 
disclosures made in line with the public interest disclosure
legislation.
 Where someone asks for a review of a decision.
 Complaints that need to be referred to other consumer, government, or state
authorities to investigate. For example, a complaint about another government
agency.
There are other issues that are subject to specific processes. This includes:  
 allegations 
of 
fraud 
that must be dealt with under the Commonwealth Fraud
Control Framework, or
 serious allegations of staff misconduct. These must be dealt with under the
Public Service Act 1999.
Staff should follow other relevant guidance and refer people to other organisations 
as appropriate in these instances. 
2. Our approach to manage feedback and
complaints
2.1 Principles 
Our approach to managing enquiries, feedback and complaints is: 
 Centered on the individual needs of the person raising issues.
 to listen and respond to people who share their feedback to improve the way
we deliver the NDIS.
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 to help address issues that are raised with us sooner and better.
 to provide a feedback process that is easy to understand and follow.
 to support people to feel safe to share their experiences with us.
This framework also observes the fundamental guiding principles outlined in the 
Commonwealth Ombudsman: Better practice guide to complaint handling (external). 
These include fairness, accessibility, efficiency, integration and first contact 
resolution.  
All feedback and complaints must be handled in line with our participant engagement 
principles. These principles are transparent, responsive, respectful, empowering, 
and connected. Our principles align with the 
 NDIS Participant Service Charter
 National Disability Insurance Scheme Act 2013 (external) (NDIS Act).
In more detail, our participant engagement principles are: 
Transparent: We will make it simple and clear to raise an enquiry, feedback, or 
complaint. We do this with accessible and well-publicised channels.  
 We will publicly publish information and policies about our processes that are
transparent, clear, accessible, and simple.
 We will be transparent with and outline our feedback and complaints handling
processes to participants and provide them with the reasons for our decisions.
 There is no wrong door to raise an issue. We will make sure channels into the
NDIA are well-publicised and accessible.
Responsive: We will consider all enquiries, feedback, and complaints quickly and 
seriously. We will let people know what to expect. 
 We will promptly acknowledge every contact and maintain timely communication
with the individual raising the enquiry, feedback, or complaint.
 We will actively manage people’s expectations for resolution throughout the
process and provide regular updates.
 We will address enquires, feedback and complaints quickly and seriously in order
of urgency and risk.
 We will triage enquiries, feedback, and complaints to the right staff for resolution,
and empower staff to resolve more issues where applicable.
Respectful: We recognise the safety and rights of people when they raise an issue. 
Our knowledgeable and accountable staff will respond to people with empathy and 
understanding.  
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 We will recognise the rights and safety of people raising issues in all
circumstances.
 We will actively listen to people raising issues and take time to fully understand
them and their circumstances.
 We will listen and respond to people raising issues with empathy, understanding,
and consideration.
 We will ensure our staff have guidance and training to engage with people in a
culturally safe, trauma-informed, and accessible way.
 We will ensure people are connected to staff that are helpful and knowledgeable.
Staff will be accountable and will have the necessary training and authority to
resolve issues.
Empowering: We encourage and enable people with disability to raise issues with 
us directly. We value their experience by learning from it to improve how we do 
things.   
 We will ensure that we provide sufficient information, publicly and directly, to
support people to make the best decisions for themselves.
 We will support people to raise their issues directly with us or with support from
their representatives.
 We will upskill staff to consistently and accurately categorise feedback and
complaints to ensure the feedback we receive can be used to improve processes
and systems.
 We value complaints data and will use it to inform decision making and
continuous improvement opportunities.
Connected: We will support people to access, engage with and navigate our 
processes. We will support them to get as close to their desired outcome as possible 
while adhering to NDIS legislation and guidelines. 
 We will actively engage people raising issues to get them as close as possible to
their desired outcomes.
 We will engage with community and advocacy services and use them to assist
people in raising their issues with us.
 We will ensure participants and the public are aware of other government and
community services and supports they can access.
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2.2 Timeframes 
The Participant Service Charter provides clear service standards and timeframes. 
After people contact us, we aim to: 
 Acknowledge all contact within 1 day of receipt.
 Contact you within 2 days of acknowledgement.
 Resolve 90% of NDIA managed responses within 21 days of receipt.
We aim to resolve issues and concerns as soon as possible, but some complex 
issues may take longer than 21 days to address. If the issue will take longer than 21 
days staff should contact the person to inform them of the progression and when the 
issue will likely be resolved. 
The following informs how we respond and communicate about enquiries, feedback, 
and complaints by:  
 Taking immediate action if there is a high or extreme risk identified to the
person or their situation.
 Keeping people informed about the progress of their enquiry or complaint at
every stage.
 Publishing regular information on our performance against the Participant
Service Guarantee through the NDIS Quarterly Report.
2.3  Steps to manage enquiries, feedback and complaints  
All our staff have a role in actively supporting the people they serve to be heard. Our 
staff ensure that any issues raised are understood, acknowledged, and appropriately 
resolved wherever possible.  
The steps involved in managing enquiries, feedback and complaints are outlined 
below.  
Step 1 - Acknowledge  
We will acknowledge contact within 1 day of receiving an enquiry, feedback, or 
complaint.  
Step 2 - Assess and record 
When we receive the enquiry, feedback, or complaint, we need to:  
 work out how we can answer the enquiry or resolve the feedback or
complaint.
 record it in our business system.
To do this we will consider: 
 the resolution that the person raising the issue is seeking.
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 who we need to work with to help resolve the issue.
o check for alerts in the NDIS business system.
o determine whether it is an enquiry, feedback, or complaint (see 3.1 for
further detail).
o determine classification level and appropriate way to action, including
who is best placed to help resolve the issue (see 3.2 for further detail).
o consider risks including risk to individual safety (see 3.3 for further
detail).
 any accessibility requirements and the person’s preferred communication
method.
 the sensitivity of the matter, including privacy considerations.
Step 3 – Contact  
We will contact people within 2 days to let them know how we are managing their 
enquiry, feedback, or complaint. People may be contacted by phone or email.  
We might ask people for more information to help us better understand the issue 
and desired resolution.  
Step 4 – Resolve or refer  
The first staff member who receives the enquiry, feedback or complaint will try to 
address and resolve it.  
If this is not possible, staff should communicate with the person on what we need to 
do and who will contact them next. We need to advise if the issue needs to be 
referred to another business area to be resolved. This may be to the business area 
where the issue first arose or the Complaints teams if it cannot be resolved at level 1 
(see 3.2 for further detail). 
We try to help people with most issues the first time they tell us about them. Where 
there are multiple issues to be investigated, staff should: 
 try to resolve what they can.
 only refer what they are unable to resolve.
Step 5 - Communicate  
We will make sure we contact the person: 
 each time we have an update.
 regularly until we find an answer to their enquiry.
 regularly until we resolve their feedback or complaint as close to their desired
outcome as possible.
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Step 6 - Respond  
We will contact people when we finish managing their enquiry, feedback, or 
complaint.  
If we need to, we will provide them with more information, explain our decision or 
provide a remedy or apology where appropriate.  
Step 7 - Follow-up 
All staff have a responsibility to tell the person about their escalation options. This 
includes within the NDIA or externally if the person is not happy with: 
 our decision.
 how we managed the enquiry, feedback, or complaint.
There may be times where it is appropriate for the review process about our decision 
to run at the same time as a complaint. Staff should advise people of their internal 
and external review rights. 
A person may be behaving unreasonably and should be managed in line with the 
Managing Unreasonable Behaviour policy and associated work practices when they:  
 refuse to accept a decision on a matter and consistently raise the same issue.
 make unreasonable demands.
 act violently, vilify others or make threats.
Step 8 - Consider and learn  
After we finish managing the enquiry, feedback or complaint, it is important to record 
all actions, decisions and themes in the relevant business system.  
Regular analysis of the issues raised through enquiries, feedback and complaints 
helps us see if there are any: 
 systemic issues we need to address.
 improvements for us to consider.
This process helps us keep improving how we do things. 
3. Classification of enquiries, feedback, and
complaints
It is important for us to classify enquiries, feedback, and complaints. This helps us: 
 connect people to the right area to help them with their issue.
 deliver a timely and suitable response.
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 use information to improve our performance and service.
Enquiries, feedback, and complaints may move between classifications if: 
 a person’s situation changes.
 more information emerges during the investigation and resolution process.
The Framework incorporates definitions, levels and uses the Escalation and 
Prioritisation matrix. This allows matters where risks are identified to be escalated as 
needed. 
3.1 Definitions 
Enquiries, Feedback and Complaints can be difficult to distinguish and may overlap 
with one another. When we say ‘enquiry’, ‘feedback’ and ‘complaint’ we mean: 
Enquiry: The act of requesting information, knowledge, or action.  
Feedback: Feedback is an observation made by a person or their representative 
about their experience which may take the form of a suggestion, opinion, or 
compliment.   
Complaint: An expression of dissatisfaction indicating an experience with the NDIA, 
or a related entity is displeasing or unacceptable and requires a resolution or 
response.  
Key distinguishing factors include:  
 A complaint or enquiry needs an intervention or resolution. Feedback only
needs acknowledgement.
 A complaint is triggered by dissatisfaction or frustration. An enquiry is not.
 An enquiry requires an action or information/knowledge sharing. Feedback
does not.
3.2 Complaint 
levels 
We classify complaints across three levels. This enables appropriate resolution and 
reporting.  
Level 1 – issues that can be resolved at first point of contact  
These issues or concerns can be resolved by the staff member and or business area 
who first receives the enquiry, feedback, or complaint. 
They can be resolved by: 
 providing 
information 
or an explanation.
 acknowledging concerns or apologising.
All NDIA staff manage Level 1 matters. This includes the National Contact Centre, 
partners in the community and teams within the Service Delivery Group.  
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Examples of issues that can be resolved at first point of contact are: 
 The issue is straightforward and can be resolved by providing information, an
explanation, acknowledging the concern and/or providing an apology, if
appropriate.
 The issue is better dealt with by another organisation and should be referred
(see 5 for further detail).
 The person does not wish to have the issue progressed further.
Level 2 – issues that require investigation  
These issues or concerns require investigation and/or coordination to resolve.  
They can be resolved by: 
 providing additional information about a decision, process, or procedure.
 correcting an error.
 providing feedback to our staff about conduct or errors in processes.
They may need input from more than one NDIA area to resolve.  
The complaints team will manage these issues and may refer matters to the 
appropriate business areas for management of actions. This may be the business 
areas where the issue first arose. Examples of issues that need investigation and/or 
coordination to resolve can include: 
 Completing an action or providing further information or explanation about the
issue by the responsible business area. An example is providing an
explanation of decision or delegate action.
 Coordinating actions or information from more than one business area to
resolve the issue. An example is if the resolution requires input from both
payments and planning.
Level 3 – issues that are complex or require formal resolution 
These issues are complex or need formal resolution. This may include issues or 
concerns that: 
 relate to Administrative Appeals Tribunal matters or need legal advice.
 need external involvement (other consumer bodies or government or state
authorities, such as state health or justice departments).
 include an allegation such as a breach of the NDIS Act or the APS Code of
Conduct.
 need a formal response including formal written complaints referred to the
Minister or members of parliament.
 cover multiple issues raised over an extended period for a participant that
requires extensive investigation.
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 are high or extreme risk matters and have a high volume of correspondence
and repeated escalation.
These issues need more detailed or formal investigation. They are managed by the 
Complaints teams with support from relevant business areas.  
Issues may be escalated from level 2 or may be referred directly to level 3 based on 
the nature of the complaint or issues raised.  
3.3  Risk assessments  
The Escalation and Prioritisation Matrix helps staff to identify enquiries, feedback 
and complaints that: 
 involve high or extreme risk.
 need a higher priority or escalated response.
The Participant Safeguarding policy (external) outlines the need to take a proactive 
and individualised approach to identify and assess risk. This means considering 
intersectionality and the compounding impact of multiple risk factors. For example, if 
there are multiple low risks identified this may mean the overall assessment is high. 
Key factors to consider are: 

