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Start here: the core remediation set for osteopaths
Osteopathy is a small profession, and a complaint can feel very public even when it is not. The Council's process is designed to protect patients and support safe practice, and the response that helps most is a practitioner who understands the standard, recognises the impact on the patient and has made changes. These eight courses build that foundation.
Ethics for osteopaths is about values and judgement: patient autonomy, honesty about what osteopathy can and cannot do, respecting cultural preferences and Te Tiriti o Waitangi obligations, and reasoning through dilemmas such as continuing treatment a patient wants but may not need. Professional standards for osteopaths is about conduct measured against the Code of Conduct and the Osteopathic Practice Competencies: consent, records, scope, referral and accountability.
The process courses then cover responding to a complaint, remediation, insight, reflection, preventing recurrence and rebuilding trust.
Core setComplete the set with these
Ethics and ethical conduct
The Council sets standards of ethical conduct through its Code of Conduct, updated in January 2023 after a critical Te Tiriti analysis of the earlier version. Ethical concerns in osteopathy often involve claims about what treatment can achieve, treatment plans that a patient felt pressured into, disregard for a patient's wishes about touch or the presence of whānau, and decisions about patients who may lack capacity, including children.
These courses help you explain your reasoning, recognise where the patient's interests or cultural needs should have changed your approach, and plan how you will handle similar situations.
RecommendedStart with these
Professionalism, conduct and attitude
Conduct concerns include how a practitioner responds to criticism, communicates with patients and colleagues, uses social media and represents the profession. The Council's guidance for osteopaths who receive a complaint is practical: listen, respond respectfully even when you think the concern is unfounded, ask what resolution the patient wants, take time to reflect and follow up in writing. A defensive first response often turns a small concern into a formal one.
These courses help you show the professional standard and what you will do differently.
RecommendedStart with these
Further relevantAdd if they fit the concern
Probity, honesty and financial integrity
Probity concerns for osteopaths include ACC or insurance claims that do not match treatment delivered, pre-paid treatment packages sold without clear information, advertising claims that cannot be supported, inaccurate notes and false declarations to the Council. Representing yourself as an osteopath without registration is a matter the Council can refer to the Ministry of Health for prosecution.
Treatment packages need particular care: the patient should know what is included, the likely number of sessions and the basis for recommending them, and should be able to stop without penalty if treatment is not helping. If honesty is in question, take legal advice early. These courses cover probity, accurate billing and records, and how to show the change is real.
RecommendedStart with these
Further relevantAdd if they fit the concern
Professional boundaries: patients and colleagues
Osteopathic treatment involves touch, positioning and sometimes undressing, often in a sole-practitioner clinic. That makes clear explanations, consent for each technique, respectful draping and the offer of a chaperone central to safe practice. Boundary concerns range from over-familiar comments and personal messages to sexual misconduct, which is among the most serious matters a responsible authority deals with. The Code of Rights protects patients from exploitation, including any abuse of a position of trust.
These courses help you identify the risk points in your own practice and introduce safeguards a committee will recognise.
RecommendedStart with these
Clinical care, assessment and records
Competence concerns usually involve assessment before treatment: screening for conditions that need referral, judging whether a technique is suitable for an individual patient, recognising when symptoms are not improving and recording the reasoning. The Osteopathic Practice Competencies set the expected standard. Records that show history, examination, consent, treatment and advice are the best evidence you can have.
Particular care is expected with groups at higher risk: infants and children, where consent comes from a parent or guardian and the child's own views still matter; older patients with osteoporosis or multiple medicines; and pregnant patients. A committee will ask whether your assessment recognised that higher risk and whether you adapted technique, explained it and recorded it. If a patient was not improving, it will also ask when you considered referral to a GP or another practitioner and whether that decision is in the notes.
RecommendedStart with these
Further relevantAdd if they fit the concern
Notification, investigation and the Tribunal
These courses help with the process itself: understanding each stage, responding in writing, preparing for a Professional Conduct Committee meeting and presenting learning at the right moment. The Council notes that complaints can be a learning tool and that the learning can be recorded as professional development.
RecommendedStart with these
Further relevantAdd if they fit the concern
Match the concern to a course
The concerns that most often lead to complaints and investigations, how they are viewed, and the courses that address each one.
Consent not obtained for a technique
Patients must understand and agree to each technique, including touch and undressing; HDC applies Rights 6 and 7 of the Code of Rights.
Inappropriate touch or comments
A boundary concern that is likely to be referred to a Professional Conduct Committee because of the trust patients place in hands-on practitioners.
Missed referral or unsuitable treatment
Usually a competence matter, assessed against the Osteopathic Practice Competencies; it may lead to a competence review.
Unsupported health claims
Advertising or advice that overstates what osteopathy can achieve raises honesty and conduct concerns under the Code of Conduct.
Billing that does not match treatment
ACC or insurance claims and treatment packages must be accurate and transparent.
