These frequently asked questions (FAQ) are to help answer some of the common questions on the proposed regulation of paramedics under the National Registration and Accreditation Scheme (National Scheme) which establishes the Paramedicine Board of Australia (the Board). The regulation of paramedics is being considered as part of the Health Practitioner Regulation National Law and Other Legislation Amendment Bill (Amendment Bill). These FAQ have been prepared in advance of the Amendment Bill being debated in Queensland Parliament and are based on AHPRA’s experience in administering the Health Practitioner Regulation National Law, as in force in each state and territory (National Law) for the current 14 registered professions.
It is intended that these FAQ will be revised subject to the Amendment Bill being passed, and if new questions are asked by paramedics and other interested stakeholders.
Download a PDF of the FAQ for paramedics (374 KB,PDF)
The purpose of the National Scheme is to protect the public. Benefits of national regulation under the National Scheme for paramedics include:
The recruitment and appointment process is underway. Subject to debate and passage of the Amendment Bill, the aim is for Health Ministers to be able to appoint members in September 2017. Depending on when the Board is appointed by Ministers, the first meeting may be in September/October 2017.
To assist National Board members/Chairs understand the governance framework for the National Scheme and perform the roles and responsibilities required under the National Law, all members complete the ‘Governance and decision-making in the NRAS’ program, during their first term of appointment. AHPRA schedules the training. All appointed Board members also receive an orientation to the National Scheme and a Board-specific induction at the start of their term.
At this stage registration of paramedics is expected to commence in the second half of 2018 (around September 2018). The date on which registration of paramedics commences is referred to as the ‘participation day’ and is to be prescribed in a regulation.
This date is subject to the National Law being amended to enable regulation of paramedics under the National Scheme and the Board being appointed by the Ministerial Council in September 2017.
AHPRA and the Board need 12 months to undertake the implementation phase, working together to prepare the profession for national regulation. This will help ensure a smooth transition so that people who are currently working or are qualified as paramedics understand what national regulation means for this profession, and what they will need to do to seek registration before the participation day.
Paramedics will hold national registration under the National Scheme. Under the National Scheme, AHPRA and the National Boards work in a collaborative partnership to protect the public. The Board (or delegate) makes registration decisions. AHPRA provides administrative and policy support to the Board.
Paramedics are not currently required to be registered in any state or territory. For the first time in Australia, paramedics will be required to seek national registration. The Board and AHPRA will need to ensure that people who are currently working or qualified as paramedics understand what national regulation means for this profession, and also what they need to do to apply for registration before the participation day.
Subject to the National Law being amended, the Board is expected to have approximately 12 months after it is established (appointed by Health Ministers prior to the participation day) to work with AHPRA to prepare the profession for national regulation.
The Board will be able to exercise some but not all of its regulatory functions during this period. For example, AHPRA and the Board will not be able to receive and manage complaints about paramedics as the profession will not yet be registered under the National Scheme.
The preparation phase is a critical time for us working together as regulatory partners, and also for the profession who will want to know as soon as possible what the registration requirements will be and what they need to do to seek registration. For information on implementation steps and duration, visit AHPRA’s Regulation of paramedics webpage.
The priority work during this period is expected to include (but may not be limited to):
On the participation day, national regulation of paramedics will start, and the Board will be able to exercise its full functions under the National Law.
Note: The Amendment Bill defines the “participation day” as a day prescribed by regulation after which an individual may be registered in paramedicine under the National Law. In practice, the participation day is planned to be the date on which registration for paramedics will commence or “go live”.
Registration fees are payable by the individual seeking registration or renewal of registration and as such can usually be claimed as an employment expense for taxation purposes. Please note this document is not intended to provide taxation or financial advice and registrants should seek their own advice or contact the ATO.
Paramedics will also be required to pay a one-off application fee as first time registrants. This fee is to cover the costs associated with processing their application and assessing a person’s eligibility and suitability for registration. This includes verification of the practitioner’s identity, assessment and verification of qualifications, training and/or expertise as a paramedic, and covers the cost of a criminal history check (in Australia), and confirmation of registration status with international regulatory bodies (as needed). Again, it is not possible to advise at this point in time what the one-off application fee for paramedics will be, as it will be determined by the Paramedicine Board (once established) and AHPRA.
