How we manage concerns

When someone raises a concern with us, we call that a notification.

 

Safe and professional practice by practitioners

Safe, professional responses by practitioners and their workplaces help us to keep future patients safe. Safe, professional practitioners, engaged by safe, responsive health services, benefit all patients and the broader community. The types of actions taken change as the risk changes.

Managing risk and supporting safe and professional practice

  Practitioners Employees, Health Services, Practices  National Boards and Ahpra 

Serious departure from accepted standards

Comply with regulatory and organisational requirements to respond to risk.

Recognise, reflect and respond to risks in own practice.

Give priority to obligations for patient safety.

Initiate and actively participate in risk management within the practice / organisation.

Change or limit practice, update knowledge or skills according to risk.

Engage with peers for support and assistance.

Notify regulator about serious concerns or those that extend beyond, or can not be managed by, the practice / health service.

Restrict privileges.

Require supervision, training, re-credentialing.

Performance management and disciplinary processes.

Monitor, analyse and respond to indicators of increasing practitioner risk.

Refer to tribunal for possible professional misconduct.

Take interim action where necessary to manage serious risk or in the public interest.

Monitor compliance with regulatory conditions.

Refer to police or other agencies where necessary.

Take regulatory action targeted to unmanaged risk — conditions, restrictions undertakings.

Make findings for unsatisfactory performance or conduct.

Respond to increasing concerns or risk

 

 

 

 

 

 

 

Respond to adverse events, error, quality concerns 

Recognise, reflect and respond to adverse events, errors and near misses.

Respond with openness and priority for patient safety.

Participate in open disclosure and adverse event reporting.

Initiate and participate in quality activities.

Act to improve practice and minimise risk of recurrence.

Reflect on and respond to patient complaints.

Monitor, respond to and report complications, adverse events, complaints.

Open disclosure.

Take actions to respond to risks and support safety.

Supervision and peer review.

Education, policy development, system changes.

Ensure culture and team support for quality and safety.

Protections and supports for patients who are more vulnerable than most.

Processes that invite and respond to patient or carer complaints.

Take account of individual practitioner and organisational actions to manage risk.

Prompt and suggest practitioners respond to poorly managed risk, gaps in professionalism or quality of practice.

Refer relevant concerns to health complaints entity.

Refer system concerns to health service or system regulator.

Analyse regulatory data to identify clusters of risk and share with others who can respond.

Promote safe professional practice and manage inherent risks

Maintain professional knowledge and skills.

Practice within scope and competence.

Exercise sound judgement about work undertaken vs referred on, according to knowledge and skills.

Engage with the profession.

Participate in quality activities.

Be aware of and adhere to standards.

Clinical audit.

Clinical effectiveness.

Research and development.

Openness.

Risk management.

Education and training.

Audit compliance with registration standards.

Standards, codes and guidelines.

Engage with and reflect community expectations for health professionals in our standards.

  Individual risk controls Organisational risk controls Regulatory risk controls

As a regulator, we will take action in response to a concern, when the actions of an individual practitioner and/or their workplaces are not sufficient, to ensure we can prevent the same thing happening again.

Most practitioners use notifications to think about and act on improvements they could make to their practice of their profession. 

We consider this and other things when deciding what to do in response. They include:

  • the regulatory history of the practitioner to see if there is a pattern of concern
  • the actions taken by the practitioner’s workplace
  • how the individual and workplace actions combine to prevent future risk to patients.

We need to assess risks that an individual practitioner might pose. Some of the things we consider when assessing risk of the practitioner, and what we may need to do in response, include the characteristics of the:

  • concerns raised to assess if knowledge, skill or judgement possessed, or care exercised by the practitioner is below a reasonable standard
  • type of practice, the inherent risk and the relevant standards or guidelines
  • practice setting, including access to professional peers and supports and the vulnerability of patient groups, and
  • practitioner, including their regulatory history and the actions they have taken in response to the concern. 
characteristics of the notification, practice, practice setting and practitioner

We call concerns notifications. 

There are several stages that notifications can go through but not every notification goes through all stages. In fact, most notifications are dealt with quickly at the initial assessment stage. Our goal is to identify as early as possible when a National Board may need to take regulatory action to protect future patients. We understand that finding out what will happen to a notification quickly is important to notifiers and practitioners. 

We must assess every notification. This involves deciding whether we need to trigger an investigation into a practitioner or not. 

The first thing we do is to confirm first that the notification relates to:

  • a registered health practitioner (or student), and
  • is something that the National Law will let us consider. See possible outcomes to understand grounds.

We then work through the following steps, repeating them when necessary at each stage. We try to speak directly to the notifier and practitioner early in the process (unless we have decided we cannot do this) and it is important to us that notifiers and practitioners understand:

  • what they can expect from our notification process
  • the support available 
  • what is going to happen and when
  • how long something might take
  • what we might need from them or need to do and why, and
  • why a National Board makes the decision that it does. 

Together Ahpra and the relevant National Board

  • Receive and understand a concern about a practitioner, including speaking to the notifier
  • Review information we hold about the practitioner, including regulatory history and assess the risk
  • Speak directly to the practitioner to gather information about their practice setting and context
  • Validate any steps taken by the practitioner and/or their workplace to manage any risk to the public
  • Take regulatory action when practitioner risk is not sufficiently managed by individual and/or organisation risk controls
 
 
 
Page reviewed 27/11/2020