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When someone makes a notification about a practitioner, we review it to see if there is a risk to the public.
This review could lead to a range of different outcomes, from no further action being taken, to conditions being placed on a practitioner’s registration, through to suspension or cancellation of registration via referral to a tribunal.
You can find more information on these and other possible outcomes by expanding the links below.
This is decided when the concern is first received.
The National Law sets down the minimum grounds for Ahpra to accept a notification (sections 141 - 144). Ahpra and the National Boards can only consider it if it meets one of these grounds. The grounds are if a registered health practitioner or student who:
When you submit a concern, you need to provide enough information for us to consider it. We will contact you to find out more if this is not enough. If we cannot establish that one or more of these grounds exist we will contact you and tell you why we cannot take you’re the concern further.
There are different reasons why a National Board may decide to take no further action:
This does not mean your concern was not taken seriously. The details of your concern will remain on record and may be taken into consideration at a later time if another similar complaint or concern is made about the practitioner.
If the Board decides to take no further action, we will contact you and explain the reasons for the Board’s decision.
We may also refer you to another organisation that may be able to provide help.
If, in reviewing a concern, a National Board determines that it is not the appropriate body to handle a matter, it may refer the concern to another agency. Other agencies can include health complaints entities, the Coroner’s Court, the police or Medicare.
The Board can refer the entire complaint or specific and relevant aspects to that other agency, making a joint decision with health complaints entities in each jurisdiction on which agency is most appropriate to manage the complaint.
If this happens, we will tell you, the practitioner, and others involved that the National Board has decided to refer the matter to another agency.
More information about the role of the National Boards and other agencies that handle complaints or concerns about practitioners and/or health services is published on this website.
National Boards can accept an undertaking from a practitioner to limit the practitioner’s practice in some way if this is necessary to protect the public. The undertaking means the practitioner agrees to do, or to not do something in relation to their profession.
Once a National Board accepts an undertaking from a practitioner, it becomes a legal obligation on the practitioner and no right of appeal is available.
When the National Board accepts an undertaking from a practitioner, the undertaking is published on the register of practitioners and may be viewed publicly at any time. When a National Board decides the undertaking is no longer required to protect the public, it is revoked and will be removed from the national register of practitioners.
If the undertaking relates to a practitioner’s health, limited information about the undertaking is published on the public register.
A National Board cannot seek an undertaking from a practitioner, or compel or require a practitioner to provide an undertaking. It is the practitioner’s undertaking and can only be given voluntarily by the practitioner to a National Board.
See also the definition of a condition.
A condition restricts a practitioner’s practice in some way. Imposing a condition means the practitioner needs to do something, or is prevented from doing something, in relation to their profession.
A National Board can impose a condition on the registration of a practitioner or student, or on an endorsement of registration, to protect the public.
Unlike an undertaking, a condition is an instrument used by the National Board and can be imposed on a practitioner’s registration, with or without the practitioner’s agreement.
Conditions are placed on a practitioner’s registration when the National Board believes this is needed to protect the public. There are a number of situations when a National Board might consider putting a condition on a practitioner’s registration. These include:
It is important to remember that conditions can also be placed on a practitioner’s registration for reasons that are not disciplinary, such as for a practitioner who is returning to practice after a break or for health reasons.
Conditions that restrict a practitioner’s practice of the profession are published on the public register of practitioners. When a National Board decides the conditions are no longer needed to protect the public, they are removed from the practitioner’s registration and no longer published.
There are some types of conditions that are used commonly. These include that the practitioner must:
There may also be conditions related to a practitioner’s health (such as a condition for psychiatric care or drug screening). The details of health conditions are not usually published on the national register of practitioners.
See also the definition of undertaking.
A National Board may caution a practitioner. A caution is a like a written warning and is intended to act as a deterrent so that the practitioner does not repeat the conduct or behaviour.
A caution is not usually recorded on the public register but may be if the National Board considers it appropriate to do so.
If a practitioner’s registration is suspended, they cannot practise their profession until a National Board or a tribunal revokes the suspension.
A tribunal has the power to suspend a practitioner’s registration after a matter has been referred to the tribunal for a hearing by a National Board.
A National Board may suspend a practitioner as a form of immediate action in the public interest, if it believes the practitioner presents a serious and immediate risk to public and that a suspension is the proportionate way to address that risk until the matter has been resolved.
Read more about immediate action.
A health panel can suspend a practitioner’s registration if the panel finds that the practitioner (or student) has an impairment and it is necessary to suspend the practitioner’s registration to protect the public.
A reprimand is a formal way of rebuking or expressing disapproval to a practitioner for something they have done. A National Board can reprimand a practitioner after a performance or professional standards panel. A tribunal can reprimand a practitioner after a tribunal hearing.
