December 2019

In this edition:


Welcome from the CEO

Welcome to our summer issue of Ahpra Report, which highlights the work of Ahpra and the National Boards over the past six months. You’ll notice a new look and a simplified logo which is part of a refresh in the lead up to our 10-year anniversary in 2020.
You can read highlights of the past year in our Annual report 2018/19. We use our health workforce data to learn and collaborate with partners to promote patient safety. The report also explains our performance as a regulator.

The biggest news in the past year was the paramedicine profession joining the National Scheme. More than 18,000 paramedics have just renewed their registration for the first time, an important milestone. Overall, registrant numbers grew by almost 41,700 in total, meaning one in 17 working Australians is on the national register of practitioners..

We’ve continued work with our Aboriginal and Torres Strait Islander health strategy group to consult on and develop an agreed definition of ‘cultural safety’. We have appointed a cultural safety training provider for Ahpra and the National Boards.

We have prepared for important reforms to the National Law which will take effect early in 2020. These include revisions to the mandatory reporting requirements for treating practitioners, to support both patient safety and registered practitioners seeking help for health issues without unnecessary fear of being reported. We’re working closely with the professions to roll out an awareness campaign to practitioners and we’ve added new practitioner-experience videos to our ‘Let’s talk about it’ notifications video series.

Finally, we’ve made a splash in international circles. In October, the Council on Licensure, Enforcement and Regulation (CLEAR) gave its Regulatory Excellence Group Award to Ahpra’s Notifications team and announced our Regulatory Operations Executive Director Kym Ayscough as the incoming president.

You’ll find more about these topics and many others in this newsletter, and we welcome your feedback. Thank you for your support over the past year and we send our best wishes for this holiday season.

Martin Fletcher
Martin.Fletcher@ahpra.gov.au

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What’s new?

Annual report for 2018/19

Being uniquely placed to collect information about Australia’s registered health practitioner workforce, we are proud to be able to share our latest annual report. The report includes information about each of the 16 registered health professions and an overall view of the registered health practitioner workforce in Australia.

In 2018/19:

  • The number of registered health practitioners continued to grow – reaching over 740,000, as did the number of students studying approved courses, and the number of notifications (complaints or concerns) made and resolved.
  • Aboriginal and/or Torres Strait Islander participation across the regulated health professions was 1 per cent. While this has increased, it is still well short of the 3.3 per cent Aboriginal and/or Torres Strait Islander representation in the general population.
  • The report also includes data about our regulatory activities, including investigations and prosecutions, and our performance in delivering the National Scheme. For example,
    • Ahpra monitored 2,584 practitioners for health, performance and/or conduct during the year.
    • Ahpra received 668 advertising related complaints and 369 title protection complaints.
    • 15 cases were successfully prosecuted before the courts; 12 of these were when someone claimed that they, or someone else, was a registered health practitioner.

To find out more, read our published annual report and its supplementary tables available on our website now. Summaries for each profession have also been published on each Board’s website, and linked from the annual report's National Boards page.

You can also access a webinar on the annual report via this link and password: AHPRA1819brief

Registration, accreditation and notifications data

 

Annual report image 

Annual report image 

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‘Let’s talk about it’ video series – a practitioner perspective on the notification process

In the last edition, we highlighted that we had launched a series of videos to better inform members of the public and registered health practitioners who are going through the notification process.

The video series, called ‘Let’s talk about it’, explains what happens when concerns are raised with the regulator, gives easy-to-follow information about the notifications process and addresses common questions, so consumers and health practitioners better know what to expect.

Since then another practitioner perspective video has been added, which provides a first-hand account of the notification process from a medical practitioner, this time a surgeon: ‘Keeping the notification process in perspective – a practitioner view.’

Ahpra CEO Martin Fletcher said the video series aims to share practitioners’ experiences.

‘Many practitioners have told us that they would have benefited greatly from hearing the voice of other practitioners who had gone through this experience – and come out the other side. They have also told us that when they are the subject of a notification, they immediately think they will lose their registration and their livelihood – that it’s a catastrophe.’

‘We understand that practitioners may feel this way. However, our data show a different story. While we have a clear focus on patient safety, many notifications end without the need for regulatory action and are often closed following initial assessment, without the need for an extended investigation,’ he said.

In the video, a surgeon describes his feelings of guilt and anxiety after a poor patient outcome and the notification that followed. As time went on, his worries increased, and he found it difficult to maintain a realistic perspective about what was likely to occur. He reflects on the value of speaking with family and friends, as well as the ongoing support of his GP and a psychologist.

The videos sit alongside other written resources available on the website, including information about understanding the notifications experience. You can view the video on the Ahpra websiteYouTube and Vimeo channels.

My experience: receiving a notification 

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Social research results help to inform our work

We recently released results from a social research project aimed at helping us understand perceptions about us and our work. Our aim was to better understand what the community, regulated health professions and our stakeholders think and feel about us, particularly in areas of understanding, confidence and trust.