Risk of harm to the health or well-being of a person including:
o family and domestic violence or abuse, including any evidence of prior
experience of violence, abuse, neglect, or exploitation.
o non-domestic violence or abuse (e.g., carer abuse).
 Instability in a person’s accommodation arrangements.
 Instability in a person’s informal support arrangements including:
o history of, or susceptibility to financial abuse.
o extent of informal and community support networks – for example,
whether there are independent trusted people to consult with, including
those who may advocate on the person’s behalf.
o participant lives alone.
 Risk associated with the person’s health related supports.
 Risk associated with the availability of plan funds to purchase supports.
 Risk associated with the availability of providers, workers, or other critical
supports including:
o having a sole provider.
o low plan use or an inability of the person to effectively use their NDIS
plan (including thin market issues).
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4. Roles and responsibilities
There is no wrong door for people to raise enquiries, feedback, or complaints. All 
staff and partners in the community are responsible for administering this framework.  
4.1  National Contact Centre 
The National Contact Centre (NCC) is often the first point of contact for enquiries, 
feedback and complaints. This includes issues raised through the NDIS website, 
xxxxxxxxx@xxxx.xxx.xx  and  xxxxxxxx@xxxx.xxx.xx email address, and the NDIS 
1800 800 110 phone number.  
 The NCC is responsible for: 
 Contacting the person via their preferred communication method to
acknowledge we received their enquiry, feedback, or complaint.
 Assessing risk and recording all enquiries, feedback and complaints received
through NCC managed channels.
 Attempting to resolve issues or concerns at the first point of contact where
possible. If this is not possible, the NCC staff member will explain to the
person their issue or concern has been recorded and the process for it to be
investigated.
 Gathering more information to support the enquiry, feedback, or complaint
resolution.
 Referring more complex feedback and complaints to the Complaints team if
they cannot be resolved at level 1.
 Referring enquiries to relevant business areas in line with enquiry processes
and procedures if they cannot be resolved at level 1. This includes completing
a risk assessment (see 3.3 for further detail).
4.2  Service Delivery Group 
Service delivery teams are often the first point of contact for people to raise issues 
and concerns. They should try to resolve issues when they are received. Service 
delivery also has an important role to support the resolution or response for more 
complex issues.  
Service delivery teams are responsible for:  
 Recording all enquiries, feedback and complaints received directly.
 Attempting to resolve all issues or concerns at the first point of contact where
possible. If this is not possible, explaining to the person:
o that the issue or concern has been recorded.
o the process for the issue to be investigated.
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 Referring more complex feedback and complaints to the Complaints team if
they cannot be resolved at level 1.
 Referring enquiries to relevant business areas in line with enquiry processes
and procedures if they cannot be resolved at first contact.
 Supporting the resolution by:
o gathering 
more 
information.
o providing planning outcomes/decisions explanations.
o correcting process/procedural issues.
o communicating with people about their issues and concerns.
4.3  Complaints team   
The Complaints team within the NDIA provides specialised support to the Agency. 
They manage issues that are complex or need formal resolution.  
The Complaints team is responsible for:  
 Triaging, investigating, and resolving or responding to feedback and
complaints in line with this framework. This includes:
o coordinating actions to resolve or respond to issues.
o communicating with people about their issues and concerns.
o written responses.
o recording actions and outcomes.
 Managing escalated complaints referred by the NCC.
 Managing feedback and complaints received by NDIA executives. This
includes NDIA CEO, Board, and other senior executives.
 Managing feedback and complaints received by the Minister.
 Providing a liaison point for external oversight bodies including the
Commonwealth Ombudsman and NDIS Commission.
 Supporting the Legal service teams on Australian Human Rights Commission
matters.
 Supporting staff when managing local complaints. This includes:
o providing 
advice.
o assisting escalation where needed.
o support to identify a complaint, review, or both.
 Managing 
the 
participant critical incident  process and responding to
notification of participant critical incidents.
4.4  Managers and leaders  
Managers and leaders across the NDIA have an important role in fostering a positive 
feedback and complaint culture. This includes welcoming and viewing all feedback 
as an opportunity to improve.  
Managers and leaders are responsible for: 
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 Supporting staff to resolve enquiries, feedback and complaints as outlined in:
o this 
framework.
o the Participant Service Charter.
 Developing staff and improving their capability to manage enquiries,
feedback, and complaints, and provide a quality service delivery experience.
 Sharing and discussing feedback and complaint data with staff and teams to
support a better understanding about:
o the themes and systemic issues.
o how this links to improving participant’s services.
 Working with partners in the community to support the NDIS Feedback and
Complaints framework application.
4.5  Partners in the community  
Following the same principles expected of NDIA staff, all partners in the community 
are responsible for:  
 Recording all enquiries, feedback and complaints received directly.
 Attempting to resolve all issues or concerns at the first point of contact where
possible. If this is not possible, explaining to the person:
o that their issue or concern has been recorded.
o the process for the issue to be investigated.
Where enquiries, feedback and complaints are received by: 
 partners in the community and are about staff performing scheme related
functions, the partners in the community will investigate the issues or
concerns using their internal feedback and complaint management
processes. All matters are to be recorded in the NDIS business system.
 the NDIA and are about a partner in the community, staff should record them
in the NDIS business system and refer them to the relevant partner
organisation to manage.
Matters should only be referred to the Complaints team to manage if they are 
assessed as level 2 or 3 (see 3.2 for further detail). This may include issues about a 
partner in the community, NDIA performance, conduct or procedure. 
Partners in the community must help any NDIA investigation when we need more 
information.  
As mandatory reporters, Partners in the community need to follow the relevant 
reportable incident protocols for each state/territory. Protected information obtained 
from the NDIA is an exception.  
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4.6  Strategic Leadership Team  
The NDIA Strategic Leadership Team (SLT) and Senior Executive Service (SES) 
lead the positive complaint and feedback culture. They create and support the 
environment where continuous improvement is an everyday practice for all agency 
staff. This includes the willingness to review practices and explore new ways of 
doing our work.  
The SLT members are accountable for their respective business areas. This 
includes managing issues in line with the timelines and practices contained in: 
 The Participant Service Charter.
 Ministerial Support Service Charter and other parliamentary guidance.
 Commonwealth Ombudsman guidance.
 NDIS Commission guidance.
5. Referrals to other organisations
There are times when the NDIA cannot resolve an enquiry, feedback, or complaint. 
This may be due to: 
 the issue out of the scope for NDIA.
 multiple contacts about the same issue which has not resulted in a
satisfactory resolution.
In these instances, staff should tell people about other external bodies who may be 
able to help them with their issue or concern.  
5.1  Enquiries, feedback, and complaints about service providers  
Service providers are independent organisations. The NDIA is not responsible for 
managing enquiries, feedback or complaints relating to service providers. Where an 
enquiry, feedback or complaint is received by the NDIA about a service provider, 
staff should: 
 record it in the NDIS business system.
 advise the person to follow the provider’s complaint and feedback processes
in the first instance.
If this has already been done, the person should be told to contact the NDIS Quality 
and Safeguards Commission (NDIS Commission).  
The NDIS Commission regulates the quality and safety of supports and services 
delivered by NDIS providers.  
The NDIS Commission takes complaints about provider services that were not: 
 provided in a safe and respectful way.
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 delivered to an appropriate standard.
People can contact the NDIS Commission by: 
 calling the NDIS Commission on 1800 035 544.
 visiting 
the 
NDIS Commission website.
We have a duty of care to maintain participants’ safety. This may result in a review 
of their plan or supports, or the NDIS Commission may review the service provider’s 
registration.  
The NDIA has a Complaints Handling and Reportable Incidents Arrangements 
Operational Protocol with the NDIS Commission. In some cases, we will transfer 
complaints or collaborate on investigations and resolutions. This may happen when 
a complaint is about a provider or if the issue affects the supports available to a 
NDIS participant.  
The Complaints team handle these issues under the Complaints Handling and 
Reportable Incidents Arrangements Operational Protocol. 
5.2  Serious incidents where abuse, neglect or exploitation is 
suggested  
All NDIA staff must report concerns about abuse, neglect, and exploitation to 
appropriate authorities where: 
 these are observed.
 suspected.
 reported through interactions with participants and service providers.
The Participant Critical Incident Framework and Practice guide outlines this 
process.  
The NDIA Participant Critical Incident team supports the handling of these incidents 
in line with the Complaints Handling and Reportable Incidents Arrangements 
Operational Protocol. 
Where staff have concerns that a person is at immediate risk and they require an 
emergency response,  staff may need to contact emergency services on “000”.  
Where possible, staff should discuss this with their line manager before contacting 
emergency services.   
5.3  Complaints which are outside of the NDIA’s control 
Some feedback and complaints need to be referred to other consumer bodies, 
government, or state authorities to investigate. For example, this could be an issue 
about another government agency.  
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Complaints to the Complaints Resolution and Referral Service (external) can be 
made by clients of services funded by the Department of Social Services (DSS) 
under the Disability Services Act (1986). These services include: 
 Disability Employment Services (DES).
 Australian Disability Enterprises (ADEs).
 Advocacy Services (funded by Department of Social Services).
5.4  External review of how we managed an enquiry, feedback or 
complaint  
If people are not happy with how we managed their enquiry, feedback, or complaint 
they can contact the Commonwealth Ombudsman by:   
 calling the office of the Ombudsman on 1300 362 072.
 visiting 
the 
Ombudsman website.
5.5  External review of our decisions  
If people are not happy with our decision, they may consider options to review our 
decision.  
If a person is not satisfied with the outcome of an internal review, they can apply for 
a review by the Administrative Appeals Tribunal (AAT). This is an independent 
tribunal.   
People cannot ask the AAT to review a ‘reviewable decision’ until the decision has 
been internally reviewed by the NDIA.  
Information about the AAT review process can be found at AAT: National Disability 
Insurance Scheme applicants website or by calling 1300 366 700.  
6. Privacy
6.1  Handling of personal information requirements  
All enquiries, feedback and complaints must be managed in line with the NDIA’s 
Privacy policy. All staff must comply with their obligations under the: 
 Privacy Act 1988 (Cth).
 National Disability Insurance Scheme Act 2013 (Cth).
This protects all records with personal information from unauthorised access, 
misuse, interference, loss, or disclosure. 
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NDIA staff and partners in the community must follow the Your Privacy and 
Information Guideline when handling personal information within an enquiry, 
feedback or a complaint.   
6.2  Authorised representatives and consent requirements  
Staff must ensure that the person raising the issue or concern is: 
 an authorised representative, or
 has the relevant consent to act on behalf of the applicant or participant, or
 has the relevant consent to get information about the participant in relation to
the issue being raised.
More information about consent can be found in the Check consent, nominee, child 
representative or self-representation authorities (Knowledge Article). 
It is important to tell people that while some issues can still be progressed without 
consent, it will limit the information that can be given to the person raising the issue 
or concern.  
6.3 Raising 
complaints 
and feedback anonymously  
It is critical that people feel safe to raise issues with the NDIA. We must ensure 
people know and understand there will be no negative consequences if they choose 
to raise a complaint with us. In some instances, people will choose to remain 
anonymous.  
We respect people’s right to make anonymous complaints and feedback. Sometimes 
to investigate an issue or concern we may need to establish and disclose a person’s 
identity to the NDIA staff member who is resolving the issue.  
Where a person expresses their wish to remain anonymous, we must tell them that 
the NDIA may not be able to fully respond to their complaint without establishing 
their identity.  
7. Continuous improvement
Enquiries, complaints, and feedback provide an opportunity to learn from consumers 
and enhance business practices and processes. Continuous improvement is an 
ongoing cycle of identifying and acting on opportunities to improve. 
The NDIA improves complaints reporting by implementing: 
 consistent work practices.
 consistent records management across the NDIA.
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Official 
Complaints Quality Framework 
Contents 
Purpose ..................................................................................................................................... 2 
Complaints Quality Framework Goals and Objectives .............................................................. 2 
Complaints Quality Framework Overview ................................................................................. 2 
Complaints Quality Checking Stages ........................................................................................ 4 
Self- Assessment Quality Checklist .......................................................................................... 4 
Pre-completion Checks ............................................................................................................. 4 
Post-completion Checks ........................................................................................................... 5 
Ongoing improvement of the Quality Checking Process........................................................... 6 
Version control .......................................................................................................................... 6 
Self-Assessment Quality Checklist ........................................................................................... 8 
Appendix One – Complaints Resolution ................................................................................... 8 
Appendix Two – Member and Senator Complaints Officers (MaSCO) ................................... 19 
Appendix Three – Ministerial External Response ................................................................... 28 
Appendix Four – Executive Complaints .................................................................................. 37 
Appendix Five – Oversight Bodies Complaints ....................................................................... 45 
Appendix Six – Informal Ministerial Response ........................................................................ 62 
Appendix Seven – Participant Critical Incident ....................................................................... 70 
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Purpose 
The NDIA Corporate Plan 2021-25 sets out the aspiration of providing a quality 
experience and improved outcomes for participants. The Corporate Plan is underpinned 
by the Participant Service Charter, the Participant Service Guarantee and the Participant 
Service Improvement Plan, which support improved quality and consistency in how the 
NDIA delivers services.  
The NDIA is committed to learning from complaints and feedback. Managing complaints 
effectively, helps provide a better experience for Participants and other stakeholders 
when something has gone wrong, or we have not met community expectations. What we 
learn from complaints and feedback helps the NDIS improve. What we learn from how 
we  manage complaints and feedback informs our continuous improvement process in 
managing complaints. 
The Complaints Quality Framework sets out the quality expectations and checking 
processes for NDIS complaints management that support the National Disability 
Insurance Agency (NDIA) to provide a quality experience and improved outcomes for 
participants. 
Complaints Quality Framework Goals and Objectives 
The Complaints Quality Framework aims to ensure: 
 The NDIA has a complaints management process that meets community and
participant expectations and that strives to achieve best practice in complaints
handling.
 That managing complaints is in adherence with approved Standard Operating
Procedures (SOPs), other guiding material, the Complaints Management
Framework and within legislative parameters listed on Complaints and Feedback
intranet page. We identify and fix issues that affect resolution of complaints.
 Complaints management processes are up-to-date and continually improved.
 Complaints Officers have the right skills and knowledge to do their job.
 Complaint recording Systems are fit-for-purpose.
Complaints Quality Framework Overview 
The Complaints Quality Framework supports procedural compliance through established 
processes to ensure employees are following and undertaking correct actions. 
The quality measures for managing complaints within the NDIA are based on four key 
focus areas of compliance.  
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*This same checklist is used for both the pre-completion and post-completion checks.
Complaints Quality Checking Stages  
Details regarding the three stages in the Framework: 
1. Self-Assessment
Complaints Officers undertake self-assessment against the Quality Check Criteria
in relation to their own work as required.  This is a resource they can use to self-
assess their performance and as they are completing their day to day work.
2. Pre-Completion Checks
Senior Complaints Officers, Team Leaders and Assistant Directors undertake pre-
completion checks to monitor proficiency of new and developing Complaints
Officers or where individuals require additional support to achieve quality
expectations. A minimum of 10 checks will be undertaken, and 80% proficiency
achieved before moving to independent complaints management. The
requirement for further pre-completion checks will be considered depending on the
new or independent Complaints Officer’s progress.
3. Post-completion Checks
Post-completion checking is undertaken using a random sample to inform
individual coaching and continuous improvement. An average of at least one check
per week is undertaken for Complaints Officers and these are completed by Senior
Complaints Officers, Team Leaders, and Assistant Directors.  The Business
Improvement Team will provide a report including trends and monitor continuous
improvement suggestions arising from the reports. The overall results are
discussed in team meetings.
Self- Assessment Quality Checklist 
 Self-assessment against quality check criteria will familiarise Complaints Officers
with the quality checking process and quality measures in the Complaints Quality
Framework.
 The quality check criteria is based on the relevant complaints SOPs and required
process steps in relevant complaints guidance material.
 The Quality Self-Assessment quality checklist includes detailed instructions for its
completion.
 New Complaints Officers can use the quality checklist to support compliance with
complaints processes during the learning phase.
 Experienced Complaints Officers can use the quality checklist to self-asses their
own work.
Pre-completion Checks 
 Pre-completion checks will be used for all new Complaints Officers, until
procedural proficiency is established. It is recommended that as a minimum, pre-
completion checks are undertaken for the first 10 complaints, including prior to
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using the Request for Action (RFA) and communicating a resolution to the 
complainant. 
 When a new Complaints Officer has reached a minimum of 80% compliance
across at least ten checks, they will progress to post-completion checking at the
same rate as other team members.
 New Complaints Officers should be provided with the opportunity to manage
different complaint themes to facilitate a broad understanding of NDIS complaints
and gaining experience with different processes. For example: Delays with
Assistive Technology, Payment Enquiries, Staff complaints and Delays with Plan
Approval.
 The Pre-completion Checks will use the same checklist in the Self-Assessment
Quality checklist.
 Pre-completion checks may be re-implemented for experienced Complaints
Officers where post-checking has identified ongoing quality issues.
Post-completion Checks 
 Following completion of Pre-completion Checks (where required), post-completion
checking will commence.
 The Post-completion checks will use the same checklist as used for Self-
Assessment Quality Checklist as well as for Pre-completion checks.
 Each month at an agreed timeframe, the Data and Analytics Team within the
Internal Review and Complaints Branch, will provide a random sample of
complaints closed in the previous month to the team responsible for conducting
post-completion checks.
 The Post-completion checking will be conducted by Senior Complaints Officers,
Team Leaders and Assistant Directors and entered on an online form.
 Post-completion checking will be a minimum of one per FTE per week or pro-rata.
 The Business Improvement Team will collect and collate data entered via the
online form and store securely.
 Monthly reports will be provided to Directors with details of individual and team
results. Directors will use high-level insights from reporting for discussion at team
meetings.
 Where ongoing quality issues are identified in post-completion checks, pre-
completion checking may be undertaken to address skills or knowledge gaps.
 Where pre-completion checks are re-implemented, additional support will be
provided to the Complaints Officer by their Team Leader/Assistant Director to
assist them in achieving quality outcomes.
 Individual feedback from Quality checking identified through post-completion
checking will be provided by Team Leaders and Assistant Directors in coaching
sessions.
 If a Complaints Officer requires further explanation or would like a quality check
decision reviewed, they should discuss with their Team Leader or Assistant
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Self-Assessment Quality Checklist 
Appendix One – Complaints Resolution 
 
