After the Australian Government activated its emergency response plan for COVID-19, in early March, Ahpra implemented its Business Continuity Plan to ensure we were well prepared to support the Australian health sector and safeguard the essential services of health practitioner regulation in Australia.
In just four weeks we transformed our organisation. Eight state and territory offices closed and all Ahpra employees were working from home with the key functions all completely upheld. All Boards moved to virtual meetings.
Ahpra and National Boards worked to regulate practitioners in light of a pandemic and the likelihood of a nationwide need for a surge health workforce. A coordinated response was essential to overseeing this work and to help jurisdictions in meeting the unique challenge.
Jurisdictions began health service planning to ensure the Australian health system had enough resources including personnel, hospital beds, and emergency and intensive care services, for what could happen in the coming days, weeks and months.
Ahpra responded to lead and oversee the scheme's emergent and unique responses to COVID-19. Two groups were set up: a Pandemic Preparedness Oversight Group with Agency Management Committee members and National Board Chairs to provide governance oversight, and a Regulatory Policy Clearing House Group. This ensured timely and appropriate regulatory policy decisions were made and communicated to all stakeholders.
To support systematic workforce contingency planning and regulatory responses across the Australian health system continuing, Ahpra convened a working group of officers from health departments across Australia to inform our response to meeting health workforce needs.
The pandemic response sub-register was established following the request from Australia’s Health Ministers to enable more health practitioners' quick return to practice.
On 1 April we announced the new sub-register to fast-track the return of experienced and qualified health practitioners to the workforce to help in the response to the COVID-19 pandemic.
More than 40,000 doctors, nurses, midwives and pharmacists who had previously held general or specialist registration and had left the Register of practitioners or moved to non-practising registration in the past three years and met other specific criteria were placed on the sub-register. This approach was similar to action being taken in other countries whose health systems were also affected by the pandemic.
The sub-register was launched on 6 April and will operate for up to 12 months. Only those practitioners who are properly qualified, competent and suitable have been returned to this temporary register. There is no obligation for anyone added to the sub-register to practise or remain on it, and they can opt out at any time. In the first two weeks 10,000 practitioners opted out.
The sub-register was a huge feat to design, develop and implement rapidly. The process included identifying eligible practitioners, designing a way to distinguish those on the sub-register and ensuring there was a simple opt-out.
On 20 April, some 5,000 physiotherapists, psychologists and radiographers were added to the sub-register. Like the first phase, it operated on an opt-out basis.
We strongly encouraged those who were not comfortable being part of the sub-register to opt out, especially anyone who had a health issue that prevented them from practising safely or who was unable to practise. Sub-registrants were also advised that they were required to have appropriate professional indemnity insurance if they wished to return to practice.
In June, Aboriginal and Torres Strait Islander Health Practitioners who met the criteria were invited to join the sub-register.
The news of the sub-register generated a huge number of calls and enquiries. Many practitioners were interested in seeing if they could ‘do their bit’ to help.
We worked closely with government and health services to monitor the need for additional health practitioners as the pandemic progressed. We encouraged practitioners who had capacity to go to their state and territory health department website to express interest in joining the COVID-19 surge workforce if it was required.
At 30 June, 35,077 practitioners remained on the sub-register.
As COVID-19 cases escalated and spread across the world in March, Ahpra and National Boards moved quickly to carry out all our regulatory functions in a completely virtual environment.
While maintaining registration standards to keep the public safe, we developed flexible regulatory approaches to respond to the needs of practitioners and health service delivery during a pandemic. The changes reflected the Boards’ existing policy and standards framework while recognising the unprecedented new environment in which health practitioners were now practising. We also introduced new policies to help create more workforce capacity. We applied the overriding principle that the Boards and Ahpra were prepared to be flexible in approaches to COVID-19, although public safety remains our first priority.
In some cases, National Boards introduced safe modifications when practitioners could not meet the usual National Board requirements. For example, many practitioners’ plans for continuing professional development (CPD) were disrupted and National Boards clarified that, while they encouraged practitioners to continue CPD relevant to their practice where possible, they did not want CPD requirements to take practitioners away from clinical care or cause additional concerns to practitioners already under extra pressure.