The social research project included a short anonymous survey to a random sample of registered practitioners and to a random sample of the broader community.

Our core role is to protect the public and we now have a baseline on which to monitor change to the level of broader community trust in Ahpra.

As expected, there are variances in both the understanding and perceptions of the roles and functions of Ahpra and the National Boards and we note that half (50 per cent) of the community respondents expressed interest in improving their understanding. Not surprisingly, all surveyed practitioners are aware of Ahpra and 79 per cent are interested in learning more about our role and functions.

How we will use the results

Our aim is that these insights will inform continued improvements across all areas of our work. The results have given us a baseline to build on and inform how we follow the regulatory principles that underpin our work as a risk-based regulator. For example, these results have directly informed our work to develop the practitioner experience videos.  

The social research results are available on the Ahpra website. The National Boards have also published profession-specific reports based on the results of the online survey of registered health practitioners.

To help inform our future work we surveyed practitioners and the community again in November 2019. Results from these latest surveys will be released in 2020.

Changes to our logo

We now regulate 16 health professions in partnership with 15 National Boards (nursing and midwifery were officially recognised as separate professions under amendments to the National Law last year). This growth was pivotal to refreshing the Ahpra logo, which also lists the National Boards and is used to represent the National Scheme.

The bold, simple design of the new logo aims to serve us well into the future and is better suited to digital platforms and for use across a variety of other materials.

The National Board logos reflect the ongoing partnership between the National Boards and Ahpra in our shared role of protecting the public. The new logos will be rolled out over coming months while we work to update our secure online service portals and other communications platforms and materials.

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Paramedics’ first registration renewal in the National Scheme

Photo of Jarrod Wakeling

More than 18,000 paramedics have renewed their registration for the first time since paramedicine became a nationally regulated health profession on 30 November 2018. Victorian Jarrod Wakeling was the first to respond when renewing his registration in October.

Jarrod graduated as a Mobile Intensive Care Ambulance Paramedic with Ambulance Victoria on 3 September 2015. His interest in science, anatomy and physiology drew him to paramedicine, as did an interest in the practical aspects of the job.

‘I’ve seen first-hand the impact paramedics can have on patients, families and bystanders during their time of need. I find this extremely rewarding,’ he said.

‘This is why I have been a paramedic for 12 years and I have no plans to do anything else.’

Paramedicine Board Chair, Associate Professor Stephen Gough ASM, last month reflected on paramedicine’s first year as a regulated profession under the National Scheme.

‘I would like to congratulate all those paramedics who have renewed their registration already and all the other paramedics around Australia who are currently in the process of renewing their registration,’ he said.

‘A significant amount of work was required to achieve the registration of paramedics. More than 18,000 paramedics currently hold registration with the Board. As we approach one year of regulation, I acknowledge with gratitude the collective work of the many who have been involved in achieving this milestone.’

Once registered, paramedics can practise anywhere in Australia within the scope of their registration and use the protected title ‘paramedic’.

Pictured: Victorian paramedic Jarrod Wakeling.

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Focus on enhancing public safety

Fake practitioners face jail and hefty fines as new regulatory powers come into force

Tougher penalties for anyone pretending to be a registered health practitioner are now in force.

From 1 July, anyone prosecuted by Ahpra for such offences face up to three years prison time per offence. Maximum fines have also risen from $30,000 to $60,000 per offence for an individual and from $60,000 to $120,000 per offence for a corporate entity.

The amendments were passed in February 2019 by the Queensland Parliament under the Health Practitioner Regulation National Law and Other Legislation Amendment Act 2019 (Qld) (the Act).

Ahpra has successfully prosecuted multiple cases of people who were falsely claiming to be registered practitioners when they were not.

It is an offence under the National Law to use one of the protected titles such as ‘medical practitioner’, and it is also an offence to knowingly or recklessly claim to be a registered practitioner when you’re not or use symbols or language that may lead a reasonable person to believe that an individual is a registered health practitioner or is qualified to practise in a health profession. These offences are known as ‘holding out’

The new offence provisions apply in all states and territories, although not yet in Western Australia. The amendments to offence provisions do not apply to the advertising offences under the National Law.

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Safety of older Australians at centre of new regulatory agreement

A memorandum of understanding (MOU) signed by the Ahpra and the Aged Care Quality and Safety Commission (the commission) will give greater protection to older Australians.

The MOU underpins the positive and collaborative working relationship that already exists between Ahpra and the commission. It will ensure that information can be appropriately shared between the two agencies where there may be concerns in aged care.

It will support the commission raising concerns about the health, performance or conduct of registered health practitioners working in aged care. In a reciprocal arrangement, we will disclose information to the commission if we have concerns about the care and safety of someone receiving Commonwealth-funded aged care services.

Coordinated public consultations helping capture community views

Ahpra and the National Boards recently coordinated the launch of three public consultations, asking people to have their say on revised guidance to help practitioners and others understand their regulatory obligations and to support a responsive and risk-based approach to health regulation.