Reprimands issued since the start of the National Scheme are published on the national register of practitioners.
A health practitioner whose registration has been cancelled is forbidden from practising the profession or working in any way as a health practitioner in that profession in all Australian states and territories.
Only a court or a tribunal has the power to cancel a health practitioner’s registration.
Since 2010, all health practitioners who have had their registration cancelled by a court or tribunal, been disqualified from practice or had their registration prohibited appear on the cancelled health practitioners register.
There is also a list of practitioners who have agreed not to practise when a National Board thinks this is in the public interest. There are circumstances when a practitioner will not appear on this list. Please call us for more information on 1300 419 495.
These case studies provide examples of the types of complaints Ahpra might receive, including how we would investigate them and what the outcome of that investigation could be.
These are published to help practitioners understand how the National Law helps them to practise safely or ethically, as well as showing members of the public what is an acceptable and unacceptable level of care and behaviour.
Note: In these case studies, we may refer to complaints as ‘notifications’ and the person making the complaint as the ‘notifier’.
A patient complained that the nurse who attended them during a hospital stay caused bruising when they made multiple attempts to insert a cannula.
Ahpra learned from its discussions with the notifier that they had also complained to the hospital and that the hospital had conducted its own inquiries into the complaint. The hospital provided the notifier with an explanation and an apology.
All medical procedures carry some degree of risk. On occasion, something may not go as planned or a complication may arise, even when things are done to the standard reasonably expected. Ahpra and the National Boards recognise this and may not require a practitioner to respond in circumstances where a known complication occurs or where another body has already responded appropriately to the complaint.
We confirmed the notifier had received an apology and explanation from the hospital and practitioner. There was no need for a regulatory response, so we closed the notification with no further action taken.
We received a notification about a nurse who presented to the emergency department (ED) suffering an acute mental health episode. A medical practitioner at the ED contacted Ahpra because they felt the nurse’s health could have a detrimental impact on their ability to practice.
We contacted the nurse’s treating practitioner to gain a better understanding of the nurse’s condition, current treatment plans and what support they had. We were also able to speak to the nurse themselves, once it was safe and appropriate for everyone involved.
The treating practitioner explained that the nurse had a mental health condition that had been well managed for several years. However recent medication changes as well as changes in family circumstances had caused upheaval in their lives, which may have led to their hospital presentation.
When managing health related notifications, Ahpra’s goal is to ensure public safety while supporting practitioners to keep practising wherever it is possible and safe to do so. A properly managed health condition should be no barrier to registered practitioner continuing to practise.
The nurse and their treating practitioner were both clear on what had led to the episode and what needed to happen to prevent that happening again. The treatment plan for the nurse was adjusted accordingly and further supports identified and put in place to help them stay well.
The Board found that the treatment plan and supports in place were appropriate to help the nurse practise safely and decided that no further action was required.
A person was admitted to hospital following an accidental overdose on prescription medication. While reviewing their medical history, a doctor at the hospital found they had been prescribed high doses of opioid-based painkillers by their general practitioner (GP) over a significant period. The frequency of prescriptions and dosages had both risen in the months prior to the overdose.
Based on this information, the doctor at the hospital made a notification to Ahpra about the GP’s prescribing practices.
Ahpra worked with the prescribing practitioner to understand how the patient was managed and their current treatment plan. We asked the practitioner about their assessment process and about the decisions they made in the treatment and management of the patient.
We spoke to the practitioner directly and we also asked them to provide a written response for the Board to consider.
The GP’s responses revealed that they did not have a confident understanding of managing patients with chronic pain and relied heavily on medication in such circumstances.
Our investigation also showed that the patient had been prescribed similar medications by other practitioners. While their GP had accessed real-time prescription monitoring systems during the patient’s treatment, they did not appear to adjust their prescribing practices in response.
Our discussions with the practitioner and their response also showed us that the practitioner wasn’t very engaged in peer support, while also seeing a lot of patients each day. Self-care did not appear to be a priority for the practitioner, and they were impacted by stress. This can be a difficult environment in which to practice and, when not managed well, increases the risk of poor outcomes.
The Board identified that the practitioner needed to make changes and improvements to the way they practised, to improve patient care and minimise risk. The Board decided to take action by imposing conditions requiring the practitioner to complete an education module about managing patients with chronic pain conditions and the appropriate use of real time prescription monitoring systems.
The practitioner was also provided with information about available peer support networks to help reduce their professional isolation.
While performing a colonoscopy to check for signs of bowel cancer in a patient, a medical practitioner found and removed several polyps (small growths) as well as a tissue sample. The patient complained that the medical practitioner had performed these procedures during the colonoscopy without their consent.
