Your role as an employer
As a healthcare employer, you have a central role in fostering both public safety and a supportive environment for your registered health professionals.
When a registered healthcare professional’s conduct, health, or performance is concerning, you have a responsibility to decide whether the issue is best addressed through your internal procedures, or if it meets the criteria for a mandatory notification to Ahpra.
This guide supports you in making informed decisions about notifications, aiming to reduce stress for both you and your employees by encouraging a balanced approach.
Ahpra has comprehensive Guidelines: Mandatory notifications about registered health practitioners (the guidelines), which features further information about mandatory reporting, including case studies and decision-making resources. We encourage all employers to read and refer to the guidelines when considering mandatory notifications.
Understanding mandatory notifications
What is a mandatory notification?
In certain circumstances, employers and practitioners must tell us if they form a reasonable belief that a practitioner’s conduct, performance or health places the public at risk.
Mandatory notifications made up 10.4% (1,165) of the notifications received in 2024.
There are four concerns that may trigger a mandatory notification. Depending on the type of concern, you must assess the risk of harm to the public when deciding whether to make a notification.
The four concerns are:
- impairment (a physical or mental impairment, disability, condition or disorder (including substance abuse or dependence) that detrimentally affects or is likely to detrimentally affect the person’s capacity to practise the profession).
- intoxication while practising
- significant departure from accepted professional standards, and
- sexual misconduct.
What is reasonable belief?
Before making a mandatory notification, a notifier must form a reasonable belief that the incident or behaviour that led to the concern actually occurred and that a risk to the public exists. For example, the notifier should have direct knowledge of the incident, or a report from a reliable source about their experience or observations. A mandatory notification should not be made based on rumours or gossip.
For more information about what reasonable belief means under the National Law, see section 2.2 of the guidelines: What is reasonable belief?
Before making a notification
Many concerns can be managed within your own procedures, without the need to engage with us, which allows you to address issues directly while offering support to the practitioner. With guidance and adjustments, you can help practitioners improve safely and sustainably while remaining in the workplace.
Concerns that do not require a mandatory notification
Concerns that do not usually need to be referred to us include:
- employment, contractual or business disputes, including poor timekeeping, unauthorised leave and non-compliance with internal policies;
- disagreements with professional decisions,
- sickness absence or concerns about your employee’s health, if these do not impact on their ability to practise safely or they are being effectively managed;
- low level communication issues;
- customer service issues;
- private family or personal disputes and civil claims; and disputes or personality clashes with colleagues or managers, unless this involves bullying or harassment.
Local resolution: Addressing concerns in the workplace
When addressing concerns in the workplace, we encourage employers to:
- Complete a local investigation: Understand the issue fully by gathering details from internal processes, so conclusions are based on comprehensive evidence.
- Contextualise the concern: Performance and conduct issues rarely occur in isolation, and various contextual factors often play a significant role. Focusing solely on individual responsibility risks overlooking these factors, which, when unaddressed, may continue to affect the workplace environment and patient outcomes.
We recommend employers review factors surrounding the incident that might form a deeper understanding of what happened, including but not limited to:
- Operational constraints: Were there staff shortages or time pressures that impacted decision-making?
- Environmental challenges: Did elements such as lighting, equipment functionality, or access to adequate PPE impact the situation?
- System failures: Were there contributing IT issues, unclear medication packaging, or other factors beyond the practitioner’s control?
- Wellbeing concerns: Did fatigue or lack of support affect the practitioner’s performance?
Most performance or conduct concerns can be resolved internally, using strategies like a performance improvement plan, additional supervision, or modifications to their role.
Examples of local first resolution include
- Performance improvement plan: Offers targeted training or mentoring. – Using training and mentoring to help the practitioner reach standards, maintaining patient safety while encouraging professional growth.
- Workplace adjustments: Limits duties to ensure patient safety, such as moving an employee with a health concern away from certain tasks. - Adjusting duties as needed to manage risk (eg modifying roles for practitioners with temporary health concerns).