We consulted on revised policy guidance on three major areas to replace current guidance, including:

  • revised Guidelines: Mandatory notifications about registered health practitioners and Guidelines: Mandatory notifications about health students
  • revised Guidelines on advertising regulated health services, and
  • a proposed Supervised practice framework (not including pharmacy and psychology).

Wide-ranging consultation is vital in the development of registration standards, codes, guidelines and policy to capture the diversity of views from the community, practitioners and other interested and affected stakeholders.

Details about currently open public consultations can be found on the Consultations page of the Ahpra website and information about closed public consultations can be found on the Past consultations page.

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Blood-borne viruses guidelines consultation

This year, several National Boards whose registrants may perform expose-prone procedures in their practice worked together to consult on new guidelines about blood-borne viruses.

The Dental, Medical, Nursing and Midwifery, Paramedicine and Podiatry Boards of Australia consulted on the draft Guidelines for registered health practitioners and students in relation to blood-borne viruses (the draft guidelines).

The draft guidelines will support practitioners in these professions to comply with the Communicable Diseases Network Australia Australian national guidelines for the management of healthcare workers living with blood borne viruses and healthcare workers who perform exposure prone procedures at risk of exposure to blood borne viruses (the CDNA guidelines).

All registered health practitioners who perform exposure-prone procedures need to comply with the CDNA guidelines. The Boards developed the draft guidelines to support health practitioners and students to decide whether they perform exposure-prone procedures in their practice and if so, how to meet the requirements of the CDNA guidelines.

The Boards are reviewing feedback from the consultation and expect to finalise and publish the draft guidelines in early 2020. 

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New social media guide to help practitioners meet obligations

In November, Ahpra and the National Boards published a new guide on the use of social media to help registered health practitioners understand and meet their obligations when using social media.

The guide includes information on how the use of social media is relevant to practitioners’ practice and outlines some common pitfalls when using social media.

CEO Martin Fletcher said, ‘Community trust in registered health practitioners is essential. Whether an online activity can be viewed by the public or is limited to a specific group of people, health practitioners have a responsibility to behave ethically and to maintain professional standards, as in all professional circumstances.’

The new guide does not stop people engaging online or via social media; instead, it encourages practitioners to be mindful of the Health Practitioner Regulation National Law when using social media.

In using social media, health practitioners should be aware of their obligations under the National Law, their Board’s code of conduct, advertising guidelines and other relevant legislation, such as privacy legislation.

The new guide replaces the Social media policy on Boards’ ‘Codes, guidelines and policies’ pages and is available under the Advertising resources section on our website. The guide will be updated as needed.

Social media tile 

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Advertising resources on National Board websites

What is Acceptible Evidence

We have recently added an advertising page to all National Board websites that lists the resources Ahpra and National Boards have developed to help practitioners understand their advertising obligations under the National Law.

This followed our recent release of another resource to help practitioners and advertisers understand if claims made in advertising are supported by acceptable evidence.

There is an important difference between acceptable evidence for claims made in advertising and the evidence used for clinical decisions about patient care. To help practitioners understand what this is, we have published a framework to help them assess advertising claims about the benefits or effectiveness of a treatment.

The new information on acceptable evidence in health advertising is available in the Advertising resources section of the Ahpra website and via the dedicated advertising resources page on National Board websites.

Meanwhile, our public consultation on the revised Guidelines for advertising regulated health services closed on 26 November 2019. We hope to publish the new guidelines in early 2020. The current Guidelines for advertising regulated health services are on the Ahpra website. 

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Learning from court and tribunal outcomes

The most serious matters under the National Law are heard by the relevant tribunal in each state and territory. These matters may be referred by the relevant National Board or by an individual health practitioner. Ahpra can prosecute individuals in some instances and these cases are heard by the relevant Magistrates’ Court.

Court and tribunal outcomes are independent and public. We publish summaries of these outcomes on the Ahpra and National Boards' websites, as well as in our newsletters. This is important as it helps both registered practitioners and members of the public to understand the acceptable levels of care and behaviour expected of health practitioners.

In the interest of transparency we also publish links to disciplinary decisions about a practitioner on the national register. The decisions we link to are those which involve adverse findings and which were delivered after the start of the National Scheme in 2010. These decisions are also publicly available on the websites mentioned below.

Below are some examples of decisions published in the past six months. For more information, follow the link in the summary, go to the Court and tribunal decisions page on the Ahpra website or access the full tribunal decisions on the Australian Legal Information Institute’s (AustLII) site.

Further information on tribunal decisions about practitioners in New South Wales is also published on the Health Care Complaints Commission website.

Dental practice

Dentist disqualified for inappropriate prescribing

A former Northern Territory dentist has been reprimanded and disqualified from holding or applying for registration until 1 July 2020 for professional misconduct after he inappropriately prescribed medication to a family member and himself.