The National Law sets out ‘grandparenting’ provisions, which are available for three years from the commencement of registration of paramedics (the participation day). They enable a person who is working or has worked as a paramedic to apply for registration even if the person does not hold an ‘approved qualification’ for registration, but has another relevant qualification/s, training and experience practising the profession. ‘Approved qualifications’ for general registration for paramedics will be decided by the Board after it is established.
The intent of having grandparenting arrangements is to ensure that practitioners who are legitimately practising the profession have a way of seeking registration and are not disadvantaged because they are not recent graduates. This is especially important because no state or territory in Australia currently has a registration system in place that could ‘automatically’ transition state and territory registered paramedics into the National Scheme.
It is important to note that all of the other eligibility requirements for registration, for example criminal history and identity checks, set out in section 52 of the National Law will apply to everyone seeking registration.
The grandparenting provisions in the Amendment Bill state that an individual is qualified for general registration in paramedicine if the individual:
These grandparenting provisions will not apply in relation to NSW vocational qualifications specified in the Amendment Bill as there is a different pathway for these practitioners.
If you let you registration lapse, you will need to re-apply for registration. Importantly, the National Law (section 53(d)) provides that individuals are qualified for general registration if they have been previously registered under the National Law. In practical terms, this means your qualifications, training and/or experience will not need to be reassessed if you were originally registered via a grandparenting pathway. However, you will still need to meet the other requirements for registration type you apply for and have your application assessed.
If you are planning to take a break from practising the profession, an alternative to letting your registration lapse may be to apply for ‘non-practising’ registration. This type of registration allows you to be registered, use the protected title ‘paramedic’ and have your name appear on the national register (as holding non-practising registration). However, when you hold this type of registration you cannot practice the profession.
At this stage, the application fee and the registration fee have not yet been decided.
Registration fees are set by the Board and AHPRA and vary between professions based on the cost of regulating each profession under the National Law. The fees vary depending on factors such as the size of the profession, the risks associated with practice, the level and complexity of complaints and notifications, and the capital reserves needed to ensure sustainability of the operations of the Board. The National Law requires that registration fees are reasonable having regard to the efficient and effective operation of the National Scheme.
Registration fees for paramedics will be set by the Board and AHPRA after the Board is established. In addition to annual registration fees, paramedics will also be required to pay a one-off application fee for first time registrants. The application fee is to cover the costs associated with processing the application and assessing a person’s eligibility and suitability for registration. This includes verification of the practitioner’s identity, assessment and verification of qualifications, training and/or experience as a paramedic, and covers the cost of a criminal history check (in Australia), and confirmation of registration with international regulatory bodies (as needed).
AHPRA will keep the profession up to date with the work that is being done – including after the Board is established later this year. AHPRA has a dedicated webpage communicating updates about the regulation of paramedics under the National Scheme and has recently employed a project manager to oversee implementation.
You can sign up to be on our mailing list. AHPRA expects to release bulletins to keep the profession and other interested stakeholders informed as we get closer to registration going live in late 2018. A comprehensive communication strategy that will include use of social media is also being developed. After the Board is established, it will have its own webpage where paramedics can go to for information.
Liaison with peak industry stakeholders, unions, and employer groups will also be critical to ensuring that paramedics in the public sector and also the private sector know about national regulation and how to apply.
The title of ‘paramedic’ will be protected under the National Law. This means that from the participation day, only persons registered as a paramedic can lawfully use this title.
It is recognised that people are employed as medics and provide valuable services in this capacity – including in the armed forces. The title ‘medic’ is not a restricted title and medics will not be required to be registered. However, as some medics have paramedic qualifications and or experience, they may wish to apply for registration as a paramedic especially while grandparenting arrangements are available.
The Board will be asked to consider a position statement that clarifies the title protection that operates under the National Scheme, particularly having regard to ‘medics’.
AHPRA expects that the vast majority of applications for registration of paramedics will be decided by the participation day and therefore most working paramedics will be registered. We strongly encourage all paramedics to begin the registration process as soon as it is open, although no paramedic will be deemed as registered until participation day.