- Supportive leave: Allows time off for treatment if an impairment affects the practitioner’s capacity to work safely. Providing time away from work for practitioners in treatment for health conditions.
By managing these concerns locally, you can protect public safety while encouraging a positive work environment and providing support.
In situations where these measures are effective, a notification may not be required. However, it is important to consider the situation carefully to understand if a notification is mandatory.
Employers should also consider other factors, including if the partitioner works at other places in the same capacity, and may be a danger to the public there also.
If a practitioner is not compliant with the strategies and measures implemented to address risk, or if there is a risk that the practitioner could place the public in harm’s way, and the threshold for making a mandatory notification is met, an employer must make a mandatory notification.
There are also cases where you are legally required to make a notification, regardless of any workplace action or resolution.
Making a mandatory notification
Mandatory notifications are intended to protect public safety and are required only when there is a reasonable belief of notifiable conduct.
When to make a mandatory notification
In certain cases, you are legally required to make a mandatory notification if you have a reasonable belief that a registered health practitioner has engaged in notifiable conduct.
In relation to a registered health practitioner, notifiable conduct, is defined as:
- practising the practitioner's profession while intoxicated by alcohol or drugs; or
- engaging in sexual misconduct in connection with the practice of the practitioner's profession; or
- placing the public at risk of substantial harm in the practitioner's practice of the profession because the practitioner has an impairment; or
- placing the public at risk of harm by practising the profession in a way that constitutes a significant departure from accepted professional standards.
Situations that typically meet the threshold for a mandatory notification include:
Practising with an impairment and placing the public at risk of substantial harm
You must make a mandatory notification if you form a reasonable belief that the practitioner is placing the public at risk of substantial harm (a high threshold for reporting harm) by practising with an impairment.
You should make a mandatory notification only if you believe there is a risk of substantial harm. A risk of substantial harm is a high threshold for reporting risk of harm to the public.
For more information about what impairment means under the National Law, see section 2.3 of the guidelines: What is impairment?
Practising while intoxicated by alcohol or drugs
You must make a mandatory notification if you form a reasonable belief that an employee practitioner is practising while intoxicated by drugs or alcohol.
For more information about what intoxication means under the National Law, see section 2.4 of the guidelines: What is intoxication while practising?
Practising in a way that significantly departs from accepted professional standards and placing the public at risk of harm.
You must make a mandatory notification if you form a reasonable belief that a practitioner is placing the public at risk of harm by practising in a way that departs significantly from accepted professional standards.
A practitioner may practise in a way that departs significantly from professional standards, but this is not enough to trigger a mandatory notification. You need to make a mandatory notification only if the practitioner is placing the public at risk of harm.
For more information about what significant departure means under the National Law, see section 2.5 of the guidelines: What is a significant departure from accepted professional standards?
Engaging in sexual misconduct in connection with their practice.
You must make a mandatory notification if you form a reasonable belief that a practitioner has or is engaging in sexual misconduct in connection with the practice of their profession.
For more information about what sexual misconduct means under the National Law, see section 2.6 of the guidelines: What is sexual misconduct?
The simplest way is to use the portal on our website, see: Ahpra Notifications page. You can also call us on 1300 419 495 and tell us that you want to make a notification.
Our website also has information about how we handle both mandatory and voluntary notifications. It also explains how to raise a concern if you are in Queensland or New South Wales.
If you are making a mandatory notification and want your identity to be confidential, please let us know. We will endeavour to keep your details confidential. Please see the Ahpra website for more information about how we manage notifications.
Similarly, you can make a notification on behalf of an employer and have the employer listed as the notifier.
A notification to Ahpra should be made as soon as practicable. In this context, the word ‘practicable’ has its ordinary meaning of ‘feasible’ or ’possible’.
We can provide general information to help you decide whether to make a mandatory notification, but we can’t tell you whether or not to notify in a specific case. If you are unsure about whether to make a mandatory notification, you may wish to seek advice from your insurer, legal advisor, or professional association on specific circumstances. You can also find more information by: visiting our website, see: Ahpra Notifications page, or calling us on 1300 419 495.
