July 2013

In this edition:

A message from the CEO

photo of martin

This edition of AHPRA Report marks the third anniversary of the National Scheme on 1 July 2013.

National registration is firmly in place. There are now more than 580,000 health practitioners registered in Australia across 14 professions. Practitioners are able to practise across borders within the scope of their registration with nationally consistent standards and flexibility. The public is starting to experience the benefits of more robust public protection. And our data are helping to inform workforce policy and planning.

Our processes for managing notifications rightly attract great interest. In response to community and practitioner feedback, AHPRA has published important new information on the notifications (complaints) process. Two new guides – one for consumers and one for health practitioners – are published with comprehensive changes to notifications sections of the AHPRA and National Board websites. More details are published in the notifications article.

Public safety is at the heart of the National Scheme. Our newly established Community Reference Group met for the first time this month. This is the first time a national consumer group with a focus on health practitioner regulation has been established in Australia. This is an important development because public safety is at the heart of the National Scheme.

Three years on, it is easy to take for granted that through the National Scheme, we have more accurate, timely and comprehensive access to data about Australia’s registered health workforce. We have recently reaffirmed our data partnership with Health Workforce Australia and the Australian Institute of Health and Welfare.

AHPRA audits practitioner compliance with mandatory registration standards on behalf of National Boards. Practitioner audits are an important part of the way that National Boards and AHPRA can better protect the public by regularly checking these declarations for a random sample of practitioners. Read more about our work underway on audit.

AHPRA Report also summarises recent consultations and policy work of National Boards. As ever, it’s been a busy few months and our program for the months ahead is just as full.

Reforms as extensive as those that delivered the National Scheme require careful implementation. We have built strong foundations and are now making the improvements and innovations that the National Scheme makes possible. I look forward to keeping you informed as we work to bring out the best of the National Scheme over the coming year.

Martin Fletcher
Chief Executive Officer
martin.fletcher@ahpra.gov.au

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Working with governments

Changes to health complaints management in Queensland are pending. On 4 June 2013, the Queensland Minister of Health, the Hon. Lawrence Springborg, introduced to the Queensland parliament the Health Ombudsman Bill 2013. The Bill is now in a parliamentary committee process and AHPRA nationally and in Queensland, along with National Boards, will be involved in consultations as required by the committee.

Health ministers appoint members to state and territory boards of the Medical Board of Australia. There is currently no Queensland Board of the Medical Board of Australia. The Medical Board of Australia has put interim arrangements in place to manage the work of the Queensland Board of the Medical Board of Australia. These arrangements relate to the core work of the state board in making registration and notification decisions about individual practitioners. More detail about these arrangements is published on the Medical Board of Australia website.

The Victorian parliamentary inquiry is also reviewing many aspects of our work from a state-specific viewpoint. The National Boards and AHPRA made submissions to – and appeared before – the Legislative Council’s Legal and Social Issues Legislation Committee’s inquiry into the performance of AHPRA. Our submissions – and transcripts of appearances by a range of parties – are published on the Parliament of Victoria website.

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Notifications guides published

This month we published new guides for health practitioners and the community about how notifications are managed in the National Registration and Accreditation Scheme.

The guide for practitioners and a series of fact sheets aim to explain to practitioners what happens when AHPRA receives a notification on behalf of a National Board. The information complements the direct correspondence that individuals receive if a notification is made about them.

AHPRA collaborated with the professional associations for practitioners registered in the National Scheme to develop the guide for practitioners. The practitioners’ guide clearly explains what happens after a concern has been raised about a health practitioner, who decides what happens, how we work with health complaints entities and what practitioners can expect from our processes.

AHPRA has also developed a guide for the community about making a complaint (or notification) about a health practitioner. This guide for notifiers, Do you have a concern about a health practitioner? A guide for people raising a concern, will be an early focus for feedback from the newly established Community Reference Group for AHPRA and the National Boards.

Both guides are published online on the AHPRA and National Boards websites in a wholly revised section on complaints and notifications.

If you have questions about our publications, contact our communications team at communications@ahpra.gov.au.

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2013/14 business planning

the words service, consistency and capability

Our business plan for 2013/14 charts a clear path for the years ahead. The actions identified in the business plan will help make sure that what we do to protect the public is effective as well as efficient. Of course, there is a strong focus on notifications – but not at the expense of our other core regulatory functions such as registration and accreditation.