 
Quality 
Q  Mandatory Steps  Evidence 
Guidance Considerations 
Response 
Area 
Options 
Right 
1  Has the complaint 
• Timeframe for contact to be made is 
• Timeframe for acknowledgment to be 
Yes/No/NA 
person 
been acknowledged 
48 hours from receipt of complaint.  
made within 48 hours from receipt of 
 
within the stream 
• Contact is made by email using a 
complaint by return email using the 
specific timeframe? 
complaint acknowledgement template  template in the SOP.  
unless phone call is the preferred 
• Check the My NDIS Interactions for 
method of contact.  
acknowledgement • Check My Customer 
Participant Service Guarantee 48 
Requests/My Documents tab for evidence 
hours but there are some stream 
of acknowledgement email sent.  
specific timeframes. 
• Date recorded in My Customer Request 
record ‘First Contact Date’ field and noted 
in Outcomes.  
• Check complaint email uploaded into My 
Customer Requests Attachments. 
2 Confirm appropriate • Third Party Consent required if 
• Is there evidence of consent on file to 
Yes/No/NA 
consent.  
complainant is not the 
investigate and resolve the complaint 
Participant/Child Rep or Nominee. 
under Details tab/Consent? 
• Interaction outlining that consent was  • Review interactions to ensure consent 
obtained if the complainant is not the  present for progress of the complaint. 
Participant/Plan Nominee.  
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Quality 
Q  Mandatory Steps  Evidence 
Guidance Considerations 
Response 
Area 
Options 
SOP Resolving Complaints 4.1 
Consent and Privacy 
3  POI checked for 
• Proof of identity required if 
• Interaction on record advising that POI 
Yes/No/NA 
initial contact – 
complainant is the Participant/Child 
checked in any phone contact 
complainant is 
Rep or Nominee and is contacted by 
participant or 
phone. 
nominee. 
SOP Resolving Complaints 4.1 
Consent and Privacy; 
 
SOP Record and verify identity for 
an individual 3.3 Verify identity 
Right 
4  Has the participant 
• If not appropriate or sensitivities 
• Check the My Customer Requests tab, 
Yes/No/NA  
Process 
record been linked 
involved to link participant/NA/provider  selecting “Categorisation” and then 
 
appropriately to the 
ensure that CR guidance was followed  “Related Parties” to confirm that the 
Complaint? 
for a 'Y' outcome.  
participant has been linked to the 
• Only one participant or provider 
Complaint.  
should be linked to a complaint in 
• Ensure that correct Participant has been 
CRM to ensure privacy of all 
linked. 
participants.  
• Check My NDIS Interaction is linked to 
SOP Resolving Complaints 4.3.2 
complaint and correct interaction 
Related Parties 
categories have been selected.  
5  Where there are 
• If no repeat complaint is on file 
• Check the participant/provider record for 
Yes/No/NA 
repeat complaints, 
response to question should be 'Y'.  
history of complaints.  
has the complaint 
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Quality 
Q  Mandatory Steps  Evidence 
Guidance Considerations 
Response 
Area 
Options 
been allocated to the  • If more than one complaint opens 
• Has complaint been assigned to 
appropriate 
about the same issue ensure that it is 
Complaints Officer who has previously 
complaints officer? 
clear who will manage all/ part of the 
dealt with complaint?  
complaint. The agreement must be 
All streams:  
documented within the complaint. 
• If there is more than one open complaint 
SOP Resolving Complaints 4.2 
about the same issue check instruction in 
Complaint assignment in CRM 
SOP Resolving Complaints 4.2 Complaint 
assignment in CRM.  
• If more than one complaint open check 
notes to identify negotiation of lead CO 
and has been recorded using Interaction 
template.  
• Check My Customer Request Record 
Outcome notes updated to reflect contact 
with complaints officer. 
6 Right 
issue/s 
• Key issues of the complaint are clear  • CRM Interaction as per template guide 
Yes/No/NA 
identified from the 
and have been confirmed with the 
outlining initial contact (phone or email) -– 
  
Complaint? 
complainant.  
with complaint issues identified and 
SOP Resolving Complaints 4.3 
communicated.  
Preliminary Investigation 
• Check that CO has identified key issues 
of the complaint and complaint has been 
thoroughly investigated. 
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Quality 
Q  Mandatory Steps  Evidence 
Guidance Considerations 
Response 
Area 
Options 
7 Risk 
correctly 
• Where a Complaints Officer
• Level 2 complaints have had risk
Yes/No/NA  
identified and 
ascertains complaint should have a
assessed by NCC. Where this is incorrect
reasoning recorded. 
high/extreme risk has the complaints
CO should check or update after speaking
officer alerted Team Leader/Assistant
with T/L or AD and add note to Outcome
Director and coded risk in complaint
Notes.
appropriately.
• An initial risk assessment has been
completed during the triage step at the
National Contact Centre (NCC) or
Track and Triage team (TTT) level.
Level 3 streams determine risk
according to Risk Prioritisation Matrix
but no guidance in SOP’s.
8 Initial 
contact/contact • Contact is made by using the
• Check interactions for evidence of SMS
Yes/No/NA 
attempts. 
participant’s preferred method of
alert prior to every contact.
contact.
• Check Interactions for evidence of
• Three documented contact attempts
successful contact, with interaction linked
with dates & times interaction
to complaint and correct interaction
templates used to record contact
categories have been selected.
made with complainant in My NDIS
• Check My Customer Request record for
Interactions and linked to My
evidence of outcome notes being updated
Customer Request If relevant, email
to reflect contact attempts/contact.
exchange uploaded into Attachments
• Review My NDIS Interactions/My
in My Customer Request complaint.
Customer Request Integrations to ensure
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Quality 
Q  Mandatory Steps  Evidence 
Guidance Considerations 
Response 
Area 
Options 
SOP Resolving Complaints 4.4.3 
communications linked and SOP has been 
When contact is established; and  
followed. 
Complaints Resolution and 
Oversight Template Guide 
9  Unable to Contact 
• Three documented contact attempts 
• Check for evidence of three genuine 
Yes/No/NA  
guidance followed. 
with dates & times Interaction 
attempts to contact the complainant using 
templates used to record contact 
their preferred communication channel. 
made with complainant in My NDIS 
• Check that if unsuccessful, an email was 
Interactions and linked to My 
sent. However, if the complainant's 
Customer Request. 
preferred contact method is email then an 
SOP Resolving Complaints 4.4.4 
email is sent as first attempt of contact. 
Unable to Contact 
10 Confirm 
Complaint 
• Ensure all fields completed in the My  • Categorisation is as per the data 
Yes/No/NA  
recorded correctly in  Customer Requests tab in CRM 
dictionary. 
accordance with 
following guidance in Data Dictionary 
• Fields/information/attachments have 
CMT Guidance 
and SOP. 
been entered as per the SOP. 
Material. 
• Complaint closed following all 
• Relevant drop-down options selected in 
requirements outlined in SOP. 
Categorisation, Overview and Outcomes 
Record Update a Complaint 3.2 
tabs. 
Record a new complaint; and 
 
Data Dictionary for My Customer 
Request App 
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Quality 
Q  Mandatory Steps  Evidence 
Guidance Considerations 
Response 
Area 
Options 
Right 
11 The 
referral 
• Clarity of outstanding issues 
Focus is on process: 
Yes/No/NA  
Referral 
(RFA/PE/Staff 
requiring referral for resolution.  
• Have issues been clearly identified in 
complaints) process 
• Review that it is within the scope of 
RFA and appropriate action has been 
was correctly 
the business area to be able to resolve  requested to address these issues?  
followed and to the 
the relevant type of complaint. Use 
• Has RFA been endorsed by SCO/TL and 
appropriate area via 
Action Assignment Contact list for 
endorsement email attached to complaint? 
the appropriate 
reference. 
channel.  
• Has the RFA been sent to the appropriate 
• Has the complaints Officer 
business area?   
 
responsible forwarded the referral to 
 
the correct business area using the 
correctly requested channels i.e. 
(RFA/Email). 
As appropriate: 
SOP Resolving Complaints 4.5 
Request for Action; 
 
SOP Resolving Complaints 4.5.1 
Agency and Partner staff 
complaints; 
 
SOP Resolving Complaints 4.6 
Payment Enquiries. 
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Quality 
Q  Mandatory Steps  Evidence 
Guidance Considerations 
Response 
Area 
Options 
 
12  Request for action 
• If not required ensure that the stream  Focus is on template use: 
Yes/No/NA  
(RFA) or Payment 
guidance was followed for a 'Y' 
• Has the RFA been sent to business area 
Enquiry (PE) 
outcome.  
within identified KPI?  
template accurately 
• Where an RFA is required the 
• Check My Customer Requests tab, 
followed?  
 
Complaints Officer is responsible for 
selecting outcome to see notes showing 
following the appropriate template 
date RFA was sent to team.  
accurately. 
• For on-system RFAs check RFA tab to 
• Ensure Payment Enquiry process 
see date it was sent to business area. For 
followed if relevant. 
off-system RFAs check attachments.            
SOP Resolving Complaints 4.5 
• Does the RFA follow the RFA template as 
Request for Action; 
per SOP and if email notification is 
Complaints Resolution and 
required does it follow RFA email template 
Oversight Template Guide; 
as per SOP.  
 
• Ensure Payment Enquiry process 
Standard Operating Procedure - 
followed 
Enter Escalation Payment Enquiry 
in NDIS Business System. 
 
13  Has RFA/PE follow 
• If not required ensure that the stream  • Check My Customer Requests tab, 
Yes/No/NFA  
up occurred with 
guidance was followed for a 'Y' 
selecting Outcome to see notes showing 
business area if 
outcome.  
follow up with business area if RFA due 
required? 
• Complaints Officers may need to 
date passed.  
follow up with the business area for a 
• An interaction will be recorded detailing 
response if not received by due date. 
that a follow-up to the RFA has been sent.  
Should a response not be received 
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Quality 
Q  Mandatory Steps  Evidence 
Guidance Considerations 
Response 
Area 
Options 
after an email reminder is sent, the 
• A copy of the Email requesting escalation 
response request is to be escalated. 
is available in the record. 
• An escalated RFA is sent when an 
RFA is returned Unresolved, additional 
info required, has not adequately 
addressed concerns and RFA is 
overdue and followed up at least once 
to the escalation person noted in the 
Request for Action Assignment 
Contacts List. 
Request for Action Assignment 
Contacts List; 
 
SOP Resolving Complaints 4.5.7 
Request for Action Escalation; Or 
 
SOP Enter Escalations Payment 
Enquiry 6.6 Receiving a response 
from the Payments Escalation 
Team. 
Right 
14  All issues within the 
• Complaint resolution considers the 
• The intent is not to determine the quality 
Yes/No/NA 
Resolution 
 
complaint have been  elements of the complaint and the 
of the resolution but to ensure that all 
 
addressed.  
requested outcome.  
issues have been addressed. 
 