Dr Desmond Worboys issued up to 65 prescriptions for benzodiazepines, up to 69 prescriptions for antibiotics and up to 15 prescriptions for paracetamol and/or codeine in a family member’s name. He also issued one prescription for benzodiazepines and six prescriptions for antibiotics in his own name. All prescriptions were filled under the Pharmaceutical Benefits Scheme with the last prescriptions issued in May 2016 after Dr Worboys had received notice of a notification made to Ahpra.

The tribunal found that Dr Worboys acted outside the scope of his registered health specialty in the treatment and care of a family member, failed to maintain professional boundaries in relation to his treatment and care of a family member and acted in a way that was contrary to the profession’s code of conduct. Dr Worboys also provided false and misleading information to an investigator about his prescribing and his employment status.

Dentist suspended for practising without professional indemnity insurance

A tribunal has found that a Western Australian dentist engaged in professional misconduct by practising as a dentist without appropriate professional indemnity (PII) insurance.

Dr Mario Cavallaro admitted that he practised without appropriate PII cover between 2013 and 2017. Dr Cavallaro also admitted that he had falsely declared he had complied with his PII responsibilities in his applications for renewal of his registration as a dentist and that he had failed to give the Dental Board of Australia notice that he no longer held PII cover as required under the National Law. He further admitted that he had failed to comply with three notices requiring him to provide the Board with details of his PII arrangements.

Dr Cavallaro admitted that his conduct constituted professional misconduct. He was reprimanded and his registration was suspended for four months.

Medical practice

Tribunal reprimands psychiatrist for relationship with patient 

A tribunal found a specialist psychiatrist guilty of professional misconduct and unprofessional conduct, banning him from applying for registration until 31 December 2019.

Dr Luke Ainsworth had failed in his management of a female patient between April 2016 and August 2016. He failed to maintain professional boundaries including by engaging in a social and intimate relationship with the patient; prescribed medication to her when they engaged in a social and/or close personal relationship, without making adequate clinical records; failed to notify the Medical Board of Australia within seven days of being charged with four offences under the Road Safety Act 1986 (Vic) and provided a false declaration to the Board when he renewed his registration on 28 August 2016, by not disclosing the criminal charges.

He also practised as a medical practitioner while he was aware, or ought reasonably to have suspected, that he had a health condition or impairment that could adversely affect his judgement, performance or his patients' health.

Dr Ainsworth has not practised since December 2016. The tribunal considered a period of three years not practising as a medical practitioner was appropriate on top of the disqualification. It also noted his cooperation throughout the investigation and the steps he has taken to address the factors that influenced his conduct.

Medical practitioner suspended for being intimate with patient

A tribunal found that Dr Ian Holten, a Victorian plastic surgeon, had engaged in professional misconduct in that he had sexual intercourse with a patient. The tribunal reprimanded Dr Holten and suspended his registration for three months. The tribunal also found that Dr Holten failed to maintain the professional boundaries that exist between a medical practitioner and their patient and so behaved in a way that constituted unprofessional conduct.

Dr Holten provided cosmetic medical and surgical services to the patient, who was known to him before she engaged his professional services. After the doctor-patient relationship started, Dr Holten and the patient contacted each other regularly and discussed their personal lives. Dr Holten and the patient had sexual intercourse in January 2014, and he had subsequently provided professional services to the patient.

The tribunal found that Dr Holten should have realised that the patient was vulnerable as he knew that she had been treated for depression. Dr Holten’s conduct was a serious transgression of the obligations he owed to the patient once he had agreed to treat her and that the patient’s vulnerability was relevant to the seriousness of the conduct.

Practitioner fined and reprimanded over inappropriate patient management and prescribing

A tribunal found a specialist general practitioner engaged in professional misconduct in relation to inadequate patient management and inappropriate prescribing of highly addictive opiate medication. The tribunal reprimanded Dr Aminah Simone Altaf, imposed auditing and mentoring conditions on her registration, and required her to pay $10,000 towards the legal costs of the Medical Board of Australia.

Dr Altaf prescribed Schedule 8 drugs to a patient with opiate dependency when she was not authorised to do so. She also prescribed unacceptably high doses of Oxycodone and Fentanyl despite receiving advice not to do this from a patient’s pain management specialist and warnings from the Health Department about the patient’s drug-seeking behaviour.

Dr Altaf agreed that she had failed to maintain adequate medical records for the same patient and had failed to report to the Department of Health and to notify Ahpra when a pharmacist dispensed Schedule 8 medications to the patient without a prescription or verbal authority.

Nursing

Tribunal bans nurse from aged care for five years

A tribunal disqualified a nurse from reapplying for registration or working in aged care for five years after she overinvolved herself in an elderly patient’s affairs and benefited from his will.

In 2015, Abha Kumar was a registered nurse working as a nurse unit manager for a residential aged care facility. She transgressed professional boundaries with her elderly patient, Mr Lionel Cox, who was admitted to the facility in July 2015 for respite care. Ms Kumar learned that he owned his own home, had no family and had not made a will. She purchased a post-office will kit for Mr Cox, which he used to write a will witnessed by two staff members of the facility under Ms Kumar’s direction. Unknown to the witnesses at the time, the will named Ms Kumar as executor and sole beneficiary of Mr Cox’s estate. The value of the estate was over $1,000,000.