Over the next year, our efforts will be focused on five core areas:

  1. embedding new services (accreditation and audit)
  2. helping boards strengthen regulation (policy and standards, workforce reform)
  3. quality and measurement (notifications, quality assurance, reporting)
  4. improving regulatory operations (stakeholder engagement and systems improvements, including online services), and
  5. enabling functional improvements (IT, data exchange, planning).

A particular emphasis in the year ahead is on measurement. We are building and implementing the tools we need to better understand trends across all areas of our work. Good measurement relies on accurate and complete comparative data, which relies on consistent systems and processes. With this focus, and these initiatives, we will be able to satisfy ourselves and the public that we are regulating effectively and efficiently by managing quality, timeliness and volume in all areas of our work.

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Registration renewals: nursing and midwifery

calender page with the 31 highlighted

More than 340,000 nurses and midwives were due to renew their registration with the Nursing and Midwifery Board of Australia (the National Board) by 31 May. Just over 96% of registered nurses and midwives had renewed their registration by late June. In addition 1% of eligible registrants have advised they are not renewing.

Online renewal opened in late March with the first in a series of email renewal reminders going to the 99.5 per cent of nurses and midwives who had supplied an email address. AHPRA also sent a hard copy renewal reminder to nurses and midwives without a known email address.

AHPRA and the National Board worked together to make sure online registration renewal information was in plain English and that registrants could easily find what they are looking for. A new Registration Renewal page links from the home pages of the AHPRA and National Board websites, and contains FAQ for nurses and midwives and their employers.

Nurses and midwives had until 30 June to submit their renewal application. An additional fee was applied in the late period. Registration has lapsed for those practitioners who did not renew.

For further information about registration renewals contact our customer service teams on 1300 419 495.

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Audit of registration standards

the word audit with a magnifing glass over the a

All registered practitioners are required to comply with a range of registration standards that have been developed by the Board that registers them. The registration standards are published on the National Board websites under Registration standards.

Each time a practitioner applies to renew their registration they must make a declaration that they have met the registration standards for their profession.

Practitioner audits are an important part of the way that National Boards and AHPRA can better protect the public by regularly checking these declarations for a random sample of practitioners. Audits help to make sure that practitioners are meeting the standards and provide important assurance to the community and the Boards.

Audit pilots

AHPRA has undertaken two pilots to audit practitioners for compliance with three registration standards:

  • continuing professional development (CPD)
  • professional indemnity insurance, and
  • recency of practice.

AHPRA is also auditing compliance with requirements in the National Law for practitioners to provide information about changes to their criminal history.

An audit of a number of nurses and midwives was conducted during their renewal period in May this year. This group was audited against the Nursing and Midwifery Board of Australia’s registration standards for recency of practice and continuing professional development.

A report for phase one of the audit pilot, which was conducted with the pharmacy profession, is available on the AHPRA website. The report describes AHPRA's approach to auditing practitioner compliance with the National Boards’ registration standards and provides valuable information for the development of practitioner audits in the National Scheme.

Using the findings from the first phase of the audit pilot, practitioners from the pharmacy, chiropractic and optometry professions were selected at random to be audited for compliance with their Board’s registration standards and the provisions in the National Law to disclose criminal history. This was phase two of the pilot. The report about this is now being finalised and will be available shortly.

During the both phases of the pilots, AHPRA and the relevant National Boards worked with key stakeholders to make sure participants would be able to provide the necessary evidence to give to the audit team, for example to demonstrate their recent practice and their participation in CPD. Accepted evidence varied for each profession and each registration standard, but examples include signed statements of service from employer(s) noting hours worked, a CV detailing dates of employment, CPD logs, and copies of current insurance certificates.

Next steps

Outcomes from both phases of the audit will inform the next steps in refining the audit framework to be applied across all professions. We have established a working group to support the transition from pilot to permanent business function. Auditing of other professions will then begin.

We will keep stakeholders up to date with detailed information on the audit page on the AHPRA website. We are working closely with all National Boards to make sure practitioners are prepared, informed and supported. We will also be working and consulting with unions, professional associations and large employers as we make random audit routine in the National Scheme.