Poor response to a patient's complaint
The Council advises listening, responding respectfully, asking what resolution is wanted and following up in writing.
Inadequate records
Thin notes make it hard to show assessment, consent and reasoning to an investigator.
Cultural safety concerns
The 2023 Code of Conduct reflects a Te Tiriti analysis; disregarding a patient's cultural needs is a conduct issue.
Who handles a concern about an osteopath
HDC first for consumer complaints
Complaints alleging that an osteopath's practice or conduct affected a health consumer must go to the Health and Disability Commissioner. The Council can still take interim protective steps while HDC considers the matter.
The Registrar and initial inquiry
The Council accepts written complaints from anyone and can also start a matter itself. It decides whether the issue concerns health, conduct or competence. In an initial inquiry you can respond to the information the Council holds. Options then include referral to a Professional Conduct Committee, a competence review, a health assessment, non-regulatory measures such as an educational letter, or no further action.
Professional Conduct Committee
If the matter goes to a PCC, you should receive an early advice letter within 14 days of the referral decision. The committee has two osteopaths and a layperson, and you can ask for a change of membership within 5 working days of being told who is proposed. An investigator takes statements and gathers clinical notes, and the PCC can issue notices requiring information. At the PCC meeting, usually about two hours and recorded, you respond to the evidence and the complainant may attend.
Within 14 days of completing its investigation, the PCC gives its recommendations or determinations. Recommendations to the Council can include a competence review, a fitness-to-practise review, a scope of practice review, a letter of counsel or referral to Police. Determinations are no further action, conciliation, or a charge before the Health Practitioners Disciplinary Tribunal.
Health Committee and the Tribunal
Health concerns go to the Council's Health Committee, which can arrange medical examination and recommend conditions or suspension. At the Tribunal a panel of a lawyer chair, three osteopaths and a layperson decides whether misconduct is proven and what penalty applies, up to cancellation.
Interim steps and what stays the same
At any stage the Council may suspend your practising certificate or impose conditions after giving you a chance to make submissions. Otherwise you continue practising and meeting your recertification requirements.
What the Council and committees look for
- Insight: do you understand the patient's experience and the effect on trust in osteopathy?
- Remediation: what have you learned and changed, and is it relevant to the concern?
- Risk of repetition: would the change hold in a busy sole-practice day?
- Candour: were you open with the patient and with the Council from the start?
- Records: do your notes support your account of consent, assessment and treatment?
- Verifiable evidence: certificates, peer discussions and audits someone can check.
How a course can help your response
A course gives dated, checkable evidence that you studied the standard, passed a 20-question assessment at 80% and reflected on your own practice. Combined with a specific reflection, it shows the Council or a PCC that you have engaged early. It cannot guarantee an outcome and is not legal advice.
They do not replace a competence programme, conditions or education set by the Council or the Tribunal unless they accept them, so check any order with them or your lawyer first.
From complaint letter to evidence of learning
- Pause and take advice from your indemnity insurer, your professional association or a lawyer before you reply.
- Pick courses by concern, starting with the core set and adding the group that matches.
- Study privately at your own pace; nobody is notified that you have enrolled.
- Write your reflection describing the event, your learning and specific changes, with no patient identifiers.
- Provide it through your adviser, for example with your response to the initial inquiry or before the PCC meeting, if they agree.
Insight, reflection and remediation explained
Insight is weighed by committees and the Tribunal but is not a defined test in the HPCA Act. For osteopaths it often means accepting that a patient's discomfort or confusion was real even if you followed your usual approach.
Reflection is your written account of learning. The Council recognises that learning from complaints can count as professional development. Statements made for a competence review or programme are protected under section 44(4) of the Act, but a PCC can require information, so write as if it may be read.
Remediation is the practical change: new consent wording, a chaperone offer on your intake form, peer review or a record template.
Support for osteopaths
Many osteopaths work alone, so isolation is a real risk during a complaint. Talk to a trusted colleague or mentor, and keep your adviser informed. If you need to talk to someone now, call or text 1737, Need to talk?, free at any time.
Start your remediation plan
Begin with the core set, add the courses that fit the concern and keep certificates and reflections together.
Questions
What does the Osteopathic Council do first when it receives a complaint?
If the complaint alleges your practice affected a health consumer, it goes to the Health and Disability Commissioner first. Otherwise, the Council decides whether the issue concerns health, conduct or competence and opens an initial inquiry in which you can respond to the information it holds. It then chooses an outcome, from no further action to referral to a Professional Conduct Committee.
Which Code of Conduct applies to osteopaths?
The Council's current Code of Conduct dates from January 2023 and replaced the September 2020 version. The Osteopathic Practice Competencies, also from January 2023, set the standards of competence. If the events happened before 2023, ask your adviser which version the committee will use, and study the current one in any case.
How quickly will I hear if my matter goes to a PCC?