Mr Cox died in August 2015 of natural causes. In November 2016, Ms Kumar sold the house she had inherited from Mr Cox for over $1,000,000.

The tribunal found that in failing to recognise her conflict of interest or reflect on her behaviour Ms Kumar had engaged in professional misconduct that was inconsistent with being a fit and proper person to hold nursing registration.

Fake nursing director successfully prosecuted

A Victorian man who had falsely claimed to be a registered nurse was convicted in the Ringwood Magistrates’ Court of four counts of holding himself out as a registered nurse, one count of unlawfully using the protected title ‘registered nurse’ and one count of unlawfully claiming to be authorised or qualified to practise in the nursing profession. He was fined $60,000 plus costs.

The charges were laid after an Ahpra investigation into allegations that the man had held himself out as a registered nurse while seeking employment, and then practising, as the director of nursing in an aged care facility (a role that required registration as a nurse). The man has never been registered with the Nursing and Midwifery Board of Australia and does not have any qualifications as a nurse.

Occupational therapy

Occupational therapist reprimanded by tribunal after criminal conviction

A tribunal has found the behaviour of a Western Australian occupational therapist constituted professional misconduct after receiving a criminal conviction.

In 2017, following a police investigation, Katherine Jenkins was charged with acting with the intention to create a false belief under the Criminal Code 1913 (WA) and subsequently failed to notify the Occupational Therapy Board of Australia of the charge, as required by law. During the criminal investigation, Ms Jenkins became unwell.

Ms Jenkins was convicted of the charge in the Armadale Magistrates Court after entering a guilty plea and sentenced to a nine-month community-based order and ordered to pay $3,929.20 in costs. Ms Jenkins also received a spent conviction. The tribunal reprimanded Ms Jenkins and placed conditions on her registration and ordered her to pay $1,200 towards the Board’s costs.

Occupational therapist reprimanded for forgery

A previously registered occupational therapist has been reprimanded by a tribunal after being found to have engaged in professional misconduct when forging his supervisor’s signature.

Ricardo Cornelio is an overseas-trained occupational therapist. His limited registration was subject to conditions including that he only practises with the supervision of a Board-approved supervisor and that he submits a supervision log and midway progress report. Mr Cornelio submitted the supervision log and midway progress report to the council on 1 November 2016, but he had forged his supervisor’s signature on both documents. Mr Cornelio admitted to the forgery and advised that he had done it because he was afraid of not getting it done in time. On 7 June 2017, Mr Cornelio allowed his registration to lapse.

Pharmacy

Tribunal cancels pharmacist’s registration after her conviction for drug theft

A pharmacist convicted of drug theft was reprimanded and had her provisional registration cancelled by a tribunal for professional misconduct.

Sara Kazeme, a provisionally registered pharmacist, was convicted in the Magistrates’ Court of Victoria in November 2016 for theft and attempted theft of prescription-only medicines as well as other pharmaceutical items. Subsequently, the Victorian Civil and Administrative Tribunal made a finding of professional misconduct against Ms Kazeme in November 2018, cancelled her registration and disqualified her from reapplying for registration for 24 months. She was also reprimanded.

The tribunal made it clear that Ms Kazeme’s actions were inconsistent with her being a fit and proper person to hold registration in the pharmacy profession. It referred to the particular level of trust that the community places in pharmacists and found that Ms Kazeme’s actions had breached this trust.

Psychology

Psychologist’s registration cancelled for professional misconduct

A tribunal has found a psychologist guilty of professional misconduct, cancelled his registration and banned him from applying for registration until 7 February 2022.

Dr Dev Roychowdhury had engaged in an intimate sexual relationship with a patient with whom he had a clinical relationship, was emotionally and physically abusive within the intimate relationship, and lied to Ahpra and the Psychology Board of Australia during the investigation and misled his colleagues for personal gain. Although Dr Roychowdhury admitted the conduct, he contended that it should be characterised as unprofessional conduct. The tribunal did not agree and found that each of the three allegations individually constituted professional misconduct.

The tribunal was concerned by the seriousness of the conduct as well as Dr Roychowdhury’s apparent lack of insight, and was satisfied that the circumstances of the case, the vulnerability of the patient and the lack of any real mitigating factors put this case in the more serious category of boundary violation, for which professional misconduct is the usual finding.

More matters

Since January, we have published 28 other tribunal or court outcomes as news items or media releases on Ahpra and/or National Board websites, including:

  • Dental Board of Australia (1)
  • Nursing and Midwifery Board of Australia (11)
  • Medical Board of Australia (12)
  • Pharmacy Board of Australia (2)
  • Physiotherapy Board of Australia (1)
  • Psychology Board of Australia (1).