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Community Reference Group established

scrabble tiles spelling out the words community engagement

AHPRA has established a Community Reference Group to work with AHPRA and the National Boards. This is the first time a national group of this kind, with a focus on health practitioner regulation, has been established in Australia. Seven members from the community, who are not health practitioners, have been appointed to the group, which will be chaired by Mr Paul Laris, a community member on two Boards in the National Scheme.

The group will have a number of roles, including providing feedback, information and advice on strategies for building better knowledge in the community about health practitioner regulation, but also advising AHPRA on how to better understand, and most importantly, meet, community needs.

AHPRA and the National Boards believe that the Community Reference Group is an important step to increasing community input into health practitioner regulation.

‘Health practitioner regulation affects everyone, because it is about public safety. But not many people are aware of how it works or what it does,’ AHPRA CEO Martin Fletcher said.

‘The Community Reference Group will work with the 14 National Boards and AHPRA and advise us how we can build community awareness, understanding and support for the Australia’s regulatory scheme for health practitioners,’ he said.

Chair, Mr Paul Laris, said the group's establishment was timely.

‘The national regulatory scheme is firmly in place. There are already community members on all National Boards, and this new advisory group will give another voice to the wider community,’ Mr Laris said.

Communiqués from meetings of the Community Reference Group will be published on the AHPRA website. A list of members of the group is published in a media statement.

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Consultation update

National Boards are continuing their scheduled three-year review of the registration, standards, codes and guideline, in addition to undertaking their ongoing Board-specific consultations.

Consultation is an important part of the National Boards’ engagement with practitioners, members of the public and other stakeholders. The feedback provided is greatly valued, and informs Boards’ development of important documents. Public consultations are widely communicated in the Board communiqués and websites, and are open to everyone.

Current public consultations

  • Psychology Board of Australia consultation on the Guidelines for the 5+1 internship program (closes 8 July), and
  • Medical Radiation Practice Board of Australia consultation on Supervised practice guidelines (closes 22 July).

To access the consultation papers, please visit the relevant Board’s website and go to News>Current consultations.

Upcoming cross-Board public consultations

  • English language skills registration standard (which is largely common to all National Boards), and
  • Criminal history registration standard (which is common to all National Boards).

All National Boards have registration standards which define the requirements that applicants, registrants or students need to meet to be registered. These two registration standards are common, or largely common, to all National Boards.

The review of these two standards is being coordinated across all National Boards later in 2013.

Recently closed consultations

  • cross-Board public consultation on common guidelines and Code of conduct. This consultation included revisions to the Guidelines for advertising (common to all National Boards), a Social media policy (common to all National Boards), and revisions to the Guidelines for mandatory notifications (common to all National Boards). Most Boards also consulted on a revised Code of conduct (either the code shared by most National Boards, or for some Boards there is a profession-specific code). Boards that did not consult on their code as part of this consultation were the Medical Board of Australia and Nursing and Midwifery Board of Australia
  • Medical Board of Australia consultation on proposed changes to the competent authority pathway and specialist pathway for international medical graduates
  • Psychology Board of Australia consultation on the Guidelines for the national psychology examination, and
  • Dental Board of Australia consultation on the Scope of practice registration standard.

For information on the outcomes of these consultations, visit the relevant Board website.

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National Board news

Aboriginal and Torres Strait Islander health practice news

Guidelines on recency of practice, continuing professional development and for registration under ‘grandparenting’ provisions

The Aboriginal and Torres Strait Islander Health Practice Board of Australia recently published guidelines on:

  • recency of practice
  • continuing professional development, and
  • registration under ‘grandparenting’ provisions.

As regulator of a new profession, the Board is keen to provide registrants and potential registrants with clear, concise, plain-English guidance that assists practitioners to understand and meet sometimes unfamiliar registration and regulatory requirements.

The guidelines are published on the Board’s website under Codes and guidelines.

Chinese medicine news

Infection prevention and control guidelines for acupuncture practice

The Chinese Medicine Board of Australia will soon publish new guidelines on infection prevention and control for acupuncture.

These guidelines are adapted from National Health and Medical Research Council (NHMRC) Australian guidelines for the prevention and control of infection in healthcare.

