Following an all-staff consultation, in September we introduced a new organisational structure to ensure a clear focus on organisational priorities. The changes included grouping together teams and roles that do similar things, addressing gaps, removing duplication and making it easier to know who does what within Ahpra.
The new structure saw the dissolution of the Business Services directorate and the creation of two new directorates, Finance and Risk, and Information Technology. Mr Clarence Yap was appointed Chief Information Officer in October and Ms Elizabeth Davenport Chief Financial Officer in January.
The two new directorates emphasise our focus on financial sustainability and information technology as key enablers of our regulatory work.
As part of the restructure, the role of state and territory managers was reviewed with a renewed focus on local stakeholder engagement.
Ahpra is structured into five directorates: Regulatory Operations, Strategy and Policy, People and Culture, Finance and Risk, and Information Technology
The National Executive is Ahpra’s national leadership group. Our state and territory managers are our senior leaders in each jurisdiction, and are based at each of our offices.
Despite the COVID-19 pandemic, the past 12 months have seen some substantial and positive changes for our staff.
We continued to support Ahpra employees through our clear People plan, including during the shift in our ways of working in March and April. The plan focused heavily on building our manager capability while also responding to the findings of the 2018 culture survey. The survey included a series of national focus groups that took an in-depth look at our culture and provide the foundation for a wider cultural change program.
Over the past year, we’ve also continued to develop our cultural measurement processes and tools through frequent employee ‘pulse’ surveys to understand contextual factors that drive employee engagement. In responding to the COVID-19 pandemic, each of our employees experienced establishing remote working arrangements in different ways due to a range of factors including geographic location, home arrangements and family commitments.
Despite the challenges presented by these new ways of working and the need to achieve balance, employee engagement results indicated that:
Other highlights of the year:
In addition to our COVID-19 response, we revised the full suite of People and Culture policies, including our updated Code of conduct launched at the end of 2019.
The National Scheme income for the full financial year to 30 June was $220.43 million, an increase of $17.22 million on 2018/19. Income for the full year. The National Scheme recorded a net surplus of $6.65 million for the full financial year.
The financial statements section of the annual report describes our financial performance in more detail, including the net result and equity position for each National Board.
Fees set for each National Board aim to meet the full costs of regulation for each profession.
Our Corporate Risk and Compliance team facilitates all strategic, enterprise and operational risk management and assurance activity for Ahpra and the National Boards.
This includes risk management, fraud and corruption control, critical and serious incident management, the insurance portfolio, internal audit and national quality assurance. Ahpra, in partnership with National Boards, seeks to manage risks in ways that allow us to meet the objectives of the National Scheme strategy.
The Corporate Assurance Framework aims to provide continuous and reliable assurance that major risks are being managed to continuously improve efficient and effective regulatory services to the Australian community. It enables leaders at all levels to demonstrate clear accountabilities for executing, managing, controlling and reporting risk to drive the continuous improvement of the National Scheme’s work.
The framework provides a common platform for all strategic, enterprise and operational risk management and assurance activity for Ahpra and the National Boards. This requires consideration of a cross-section of risks to the National Scheme’s objectives, including community trust and organisational, operational and financial risk.
The Corporate Assurance Framework is overseen by the Finance, Audit and Risk Management Committee (FARMC).
Ahpra’s assurance framework has adopted the ‘three lines of defence’ model. The three lines are the chain of supervision, reviews initiated by senior management and reviews initiated by the Agency Management Committee or its committees.
We are not aware of any significant risk management issues that would prevent Ahpra from meeting the National Scheme’s goals and objectives that have not been identified, assessed and which do not have an appropriate management and/or mitigation plan. We are satisfied that work is underway that is designed to ensure Ahpra identifies, assesses, monitors and manages risks appropriately.
Throughout the financial year, our insurance portfolio was up to date and was reviewed and renewed for a further 12 months on 30 June.
In February Ahpra formed a Business Continuity Planning Working Group, in anticipation of government directives that people should work from home and to support a workforce surge. A complete governance framework was put in place to oversee Ahpra’s pandemic response and recovery. The impact of COVID-19 is expected to continue into the future, so as the situation changes the governance arrangements will be adapted to ensure they are adequate and appropriate to meet needs in the recovery and transformation phases.