If a practitioner can’t meet the CPD standard because of the COVID-19 pandemic, then generally National Boards indicated they wouldn't take action for the registration period during which the COVID-19 emergency is in force. Similarly, where needed, some additional flexibility was introduced for interns and other practitioners doing supervised practice.
In other cases, our existing regulatory framework was already flexible enough and we only needed to explain how it applied in the context of a pandemic. Telehealth became a key modality to help maintain access to services and reduce the risk of community transmission of the novel coronavirus that causes COVID-19 while providing protection for patients and health practitioners. To support the safe and effective use of telehealth by registered health practitioners, we developed Telehealth guidance for practitioners – with responses to frequently asked questions, for all National Scheme professions. The National Scheme’s title protection model of regulation means that Boards do not prescribe what individual practitioners can and cannot do. In this context, the Medical Board of Australia provided additional guidance to respond to queries about medical practitioners working outside their usual scope of practice.
In the education and training context, outcome-based accreditation standards already provided significant flexibility to education providers. Accreditation authorities individually and collectively clarified how the standards could accommodate changes made to program delivery. National Boards, accreditation authorities, Ahpra and the Commonwealth Departments of Health and Education developed joint national principles for clinical education.
Through all of this, National Boards and Ahpra drew on the strength of the partnerships and collaboration in the National Scheme. We recognised that by working together, and encouraging practitioners to draw on existing regulatory frameworks and their inherent professional judgement, we could support safe responses to COVID-19.
Ahpra set up a dedicated section of its website for COVID-19 information on 19 March. It was promoted at the top of all webpages and all National Board websites linked to it.
The COVID-19 portal was segmented into relevant topics, including National Board and profession-specific information, workforce resources and FAQs. The Nursing and Midwifery Board of Australia, as the National Board regulating the largest COVID-19 priority workforce profession, also had a dedicated COVID-19 webpage.
National Boards sent a total of 91 COVID-19 email updates directly to different practitioner groups. These were also published in the news section of individual Board websites and linked from the Ahpra website COVID-19 portal. We also emailed public health messages to registered health practitioners on behalf of governments.
Between 17 March and 30 June, the COVID-19 portal received over 158,000 unique page views. The updates page attracted over 115,000 (unique) views, the FAQs page over 82,000, and the pandemic sub-register over 60,000. The most popular day was 2 April, the day all 15 National Boards emailed registrants, with over 20,000 page views.
The COVID-19 pandemic meant many practitioners and community members were looking for answers during a national health crisis.
Early on, our Customer Service team (CST) was inundated with calls and web enquiries about our regulatory response. Enquiries were varied, ranging from questions about the pandemic sub-register to the supply of personal protective equipment and protocols surrounding the use of telehealth. A high volume of calls came from previously registered health practitioners and members of the public wanting to know how they could quickly re-register to practise again or help in general with the COVID-19 healthcare efforts.
While working to meet the large volume of enquiries, CST members were also dealing with the transition to working remotely due to Ahpra offices closing. To help respond to queries, a Regulatory Policy Clearing House Group was established to provide accurate and up-to-date information as quickly as possible. CST kept the Clearing House informed about the types of enquiries coming in so website resources, including FAQs, could be developed and updated as required.
Many practitioners and community members also turned to social media with their enquiries and comments. Examples of the types of queries received were questions about guidelines for safe practice and the effect of COVID-19 restrictions on a practitioner’s practice. Many of the people who contacted us expressed feelings of worry and anxiety, so our responses needed to be empathetic. The Clearing House Group coordinated responses to external, regulatory and policy-related queries to answer these enquiries promptly.
As communities went into lockdown, there was a significant increase in user activity and engagement with our social media platforms, particularly on Facebook and with our newly established Instagram platform. We noticed a shifting expectation in audiences who became more comfortable with less formal content. In response, we began releasing new content and sharing COVID-19 related posts from government sources to support our stakeholders and followers. One example of this type of engagement was our statement condemning racism in healthcare, which achieved significant engagement and was seen over 40,000 times.
The effect on COVID-19 on different aspects of Ahpra and the Nationals Boards’ work is also covered in other sections of the annual report.