The guidelines make specific policy statements with guidance on:

  • reprocessing/reuse of critical items
  • hand hygiene and alcohol-based hand rub
  • appropriate use of gloves
  • disposal of clinical waste
  • skin preparation prior to skin penetration in acupuncture practice
  • post-treatment considerations, and
  • prevention and management of sharps injuries.

All Chinese medicine practitioners who are registered to practise acupuncture must comply with specific requirements of the guidelines as well as relevant state, territory and local government requirements that apply to their place of business.

Once the guidelines are finalised, the Board will publish them under Codes and guidelines on its website.

Chiropractic news

Position statements on providing health information and paediatric care

The Chiropractic Board of Australia recently published two position statements:

  • Providing health information (including vaccination) – chiropractors have a responsibility to promote the health of the community, and are obliged to give balanced, objective and evidence-based information to patients, to help them make informed health decisions. In maintaining good practice, practitioners should consider the balance of benefit and harm in all clinical decisions, based on best available information.
  • Paediatric care – chiropractors need to deliver effective health care within an ethical framework. Like all health practitioners, chiropractors must take particular care to gain informed consent when managing the care of children and young people. Good chiropractic practice involves placing the interests and wellbeing of the child or young person first, and keeping parents and guardians informed.

The position statements are available in the FAQ and fact sheets section on the Board website.

You can also refer to the Board's media release on the position statements.

Medical news

The Medical Board of Australia and Australian Medical Council have released a joint newsletter on the National Internship Framework.

The Medical Board of Australia has also put interim arrangements in place to manage the work of the Queensland Board of the Medical Board of Australia. More information is published in this article.

The Board has also published detailed information for medical practitioners with limited registration (public interest – occasional practice).

Psychology news

The Psychology Board of Australia and AHPRA are working together to develop a National Psychology Examination which is intended to be implemented from 1 July 2013 for applicants seeking general registration.

To ensure that the examination is of the highest quality, in recent months there has been considerable effort placed on:

  • developing efficient and appropriate processes and procedures to support all aspects of the delivery and administration of the national exam. Our top priority has been to make certain that candidates can be confident of a positive experience associated with sitting the exam
  • updating the Board’s website with information that will be released closer to the exam date. This will give candidates concise details about the exam regulations, support and how to register and sit the exam, and
  • developing a ‘practice exam’ so candidates can understand the structure of the exam and get a ‘look and feel’ for the exam. This has been a key requirement from the Board aimed at demonstrating the standards expected from candidates and, at the same time, reducing exam anxiety.

A National Exam Committee has been established and is working to finalise the curriculum and format of the exam, including development of exam questions and required readings. The committee will work closely with AHPRA on the implementation plan and set-up for the computer-based platform for the exam.

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Information exchange

Health and Care Professions Council visit

In February, AHPRA hosted a two-day visit from the Chair and CEO of the United Kingdom’s Health and Care Professions Council (HCPC). As a well-established statutory organisation with very similar functions to ours, the HCPC has much experience and expertise to share.

HCPC regulates 16 professions, including virtually all health professions except medicine, nursing and midwifery, dentistry and pharmacy. It also regulates clinical and biomedical scientists, prosthetists/orthotists, and ‘care’ professions such as social work; a total of 315,000 practitioners. This year, HCPC will hold about 350 fitness-to-practise tribunals and will receive about 1,800 allegations.

The visit included a series of meetings with AHPRA senior staff at which ideas and knowledge were exchanged to enable innovation, and to facilitate future collaboration between the two organisations. Since HCPC was set up in 2001 it has had to deal with similar issues to those faced by AHPRA in moving many professions to a single, integrated, cost-effective system of regulation with shared standards and processes. AHPRA is learning from this experience.

Find out more about HCPC on the HCPC website.

Data exchange strengthens health workforce planning

A renewed commitment to timely information-sharing and constructive engagement is the feature of the partnership between AHPRA, Health Workforce Australia (HWA) and the Australian Institute of Health and Welfare (AIHW). Each organisation has statutory obligations to share information that aims to improve health workforce policy and planning in Australia.

In May 2012, the three parties signed a memorandum of understanding (MOU) outlining how national health workforce registration data would be shared, consistent with the National Law. Reviewing the MoU this month, the parties affirmed that it continued to provide a clear and appropriate framework for the agreement between them.