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Sharing learning opportunities with international regulators

Ahpra scoops international regulatory excellence award

The Council on Licensure, Enforcement and Regulation (CLEAR) has bestowed its Regulatory Excellence Group Award on Ahpra’s Notifications team, recognising its contribution to improving the experience of health practitioners and the public when engaging with the regulator. National Director Notifications, Matthew Hardy, accepted the award on behalf of his team and project leaders National Engagement Advisor Susan Biggar and Program Manager Monica Lambley.

The prestigious award recognises an outstanding team contribution to the enhancement of occupational or professional regulation, regulatory processes or consumer and public protection. To receive the award the team had to demonstrate exceptional leadership, vision, creativity, results and outcomes above and beyond the regular functions of the job or expectations, and beyond what is normally achieved.

CEO Martin Fletcher said the work done by the award-winning team has made a tangible difference.

‘The impact of their work has been profound and far-reaching. They have led the introduction of surveys and interviews to ask how practitioners and the public have felt through the notifications process, which has led to real changes in how we do our work. Since 2016, we have received over 5,000 surveys and conducted nearly 100 face to face interviews with practitioners and notifiers,’ he said.

‘This work has transformed our staff training and support materials to ensure we deliver more empathetic approaches to responding to practitioners and the public, and that we are well prepared to deal with difficult situations.’

The award was given at CLEAR's 2019 Annual Educational Conference in Minneapolis, Minnesota on 20 September.

Photo of Matt Hardy accepting award 
Notifications Director Matthew Hardy (R) receives regulatory excellence award at CLEAR 2019 conference.

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Ahpra director Kym Ayscough appointed incoming President of CLEAR

Kym Ayscough

At the same conference, our Regulatory Operations Executive Director Kym Ayscough was announced as the incoming President of CLEAR. Kym has been a member of the CLEAR board of directors since 2016 and is the first president from the southern hemisphere.

CLEAR promotes regulatory excellence through conferences, education programs, webinars, seminars and symposia. It’s a neutral forum to encourage and provide for the sharing of best practices in regulation and has a stated interest in closer ties with the regulatory community in Australasia.

Kym is looking forward to the challenge of leading the board in CLEAR’s mission to bring together the international regulatory community.

‘Global mobility makes the work of CLEAR really important and relevant for all regulators. The opportunity for regulators to share experiences across professions and across borders makes a significant contribution to the regulators’ public protection mission. Over the next year, I am looking forward to playing my part in helping CLEAR give this unique opportunity to regulators,’ she said.

Pictured: Regulatory Operations Executive Director Kym Ayscough, incoming President of CLEAR. 

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New projects and programs

Medical Board of Australia launches Medical Training Survey

In August the Medical Board of Australia launched a Medical Training Survey, asking more than 30,000 doctors in training about the quality of their training and to identify issues that could affect patient safety, including environment and culture, unacceptable behaviours and the quality of supervision.

Ten thousand doctors in training (27 per cent) took the time to share their feedback, which will build the first national, comprehensive picture of medical training in Australia.

We’re currently analysing the data and will publish the survey results in early 2020. To maintain confidentiality, we will only publish results with 10 or more responses.

Based on participation rates, we expect to be able to report by state and territory, specialist medical college and type of doctor in training – interns, prevocational and unaccredited trainees, specialist trainees and international medical graduates. Individual hospital-level reporting will be possible where there were more than 10 responses for that hospital. We expect this level of detail to build year on year.

The results of the survey will help us to better understand the strengths and weaknesses in medical training across Australia. They will help build an evidence base that we can learn from to improve the culture of medicine. Survey results will start to tell an important story about the culture and quality of training, and trigger ideas and discussion of what we can all do to improve it.

Information about the survey can be found at www.medicaltrainingsurvey.gov.au.

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Public awareness campaign on mandatory notifications

Recently, Ahpra and the National Boards launched a public awareness campaign on mandatory notifications. Primarily it’s an education campaign that aims to:

  • encourage registered health practitioners to seek the help they need by removing unnecessary fears they’ll be subject to a mandatory notification, and
  • provide greater clarity to treating practitioners on when they need to make a mandatory notification.

It also highlights the upcoming National Law amendments (likely to take effect in early 2020) that will change the threshold for when a treating practitioner must make a mandatory notification.

We’ve developed new resources to explain the changes and to help practitioners better understand mandatory notifications and when they do and do not need to be made. These resources are available on our website.

What’s changing in 2020?

Legislative amendments passed on 26 February 2019, as part of the Health Practitioner Regulation National Law and Other Legislation Act 2019, included amendments to mandatory reporting which will apply to all states and territories except Western Australia.

The changes only apply to the mandatory notification requirements for treating practitioners – they do not affect the obligations of other registered practitioners, employers or education providers.

Under these National Law amendments, three of the four types of conduct (impairment, intoxication and practice outside of professional standards) which may lead to a mandatory notification will have the same threshold for reporting by treating practitioners. It is: substantial risk of harm. The threshold for reporting substantial risk of harm focuses on current and future high risks of material harm.

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Launch of podcast about vexatious notifications

Our new podcast is the first in an exciting series in development to provide greater insight into the work of health practitioner regulation and information about key healthcare concerns.