Mandatory notifications are treated in the same way as all notifications received by Ahpra.
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.
When handling a mandatory notification, together Ahpra and the relevant National Board
- Receive and understand a concern about a practitioner, including speaking to the notifier, for employers, this may include contacting the workplace to gather information about
- how serious your concerns are
- what you have already done to manage risk for this practitioner and how successful it has been, and
- any other information or evidence needed for the National Board to decide.
This may be done through formal, non-compulsory discussions or using the authority granted to Ahpra and the National Boards under the National Law. Further information is available under investigations.
- 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
Further information about how we manage concerns and what to expect throughout the notifications process is available at the below links:
Supporting your employees in the workplace
Business structure, governance and policies
Beyond managing notifications, your role involves supporting practitioners in maintaining safe, effective practice.
Organisations where registered health practitioners work also manage risks at the front line of care delivery. They are instrumental in investigating and responding to risk in the workplace.
Workplaces that do this well:
- have strong clinical governance, policies and procedures in place and they review these often
- investigate and review the incident
- restrict practice where appropriate by:
- scope or activities
- supervision of others, and/or
- vulnerable patients
- provide education and training to improve performance
- assess or re-credential practitioners where relevant
- supervise the practitioner
- respond to adverse events and supporting quality and safety, and
- notify Ahpra when there are ongoing concerns about the practitioner and when mandatory notifications are required.
The notification process
The notification process can be stressful for the practitioner in question and yourself as an employer.
The Ahpra website features a collection of resources to assist practitioners who have had a notification made about them, including a list of support services and a page dedicated to understanding the practitioner notification experience.
Frequently asked questions
Are there consequences for not making a mandatory notification?
A mandatory notification should not be made based on a fear of a penalty for not notifying. Mandatory notifications should only be made when you think the threshold for notifying is met. If a health practitioner fails to make a mandatory notification it may be a breach of professional standards. There are other possible consequences for employers and education providers.
While it is not common for action to be taken, you must make a mandatory notification when you believe the threshold is met. If in doubt, we encourage potential notifiers to seek advice. You can speak to your insurer, legal advisor, or professional association. You can also call Ahpra on 1300 419 495 for clarification or to seek more information about making a notification.
We must report an employer’s failure to make a mandatory report to the responsible minister in the relevant state or territory. The minister must then report it to a health complaints entity, the employer’s licensing authority or another appropriate entity as soon as possible.
Do I have to make a mandatory notification after a health practitioner resigns?
Yes. If you believe that the threshold for making a mandatory notification is met, you must make a mandatory notification even if the employee has resigned.
Non-disparaging clauses in resignation agreements do not exempt someone from needing to make a mandatory notification.
If the behaviour or incident does not reach the threshold for making a mandatory notification, but you have significant concerns about the ongoing risk of harm to the public, you should consider making a voluntary notification.
Are registered practitioners employed by an indemnity provider exempt from notifying?
There are exemptions for registered health practitioners employed by a professional indemnity insurer in certain circumstances. The exemptions are set out in the National Law and the Guidelines: Mandatory notifications about registered health practitioners and Guidelines: Mandatory notifications about registered students.
Non-disparaging clauses in resignation agreements do not exempt someone from needing to make a mandatory notification.
I’m not certain I should make a notification, who can I speak to?
If in doubt, we encourage you to seek advice. You can speak to your insurer, legal advisor, or professional association. You can also call Ahpra on 1300 419 495 for clarification or to seek more information about making a notification.
I have concerns about a student, am I required to make a mandatory report?
Separate guidelines have been developed for mandatory notifications about registered health practitioners and registered students. This is because of the limited circumstances when a mandatory notification must be made about a registered student. The guidelines for students are available here.
More information
For more guidance, see Ahpra’s detailed mandatory notification guidelines on our website.
We also have a range of resources to help you understand mandatory notifications.