   
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Quality 
Q  Mandatory Steps  Evidence 
Guidance Considerations 
Response 
Area 
Options 
• The requested outcome may not be 
• Have the issues identified in the 
possible however all matters must be 
complaint been discussed with 
discussed, reasoning explained and/or  complainant and resolved? 
attempted resolution with the 
• Where some action cannot be completed 
complainant.  
has this been explained in the response 
SOP Resolving Complaints 4.1 – 4.7  and in outcome notes? 
• Have appropriate interactions/notes been 
recorded to reflect the action taken?  
15 Closure 
steps 
• Closure steps followed as per the 
Review the process used in complaints 
Yes/No/NA 
followed? 
Resolving Complaints SOP and 
management. Closure steps include: 
 
   
completed in CRM.  
• Clear summary of actions taken, and 
• All relevant NDIA guidance material 
resolution reached  
has been followed such as template 
• All supporting documents relevant to the 
from Complaints Resolution and 
complaint are correctly attached to the 
Oversight template guide. 
complaint 
SOP Resolving Complaints 4.8 
• Interactions linked to the Complaint; 
Closing complaint item; 
• All RFAs completed and closed; 
 
• Evidence recorded that the Complainant 
Data Dictionary for My Customer 
has been advised of the closure of the 
Request App; 
complaint except in case of Escalated and 
 
Persistent complainant 
SOP Enter Escalations Payment 
• Complaint appropriately closed in system 
Enquiry in NDIS Payment System; 
• Ensure the record contains a summary 
 
brief outline of the complaint and outcome. 
V3.4                             Complaints Quality Framework and Checklist                                   16 
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Quality 
Q  Mandatory Steps  Evidence 
Guidance Considerations 
Response 
Area 
Options 
SOP Record Update a Complaint; 
•  All interactions have been recorded in a 
Complaints Resolution and 
respectful and professional manner 
Oversights Template Guide. 
• Ensure all attachments have been 
uploaded to My customer 
Requests/Attachments tab 
16  Follow up interaction  • A follow up interaction is required 
• Follow up interaction created with 
Yes/No/NA 
recorded where 
when a complaint has been closed but  appropriate due dates and linked to My 
 
necessary? 
the business area indicated there were  Customer Request record.  
actions outstanding beyond the date of  • Where complaint was closed but further 
closure.  
actions required to ensure complaint is 
• It is important to review the 
fully resolved I.e. action is required beyond 
interactions following the due date for 
the due date of the complaints. Ensure that 
evidence that the business area took 
follow-up process was created. 
V3.4                             Complaints Quality Framework and Checklist                                   17 
Page 38 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q  Mandatory Steps  Evidence 
Guidance Considerations 
Response 
Area 
Options 
the required action OR the Complaints  • Where Ongoing Monitoring has been 
Officer followed up on completion of 
closed appropriate interaction detailing the 
the item and that the participant has 
outcome are recorded. 
been advised of this. 
SOP Resolving Complaints 4.7 
Follow-up Process 
 
 
 
V3.4                             Complaints Quality Framework and Checklist                                   18 
Page 39 of 98
 

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Official 
 
Appendix Two – Member and Senator Complaints Officers (MaSCO) 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
  
1  Has the My 
MaSCO complaint follows: Members 
• Categorisation is as per the  Yes/No/NA 
Right 
Customer Request 
and Senators Contact Officer Creating  data dictionary 
Intake 
record been entered 
a My Customer Request Record in 
• Correct participant/provider 
Process 
correctly? 
CRM and Member and Senators 
record has been linked  
Contact Officer Triaging and Allocating  • 
Representations SOP 
Fields/information/attachment
https://intranet.ndiastaff.ndia.gov.au/se s have been entered as per 
rvice-delivery/complaints  
the SOP 
 
2  Has correct Senior 
MaSCO complaint follows: Member 
• Check the 
Yes/No/NA 
Complaints Officer 
and Senators Contact Officer Triaging  participant/provider record for 
been assigned? 
and Allocating Representations SOP 
history of complaints.  
https://intranet.ndiastaff.ndia.gov.au/se • If complaints have been 
rvice-delivery/complaints 
received within past 6 weeks, 
same Senior Complaints 
Officer is assigned.  
• If repeat complaints 
received, same Senior 
Complaints Officer is 
assigned who has previously 
dealt with complaint. 
V3.4                             Complaints Quality Framework and Checklist                                   19 
Page 40 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
3  Has the complaint 
MaSCO complaint follows: Member 
• Date recorded for 
Yes/No/NA   
been acknowledged 
and Senators Contact Officer Triaging  acknowledgement in My 
within one business 
and Allocating Representations SOP 
Customer Requests record 
day of receipt? 
https://intranet.ndiastaff.ndia.gov.au/se ‘Outcome Notes’ is within one 
rvice-delivery/complaints 
business day.  
• Date recorded in My 
Customer Request record 
‘First Contact Date’ field is 
within one business day.  
• Email attached in My 
Customer Requests linked 
documents sent date aligns 
with dates recorded in above 
fields and is within one 
business day. 
 
4  Has the one day 
MaSCO complaint follows: Members 
• Check the linked documents  Yes/No/NA 
 
acknowledgement 
and Senators Contact Officer 
to the My Customer 
 
been completed 
Managing a Complaint SOP 
Requests/Feedback tab or 
correctly? 
https://intranet.ndiastaff.ndia.gov.au/se the My Documents tab for 
 
rvice-delivery/complaints 
evidence of the 
 
acknowledgement email sent 
 
and confirm the SOP has 
 
been followed (i.e., correct 
template has been used).  
V3.4                             Complaints Quality Framework and Checklist                                   20 
Page 41 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
 
*If high/extreme risk, has 
 
RFA been sent prior to 
Right 
acknowledgement email 
person 
being sent as per SOP.  
  
5  Has POI and/or 
MaSCO complaint follows: Members 
• Is there consent and if not 
Yes/No/NA 
 
consent been 
and Senators Contact Officer 
has it been sought?  
  
confirmed? 
Managing a Complaint SOP 
• Has POI been completed 
https://intranet.ndiastaff.ndia.gov.au/se (phone call acknowledgement 
rvice-delivery/complaints 
only)  
• Review interactions to 
ensure the SOP has been 
followed. 
6  Has contact with the 
MaSCO complaint follows: Members 
• Check Interactions for 
Yes/No/NA 
complainant 
and Senators Contact Officer 
evidence of contact attempts 
occurred within two 
Managing a Complaint SOP 
and/or successful contact, 
business days? 
https://intranet.ndiastaff.ndia.gov.au/se interaction is linked to 
rvice-delivery/complaints 
complaint and correct 
interaction categories have 
been selected.  
• Check My Customer 
Request record for evidence 
of outcome notes being 
updated to reflect contact 
attempts/contact.  
V3.4                             Complaints Quality Framework and Checklist                                   21 
Page 42 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
• Review interactions/My 
Customer Request record to 
ensure the SOP has been 
followed. 
 
7  Has contact been 
MaSCO complaint follows: Members 
• If more than one complaint 
Yes/No/NA 
made with other COs  and Senators Contact Officer 
open has Senior Complaints 
if duplicate 
Managing a Complaint SOP 
Officer approached other 
https://intranet.ndiastaff.ndia.gov.au/se
complaints? 
rvice-delivery/complaints 
Complaints Officers 
assigned?  
 
• Check My Customer 
Request record for evidence 
of outcome notes being 
updated to reflect contact 
with complaints officer. 
 
8  Has a weekly update  MaSCO complaint follows: Members 
• Check My Customer 
Yes/No/NA 
been provided? 
and Senators Contact Officer 
Requests tab, selecting 
Managing a Complaint SOP 
‘outcome’ to see date of 
https://intranet.ndiastaff.ndia.gov.au/se
rvice-delivery/complaints 
update.  
• Check the linked documents 
to the My Customer 
Requests/Feedback tab or 
the My Documents tab for 
evidence of the update email 
sent and confirm the SOP 
has been followed (i.e., 
V3.4                             Complaints Quality Framework and Checklist                                   22 
Page 43 of 98
 

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Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
correct template has been 
used).  
 
9  Has RFA been 
MaSCO complaint follows: Members 
• Have issues raised in 
Yes/No/NA 
submitted? 
and Senators Contact Officer 
complaint been thoroughly 
   
Managing a Complaint SOP and 
investigated and has an RFA 
Member and Senators Contact Officer  been submitted? 
Off-System RFA Template 
Right 
10 Accurate 
MaSCO complaint follows: Members 
• Have issues been clearly 
Yes/No/NA 
Referral 
identification of 
and Senators Contact Officer 
identified in RFA and 
  
 
referral reason and 
Managing a Complaint SOP and 
appropriate action has been 
correct business 
Member and Senators Contact Officer  requested to address these 
area for action. 
Off-System RFA Template and  
issues?  
Request for Action Assignment 
• Has the RFA been sent to 
Contacts List  
the appropriate business 
https://intranet.ndiastaff.ndia.gov.au/se area?  
rvice-delivery/complaints  
• Are the timeframes in the 
RFA in line with the risk 
identified? 
11  RFA sent within KPI?  MaSCO complaint follows: Members 
• Has the RFA been sent to 
Yes/No/NA 
and Senators Contact Officer 
business area within 
  
Managing a Complaint SOP and 
identified KPI?  
Member and Senators Contact Officer  • Check My Customer 
Off-System RFA Template 
Requests tab, selecting 
outcome to see notes 
V3.4                             Complaints Quality Framework and Checklist                                   23 
Page 44 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
showing date RFA was sent 
to team.  
• For on-system RFAs check 
RFA tab to see date it was 
sent to business area. For 
off-system RFAs check 
attachments. 
12  Request for action 
MaSCO complaint follows: Members 
• Does the RFA follow the 
Yes/No/NA 
(RFA) or Payment 
and Senators Contact Officer 
RFA template as per SOP 
   
Enquiry template 
Managing a Complaint SOP and 
and if email notification is 
accurately followed. 
Member and Senators Contact Officer  required does it follow RFA 
Off-System RFA Template  
email template as per SOP.  
https://intranet.ndiastaff.ndia.gov.au/se • Ensure Payment Enquiry 
rvice-delivery/complaints 
process followed 
 
13  Has follow up 
MaSCO complaint follows: Members 
• Check My Customer 
Yes/No/NA  
occurred with 
and Senators Contact Officer 
Requests tab, selecting 
  
business area if RFA  Managing a Complaint SOP 
outcome to see notes 
due date has 
https://intranet.ndiastaff.ndia.gov.au/se showing follow up with 
passed? 
rvice-delivery/complaints 
business area if RFA due 
date passed. 
V3.4                             Complaints Quality Framework and Checklist                                   24 
Page 45 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
Right 
14 Reasonable 
MaSCO complaint follows: Members 
• Have the issues identified in  Yes/No/NA 
Resolution 
resolution of 
and Senators Contact Officer 
the complaint been 
complaint? 
Managing a Complaint SOP 
addressed?  
https://intranet.ndiastaff.ndia.gov.au/se • Was the requested action in 
rvice-delivery/complaints 
the RFA completed? 
• Have the actions been 
explained in the response to 
the MP/Senator and relevant 
detail provided addressing 
why these are the appropriate 
actions?  
• Have appropriate 
interactions/notes been 
recorded to reflect the action 
taken?  
• Where some action cannot 
be completed has this been 
explained in the response 
and in outcome notes?  
• Have appropriate next steps 
been provided in response to 
MP/Senator where 
applicable? 
Right 
15 Closure 
steps 
MaSCO complaint follows: Members 
Closure steps include: 
Yes/No/NA 
Resolution 
followed? 
and Senators Contact Officer 
V3.4                             Complaints Quality Framework and Checklist                                   25 
Page 46 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
Managing a Complaint SOP 
• All 
  
https://intranet.ndiastaff.ndia.gov.au/se correspondence/conversation
rvice-delivery/complaints 
s recorded and uploaded to 
appropriate area in CRM; 
• All Interactions linked to the 
Complaint; 
• All RFAs completed and 
closed; 
• Clear expectations provided 
to MP/Senator regarding the 
closure of complaint; 
• Apply detailed Outcome 
Notes and change status of 
Complaint to Closed.  
• Ensure the My Customer 
Request record has been 
updated to provide a brief 
outline of the complaint and 
outcome. 
• Has the complaint been 
closed within 21 days? 
 
16  Follow up recorded 
MaSCO complaint follows: Members 
• Create follow up interaction 
Yes/No/NA 
where necessary? 
and Senators Contact Officer 
in CRM for actions unlikely to   
Managing a Complaint SOP 
be completed by complaint 
 
due date;                           
V3.4                             Complaints Quality Framework and Checklist                                   26 
Page 47 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
https://intranet.ndiastaff.ndia.gov.au/se • Where complaint was 
  
rvice-delivery/complaints 
closed but there were further 
actions required to ensure 
complaint is fully resolved 
i.e., action is required beyond 
the due date of the complaint 
(s100 completed, plan 
approved following escalated 
s48, plan implemented 
following escalated approval). 
Follow up interaction created 
with appropriate due dates 
and linked to My Customer 
Request record.  
• Follow Up created as per 
SOP. 
 
