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What to expect from a health assessment
Under the National Law1, a National Board may require a registered health practitioner or student to undergo a health assessment if it reasonably believes, because of a notification or for any other reason, that the practitioner or student has, or may have, an impairment that does or may adversely affect their capacity to practise.
The National Law defines impairment. In relation to practitioners, this is a ‘physical or mental impairment, disability, condition or disorder (including substance abuse or dependence) that detrimentally affects or is likely to detrimentally affect’ their capacity to practise. For students, the impairment would, or be likely to, affect their capacity to undertake clinical training.
This fact sheet aims to provide more detailed information for practitioners about what is involved in a health assessment and answer some frequently asked questions.
The Board usually becomes aware of possible impairment when it receives a notification from another health practitioner (whether or not they are in a treating relationship with the impaired practitioner), an employer, a member of the public or, on occasions, officers of the relevant state or territory drugs of dependence unit or the police.
There are two main reasons the Board seeks an independent assessment:
- Independent health assessors take an objective view because they lack prior knowledge of the impaired practitioner and have no ongoing responsibility for continuing care.
- A treating practitioner may be reluctant to provide a report which breaches their patient’s confidentiality and which might result in restrictions on their patient’s ability to practise. Either of these could disrupt an effective treating relationship.
However, treating practitioners who believe their patients can practise safely can, and do, provide reports which support their patients’ ability to practise. These reports can be very useful to a Board that requires ongoing monitoring of an impaired practitioner’s compliance with treatment after the health assessment has been carried out.
The existence of a health problem on its own does not trigger the need for a health assessment. A National Board has to believe that the practitioner’s or student’s health problem meets the definition of an impairment in the National Law and therefore, may place the public at risk. For example, a practitioner with a mental illness who demonstrates insight into their condition and complies with recommended treatment is unlikely to place the public at risk.
Another practitioner with a similar illness who lacks insight and/or refuses to comply with treatment recommendations, may pose a risk. In this case, the Board may believe the practitioner has or may have an impairment, and require an independent assessment, which may lead to the Board placing restrictions on the practitioner’s registration that limit their practice in some way in order to protect the public.
The health assessment is conducted by an experienced and appropriately qualified, independent medical practitioner or psychologist who is not a member of the National Board. The consultation is booked by AHPRA staff and the practitioner or student is advised of the appointment time and place.
Both the practitioner and health assessor are asked whether any conflict of interest exists which would preclude the assessor from carrying out the assessment. The Board pays for the assessment and the assessor writes a report for the Board.
The practitioner or student who was assessed is given a copy of the report unless the report contains information that may be prejudicial to their health or wellbeing. In this case it is given to a medical practitioner or psychologist nominated by the practitioner or student. The medical practitioner or psychologist will then decide when it is appropriate to discuss the report with the practitioner or student.
After the practitioner or student who was assessed receives the report, a person nominated by the Board (usually a Board member or AHPRA staff member) must discuss the report with them. This provides an opportunity to discuss ways of dealing with the findings of the report, if it is necessary to alter the way the practitioner practises the health profession. This discussion is usually also attended by an AHPRA staff member.
The Board reviews the outcome of this discussion at its next meeting and will decide if any restrictions on the practitioner or student’s registration are needed to protect the public. The practitioner is then advised of the Board’s decision.
As a result of a health assessment a Board may decide to:
- take no further action
- refer the matter to a health panel (see separate fact sheet)
- impose conditions on/accept an undertaking from the practitioner. In this case, AHPRA monitors the practitioner’s compliance with the conditions or undertaking while they are in place (see the fact sheet on monitoring and compliance)
- investigate the practitioner
- require the practitioner undergo a performance assessment, or
- refer the matter to a tribunal.
This document will be reviewed in May 2014.
1 The Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).