Episode one, Vexatious notifications, takes a deep dive into a subject of concern for many health practitioners who fear that wrong motives could provoke a patient or colleague to report them to the regulator inappropriately.

Host Susan Biggar (Ahpra’s National Engagement Adviser) speaks with Associate Professor Marie Bismark, University of Melbourne; Kate Griggs, a health consumer advocate and member of Ahpra’s consumer reference group; Dr Sara Bird, manager of medico-legal and advisory services at MDA National; and Ahpra’s National Director of Notifications, Matthew Hardy.

This episode talks about the defining characteristics of vexatious notifications and how common they are. It also looks at the impact they have on practitioners and explores how the regulator is working to identify, respond to and manage vexatious notifications.

CEO Martin Fletcher says the podcast is a continuation of the work Ahpra and the National Boards have been doing to improve the notifications experience for notifiers, practitioners and their support people, and to make information about notifications accessible to a broader range of people.

‘We know that being the subject of a notification is often very stressful for a practitioner. While the numbers are small, we recognise that the impact of a vexatious notification is very significant for the practitioner,’ he said.

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Ahpra in numbers

Stats infographic

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Health workforce update

Infographic of growth

  

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National Board news

Publications and projects roundup

The National Boards publish regular e-newsletters and communiqués about their activities, which you can read on their websites. Recent publications and projects are listed below.

All boards

Published registration renewal reminders and information, and guidance on how to apply for registration online

Released registration data (quarterly reports)

Released 2018/19 annual report and published individual profession-specific summaries

Announced launch of podcast about vexatious notifications

Published new social media guide

Announced paramedics' first registration renewal in National Scheme

Published an update on one in 17 working Australians on the national register

Released social research project results

Announced revised CPD guidelines for five National Boards published

Announced Ahpra and National Boards’ updated logos

Announced Ahpra’s international regulatory excellence award

Announced public consultations underway to boost patient safety

Announced new video: Keeping the notification process in perspective – a practitioner view

Announced safety of older Australians at centre of new regulatory agreement

Published revised registration standards   

Announced cultural safety training provider for Ahpra and National Boards

Announced practitioner CPD survey                                                 

Announced National Boards’ fees set for 2019-20

Fake practitioners face jail and hefty fines as new regulatory powers come into force

Aboriginal and Torres Strait Islander Health Practice Board

Published its profession-specific annual report summary 2018/19

Published two downloadable brochures on the profession, for prospective practitioners and for potential employers

Published revised registration standards which took effect on 1 December 2019

Chinese Medicine Board

Published its profession-specific annual report summary 2018/19

Invited Chinese medicine practitioners, students and stakeholders to a forum on policy issues and notifications trends

Published a request for proposal on development and implementation of Chinese medicine regulatory exams

Published revised registration standards which took effect on 1 December

Conducted annual revision of Nomenclature compendium of commonly used Chinese medicine herbs

Chiropractic Board

Published its profession-specific annual report summary 2018/19

Published revised CPD registration standard and guidelines which took effect on 1 December

Dental Board

Published its profession-specific annual report summary 2018/19

Published its approved revised Scope of practice registration standard

Dentist suspended for practising without professional indemnity insurance

Observed and promoted International Infection Prevention Week

Dentist disqualified for inappropriate prescribing

Medical Board

Published its profession-specific annual report summary 2018/19

Published intern survey results

Practitioner fined and reprimanded over inappropriate patient management and prescribing

Conducted public consultation on draft revised registration standard for continuing professional development

Conducted public consultation on revised Good practice guidelines for the specialist international medical graduate assessment process

Tribunal rejects medical practitioner’s appeal against reprimand and conditions on registration

Tribunal reprimands psychiatrist for relationship with patient

Tribunal makes adverse findings about medical practitioner

Tribunal imposes conditions on medical practitioner's registration

Tribunal cautions medical practitioner for inappropriately treating patients with ADHD

Tribunal reprimands doctor for practising without professional indemnity insurance

Medical practitioner reprimanded and fined for professional misconduct

GP suspended for 15 months for having a sexual relationship with patient

Medical practitioner suspended for being intimate with patient

Victorian doctor suspended for three months for personal relationship with patient

Announced Medical Training Survey: doctors in training to rate their medical training

Medical practitioner reprimanded for unlawfully prescribing schedule 8 medicines

Medical Radiation Practice Board

Published its profession-specific annual report summary 2018/19

Released professional capabilities for medical radiation practitioners to celebrate World Radiography Day

Nursing and Midwifery Board

Published its profession-specific annual report summary 2018/19

Tribunal suspends nurse who breached professional boundaries

Tribunal cancels nurse’s registration for professional misconduct

Fake nurse carrying out cosmetic injectables successfully prosecuted

Released new framework that offers decision-making support for nursing and midwifery

Tribunal disqualifies former nurse for four and a half years

Tribunal cancels midwife's registration for false renewal declarations

Tribunal disqualifies former nurse for six years for professional misconduct

Suspended nurse found working in aged care facilities pleads guilty to 66 charges