17  Follow up interaction  MaSCO complaint follows: Members 
• Where complaint was 
Yes/No/NA 
closed? 
and Senators Contact Officer 
closed with follow up 
   
Managing a Complaint SOP 
interaction, interaction was 
https://intranet.ndiastaff.ndia.gov.au/se closed within due date or 
rvice-delivery/complaints 
notes provided as to further 
follow up if unable to be 
closed by due date.  
• Where appropriate 
MP/Senator’s office has been 
provided update and follow 
V3.4                             Complaints Quality Framework and Checklist                                   27 
Page 48 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
up interaction notes this 
action. 
  
 
Appendix Three – Ministerial External Response 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
Right 
1 
Has the My 
• Ensure all fields completed in the My  • Categorisation is as per the  Yes/No/NA  
Intake 
Customer Request 
Customer Requests tab in CRM 
data dictionary. 
Process 
record been entered 
following guidance in Data Dictionary 
• Correct participant/provider 
 
correctly? 
and SOP. 
record has been linked (Only 
 
• Complaint closed following all 
1 participant should be linked 
requirements outlined in SOP. 
to any one complaint in CRM 
Record Update a Complaint 3.2 
to ensure privacy of all 
Record a new complaint; and 
participants). 
Data Dictionary for My Customer 
• Fields/information/ 
Request App 
attachments have been 
entered as per the SOP. 
2 
Has the complaint 
Participant Service Guarantee 48 
• Date recorded for 
Yes/No/NA  
been acknowledged 
hours but there are some stream 
acknowledgement in My 
within two business 
specific timeframes. 
Customer Requests record 
days of receipt? 
V3.4                             Complaints Quality Framework and Checklist                                   28 
Page 49 of 98
 

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Disclosure Log - FOI 24/25-1037
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
 
‘Outcome Notes’ is within two 
business days.  
• Date recorded in My 
Customer Request record 
‘First Contact Date’ field is 
within two business days.  
• Email attached in My 
Customer Requests linked 
documents sent date aligns 
with dates recorded in above 
fields and is within two 
business days (Contact is 
made by email generally 
unless it is noted on the file 
that a phone call has been 
requested). 
3 Has 
correct 
SOP Resolving Complaints 4.2 
• Check the 
Yes/No/NA 
Complaints Officer 
Complaint assignment in CRM 
participant/provider record for 
been assigned? 
history of complaints.  
• If more than one complaint 
open, ensure the issues are 
appropriately consolidated 
and that it is clear who will 
manage which part of the 
complaint.  
V3.4                             Complaints Quality Framework and Checklist                                   29 
Page 50 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
• Check the linked documents 
to the My Customer 
Requests/Feedback tab or 
the My Documents tab for 
evidence of the 
acknowledgement email sent 
and confirm the SOP has 
been followed (i.e., correct 
template has been used).  
*If high/extreme risk, has the 
complaint been escalated to 
TL or AD as per SOP. 
Right 
5 
Has POI or consent 
• Is there consent and if not has it 
• Is there evidence of consent  Yes/No/NA  
person 
been confirmed?  
been sought?  
on file to investigate and 
 
 
• Review interactions to ensure the 
resolve the complaint under 
SOP has been followed. 
Details tab/Consent. 
SOP Resolving Complaints 4.1 
• Has POI been completed 
Consent and Privacy 
(phone call acknowledgement 
only) or Third Party Consent 
document in Inbound Docs? 
• Review interactions to 
ensure the SOP has been 
followed 
V3.4                             Complaints Quality Framework and Checklist                                   30 
Page 51 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
Right 
6 
Has contact with the 
• Contact is made by using the 
• Check Interactions for 
Yes/No/NA  
Complaint 
complainant 
participant’s preferred method of 
evidence of contact attempts 
Managem
occurred during the 
contact.  
and/or successful contact, 
ent 
complaint 
• Three documented contact attempts 
interaction is linked to 
Process 
management 
with dates & times interaction 
complaint and correct 
 
process?  
templates used to record contact 
interaction categories have 
made with complainant in My NDIS 
been selected.  
Interactions and linked to My 
• Check My Customer 
Customer Request If relevant, email 
Request record for evidence 
exchange uploaded into Attachments 
of outcome notes being 
in My Customer Request complaint.  
updated to reflect contact 
SOP Resolving Complaints 4.4.3 
attempts/contact.  
When contact is established; and 
• Review interactions/My 
  
Customer Request record to 
Complaints Resolution and 
ensure the SOP has been 
Oversight Template Guide 
followed. 
Three documented contact attempts 
with dates & times Interaction 
templates used to record contact 
made with complainant in My NDIS 
Interactions and linked to My 
Customer Request. 
SOP Resolving Complaints 4.4.4 
Unable to Contact. 
V3.4                             Complaints Quality Framework and Checklist                                   31 
Page 52 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
7 
Has contact been 
SOP Resolving Complaints 4.2 
• If more than one complaint 
Yes/No/NA  
made with other COs  Complaint assignment in CRM. 
open has Senior Complaints 
 
if duplicate 
Officer approached other 
complaints? 
Complaints Officers 
assigned?  
• Check My Customer 
Request record for evidence 
of outcome notes being 
updated to reflect contact 
with complaints officer. 
 
8 
Has RFA been 
As appropriate: 
• Have issues raised in 
Yes/No/NA  
submitted?  
SOP Resolving Complaints 4.5 
complaint been thoroughly 
 
Request for Action; 
investigated and has an RFA 
SOP Resolving Complaints 4.5.1 
been submitted? 
Agency and Partner staff 
complaints; 
SOP Resolving Complaints 4.6 
Payment Enquiries. 
Right 
9 Accurate 
As appropriate: 
• Have issues been clearly 
Yes/No/NA  
Referral 
identification of 
SOP Resolving Complaints 4.5 
identified in RFA and 
 
referral reason and 
Request for Action; 
appropriate action has been 
correct business 
SOP Resolving Complaints 4.5.1 
requested to address these 
area for action. 
Agency and Partner staff 
issues?  
complaints; 
V3.4                             Complaints Quality Framework and Checklist                                   32 
Page 53 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
• SOP Resolving Complaints 4.6 
• Has the RFA been sent to 
Payment Enquiries. 
the appropriate business 
area?  
• Has the risk been assessed 
correctly based on the 
information available as per 
Escalation Prioritisation 
Matrix?  
• Are the timeframes in the 
RFA in line with the risk 
identified? For on-system 
RFAs check RFA tab to see 
date it was sent to business 
area. For off-system RFAs 
check attachments. 
10  Request for action 
SOP Resolving Complaints 4.5 
• Does the RFA follow the 
Yes/No/NA  
(RFA) or Payment 
Request for Action; 
RFA template as per SOP 
Enquiry template 
Complaints Resolution and 
and if email notification is 
accurately followed?  Oversight Template Guide; 
required does it follow RFA 
• Standard Operating Procedure - 
email template as per SOP.  
Enter Escalation Payment Enquiry 
• Ensure Payment Enquiry 
in NDIS Business System. 
process followed 
 
11  Has follow up 
Request for Action Assignment 
• Check My Customer 
Yes/No/NA 
occurred with 
Contacts List; 
Requests tab, selecting 
business area if RFA 
outcome to see notes 
V3.4                             Complaints Quality Framework and Checklist                                   33 
Page 54 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
due date has 
SOP Resolving Complaints 4.5.7 
showing follow up with 
passed? 
Request for Action Escalation; Or 
business area if RFA due 
SOP Enter Escalations Payment 
date passed. 
Enquiry 6.6 Receiving a response 
from the Payments Escalation 
Team. 
Right 
12 Reasonable 
SOP Resolving Complaints 4.1 – 4.7  • Have the issues identified in  Yes/No/NA  
Resolution 
resolution of 
the complaint been 
complaint. 
addressed?  
• Was the requested action in 
the RFA completed? 
• Have the actions been 
explained in the response to 
the MP/Senator and relevant 
detail provided addressing 
why these are the appropriate 
actions?  
• Have appropriate 
interactions/notes been 
recorded to reflect the action 
taken?  
• Where some action cannot 
be completed has this been 
explained in the response 
and in outcome notes?  
V3.4                             Complaints Quality Framework and Checklist                                   34 
Page 55 of 98
 

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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
• Have appropriate next steps 
been provided in response to 
MP/Senator where 
applicable? 
 13 
Closure 
steps 
• SOP CMT Finalising a Ministerial 
Closure steps include: 
Yes/No/NA 
followed? 
Complaint   
• All correspondence/ 
 
• SOP Resolving Complaints 4.8 
conversations recorded and 
 
Closing complaint item. 
uploaded to appropriate area    
• Data Dictionary for My Customer 
in CRM; 
Request App 
• All Interactions linked to the 
• SOP Enter Escalations Payment 
Complaint; 
Enquiry in NDIS Payment System 
• All RFAs completed and 
• SOP Record Update a Complaint 
closed; 
• Complaints Resolution and 
• Create follow up interaction 
Oversights Template Guide. 
in CRM for actions unlikely to 
be completed by complaint 
due date; 
• Clear expectations provided 
to Complainant and 
MP/Senator regarding the 
closure of complaint; 
• Apply detailed Outcome 
Notes and change status of 
Complaint to Closed.  
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
• Ensure the My Customer 
Request record has been 
updated to provide a brief 
outline of the complaint and 
outcome. 
• Has the complaint been 
closed within 21 days? 
 
14  Follow up recorded 
 SOP Resolving Complaints 4.7 
• Where complaint was 
Yes/No/NA  
where necessary.  
Follow-up Process 
closed but there were further 
  
actions required to ensure 
complaint is fully resolved 
i.e., action is required beyond 
the due date of the complaint 
(s100 completed, plan 
approved following escalated 
s48, plan implemented 
following escalated approval). 
• Follow up interaction 
created with appropriate due 
dates and linked to My 
Customer Request record.  
• Follow Up created as per 
SOP. 
 
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Appendix Four – Executive Complaints 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
Right 
1  Has 2 day contact 
Participant Service Guarantee 48 
• Timeframe for 
Yes/No/NA 
Intake 
been completed and  hours but there are some stream 
acknowledgment/contact to 
Process 
recorded correctly 
specific timeframes. 
be made using the template 
 
within timeframes? 
• Ensure that the stream guidance was  in the SOP.  
followed.   
• Check the My NDIS 
 
Interactions for 
CEO Complaints and Advocate 
acknowledgement  
Complaints: 
• Check My Customer 
• Timeframe for contact to be made is 
Requests/My Documents tab 
48 hours from receipt of complaint.  
for evidence of 
acknowledgement email sent.  
• Contact is made by email using a 
complaint acknowledgement template  • Date recorded in My 
unless phone call is the preferred 
Customer Request record 
method of contact. 
‘First Contact Date’ field and 
noted in Outcomes. 
  
• Check complaint email 
Media complaints: 
uploaded into My Customer 
From 2 hours to 1 day depending 
Requests Attachments. 
upon Media Branch request. 
 
2  Has an email 
Check My Customer Requests 
• The Executive Complaints 
Yes/No/NA 
acknowledgement 
Outcome Notes for evidence that an 
team will provide an 
been sent to the 
email was sent to the CEO/SES 
acknowledgement to the 
referring Executive? 
advising that the complaint has been 
Executive office within two 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
received and allocated to a CO as per  business hours noting that a 
SOP: 
complaints officer will move 
Board and Executive Complaints 
forward with this complaint, 
Service Standards 
see templates below. 
 
 
 
3  Has the complaint 
• Ensure all fields completed in the My  • Check fields are completed 
Yes/No/NA 
been recorded in 
Customer Requests tab in CRM 
in the My Customer Requests   
CRM correctly, 
following guidance in Data Dictionary 
tab in CRM, including non-
including the Source  and SOP. 
mandatory fields.  
of Information? 
• Complaint closed following all 
• Categorisation is as per the 
requirements outlined in SOP CMT 
data dictionary 
Investigating, Managing and Closing a  • Correct participant/provider 
Complaint  
record has been linked  
Record Update a Complaint 3.2 
• Fields/information/ 
Record a new complaint; and 
attachments have been 
 
entered as per the SOP. 
Data Dictionary for My Customer 
Request App 
 
4  Has the RFA risk 
Level 3 streams determine risk 
• Executive Complaints have 
Yes/No/NA  
rating been recorded  according to Risk Prioritisation Matrix.  a process in place which 
  
to the RFA tile? 
Process for recording Risk Rating in 
requires us to record the level 
RFA. See: 
of complexity of the complaint 
SOP Executive Complaints - 
in the RFA tile for data 
Receive, Record, Manage and Close 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
2.1 How to record risk rating  
reporting purposes. Open the 
 
Request for Action 
 
 
 5  Where there are 
• If more than one complaint open 
• Check the 
Yes/No/NA 
repeat complaints, 
about the same issue ensure that it is 
participant/provider record for 
has the complaint 
clear who will manage all/ part of the 
history of complaints.  
been allocated to the  complaint. The agreement must be 
• Complaint has been 
appropriate 
documented within the complaint.  
assigned to Complaints 
complaints officer? 
* To avoid duplication, if the complaint  Officer who has previously 
is addressed to multiple areas within 
dealt with complaint.  
the NDIA and it is not yet being 
All streams: 
addressed by any other areas, the 
• If there is more than one 
Executive Complaints inbox manager 
open complaint about the 
will advise that they are managing its 
same issue check instruction 
resolution.  
in SOP Resolving Complaints 
 
4.2 Complaint assignment in 
Executive Complaints - Receive, 
CRM 
Record, Manage and Close  
• If more than one complaint 
1. Receiving a referral in the Exec 
open check notes to identify 
Complaints mailbox – 1.4 
negotiation of lead CO and 
And 
recorded using Interaction 
Board and Executive Service 
template p  
Standards 3.09 Managing Complaints  • Check My Customer 
and Enquiries in collaboration with 
Request record Outcome 
notes updated to reflect 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
other Business Areas including 
contact with complaints 
referrals to other Business Areas 
officer.  
  