As well as our work to enable staff to work from home, we redeployed staff into our registration functions to fast-track the renewals process and to ensure health professionals were registered and available to work without delay.
In June, the Commonwealth Department of Health provided a one-off grant of $6.26 million to fund additional costs incurred and committed in response to COVID-19. The objective of the grant is to support Ahpra and National Boards to increase the pool of appropriately trained health practitioners registered and available to work in COVID-19-related roles. Other work, related to communicating with practitioners on changes to regulatory requirements and other relevant guidance, is also supported through this grant.
This year, we comprehensively reviewed Ahpra’s Public interest disclosure (whistleblower) policy. A dedicated lawyer has been assigned to review all instruments of delegation, sub-delegation and administrative authorisations. This work is ongoing and the review is expected to be completed in 2020/21, with management of these instruments to remain the responsibility of Corporate Legal.
Corporate Legal has recently begun a review of its standard contractual terms to ensure that they are up to date with recent legal developments and reflect best practice procurement and contracting processes. This is occurring in parallel with Ahpra’s review of its procurement processes more broadly, including drafting a revised procurement policy and holistic management of the contract lifecycle.
Ahpra received 286 applications for access to documents under the Commonwealth Freedom of Information Act 1982 (FOI Act). We also received 20 applications for internal review of an FOI decision.
The National Health Practitioner Ombudsman and Privacy Commissioner (NHPOPC) notified Ahpra that 15 applications for external review of an Ahpra FOI decision had been made. The NHPOPC also notified Ahpra that seven external reviews had been closed as withdrawn. In one matter the NHPOPC decided to affirm Ahpra’s decision. In one matter the NHPOPC notified Ahpra that a decision about whether to release documents was being upheld but that the reasons for withholding access to documents were being varied. There were no matters in which the NHPOPC notified Ahpra that the original decision was being replaced by decision to grant an applicant further access to documents.
During the year, 274 FOI applications were finalised. At 30 June, 34 FOI matters were open and had not been finalised.
Ahpra issued 129 evidentiary certificates.
We responded to 104 subpoenas and orders to produce documents issued by courts and tribunals about proceedings in which neither Ahpra nor a National Board were a party.
A former registered health practitioner faced criminal charges and occupational disciplinary proceedings about the alleged sexual assault of a former patient. The patient also started civil proceedings against the practitioner. The court, at the patient’s request, issued a subpoena to Ahpra ordering that documents of potential assistance to the court in resolving the matter be produced within two weeks.
To respond to the subpoena Ahpra identified 447 documents, comprising 15,297 pages, that fell within the scope of the subpoena. Many of these documents were held in offsite archival storage. These documents were collated and assessed for return to the court along with submissions about the steps the court could take to protect the privacy and other interests of third parties referred to in the documents.
Straightforward complaints (stage 1) are handled by the Ahpra area that receives them, and complex complaints (stage 2) are managed by a National Complaints team. Stage 3 complaints are investigated or reviewed externally by the National Health Practitioner Ombudsman and Privacy Commissioner (NHPOPC). We report annually on all stage 2 and 3 complaints.
This year we recorded an increase in the number of complaint matters dealt with directly by Ahpra. This increase is largely attributed to improvements made in recording complaints received. We received 401 stage 2 complaints directly, up from 297 last year.
We are continuing to refine our data to improve our reporting on administrative complaints and have recently invested in technical improvements to enable complaints to be submitted online.
This year we received 119 stage 2 complaints about notification matters. This is a decrease from the previous reporting period when we received 129. Of these 119 complaints, 35.3% were about dissatisfaction with the regulatory outcome of a notification. Other categories of complaint were about our processes and policies and communication during the management of a notification.
This year we received 216 stage 2 complaints about registration matters. This is an increase from 161 the previous year. Of the 216 complaints received about registration matters, 36.1% were about delay in registration applications. Last year, 65.8% of registration complaints were about delay. Other categories of complaint were concerns about fees, registration policy and our communication with applicants.
We assisted the NHPOPC with 117 investigations started during the reporting period.