The AIHW and HWA welcomed the establishment of an AHPRA data quality team and were briefed on AHPRA’s strategic plan to safeguard data quality.

‘The data collected by AHPRA through the National Scheme creates common information across professions and jurisdictions – in effect it ensures we are comparing apples with apples, statistically speaking,’ AIHW CEO David Kalisch said.

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AHPRA people: meet Dominique Saunders 

photo of dominique

As AHPRA’s General Counsel, Dominique Saunders leads and supports the legal team at the National Office as well as the legal teams around the country, and advises the AHPRA Executive as a member of the senior leadership team.

With more than 20 years’ legal experience in the community, public and private sectors, plus training as a social worker, Dominique is well respected in her profession. She brings particular expertise in human rights, health, mental health, disability and discrimination law to her role at AHPRA.

When the National Registration and Accreditation Scheme was being set up, Dominique was Corporate Counsel, Executive Director at Western Health in Melbourne. She was inspired to come to AHPRA by the challenge of being involved in the start-up of a national regulatory body. As she explains, ‘With my background in regulation working with the Nurses Board of Victoria and then my experience in the delivery of public health services in a multi-site hospital in inner Melbourne, I was keen to make a contribution to good governance and robust decision-making.’

Dominique believes that such decision-making is based on sound knowledge of the law but must remain solution-focused. ‘As well as sound processes within AHPRA and the National Scheme, the public interest is crucial,’ she says.

The ‘challenge’ aspect of implementing the National Scheme has not been lacking. ‘As AHPRA is the first agency of its size and kind in the world, the establishment of a statutory national organisation has required strong, yet sensitive leadership in the management of staff across national and state and territory offices and close partnership with Boards in the regulation of more than 580,000 health professionals nationally,’ Dominique says.

Achievements at AHPRA include the development of corporate strategies and priorities and governance frameworks, ensuring statutory compliance, establishing complaints systems, reporting frameworks and risk management protocols. These are essential structures underpinning the National Scheme, without which the regulation of the professions or the protection of the public would not occur.

Dominique’s role at AHPRA reflects her longstanding commitment to human rights in a broad range of areas and jurisdictions. She was a key contributor to the development of the Victorian Charter of Human Rights and Responsibilities legislation, same-sex law reforms introduced by the Commonwealth government and community access to justice initiatives.

In the fields of discrimination and disability, she led in areas as varied as law reform of disability services, crimes mental impairment legislation and a high-profile sex discrimination case, in which she acted for three young girls fighting for the right to play Australian Rules football in mixed teams. The decision in this matter changed the law and the case is the subject of a documentary DVD used by legal educators and in schools.

This enduring contribution and commitment to human rights is reflected in two recent awards. In 2012 the Law Institute of Victoria awarded her the Paul Baker Award for outstanding contribution in Human Rights and Administrative Law. She also received the Achievement Award for Excellence in Government and In-house Law presented by the Women Lawyers’ Association.

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Advice and information

Information online

The AHPRA website is a great place to start when you are looking for information on many different questions about the National Scheme. Try our new and improved search function to find the information you need quickly.

Email advice

Submit an online enquiry form any time and we will get back to you as soon as possible. There are categories of enquiries to select, reflecting the most common information requests, including getting your user ID and password reissued, or checking your application status.

Phone

Our customer service teams have a detailed knowledge of National Board rules, standards and guidelines. Call from within Australia on 1300 419 495 between 09:00am – 05:00pm local time or from overseas on +61 3 8708 9001 between 09:00am – 05:00pm Australian Eastern Standard Time Monday to Friday.

State and territory offices

AHPRA has an office in each capital city. Contact details are published on our website.

Publications and other information

National Boards produce registration standards, along with guidance and advice that expand on these standards, to support professional practice. We publish detailed information on the National Board websites about registration standards and a wide range of general news and information relevant to health practitioners. You can access all publications through the AHPRA website, which provides a portal to the websites of the National Boards.

Current consultations

The National Boards frequently seek feedback from the professions, the community and other stakeholders on a range of issues. Check the National Board websites regularly via the AHPRA website to keep up to date with current consultations.

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      Page reviewed 30/05/2014