The Council's complaints process says an early advice letter is sent within 14 days of the decision to refer the matter to a Professional Conduct Committee. You will also be told who is proposed for the committee, and you can request a change of membership within 5 working days if you have a genuine concern about a member.
Will the complainant be at the PCC meeting?
They may be. The Council's process allows the complainant to attend the PCC meeting to give their account, and you respond to the evidence. Meetings usually last about two hours and are recorded. Prepare with your adviser, and bring a clear, calm account supported by your records and any evidence of learning.
What is a letter of counsel?
A letter of counsel is one of the recommendations a Professional Conduct Committee can make to the Council. It is a formal written caution about your conduct rather than a disciplinary penalty. Take it seriously: completing a relevant course and recording a reflection shows you have acted on it.
What is an educational letter?
An educational letter is a non-regulatory measure the Council can use after an initial inquiry when it wants you to consider an aspect of practice but does not need formal action. Use it as a prompt: a short course and a written reflection kept in your professional development record show you responded.
Can learning from a complaint count as professional development?
The Council says complaints can be a learning tool and the learning can be recorded as professional development. A relevant course with a written reflection is a practical way to capture it. Keep the record de-identified, link it to the competencies and include it in your recertification evidence where it fits your plan.
How should I reply to a patient who complains directly to me?
The Council's guidance is to listen and try to understand the patient's reasons, respond respectfully even if you think the concern is unfounded, ask what resolution they want, take time to reflect if needed, and follow up in writing with any changes to your practice and their options if they remain unhappy. Contact your insurer if the complaint is serious.
Can the Council suspend me before the investigation ends?
Yes, at any stage the Council may suspend your practising certificate or impose conditions to protect the public, after giving you an opportunity to make submissions. This is an interim protective step, not a finding. In most matters it is not needed and you continue practising.
What happens at the Tribunal for an osteopath?
If a Professional Conduct Committee lays a charge, the Health Practitioners Disciplinary Tribunal hears it with a panel of a lawyer chair, three osteopaths and a layperson. It decides whether professional misconduct is proven and, if so, the penalty, which can include censure, a fine up to NZ$30,000, conditions, suspension or cancellation, and costs.
Which extra courses suit a consent complaint?
Start with the core set, then add informed consent, chaperones and boundaries, because consent complaints in hands-on care often involve how touch and undressing were explained. Documentation is useful too, because a record of what was discussed is your best evidence. Finish with a reflection naming the changes you have made.
How long are the courses?
Each course carries two or three hours of estimated learning time depending on the topic. You study online at your own pace with knowledge checks, then complete a 20-question assessment with an 80% pass mark. Your certificate and reflective account are available immediately.
Does a health concern go through the same PCC route?
No. Health concerns are dealt with by the Council's Health Committee, which can arrange a medical examination and may recommend conditions or suspension to protect patients. The focus is safe practice and support, not discipline. Talk to your doctor and adviser if a health issue is affecting your work.
Should I keep treating the patient who complained?
Often it is better not to, but decide with your adviser. Continuing care can be difficult for both of you while a complaint is open, and the patient may prefer another practitioner. If you end the relationship, do it respectfully, explain how they can get ongoing care, make records available and document the conversation. Never end care in a way that looks like retaliation for complaining.
Why does the Te Tiriti analysis of the Code matter to my matter?
The Council reviewed its Code of Conduct through a critical Te Tiriti o Waitangi analysis before the January 2023 version. Cultural safety is therefore part of the conduct standard, not an optional extra. If a complaint involves a Māori patient or whānau, a committee may consider whether your care respected their values and preferences. The cultural safety and health equity course helps you reflect on this.
Where can I get advice and support?
Start with your professional indemnity insurer, which may provide legal advice for regulatory matters. Your professional association can offer guidance, and a lawyer experienced in HPCA Act matters can represent you. For emotional support at any time, call or text 1737, Need to talk?, which is free.
Official sources
Checked October 2026. Rules and processes change, so confirm the current position with the official source. This page is general information, not legal advice.
- Osteopathic Council of New Zealand: standards of competence and conduct
- Osteopathic Council of New Zealand: complaints process (2021)
- Health and Disability Commissioner: Code of Rights
- Health and Disability Commissioner: what if a complaint is made about me?
- Health Practitioners Disciplinary Tribunal
- Ministry of Health: responsible authorities
How these courses are built
Official sources only
Every legal and regulatory point comes from primary sources: the HPCA Act 2003, the responsible authorities' standards and the Code of Health and Disability Services Consumers' Rights. Anything we cannot confirm is left out.
Original, edition by edition
Lessons, scenarios and assessment questions are written by us for each edition separately, then checked for accuracy, teaching quality and fair assessment before publication.
Reviewed when rules change
When a code, standard or law changes, the affected courses are reviewed and updated. Reported errors in legal or regulatory facts are corrected first.