Improving the registration renewal process

Renewal campaigns for all 14 regulated professions ran smoothly and produced strong results this year, with the number of health practitioners renewing online reaching a new high. Overall, 98.07% of registered practitioners chose to take advantage of this quick and easy method of renewing their registration. This extremely high online renewal rate continues to position AHPRA at the forefront among its international peers in this area of performance.

More than half the practitioners on the national register are nurses or midwives. AHPRA worked with the Nursing and Midwifery Board of Australia to complete a comprehensive review of the Board’s renewal-related correspondence. Testing new material with a group of registered nurses and midwives received overwhelmingly positive feedback. The improved correspondence was used during the Board’s renewal campaign, supported by increased social media activity and a new video that guides practitioners step by step through the online renewal process.

More than 370,000 nurses and midwives were due to renew their registration by 31 May 2016. Over 98% renewed online and on time – the Board’s highest ever online renewal rate. The customer service teams received 17% less phone calls and 30% less web enquiries from practitioners about the renewal process compared with the level of enquiries in May 2015. In a survey about their renewal experience, 95% of respondents said the email reminder instructions were perfectly or mostly understood. Importantly, 85% of respondents indicated they did not need to contact AHPRA while completing their renewal.

Improving the way we deal with concerns

This year, AHPRA continued to implement practical actions to improve the experience for both the public and practitioners when making, or being the subject of, a complaint (notification).

Communication materials have been redrafted, starting with a more conversational and less formal approach to letters, and we made web content easier to navigate and understand. We’ve taken a more flexible and accessible approach to how and when we communicate with notifiers by offering face-to-face meetings and scheduling phone calls to discuss outcomes.

An essential part of improving customer experience was ensuring staff were supported and skilled, as well as able to understand the process from both the practitioner and notifier perspective. We have continued to work with the Australian Medical Association (AMA) and others to look at ways in which practitioner experience can be improved when a notification is made.

Improvements include significantly reduced time frames for assessing matters; developing a decision matrix with the health complaints entities (HCEs) we work with in each state and territory to better steer complaints and notifications to the most appropriate pathway; improved communication with practitioners; and more regular review of notifications by senior staff and Board members at specific times, to make sure regulatory work is on track.

In response to the review of the National Scheme, a comprehensive program of work has been led by a working group involving AHPRA, the National Boards and health complaints organisations in each state and territory. To strengthen joint work on complaints management, the working group led the implementation of a number of improvements to promote greater consistency and collaboration. This included better communication with complainants and with each other, to support joint consideration of complaints.

We also initiated an information campaign about the roles and responsibilities of AHPRA, the National Boards and the HCEs, including producing a brochure for the public on the most suitable organisation through which to direct a complaint.

Improving risk assessment and ensuring thorough investigations

This year, AHPRA focused on how we can continue to improve the notifications process by further developing a risk-assessment tool to better identify risks to public safety, act on risks faster and manage notifications more consistently nationwide.

The risk assessment tool is designed to promptly recognise the potential risk associated with a notification as it’s received, and structure an approach to how we manage known and unknown risks for each notification. The tool is currently being trialled in Victoria, Tasmania and the Australian Capital Territory, where it has been incorporated in the notifications process.

The tool identifies areas of risk or potential risk of harm and what information is needed to adequately assess risk. It offers an improved approach to the early identification and management of risk, as well as improving communication with both the notifier and the practitioner who is the subject of the notification.

We have also invested in our investigative capability by strengthening investigator training.

Raising awareness of the scheme

To increase awareness of the National Scheme and how it protects public health and safety, we rolled out a nationwide campaign aimed at employers, practitioners and the general public.

The campaign was delivered in three phases, mostly through our social media channels and advertisements in news media and major health publications across the 14 professions.

The first phase, ‘Know your obligations’, targeted people who employ health practitioners. They were reminded about their legal obligations when recruiting and managing practitioners, and the importance of staying up to date with the status of each employee’s registration. The second phase, the ‘Not-so-small print’ campaign, focused on informing registered health professionals about their obligations under the scheme, including mandatory reporting and complying with the Guidelines for advertising regulated health services.

The third phase, ‘Be safe in the knowledge’, was designed to educate members of the community about the national register of practitioners and what to do if they have any concerns about an individual practitioner and their services.

Being transparent and holding ourselves accountable

As part of a continuous focus on improving transparency and accountability, AHPRA introduced a new initiative in April 2016: the release of quarterly performance reports. These reports contain comprehensive information about the performance of AHPRA and the National Boards in each state and territory over a three-month period.

Data relate to our main areas of activity – managing registration, managing notifications (excluding NSW), offences against the National Law, and monitoring health practitioners and students with restrictions on their registration.