Ahpra reached out to the practitioner to understand their informed consent process and how the procedure was conducted. We had a discussion with the practitioner over the phone and got them to provide a brief written response.
The practitioner had an informed consent process, but it did not specifically detail the procedures that might need to be performed during a colonoscopy and why they might be necessary. The patient also claimed that while reassuring them about the procedure, the medical practitioner said it was ‘just a quick check to make sure everything is okay’. The patient took this to mean that there would not be any surgical procedures performed during the colonoscopy.
Poor communication is both a cause and factor of many complaints. Maintaining an awareness of the Code of conduct and the requirements for effective patient communication are critical to ensuring care is provided to the standard expected.
A poor understanding of the requirements of the Board’s Code of conduct was a key feature in instance. Gaining informed consent for a procedure includes explaining and gaining consent for actions that are likely to be taken during the procedure.
However, in response to the notification, the practitioner proactively worked with their employer to update their consent forms and procedures. They reviewed the complaint, made sure their new process would address the concerns raised, and contacted the patient to apologise and share their new process.
Given the positive way the practitioner engaged with the complaint and the work done to improve their processes, no further action was necessary.
A routine check of the register of practitioners by a medical service showed that one of their practitioners was not registered, despite being employed by the service and seeing patients. The employer made a notification to Ahpra.
Investigations showed the practitioner’s registration lapsed on the 30 September 2024. Taking into account the one-month grace period under the National Law, they were technically unregistered from 1 November 2024.
The practitioner was reasonably aware that their registration had lapsed. They told their employer there had been a problem with the processing of their registration renewal, but that it had since been fixed. Despite telling their employer this, they had not applied for registration with the Medical Board of Australia.
The practitioner conducted clinical consultations with patients and performed surgical procedures on patients for a period of four months while unregistered.
Practising while unregistered carries a range of personal and professional risks for practitioners and their patients. This includes the practitioner breaching their professional indemnity insurance obligations under the Health Practitioner Regulation National Law. This could expose the patient and practitioner to further risk if something goes wrong during treatment conducted while the practitioner is not registered.
The practitioner’s dishonesty to his employer when asked about his registration was also particularly concerning and contributed to how the Board viewed the seriousness of the conduct.
The practitioner was charged with several offences relating to practising without registration and was ordered by the Magistrates Court to pay $20,000 with no conviction recorded.
Following the criminal case the Medical Board referred the practitioner to the responsible tribunal for professional misconduct.
A patient made a notification about a practitioner’s standard of care. The patient stated that their health needs had not been properly assessed, and they had not received the treatment they needed for their chronic pain condition.
To determine whether the practitioner’s performance was to a reasonable standard, an Ahpra case manger obtained patient records and a response from the practitioner.
In their response, the practitioner provided their process for undertaking patient assessment, including patient history and individual risk factors, informed consent, and clinical decision making.
The practitioner demonstrated a sound understanding of patient assessment and clinical decision making, however their assessment of the patient as articulated in their response was not supported by their clinical records.
Good clinical records reduce the risk of medical errors and ensure an accurate picture of the patient’s clinical circumstances. They also support continuity of care, allowing for enhanced communication between healthcare professionals.
The practitioner identified that their clinical records were not up to standard after reviewing the patient records as part of the notifications process. They undertook self-directed learning in relation to clinical record keeping with the support of their legal representative.
The Board found that the practitioner’s record keeping was below standard but decided to take no further action as the practitioner had already taken appropriate steps to fix the concern.
Registered practitioners are allowed to use social media for both personal and professional purposes. If a notification is made about a practitioner’s social media use, Ahpra will investigate based on a practitioners obligations under the National Law, just as they would for any other notification.
More information about social media use, including case studies relating to notifications, is available here: Australian Health Practitioner Regulation Agency - Social media: How to meet your obligations under the National Law.
A full record of decisions made by adjudication bodies (other than panels) relating to complaints made about health practitioners or students is published in the Australian Health Practitioner Law Library published on the Australian Legal Information Institute’s (AustLII) website.
We also publish a link to tribunal or court decisions on each practitioner’s record on the Public register which involve adverse findings and which were delivered after the start of the National Registration and Accreditation Scheme. You can also search the register of cancelled, disqualified and/or prohibited health practitioners.
Read the decision here.
Nursing and Midwifery Board of Australia v Edwards
Nursing and Midwifery Board of Australia v Ballarto
Nursing and Midwifery Board
AHPRA v Michael Simon
Read the media release.
Ms Jessica Anne Schouten: A tribunal has suspended a nurse for four months after she admitted to professional misconduct concerning misappropriated drugs. Read the news item.