6  Has contact been 
• Proof of identity required if 
• Is there evidence of consent  Yes/No/NA 
 
made in line with 
complainant is the Participant/Child 
on file to investigate and 
  
 
valid consent? 
Rep or Nominee and is contacted by 
resolve the complaint?  
phone. 
 
• Has POI been completed 
• Third Party Consent required if 
(phone call acknowledgement 
 
complainant is not the 
only) or Third party Consent 
 
Participant/Child Rep or Nominee  
document in Inbound Docs? 
 
• Interaction outlining that consent was  • Review interactions to 
  
obtained if the complainant is not the 
ensure the SOP has been 
 
Participant/Plan Nominee.  
followed. 
 
• Contact is made by using the 
• Check My Customer 
 
participant’s preferred method of 
Request record for evidence 
contact.  
of outcome notes being 
  
• Appropriate Interaction templates 
updated to reflect contact 
 
should be used to record contact 
attempts/contact.  
 
made with complainant in My NDIS 
• Review My NDIS 
 
Interactions and linked to My 
Interactions/My Customer 
Customer Request  
Request Interactions to 
 
ensure communications 
SOP Resolving Complaints 4.1 
linked and SOP has been 
Consent and Privacy; 
followed. 
 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
SOP Resolving Complaints 4.4.3 
When contact is established; and  
 
Complaints Resolution and 
Oversight Template Guide 
7   Have interactions 
SOP Executive Complaints – 
• Check Interactions for 
Yes/No/NA 
been linked 
Receive, Record, Manage and Close  evidence of contact attempts 
  
correctly? 
2.4 Interactions 
and/or successful contact, 
 
interaction is linked to 
complaint and correct 
interaction categories have 
been selected.  
8  Have the necessary 
• Closure steps followed as per the 
 • Ensure that complaint and 
Yes/No/NA 
documents been 
SOP and reviewed in CRM.  
all attachments have been 
  
attached? 
• All relevant NDIA guidance material 
uploaded to My customer 
has been followed. 
Requests/Attachments tab 
 
• All relevant CMT guidance followed 
• All stream specific guidance 
followed. 
 
SOP Executive Complaints – 
Receive, Record, Manage and Close 
4.1 How to close a complaint  
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
9  Was the complaint 
• Complaint is resolved within PSG 
• Complaint appropriately 
Yes/No/NA 
closed within 21 
Timeframes and/or stream specific 
closed in system within 21 
  
days? 
requirements. 
days of receipt. 
 
 
 
  
 
10  Has the complainant  SOP Executive Complaints – 
• Evidence recorded that the 
Yes/No/NA 
  
been informed the 
Receive, Record, Manage and Close  Complainant agreed to the 
   
 
complaint will now be  4.1 How to close a complaint 
closure of the complaint  
closed? 
• All interactions have been 
conducted and recorded in a 
respectful and professional 
manner. 
11 Is 
the 
Outcome 
SOP Executive Complaints – 
• Ensure the record contains 
Yes/No/NA 
clearly recorded in 
Receive, Record, Manage and Close  a brief outline of the 
   
the Complaint tile? 
4.1 How to close a complaint 
complaint and outcome. 
 
12  Has any necessary 
SOP Executive Complaints – 
•  Feedback provided to 
Yes/No/NA 
feedback been 
Receive, Record, Manage and Close  relevant business area using      
provided to relevant 
4.1 How to close a complaint; 
areas?  
 
Request for Action Assignment 
Contacts List; 
 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
 
13  Has a follow up 
• A follow up interaction is required 
• Where complaint was 
Yes/No/NA 
interaction been 
when a complaint has been closed but  closed but there were further 
recorded if required?  the business area indicated there were  actions required to ensure 
actions outstanding beyond the date of  complaint is fully resolved 
closure.  
i.e., action is required beyond 
• It is important to review the 
the due date of the complaint 
interactions following the due date for 
(s100 completed, plan 
evidence that the business area took 
approved following escalated 
the required action OR the Complaints  s48, plan implemented 
Officer followed up on completion of 
following escalated approval). 
the item and that the participant has 
Check My NDIS Interactions 
been advised of this. 
tab: 
 
• Follow up interaction 
SOP Resolving Complaints 4.7 
created with appropriate due 
Follow-up Process 
dates and linked to My 
Customer Request record.  
• Follow Up created as per 
SOP. 
• Where complaint was 
closed with follow up 
interaction, interaction was 
closed within due date or 
notes provided as to further 
follow up if unable to be 
closed by due date. 
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Appendix Five – Oversight Bodies Complaints 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
Right 
1  Has the complaint 
• Timeframe for contact to be made is 
• Check My NDIS Interactions  Yes/No/NA 
 
Intake 
been acknowledged 
within NDIA agreed response time 
for evidence of complaint 
Process 
within the stream 
with external body: 
acknowledgement 
 
specific timeframe? 
Commonwealth Ombudsman: 
• Check My Customer 
• 7a - No acknowledgment required. 
Requests/My Documents tab 
Must be completed within five 
for evidence of written 
business days. No contact with 
communication.  
complainant unless requested to 
• Check complaint email 
contact (rare). 
uploaded into My Customer 
• s8 - Acknowledgment to OMBO 
Requests Attachments. 
within 24 hours. Acknowledgement to 
• Check acknowledgement is 
complainant not required unless 
recorded in My Customer 
specifically requested. 
Requests record ‘Outcome 
• Warm transfer – CO to contact 
Notes’ using appropriate 
complainant within five business days 
template. 
and manage as a level 2 complaint. 
• Check date recorded in My 
 
Customer Request record 
• ADC - No acknowledgement 
‘First Contact Date’ field is 
required or contact with complainant. 
within 48 hours of receipt of 
Within 48 hrs Oversight must refer 
complaint into Agency.  
request to NSW Ops to undertake 
• Check Acknowledgement 
discreet check-in with participant that 
email uploaded in My 
the report relates to. Stand-alone 
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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
customer request tile is created on 
Customer Requests 
CRM and participant is linked to 
Attachments. 
complaint tile via an interaction. 
• Check ADC item is linked to 
Details are recorded on CRM within 
participant via an interaction 
this tile. 
Response time to ADC depends on 
assigned risk - High risk five bus days 
and all other 10 bus days. 
Occasionally NDIA receives referral of 
info - no action required but refer to 
NSW Ops for their information. 
 
• NDIS Commission In/out/Request 
for Information -  
Referral In: contact the complainant 
within two bus days. Response to 
Commission within 14 days. Complaint 
to be finalised within 21 days.  
Referral Out: Refer to Commission 
within five business days. No contact 
with complainant. Request for info - 
Respond to Commission within 5-14 
days (depending on risk). 
• Adults Safeguards Unit SA - No 
acknowledgement required or contact 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
with complainant. Within 48 hrs 
Oversight must refer request to 
Escalations SA to undertake discreet 
check-in with participant that the report 
relates to. Stand-alone customer 
request tile is created, and participant 
is linked via an interaction. Off system 
RFA used and uploaded to CRM. 
Response time to SA ASU depends 
on assigned risk - High risk five 
business days and all other 10 bus 
days. Occasionally NDIA receives 
referral of info - no action required but 
refer to Escalations SA for their 
information. 
• Vic Disability Services 
Commissioner - Acknowledgement to 
DSC within 24 hours. Contact with 
participant required within 2 days 
unless stated otherwise. All processes 
recorded on CRM tile as per warm 
transfer process. CRM tile linked to 
participant via related party’s screen. 
• AHRC - Acknowledgement required 
to legal team within 24 hours. No 
contact with complainant. Complaint 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
recorded on CRM tile and linked to 
participant via related party’s screen. 
 
2  Has the participant 
• ADC and SA ASU are linked to 
• Check the My Customer 
Yes/No/NA 
been linked 
participant via an interaction on the 
Requests tab, selecting 
 
appropriately to the 
participant’s record. All others are 
“Categorisation” and then 
Complaint? 
linked via the related party’s screen. 
“Related Parties” to confirm 
• If not appropriate to link participant 
that the participant has been 
ensure that the stream guidance was 
linked to the Complaint.  
followed. 
For ADC and SA ASU check 
• Only one participant or provider 
that participant has been 
should be linked to a complaint in 
linked via an interaction to the 
CRM to ensure privacy of all 
complaint. 
participants.  
• Ensure that correct 
 
Participant has been linked. 
SOP Resolving Complaints 4.3.2 
• Check My NDIS Interaction 
Related Parties. 
is linked to complaint and 
correct interaction categories 
have been selected.  
 
 3  Where there are 
• If more than one complaint is open 
• Same CO is allocated 
Yes/No/NA 
 
repeat complaints, 
about the same issue ensure that it is 
where workloads permit.  
has the complaint 
clear who will manage all/ part of the 
been allocated to the  complaint. The agreement must be 
appropriate 
documented within the complaint.  
complaints officer? 
• Same CO is not allocated as a rule 
but preferred where workloads permit. 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
 
SOP Resolving Complaints 4.2 
Complaint assignment in CRM. 
Right 
4 Confirm 
appropriate  Complaint lodged via an external 
Applies to any complaint 
Yes/No/NA 
person 
consent obtained to 
stakeholder usually has consent to 
where contact is made with 
  
 
receive complaint? 
lodge with Agency based on existing 
complainant: 
 
  
policy and legislation between the two  • Is there evidence of consent 
Agencies. 
 
on file to investigate and 
• Proof of identity required if 
resolve the complaint?  
 
complainant is the Participant/Child 
• Has POI been completed 
 
Rep or Nominee and is contacted by 
(phone call acknowledgement 
 
phone. 
only) or Third party Consent 
 
• Third Party Consent required if 
document in Inbound Docs? 
 
complainant is not the 
• Review interactions to 
 
Participant/Child Rep or Nominee  
ensure the SOP has been 
 
• Interaction outlining that consent was  followed. 
obtained if the complainant is not the 
 
Participant/Plan Nominee.  
 
 
Right 
SOP Resolving Complaints 4.1 
Complaint 
Consent and Privacy. 
Managem
ent 
5   Where appropriate 
• When stakeholder is an external 
Note: Where stakeholder is 
Yes/No/NA 
Process 
contact made with 
body all documentation is included 
an external body all 
  
Complainant to 
within the My Customer Request 
documentation is to be 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
 
clarify issues raised 
complaint tile but NOT My NDIS 
recorded within the My 
within the complaint.  interactions. When contact with a 
Customer Request Outcomes 
participant is required this will follow 
tab and complaint 
usual process. 
interactions and NOT 
• Contact is made by using the 
recorded My NDIS 
participant’s preferred method of 
interactions.  
contact.  
• When there is contact with a 
• Appropriate Interaction templates 
participant this will follow 
should be used to record contact 
usual process using the 
made with complainant in My NDIS 
participant’s preferred 
Interactions and linked to My 
method of contact• Check My 
Customer Request  
Customer Requests 
 
Interactions for evidence of 
contact made and details of 
SOP Resolving Complaints 4.4.3 
the content of the 
When contact is established; and  
conversation are clearly 
 
recorded. If written 
Complaints Resolution and 
communication, check that a 
Oversight Template Guide 
copy has been uploaded to 
the My Customer 
Requests/Attachments tab.  
• Check that appropriate 
Interaction templates used to 
record contact made with 
complainant in My NDIS 
interactions.  
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
6  Contact & Unable to 
• Applicable when the External Agency  • Applicable when the 
Yes/No/NA 
 
Contact guidance 
requires that you contact the 
External Agency requires that 
followed. 
complainant: 
you contact the complainant: 
• Due to the nature of Oversight 
• Check for evidence of two 
complaints, lack of contact with 
genuine attempts to contact 
complainant would not be an 
the complainant by phone.  
impediment to progress of complaint. 
• Check that if unsuccessful, 
• Review Interactions for evidence of 
an email was sent. However, 
contact attempts as per the Unable to 
if the complainant's preferred 
Contact process.  
contact method is email then 
 
an email is sent as first 
SOP Resolving Complaints 4.4.4 
attempt of contact. 
Unable to Contact 
7 Right 
issue/s 
All Oversight Stream work is from an 
Note: Where stakeholder is 
Yes/No/NA 
identified in the 
external body who have provided 
an external body all 
  
Complaint? 
issues for review.  
documentation is to be 
• Contact with complainant will clarify 
recorded within the My 
issues raised in Ombo and NDIS 
Customer Request Outcomes 
Commission warm transfers  
and interactions. 
• Further clarification can be sought 
Conversations with 
from Ombudsman investigation 
participant should be 
officers for section 8 investigations 
recorded in MY NDIS 
where required.  
interactions. 
• A check-in call with the participant 
from NSW Ops can clarify issues not 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
clearly identified in an ADC or SA ASU  • Check that Complaints 
referral. 
Officer has identified key 
• Where contact with the participant 
issues of complaint.  
has been made, this should be 
• This includes identifying the 
recorded in a My NDIS Interaction 
specific issues the 
linked to the complaint and if relevant,  complainant has raised and 
email exchange uploaded into 
determining whether the 
Attachments in My Customer Request  investigation should be 
complaint. 
limited to addressing an 
 
individual issue or is of a 
SOP Resolving Complaints 4.3 
more general nature requiring 
Preliminary Investigation 
broader consideration. 
 