However, based on experience introducing national registration for other professions, there can be a last minute rush of applications, all of which may not be able to be decided by the participation day by the Board. Understandably this can be stressful for the applicants and their employers who are managing rosters. Ultimately this uncertainty can have an impact on the provision of health services – especially in regional or rural areas.
To help manage this situation, if a person has applied to the Board for registration before the participation day, but the Board has not decided the application, the applicant does not commit an offence against the National Law by calling themselves a paramedic while the application is being decided. That is, the person can take and use the title ‘paramedic’ and hold themselves out as a paramedic while the application is being decided.
Further, if an eligible paramedic submits a late application to the Board, the applicant can be assured that no enforcement action will be taken against them provided they submit their application within 90 days after the participation day.
There will be significant communication with the paramedic profession in the lead up to registration ‘going live’. Every effort will be made to ensure that paramedics understand what they need to do and provide when applying for registration, and that employers also understand the process and the consequences if a person who is employed as a paramedic is not registered – particularly after the 90 day grace period expires.
There is no ‘automatic’ transition for paramedics – you will need to apply for registration.
Applicants seeking to register as a paramedic will apply via the AHPRA or the Board’s website through an online application process. We anticipate this will become available in 2018 once the Board has consulted on registration standards and submitted the standards for approval by Health Ministers. Information on the requirements and the process will also be publicly available then.
The relevant delegate on behalf of the Board will review and decide the outcome in line with the National Law. Paramedic applicants will be assessed against the requirements of the National Law and the registration standards, including grandparenting arrangements.
The purpose of grandparenting arrangements is to enable a person who is working or has worked as a paramedic to apply for registration even if the person does not hold an ‘approved qualification’ for registration, but has another relevant qualification/s, training and experience practising the profession.
The Board (once established) will work with AHPRA to advise paramedics what they will need to do to apply for registration. At this stage, we anticipate the Board may be appointed around September 2017, and if so, national regulation of paramedics will start approximately 12 months after that (around September 2018). During this 12 month period, the Board will publicly consult on the registration standards for the profession, which will set out requirements for registration including for those who hold an overseas qualification and/or registration.
All criminal history disclosures and disciplinary orders or decisions can be considered - past or present.
One of the mandated registration standards that the Board needs to develop and submit to the Ministerial Council is for assessing the criminal history of paramedic applicants. All 14 current National Boards have the same approved criminal history registration standard.
When applications for registration as a paramedic are assessed, the Board will assess the suitability of an applicant for registration, and take into account:
We encourage paramedics who are currently not working to keep informed of the registration standards and explore their options and requirements for registration particularly while the grandparenting arrangements are available for three years. Three scenarios for a person who is not currently working include:
The National Board member vacancies were publicly advertised on 29 May 2017, in accordance with the National Law. In deciding whether to appoint an eligible and suitable person as a member or Chair of a National Board, the Australian Health Workforce Ministerial Council (Ministerial Council) must have regard to the skills and experience of the person that are relevant to the Board’s functions.
The size and composition of the Board is also decided by the Ministerial Council. Ministers asked AHPRA to issue a call for expressions of interest/nominations for appointment to a nine person National Board.
This means recruitment of six practitioner members and three community members:
AHPRA facilitates the recruitment process which includes advertising the vacancies, receiving and verifying all applications and expressions of interest, answering queries about the process, and conducting all required probity checks.
AHPRA is not part of the selection advisory panel and does not decide who is selected or appointed.
The remuneration for members of a National Board was determined by the Australian Health Workforce Ministerial Council under a ‘sitting fees’ model at the start of the National Scheme in 2010. Business rules for the payment of sitting fees and expenses are set by AHPRA. Remuneration is usually adjusted on an annual basis according to the consumer price index. Board members are also entitled to reimbursement of any reasonable out-of-pocket expenses incurred during the course of undertaking board business.
AHPRA recognises that appointed board members who are government or statutory employees may be bound by their employer policy about payment for work undertaken outside of the employer, which may alter the way board members are remunerated. As a general principal, if a board member undertakes board business during usual business hours (with the agreement of the employer) and continues to be paid by that employer, he/she will not receive remuneration – i.e there is no ‘double-dipping’.