Tribunal bans nurse from aged care for five years

Announced changes to assessment of internationally qualified nurses and midwives

Tribunal cancels nurse’s registration for professional misconduct

Tribunal suspends nurse for two years for professional misconduct

Fake nursing director successfully prosecuted

Fake nurse successfully prosecuted

Tribunal disqualifies former nurse for two years for criminal offences

Tribunal disqualifies nurse for professional misconduct

Occupational Therapy Board

Published its profession-specific annual report summary 2018/19

Published documents on the role and responsibilities of occupational therapy stakeholders

Occupational therapist reprimanded by tribunal after criminal conviction

Occupational therapist reprimanded for forgery

Published revised registration standards which took effect on 1 December 2019

Optometry Board 

Published its profession-specific annual report summary 2018/19

Published revised CPD guidelines 

Published minor amendments to guidelines for use of scheduled medicines

Published new guide to help public know what to expect when visiting an optometrist

Published review confirming Australian optometrists providing safe and effective care

Published revised CPD registration standard

Launched a CPD survey of practitioners

Osteopathy Board

Published its profession-specific annual report summary 2018/19

Capabilities for osteopathic practice in effect on 1 December 2019

Published new video to help osteopaths understand their revised capabilities

Paramedicine Board

Published its profession-specific annual report summary 2018/19

Announced paramedics' first registration renewal in the National Scheme

Announced paramedicine competence assessments available

Approved additional English language test

Pharmacy Board

Published its profession-specific annual report summary 2018/19

Published Pharmacy Internship Experience Survey update

Published position statement on pharmacist prescribing

Recognised the role of pharmacists in ensuring safe use of medicines

Pharmacist’s registration cancelled for professional misconduct

Tribunal cancels pharmacist’s registration after her conviction for drug theft

Physiotherapy Board

Published its profession-specific annual report summary 2018/19

Held physiotherapy stakeholder event

Announced World Physical Therapy Day: theme celebrates physiotherapists providing care to chronic pain patients

Published ‘CPD and you’ webinar recording

Podiatry Board

Published its profession-specific annual report summary 2018/19

Recognised the important role of podiatrists in the community in Foot Health Week

Psychology Board

Published its profession-specific annual report summary 2018/19

Published new registration standard and guidelines on area of practice endorsements

Tribunal cancels psychologist’s registration

Invited practitioners to join a focus group on mandatory notifications for health practitioners

Published revised registration standard on professional indemnity insurance, in effect on 1 December 2019

Published new guidelines for the national psychology exam

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In conversation with....

Photo of Gill Callister

AManC Chair Gill Callister PSM

In August, we welcomed Gill Callister as the new Chair of the Agency Management Committee (AManC). We asked Gill about her background and what she brings to her new role in regulation.

Starting her career as a social worker, Gill’s calling is public policy and service delivery.

Gill served as Secretary of the Victorian Department of Education and Training from 2015 until 2019. Before that, she was the Secretary of the Victorian Department of Human Services, where she led policy, legislative and service delivery reform.

‘The common thread throughout my career is working with the most vulnerable in our community – in child protection and youth justice, disability, housing and homelessness, family violence and mental health and drugs to name a few,' Gill told us.

‘As AManC Chair I hope I can bring a lens of social inclusion and social policy to the work we do as a regulator.’

Gill believes Ahpra serves as a model for regulation that could be instructive for other forms of professional regulation across Australia.

‘Achieving the balance of public safety and professional respect is at the heart of our work at Ahpra, and the architecture of the National Scheme is testament to the strong partnerships necessary to make this work,’ she said.

'It’s not easy to gain the trust of the public, the professions and government, but it’s clearly something Ahpra continues to do.’

Gill acknowledges that effective regulation requires constant effort.

‘The royal commissions into aged care and disability have raised issues of regulatory practices – or the lack of them – and the Royal Commission into the Management of Police Informants in Victoria is raising a number of questions of ethical practice and its role in our legal system.

‘The Royal Commission into Institutional Responses to Child Sexual Abuse identified systemic abuse of children by people in positions of power and trust and there is much we can learn from this about preventing abuse in future.

‘Our understanding of these issues as a community has shifted and our expectations are that our regulators will reflect this in new standards that do not tolerate unsafe or abusive practices,’ Gill said.

Gill believes that the work of registered health practitioners is often difficult and generally done with great care and expertise, and that reputation must be upheld through a clear and transparent approach to regulation.

‘At its heart it’s about protecting the public interest and public safety, and every member of the public who has a right to expect a safe and professional service from their health practitioners.’

Away from the office, Gill loves spending time with her family.

‘I have a wonderful family – a husband and three grown children – two of whom are registered health professionals. The other one is a writer and performer in the arts. Over many years I have been on call 24/7 so work and family have been intertwined, something my family have borne with infinite patience (mostly).’

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If you have any comments or suggestions about Ahpra Report, please send them to newsletters@ahpra.gov.au

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Page reviewed 20/12/2019