 8 
Confirm 
Complaint 
• Ensure all fields completed in the My  Follow as per all complaints 
Yes/No/NA 
recorded correctly in  Customer Requests tab in CRM 
stream practice: 
 
accordance with 
following guidance in Data Dictionary 
• Check fields are completed 
CMT Guidance 
and SOP. 
in the My Customer Requests 
Material 
• Complaint closed following all 
tab in CRM, including non-
requirements outlined in SOP CMT 
mandatory fields.  
Investigating, Managing and Closing a  • Categorisation is as per the 
Complaint  
data dictionary 
 
• Correct participant/provider 
Record Update a Complaint 3.2 
record has been linked  
Record a new complaint; and 
• Fields/information/ 
attachments have been 
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Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
Data Dictionary for My Customer 
entered as per the SOP. 
Request App 
Particularly ensure response 
attachment is uploaded for all 
complaints 
• Complaint closed following 
all requirements outlined in 
SOP CMT Investigating, 
Managing and Closing a 
Complaint 
 
9 Risk 
correctly 
• Wider range of considerations can be  • Check that information 
Yes/No/NA 
 
identified and 
applied in the Oversight Bodies space  contained in the Complaint 
  
 
reasoning recorded. 
due to the nature of the complaints.  
and the participant’s 
circumstances have been 
 
• Allocating officer determines Risk 
Assessment. 
applied to the Escalation 
 
• Risk assessment recorded in 
Prioritisation Matrix and 
 
Outcomes for each complaint. 
recorded My Customer 
 
Requests Outcomes. 
• Justification for priority level to be 
 
documented by the CO in My 
• Check that appropriate 
 
Customer Requests Outcomes tab. 
timeframe applied based on 
the risk rating. 
 
 
 
Escalation Prioritisation Matrix; and  
 
 
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Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
 
Relevant stakeholder SOP available 
 
on Complaints and Participant 
 
Incidents Team web page 
Right 
10  The referral process 
• Clarity of outstanding issues 
• Have issues been clearly 
Yes/No/NA 
Referral 
was correctly 
requiring referral for resolution.  
identified in RFA and 
  
 
followed and to the 
• Review that it is within the scope of 
appropriate action has been 
appropriate area via 
the business area to be able to resolve  requested to address these 
the appropriate 
the relevant type of complaint. Use 
issues?  
channel. 
Action Assignment Contact list for 
• Has the RFA been sent to 
reference. 
the appropriate business 
• Has the complaints Officer 
area?  
responsible forwarded the referral to 
• Has the risk been assessed 
the correct business area using the 
correctly based on the 
correctly requested channels i.e. 
information available as per 
(RFA/Email)  
Escalation Prioritisation 
 
Matrix?  
As appropriate: 
• Are the timeframes in the 
SOP Resolving Complaints 4.5 
RFA in line with the risk 
Request for Action; 
identified? For on-system 
RFAs check RFA tab to see 
 
date it was sent to business 
SOP Resolving Complaints 4.5.1 
area. For off-system RFAs 
Agency and Partner staff 
check attachments. 
complaints; 
 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
SOP Resolving Complaints 4.6 
Payment Enquiries. 
11  Request for action 
• Where an RFA is required the 
• Check that the RFA follows 
Yes/No/NA 
(RFA) or Payment 
Complaints, Officer is responsible for 
the RFA template as per SOP    
Enquiry (PE) 
following the appropriate template 
and if email notification is 
template accurately 
accurately. 
required does it follow RFA 
followed? 
• Ensure Payment Enquiry process 
email template as per SOP.  
followed if relevant. 
• Check that there are no 
 
errors in RFA or missed 
SOP Resolving Complaints 4.5 
fields.  
Request for Action  
• Check that complaint issues 
 
described accurately and 
clearly.  
Complaints Resolution and 
Oversight Template Guide 
• Reference to next steps as 
determined in complaint 
 
investigation to be included. 
Standard Operating Procedure - 
• Check that if it is a Payment 
Enter Escalation Payment Enquiry 
Enquiry that Payment Enquiry 
in NDIS Business System. 
process followed as per SOP 
including linked interaction to 
My Customer Requests 
Interactions. 
 
12  When referring to 
•  For RFA/PE or referral to another 
• Evidence that information 
Yes/No/NA 
another business 
business area where a risk rating is 
contained in the Complaint 
   
area has an accurate  required the Risk level must be 
and the participant’s 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
risk assessment 
assessed against Escalation 
circumstances have been 
been conducted 
Prioritisation Matrix 
applied to the Escalation 
based on the 
 
Prioritisation Matrix and 
information 
Escalation Prioritisation Matrix. 
recorded in the RFA 
available? 
template. 
• Appropriate timeframe 
selected based on risk rating.  
• Has the RFA been sent to 
business area within 
identified KPI?  
• Check My Customer 
Requests tab, selecting 
outcome to see notes 
showing date RFA was sent 
to team.  
• For on-system RFAs check 
RFA tab to see date it was 
sent to business area. For 
off-system RFAs check 
attachments. 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
 
13  Has follow up 
• Complaints Officers may need to 
• Check My Customer 
Yes/No/NA 
 
occurred with 
follow up with the business area for a 
Requests tab, selecting 
  
 
business area if 
response if not received by due date.  
Outcome to see notes 
RFA/PE due date 
showing follow up with 
 
• Should a response not be received 
has passed? 
after an email reminder is sent, the 
business area if RFA due 
 
response request is to be escalated to  date passed.  
 
the escalation person noted in the 
• An interaction will be 
 
Request for Action Assignment 
recorded detailing that a 
 
Contacts List. 
follow-up to the RFA has 
 
 
been sent.  
 
Request for Action Assignment 
• A copy of the Email 
requesting escalation is 
 
Contacts List; 
available in the record. 
 
 
  
 
SOP Resolving Complaints 4.5.7 
Request for Action Escalation; Or 
 
 
 
SOP Enter Escalations Payment 
 
Enquiry 6.6 Receiving a response 
from the Payments Escalation Team  
Right 
14  All issues within the 
• Complaint resolution considers the 
• Ensure appropriate template  Yes/No/NA 
Resolution 
complaint have been  elements of the complaint and the 
completed accurately and 
 
 
addressed. 
requested outcome.  
that the resolution letter 
   
includes reference to the 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
• The requested outcome may not be 
steps taken by the business 
possible however all matters must be 
area to resolve the complaint.  
addressed with the complainant.  
• Complainant contacted by 
SOP Resolving Complaints 4.1 – 4.7  their preferred contact 
method to advise of the 
complaint outcome and 
actions taken. 
• Check that there is 
documented evidence 
indicating that the complaint 
resolution addresses the 
elements of the complaint 
and the requested outcome.  
• Was the requested action in 
the RFA completed?  
• Have appropriate 
interactions/notes been 
recorded to reflect the action 
taken?  
• Where some action cannot 
be completed has this been 
explained in the response 
and in outcome notes?  
• Next steps and/or the 
participant’s further right to 
V3.4                             Complaints Quality Framework and Checklist                                   58 
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
escalate their complaint were 
explained. 
 15 
Closure 
steps  • Closure steps followed as per the 
Closure steps include: 
Yes/No/NA 
followed? 
SOP and reviewed in CRM.  
• All correspondence/ 
   
• All relevant NDIA guidance material 
conversations recorded and 
has been followed. 
uploaded to appropriate 
• All relevant CMT guidance followed 
areas in CRM; 
 
• Interactions linked to the 
SOP Resolving Complaints 4.8 
Complaint where it is 
Closing complaint item 
appropriate to do so; 
•  All RFAs completed and 
closed; 
•  Create follow up interaction 
in CRM for actions unlikely to 
be completed by complaint 
due date; 
•  Clear expectations 
provided to complainant 
regarding the closure of 
complaint; 
• Apply Outcome Notes 
template and change status 
of Complaint to Closed.  
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Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
• Ensure the record contains 
a brief outline of the 
complaint and outcome. 
• Ensure that complaint and 
all attachments have been 
uploaded to My customer 
Requests/Attachments tab 
• Has the complaint been 
closed within 21 days or 28 
days for a Section 8 
investigation? 
 
16  Follow up recorded 
• A follow up interaction is required 
• General practice in the 
Yes/No/NA 
where necessary? 
when a complaint has been closed but  Oversight Bodies space is to 
 
the business area indicated there were  ensure that the resolution 
actions outstanding beyond the date of  correspondence includes 
closure.  
references to the completed 
• It is important to review the 
actions by the business area.  
interactions following the due date for 
• Follow up on the 
evidence that the business area took 
outstanding actions post-
the required action OR the Complaints  closure of complaint must be 
Officer followed up on completion of 
conducted if the business 
the item and that the participant has 
area’s actions are 
been advised of this. 
outstanding at the time of 
 
closure.  
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Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
SOP Resolving Complaints 4.7 
• Where complaint was 
Follow-up Process 
closed but there were further 
actions required to ensure 
complaint is fully resolved 
i.e., action is required beyond 
the due date of the complaint 
(s100 completed, plan 
approved following escalated 
s48, plan implemented 
following escalated approval). 
Check My NDIS Interactions 
tab: 
• Follow up interaction 
created with appropriate due 
dates and linked to My 
Customer Request record as 
per SOP. 
• Where complaint was 
closed with follow up 
interaction, interaction was 
closed within due date or 
notes provided as to further 
follow up if unable to be 
closed by due date.  
  
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Official 
 
Appendix Six – Informal Ministerial Response 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
Right 
1 
Has the My 
• Ensure all fields completed in the My  • Categorisation is as per the  Yes/No/NA  
Intake 
Customer Request 
Customer Requests tab in CRM 
data dictionary; 
Process 
record been entered 
following guidance in Data Dictionary 
• Correct participant/provider 
 
correctly? 
and SOP. 
record has been linked (Only 
 
• Complaint closed following all 
1 participant should be linked 
requirements outlined in SOP. 
to any one complaint in CRM 
 
to ensure privacy of all 
Record Update a Complaint 3.2 
participants); 
Record a new complaint; and 
• Fields/information/ 
 
attachments have been 
Data Dictionary for My Customer 
entered as per the SOP 
Request App 
2 
Has the complaint 
Participant Service Guarantee 48 
• Date recorded for 
Yes/No/NA  
been acknowledged 
hours but there are some stream 
acknowledgement in My 
within Informal 
specific timeframes. 
Customer Requests record 
Response stream 
‘Outcome Notes’ is within 
guidelines? 
stream requirement. 
 
• Date recorded in My 
Customer Request record 
‘First Contact Date’ field is 
within stream requirement.  
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Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
• Email attached in My 
Customer Requests linked 
documents sent date aligns 
with dates recorded in above 
fields and is within stream 
requirement. (Contact is 
made by email generally 
unless it is noted on the file 
that a phone call has been 
requested). 
3 Has 
correct 
SOP Resolving Complaints 4.2 
• Check the 
Yes/No/NA 
Complaints Officer 
Complaint assignment in CRM. 
participant/provider record for 
been assigned? 
history of complaints.  
• If more than one complaint 
open, ensure the issues are 
appropriately consolidated 
and that it is clear who will 
manage which part of the 
complaint.  
• Check the linked documents 
to the My Customer 
Requests/Feedback tab or 
the My Documents tab for 
evidence of the 
acknowledgement email sent 
and confirm the SOP has 
V3.4                             Complaints Quality Framework and Checklist                                   63 
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Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
been followed (i.e., correct 
template has been used).  
*If high/extreme risk, has the 
complaint been escalated to 
TL or AD as per SOP. 
Right 
5 
Has POI or consent 
• Is there consent and if not has it 
• Is there evidence of consent  Yes/No/NA  
person 
been confirmed?  
been sought?  
on file to investigate and 
 
 
• Review interactions to ensure the 
resolve the complaint under 
SOP has been followed. 
Details tab/Consent. 
 
• Has POI been completed 
SOP Resolving Complaints 4.1 
(phone call acknowledgement 
Consent and Privacy 
only) or Third Party Consent 
document in Inbound Docs? 
• Review interactions to 
ensure the SOP has been 
followed 
Right 
6 
Has contact with the 
• Contact is made by using the 
• Check Interactions for 
Yes/No/NA  
Complaint 
complainant 
participant’s preferred method of 
evidence of contact attempts 
Managem
occurred during the 
contact.  
and/or successful contact, 
ent 
complaint 
• Three documented contact attempts 
interaction is linked to 
Process 
management 
with dates & times interaction 
complaint and correct 
 
process?  
templates used to record contact 
interaction categories have 
made with complainant in My NDIS 
been selected.  
Interactions and linked to My 
• Check My Customer 
Customer Request If relevant, email 
Request record for evidence 
V3.4                             Complaints Quality Framework and Checklist                                   64 
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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
exchange uploaded into Attachments 
of outcome notes being 
in My Customer Request complaint. 
updated to reflect contact 
  
attempts/contact.  
SOP Resolving Complaints 4.4.3 
• Review interactions/My 
When contact is established; and  
Customer Request record to 
 
ensure the SOP has been 
followed 
Complaints Resolution and 
Oversight Template Guide: and/or 
 
SOP Resolving Complaints 4.4.4 
Unable to Contact 
7 
Has contact been 
SOP Resolving Complaints 4.2 
• If more than one complaint 
Yes/No/NA  
made with other COs  Complaint assignment in CRM. 
open has Senior Complaints 
 
if duplicate 
Officer approached other 
complaints? 
Complaints Officers 
assigned?  
• Check My Customer 
Request record for evidence 
of outcome notes being 
updated to reflect contact 
with complaints officer. 
 