The current remuneration (daily sitting fee) is as follows:
In accordance with the National Law the Ministerial Council decides the term of appointment for all board members – which may be for a period of up to three years. Board members may then seek reappointment for a further term/s when the vacancies are publicly advertised. Consistent with the Australian Health Ministers’ Advisory Council (AHMAC) endorsed National Board Succession Planning Principles, a board member may serve up to (and including) three consecutive terms of appointment on a National Board (i.e. up to nine years total).
National Board Chairs have important leadership responsibilities and are seen as setting the tone and direction for their board within the National Scheme. A Board Chair is expected to be able to deftly manage divergent professional and other stakeholder views; engage openly and strategically and build and maintain professional stakeholder relationships; have a solid understanding of contemporary practice (including the dynamics of each profession and related factions); build strong working relationships with partner stakeholders (including AHPRA, accreditation authorities, and co-regulatory authorities), and be able to lead a consensus driven, balanced and effective board that protects the public.
National Board Chairs are therefore remunerated at a higher rate – $784 for a full day sitting (the rate for an ordinary board member is $642).
The Ministerial Council decides who will be appointed as Board Chair when all member appointments are made. Currently under the National Law, only appointed practitioner members are eligible to also be appointed Board Chair. In August 2015, Australian Health Ministers announced acceptance of recommendation 26 of the Report on the independent review of the National Registration and Accreditation Scheme, that the National Law be amended to enable Ministers to appoint either a practitioner member or a community member of a National Board as Chair. However, this change to the National Law has not yet been made.
AHPRA provides administrative and policy support to National Boards and has an office in each state and territory. This provides local knowledge and support within a national framework. Once established, the Board may establish committees to support its work. For example, the Board may wish to establish a registration committee to assist with assessing applications for registrations. However, these are not geography-based committees. This would be consistent with the experience and approach of the four additional National Boards established in 2011 to regulate Aboriginal and Torres Strait Islander health practice, Chinese medicine, medical radiation technology, and occupational therapy.
There are five mandated registration standards that all National Boards are required to develop, publicly consult on, and submit for approval by the Ministerial Council.
The registration standards will set requirements for:
The Board may also need to develop other codes and guidelines that will provide guidance to registered paramedics - for example so that paramedics know what they need to provide if applying for general registration via the grandparenting arrangements.
Yes. One of the priorities for the Board will be to develop and consult on these registration standards and their requirements, so that paramedic stakeholders can have their say before the standards are finalised and recommended for approval by Health Ministers.
Approved registration standards set requirements for registration - including English language skills, criminal history, professional indemnity insurance arrangements, continuing professional development (CPD), and recency of practice. All approved registration standards are published on each of the National Boards’ websites. As a general principal, requirements for registration should be consistent across all of the professions regulated under the National Scheme, and any profession-specific variance needs to be clearly articulated.
This depends on which registration standard is not met by the applicant. A person applying for paramedic registration will be able to see the requirements for registration and what is required to meet each registration standard. Where an applicant is refused registration initially, they are advised of the reasons for that decision. Fresh applications for registration can be lodged at anytime or preferably once they meet the relevant registration standard.
Like the other National Boards that have been established under the National Scheme, the Board will decide what qualifications are to be approved for registration purposes. This will be a priority for the Board, once it is established later this year.
Under the National Law, an approved qualification is a one obtained by completing an approved program of study for the profession. An approved program of study means an accredited program of study approved by the National Board.
Therefore, another priority matter to be decided by the Board will be the appointment of an accreditation authority that will be tasked with developing accreditation standards for approval by the Board and providing reports on accredited programs of study to the Board. Based on experience with the entry of four additional health professions to the National Scheme in 2012 (Aboriginal and Torres Strait Islander health practice, Chinese medicine, medical radiation practice and occupational therapy), the accreditation standards are expected to be developed and approved approximately12-15 months after the accreditation authority is appointed. It is then expected to take the accreditation authority two to three years to assess and accredit all the paramedicine programs.
This means it will not be possible for a program of study to be accredited under the National Law before the ‘participation day’ (the commencement of registration of paramedics). The National Law sets out time-limited provisions, which are available for three years from the participation day to ensure that the Board can approve programs of study before they are accredited under the National Law. These provisions allow the Board to approve, or refuse to approve, programs of study as providing a qualification for registration in paramedicine based on the programs of study accredited by the Council of Ambulance Authorities (CAA) at the time of the Board’s decision. The CAA is the current accrediting body for programs of study for paramedicine and its membership includes the ambulance authorities of each state and territory.