The public and practitioners have been invited to provide feedback on this new reporting approach. Reports are made available on our statistics page

Seeking feedback from the community and professions

Our commitment to working with the community is ongoing through our Community Reference Group (CRG). This group meets regularly and consists of members of the community who are not registered health practitioners. They provide feedback, information and advice on strategies for building better knowledge in the community about health practitioner regulation. Feedback is sought on topics such how to improve the notifier experience and increasing public awareness of key issues. We also gain feedback, information and advice from the Professions Reference Group (PRG).

The membership of the PRG consists of one representative from a professional association for each of the regulated professions and one representative from the Health Professions Accreditation Councils’ Forum. Quarterly meetings are held to discuss AHPRA’s operations, such as improvements to AHPRA’s processes, and raising public awareness of the register.

Both groups publish communiques on the AHPRA website after each meeting for transparency. For more information visit our CRG meetings page. For more information visit our PRG meetings page.

Prosecuting statutory offences

AHPRA prosecuted nine individuals in the Magistrates’ Court for statutory offences under the National Law during 2015/16, resulting in six convictions. Those convicted were fined and/or ordered to complete a period of community service or good behaviour.

Three matters resulted in non-convictions, with these individuals being fined and/or receiving a community service or good behaviour order. One matter also resulted in a conviction being recorded against a company. A significant court outcome for 2015/16 saw an imposter nurse jailed. A joint investigation by AHPRA, other health agencies and the police led to the successful prosecution of a woman who falsely claimed to be a registered nurse. She had been employed as a nurse at a number of aged care facilities across South Australia and New South Wales, and dishonestly received more than $340,000 in wages. A notification about her care of an elderly patient led to an investigation, which uncovered long-term dishonest conduct, including identity theft and the production of false documents.

The woman pleaded guilty in court to seven counts of deception and was jailed for four years with a non-parole period of 14 months. She was ordered to pay almost $30,000 to the Australian Tax Office for undeclared earnings. In a later court hearing, she was fined a further $7,000 after pleading guilty to 20 charges of breaching the National Law by using the protected title of ‘registered nurse’ and for holding out that she was a registered nurse.

The health sector and news media continue to show strong interest in the outcomes of our regulatory actions to protect the public from potential harm. We proactively engaged with the media during the year to highlight court and tribunal outcomes and increase public awareness of the scheme.

Ensuring practitioners meet advertising requirements

The National Law limits how regulated health services can be advertised (and bans certain ways of advertising regulated health services).

The National Scheme’s approach to achieving compliance with the National Law initially focuses on education and helping practitioners understand the law. When advertising complaints are received, we aim to achieve compliance as quickly and effectively as possible. This means we warn practitioners whose advertising practices fall outside the law, and remind them of their obligation to ensure any advertising is lawful.

Over the past 12 months, there has been a growth in the number of complaints about advertising, particularly in relation to chiropractors. AHPRA worked closely with the Chiropractic Board of Australia to develop a Statement on advertising, which was released in March 2016 via the Chiropractic Board of Australia’s website. This document provides clarity about unacceptable advertising of chiropractic services.

In addition, AHPRA’s Statutory Offences Unit has been working through a large number of complaints with the aim of achieving compliance as quickly and effectively as possible.

Developing the Aboriginal and Torres Strait Islander health workforce

The relatively new profession of Aboriginal and Torres Strait Islander health practice joined the National Scheme in July 2012. The profession is growing rapidly, with the number of registered practitioners more than doubling between 2012 and 2016.

One of the main barriers to registration, particularly for people working in remote communities, is the ability to access an accredited program of study. During 2015/16, AHPRA’s Accreditation Unit supported the profession’s independent Accreditation Committee in assessing nine applications to accredit programs of study under the National Scheme. The overall number of approved training programs in Aboriginal and Torres Strait Islander health practice is expected to reach 15 in the coming year.

AHPRA continued to strengthen its connections with Aboriginal community-controlled health services and registered training organisations to increase awareness of the important benefits of registration under the National Scheme and offering accredited programs.

AHPRA has worked closely with training providers to encourage them to apply for accreditation and to help them understand and fulfil the rigorous requirements of the accreditation process. Some providers sent trainers to deliver accredited programs in remote communities, making training more accessible to people living and working in these communities.

This work supports the Australian Government’s National Aboriginal and Torres Strait Islander health plan 2013–2023 and the National Aboriginal and Torres Strait Islander health workforce strategic framework (2011–2015). It also contributes to the national Closing the gap on Indigenous health issues targets for addressing the disparity between non-Indigenous and Indigenous Australians in areas such as life expectancy, child mortality and employment.