8 
Has RFA been 
As appropriate: 
Have issues raised in 
Yes/No/NA  
submitted?  
SOP Resolving Complaints 4.5 
complaint been thoroughly 
 
Request for Action; 
V3.4                             Complaints Quality Framework and Checklist                                   65 
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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
 
investigated and has an RFA 
SOP Resolving Complaints 4.5.1 
been submitted? 
Agency and Partner staff 
complaints; 
 
SOP Resolving Complaints 4.6 
Payment Enquiries. 
Right 
9 Accurate 
As appropriate: 
• Have issues been clearly 
Yes/No/NA  
Referral 
identification of 
SOP Resolving Complaints 4.5 
identified in RFA and 
 
referral reason and 
Request for Action; 
appropriate action has been 
correct business 
 
requested to address these 
area for action. 
issues?  
SOP Resolving Complaints 4.5.1 
Agency and Partner staff 
• Has the RFA been sent to 
complaints; 
the appropriate business 
area?  
 
• Has the risk been assessed 
SOP Resolving Complaints 4.6 
correctly based on the 
Payment Enquiries. 
information available as per 
Escalation Prioritisation 
Matrix?  
• Are the timeframes in the 
RFA in line with the risk 
identified? For on-system 
RFAs check RFA tab to see 
date it was sent to business 
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Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
area. For off-system RFAs 
check attachments. 
10  Request for action 
 SOP Resolving Complaints 4.5 
• Does the RFA follow the 
Yes/No/NA  
(RFA) or Payment 
Request for Action; 
RFA template as per SOP 
Enquiry template 
 
and if email notification is 
accurately followed. 
Complaints Resolution and 
required does it follow RFA 
Oversight Template Guide; 
email template as per SOP.  
 
Ensure Payment Enquiry 
process followed. 
Standard Operating Procedure - 
Enter Escalation Payment Enquiry 
in NDIS Business System. 
 
11  Has follow up 
Request for Action Assignment 
• Check My Customer 
Yes/No/NA 
occurred with 
Contacts List; 
Requests tab, selecting 
business area if RFA   
outcome to see notes 
due date has 
SOP Resolving Complaints 4.5.7 
showing follow up with 
passed? 
Request for Action Escalation; Or 
business area if RFA due 
date passed. 
 
SOP Enter Escalations Payment 
Enquiry 6.6 Receiving a response 
from the Payments Escalation 
Team. 
V3.4                             Complaints Quality Framework and Checklist                                   67 
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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
Right 
12 Reasonable 
SOP Resolving Complaints 4.1 – 4.7  • Have the issues identified in  Yes/No/NA  
Resolution 
resolution of 
the complaint been 
complaint? 
addressed?  
• Was the requested action in 
the RFA completed? 
• Have the actions been 
explained in the response to 
the MP/Senator and relevant 
detail provided addressing 
why these are the appropriate 
actions?  
• Have appropriate 
interactions/notes been 
recorded to reflect the action 
taken?  
• Where some action cannot 
be completed has this been 
explained in the response 
and in outcome notes?  
• Have appropriate next steps 
been provided in response to 
MP/Senator where 
applicable? 
 13 
Closure 
steps 
SOP Resolving Complaints 4.8 
Closure steps include: 
Yes/No/NA 
followed? 
Closing complaint item; 
V3.4                             Complaints Quality Framework and Checklist                                   68 
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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
 
• All correspondence/ 
 
Data Dictionary for My Customer 
conversations recorded and 
 
Request App; 
uploaded to appropriate area    
 
in CRM; 
SOP Enter Escalations Payment 
• All Interactions linked to the 
Enquiry in NDIS Payment System; 
Complaint; 
 
• All RFAs completed and 
SOP Record Update a Complaint 
closed; 
Complaints Resolution and 
• Create follow up interaction 
Oversights Template Guide. 
in CRM for actions unlikely to 
be completed by complaint 
due date; 
• Clear expectations provided 
to Complainant and 
MP/Senator regarding the 
closure of complaint; 
• Apply detailed Outcome 
Notes and change status of 
Complaint to Closed.  
• Ensure the My Customer 
Request record has been 
updated to provide a brief 
outline of the complaint and 
outcome. 
V3.4                             Complaints Quality Framework and Checklist                                   69 
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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
• Has the complaint been 
closed within 21 days? 
 
14  Follow up recorded 
SOP Resolving Complaints 4.7 
• Where complaint was 
Yes/No/NA  
where necessary? 
Follow-up Process 
closed but there were further 
  
actions required to ensure 
complaint is fully resolved 
i.e., action is required beyond 
the due date of the complaint 
(s100 completed, plan 
approved following escalated 
s48, plan implemented 
following escalated approval). 
Follow up interaction created 
with appropriate due dates 
and linked to My Customer 
Request record.  
• Follow Up created as per 
SOP. 
 
Appendix Seven – Participant Critical Incidents 
 
V3.4                             Complaints Quality Framework and Checklist                                   70 
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Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
Right 
1  Was the PCI changed 
• The PCI will be the actioning 
• Even though PCI may only 
Yes/No/NA 
Intake 
into officer’s name in 
officer’s name in both CRM and the 
be a few days apart often we 
Process 
CRM and Tracker and 
PCI tracker. 
can be working on incidents 
 
were any additional 
• Any additional PCIs received on 
received in the last 24 hours. 
unassigned PCIs for 
the same date should also be in the  As such PCI may already be 
the same participant 
actioning officers name in CRM and  closed when a new PCI 
also taken? 
the tracker. 
comes in the next day.  
 
 
 
 
SOP Internal notification of a 
Participant Critical Incident 3.4 
Assess the participant critical 
incident form notification 
 
2  Was this incident 
• Check both the tracker and CRM 
• Where multiple categories 
Yes/No/NA 
classified correctly in 
to ensure correct categories and 
have been identified the 
line with criteria from 
subcategories have been selected. 
category presenting the 
PCI framework? 
 
biggest risk should be 
SOP Internal notification of a 
selected. 
Participant Critical Incident 3.4 
 
Assess the participant critical 
incident form notification 
 
3  Has an RFA enquiry 
• Ensure all fields are completed in 
• Tracker notes should 
Yes/No/NA 
been completed with 
the RFA word document and correct  indicate if a red rated incident   
the correct risk 
template used. 
was recorded. It should be 
assessment applied 
directed to the officer’s line 
V3.4                             Complaints Quality Framework and Checklist                                   71 
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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
and due date noted, if 
• Check the risk level applied in the 
manager who in turn will 
applicable? Where 
risk matrix to see if the correct 
reports the incident through 
applicable have red 
response date was used. 
to the Risk Team. 
rated incidents been 
 
 
reported to the Risk 
SOP Internal notification of a 
Team? 
Participant Critical Incident 3.4 
Assess the participant critical 
incident form notification 
 
4  Was the RFA enquiry 
• Has the PCI been summarized 
• The incident summary 
Yes/No/NA  
clear about the 
accurately?  
should cover the key 
  
actions/information 
• Do the proposed actions address 
elements of the incident and 
requested? 
the concerns raised in the PCI and 
not say “see attached PCI” or 
ensure the participants safety both 
be a copy and paste of the 
immediately and long term within 
incident summary from the 
scope of the Agency? 
PCI form. 
 
• The requested actions 
SOP Internal notification of a 
should be clear and 
Participant Critical Incident 3.4 
measurable with definitive 
Assess the participant critical 
outcome requests. 
incident form notification. 
 
 5  Have all 
• Were sufficient actions taken by 
• This may involve the PCI 
Yes/No/NA 
immediate/emergency 
the PCI officer to address any 
officer contacting emergency 
response actions been  immediate risk to the participant’s 
services or ensuring 
safety?  
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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
undertaken or 
 
emergency services were 
requested? 
SOP Internal notification of a 
contact by others.  
Participant Critical Incident 3.4 
• This may also involve 
Assess the participant critical 
seeking clarification around 
incident form notification 
incidents to understand the 
level of risk when the 
information supplied is vague 
or unclear. 
  
6  Were all areas of 
• Secondary incidents may be 
• Is there evidence of consent  Yes/No/NA 
 
concern raised within 
identified as part of an investigation 
on file to investigate and 
  
 
the PCI addressed and  into the primary concerns raised and  resolve the complaint?  
relevant actions taken 
these should be addressed. 
 
• Often secondary incidents 
as per the SOP? 
• Closure email and the tracker 
will be present in PCI 
 
should include these secondary 
involving unauthorised 
 
incidents and the actions taken to 
restrictive practices (URP) 
 
address them  
when the URP involves 
  
 
abuse or neglect 
 
SOP Internal notification of a 
• The actions taken section of 
 
Participant Critical Incident 3.4 
the closure email and the 
tracker notes should show 
 
Assess the participant critical 
incident form notification 
what actions were taken to 
  
 
address the incidents. 
 
7  Have all external 
• The NDIS Quality & Safeguard 
• The PCI tracker will indicate  Yes/No/NA 
 
notifications including 
Commission must be notified of 
if the NDIS Quality & 
  
the NDIS Commission 
V3.4                             Complaints Quality Framework and Checklist                                   73 
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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
 
been completed as 
incident involving providers whether  Safeguard Commission was 
applicable? 
registered or unregistered.  
notified 
• These reports must be made 
• Other external notifications 
within 48 hours of the PCI being 
may include but are not 
identified as a critical incident with 
limited to Child Protection, 
the exception of URP PCIs which 
state based disability 
must be reported within 5 days. 
authorities such as the 
 
Ageing & Disability 
SOP Closure and reporting of a 
Commission in NSW, non-
participant critical incident 3.2 
emergency police (131444) 
Documenting and Closure of CRM   
items  
  
8  Have the reporter and if   • The closure email will show all 
 • The PCI OneNote contact 
Yes/No/NA 
applicable, other 
parties notified. This email will be 
page shows all relevant areas    
stakeholders been 
sent from the PCI inbox but also 
that closure email need to be 
informed of the 
have the PCI inbox cc’ed in. 
sent to. 
outcome? 
 
• With the exception of PCI 
SOP Closure and reporting of a 
sent from NCC staff closure 
participant critical incident 3.2 
emails should also include 
Documenting and Closure of CRM  any internal NDIS staff or 
items. 
inboxes included in the initial 
email reporting the PCI. 
9  Was the incident 
 • Complaint appropriately closed in 
• Please note this is 21 
Yes/No/NA 
closed by the due 
system within 21 days of receipt. 
calendar days not business 
  
date? 
days. 
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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
 
 
SOP Closure and reporting of a 
participant critical incident3.2 
Documenting and Closure of CRM 
items. 
 
10 If 
follow 
up 
actions 
• Follow up actions should be used 
•  Tracker should show 
Yes/No/NA 
  
were recorded has 
when the only outstanding work is 
additional notes indication 
   
 
these been closed? 
waiting for a response from other 
additional follow up actions 
(N/A is no F/up) 
business areas. PCIs in follow up 
as well as actions taken at 
will be closed in CRM but placed in 
the time the PCI is changed 
finalised with follow up in the 
from finalised with follow up 
tracker. 
to finalised. 
 
 
SOP Closure and reporting of a 
participant critical incident3.2 
Documenting and Closure of CRM 
items. 
11  If applicable, has 
• Feedback should be supplied 
• Feedback to the NCC is via  Yes/No/NA 
feedback been 
when information within a PCI 
the NCC feedback tracker 
   
delivered to relevant 
indicates actions or inaction of NDIA  located in the PCI folder in 
stakeholders? Was this  staff contributed to placing a 
the R drive. 
done in line with 
participant at risk. 
• Feedback to all other NDIA 
guidance materials? 
staff should be directed 
through the PCI officers line 
manager. 
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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
 
 
12  Were all the actions 
• The closure email should have 
• Actions taken should clearly  Yes/No/NA 
detailed in the 
sufficient information in the actions 
show what actions were 
   
response? 
taken section to clearly 
taken by whom to address 
communicate why the PCI officer 
the incident.  
feels no further action is required.  
Actions taken may still be required 
even in the event of a withdrawn 
PCI. 
 
SOP Closure and reporting of a 
participant critical incident3.2 
Documenting and Closure of CRM 
items 
 
13  Have acronyms been 
• PCI have set templates to be used.  • Correct templates can be 
Yes/No/NA 
used correctly and 
All highlighted sections must be 
located in PCI one note 
emails sent without 
removed and correct subject lines 
template page.  
administration errors? 
used. 
 
• All text must be in a uniform font 
and size (Arial 11) 
 
SOP Closure and reporting of a 
participant critical incident3.2 
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Disclosure Log - FOI 24/25-1037
Official 
 
Quality 
Q 
Mandatory Steps 
Evidence 
Guidance Considerations 
Response 
Area 
Options 
Documenting and Closure of CRM 
items 
 
14  Has the outcome been  • PCIs status should be updated as 
• Comments in CRM should 
Yes/No/NA 
clearly reported in the 
withdrawn, closed or delete -
be limited to: Relevant 
tracker including any 
duplicate when closed in CRM with 
business areas notified, or 
actions taken prior to 
no details regarding the actions 
similar. 
closure and has the 
taken. 
PCI been correctly 
• Full details on the actions taken 
closed in CRM? 
should be in the tracker. 
 
SOP Closure and reporting of a 
participant critical incident 3.2 
Documenting and Closure of CRM 
items 
 
15  Have all relevant 
• All emails pertaining to the PCI 
• PCI and associated 
Yes/No/NA 
documents been filed 
including the initial email lodging the  correspondence are to be 
correctly? 
PCI should be file correctly in 
filed by the month the initial 
Outlook. This includes cc’ing in the 
PCI email was received not 
PCI inbox on all outgoing 
the month it is closed. 
correspondence to ensure record of 
emails sent are filed correctly. 
 
 
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