In summary, there will be three main pathways to be ‘qualified’ for general registration as a paramedic:
All applicants for registration in paramedicine will be required to meet the registration standards to be developed by the Board, regardless of which pathway they use to qualify for registration.
AHPRA will publish a list of all approved qualifications and programs of study.
NSW initially reserved its right as a sovereign state to participate in the registration of paramedics under the National Scheme, pending resolution of policy issues. This included preservation of the paramedic vocational qualification delivered by the Ambulance Service of NSW.
On 7 October 2016, Health Ministers agreed to include a provision in the National Law to specify that a person will be qualified for general registration as a paramedic if they hold the Ambulance Service of New South Wales paramedic qualification - that is, they will hold an accepted qualification.
This decision made by all Health Ministers is a pragmatic one, to ensure the participation of all states and territories in the national registration scheme for paramedics. This is an important outcome for the National Scheme. It ensures that paramedics will be registered nationally, which is consistent with all other professions regulated under the National Scheme. This outcome also provides greater clarity and protection for the public, in that employers and consumers will be able to go to one place - the national register of practitioners maintained by AHPRA - to inform themselves about whether a paramedic is registered to use the title and/or has any conditions on their right to practice.
No. This provision has been ‘ring fenced’ so that it only applies for paramedics who hold a Diploma of Paramedical Science, Diploma of Paramedical Science (Ambulance), Advanced Diploma of Paramedical Science (Ambulance), Diploma in Paramedical Science (Pre-Hospital Care) or Advanced Diploma Paramedical Sciences (Pre-Hospital Care) issued by the Ambulance Service of NSW. If a paramedic from another state or territory has vocational training and/or a diploma level qualification issued by a different education provider, they can apply for general registration using the grandparenting arrangements.
Under the National Law, National Boards decide the accreditation authority that exercises the accreditation functions for the profession under the National Scheme. Therefore one of the priority decisions for the Board will be to decide whether the accreditation authority will be an external body or an accreditation committee established by the Board.
Yes. The CAA accreditation of study programs will remain valid despite any decisions that the Board will need to make about approved programs for registration purposes and the accreditation authority. Section 310 of the National Law explicitly provides a mechanism for the Board to use the CAA accreditation (for a limited time) to enable the Board to decide whether or not to approve a program as providing a qualification for registration in paramedicine.
This mechanism enables the Board to consider whether or not to approve programs accredited by CAA and published on the CAA website immediately before the Board commences its work or in the period between when the Board commences its work and when paramedicine registration starts. The Board’s ability to approve through this mechanism continues for up to three years after paramedicine registration starts. Under the National Law, the Board is responsible for the approval of accreditation standards submitted to it by the accreditation authority that the Board has appointed. The Board is also responsible for approving accredited programs of study as providing qualifications for registration in the health profession.
The accreditation authority, appointed by the Board to undertake the accreditation functions in the National Law, is responsible for developing accreditation standards (for approval by the Board) and for accrediting programs of study in accordance with the National Law.
We can’t give an absolute guarantee for any programs, because it’s the Board, not AHPRA, that will make the decisions on whether a current program that is accredited by the CAA is a suitable qualification for the purposes of registration in paramedicine.
The exception is that people who hold the Ambulance Service of NSW Diploma of Paramedical Science are qualified for registration - Section 312 of the National Law will provide for this. Even in this case, people will still need to satisfy the other mandatory regulatory standards (e.g Criminal history, English language, recency of practice etc).
For the first three years after paramedicine registration starts, the Board may decide a qualification is adequate, even if it is not accredited by the CAA or by the accreditation authority. If there is a lack of evidence that graduates are competent for practice, the Board may require them to complete some further study, training, assessment or supervised practice in order to qualify for general registration.
No - you will need to apply for general registration. Students due to complete an Australian approved program of study in the other 14 register professions can apply for registration 4-6 weeks before they complete their course. Further information on graduate applications for the other registered professions can be found in AHPRA’s FAQ on graduate applications.
No - the national register of students registered under the National Scheme is not public. The public register is for registered health practitioners.