This year we worked with the NHPOPC to implement an early resolution transfer process, which began in September 2019. This process was designed to allow Ahpra an opportunity to quickly resolve complaints directly without the need for investigation by the NHPOPC. The NHPOPC transferred 130 complaints to Ahpra under these arrangements. The NHPOPC also referred 38 (July–September 2019) complaints to Ahpra for response in accordance with the arrangements that were in place before the implementation of the early resolution transfer process.
Ahpra implemented new technologies to modernise its cyber security operations centre and strengthened the incident detection and response capabilities. Ahpra has also implemented a modern user awareness platform to train users in the defence of emailed threats such as phishing.
Ahpra developed a Cyber security strategy 2020 with a roadmap to improve our IT security capabilities. It considers cyber security industry trends and provides a coherent portfolio of security initiatives that align with the overall business and IT strategy.
We carried out a series of major initiatives to upgrade our technology infrastructure and capabilities. We performed core system updates to Sitecore, TRIM, Windows operating system, Pivotal, Microsoft Office 365 and Exchange Online to improve the usability, performance, stability and maintainability of those platforms. The Office 365 and Exchange Online platforms are cloud-based solutions that improve the accessibility of office productivity tools from any mobile device, outside of Ahpra’s office environment.
New and improved business capabilities were also introduced. A new corporate intranet was launched with an improved design, modern content and staff search capability. Developed using the cloud-based Office 365 platform, it provides easy access from mobile devices for the first time. This initiative also introduced self-publishing and additional functions such as Stream and Yammer, which now give staff the ability to publish in the medium best suited to their audience.
A new Customer Service Call Centre platform using the Genesys Purecloud platform was also rolled out to replace the Cisco system. The new platform has not only improved the Customer Service team’s call flow management but has also given them new capabilities and real-time reporting, which is a vast improvement on the previous system.
When COVID-19 arrived in early 2020, IT was at the forefront of Ahpra’s response to upgrade existing capabilities and deliver new ones for all Ahpra staff to work remotely. IT worked in close partnership with the Business Continuity Planning team to complete this project successfully in a record time of 3.5 weeks. We equipped all 1,000+ Ahpra staff with laptops to work from home using upgraded virtual private networks integrated into Ahpra’s IT environment.
The recently completed components of the Digital House program created a foundation technology platform with key functions.
We moved our Trans-Tasman Mutual Recognition forms online and built a portal to support the online document upload. While this work was already well underway, we were able to rapidly speed up the final stages in response to the COVID-19 pandemic.
In March the new outcomes-based assessment for internationally qualified nurses and midwives (IQNMs) went live. For the first time IQNMs can self-check, create an account, establish and submit a portfolio, apply online and do Part 1 and 2 orientation to the Australian healthcare system and regulatory environment. The self-check also enables relevant applicants to schedule a multiple choice exam, and all of this through an online experience.
Our work in forms and registration has produced tangible benefits for staff, applicants and practitioners. However, some of our biggest efforts have been behind the scenes – establishing the digital foundations.
The continuation of the program will enable the work and experience gained to be extended to other professions and Ahpra functions and will culminate in the delivery of a business platform for Ahpra’s staff and stakeholders.
Ahpra formed a Business Continuity Planning Working Group in February, in response to COVID-19 and in anticipation of government directives that people should work from home if they can.
This decision served us well as it meant we could start preparing for staff to work remotely, even before it became a requirement.
Early on, we ordered additional laptops for staff who didn’t already have one, prioritising our Customer Service and Registration teams. More than 350 monitors and 65 dongles and accessories were also provided to staff who needed them to work effectively from home.
Our team prepared the laptops, including installing necessary software, upgraded Ahpra’s virtual private network and spent time supporting staff to connect to their home internet and user profile. This work started on 17 March, with the last laptop dispatched on 25 March. The first 100 new laptops that arrived on the morning of 24 March were made ready in less than 24 hours. As well as preparing the laptops, the team produced guides and instructions for many staff who had never worked from home before.
By the time our Sydney office closed on Monday 30 March and Adelaide and Brisbane followed on Tuesday 31 March, all staff were able to work from home.
The service desk manager described the work effort as a ‘race against time’. This project was one of many that, thanks to our dedicated staff, enabled us to become a fully functional remote-working organisation within weeks.