Restrictions allow practitioners to start or continue providing healthcare while keeping the public safe.
We monitor any restrictions that are placed on a practitioner’s registration and ensure that they comply with advertising requirements.
There was a 1.9% increase in cases being monitored from 2020/21. The number of monitored cases tends to follow the trend in registration numbers.
Of the 4,740 cases at 30 June:
Many practitioners find restrictions difficult, but they are a way of allowing practitioners to provide healthcare while keeping the public safe.
Restrictions can be put in place during the initial application or renewal process; for example, when a practitioner is:
A National Board may decide that a practitioner can be registered and provide healthcare while the shortfall is addressed through supervision, additional education, mentoring or limiting scope of practice.
Restrictions can also be used in response to a notification where a Board believes that:
For example, a practitioner alleged to have entered into an inappropriate sexual relationship with a patient may be prohibited from seeing patients of that gender while the investigation is underway, under the process of immediate action. A practitioner with an alcohol-use disorder may be required to conduct supervised breath tests before each shift.
Where a Board imposes the requirements, we use the term conditions. Sometimes a practitioner is aware of what they need to do and provides an enforceable undertaking that they will meet additional requirements. We use the term restrictions to include both conditions and undertakings.
We gather information to monitor health practitioners and students with restrictions on their registration or whose registration has been suspended or cancelled, and to assess compliance with restrictions. The types of information we gather are listed in the restrictions. Monitoring plans are used to guide our monitoring and compliance activities, and to help practitioners understand what is required of them and how to comply with the restrictions.
For example, a practitioner subject to supervision restrictions is required to find a potential supervisor and nominate them for Board approval. The monitoring plan shows the practitioner when the supervision plan and forms are due, how to access them from our website, and where to submit the information. After we receive the supervision plan and the Board approves the supervisor, we receive routine reports from the supervisor to confirm that the practitioner is progressing as expected. Once the practitioner has achieved the required hours of supervision or the required standard of competence, they can apply to have the restrictions reviewed. We seek a final report from the supervisor, and the Board considers removal of the restrictions.
We have a National Restrictions Library and we use the same wording about restrictions for similar cases. This ensures that the restrictions are achieving the desired outcome, are understood by practitioners and that we can develop consistent monitoring plans.
Where a practitioner does not do what the restrictions require, we first seek an explanation from them. The Board may choose to take additional regulatory action, such as a caution or additional restrictions, to ensure the public remains protected.
We also monitor a group of practitioners who are not permitted to practise because they have had their registration cancelled or suspended, have surrendered their registration or are restricted from practising.
We monitor these practitioners to confirm they are not practising. We do this by communicating with former employers, conducting site visits, checking advertising and ensuring that the original issues are reviewed if the practitioner subsequently applies for practising registration.
We recognise that having to comply with restrictions can be confusing and stressful for practitioners. We published additional guidance to help practitioners understand our processes, including information on how to ask the Board to change or remove restrictions, and on the evidence that a Board is likely to need to help in making the right decision.
Supervision is our most common restriction category, so we have provided extra advice on the expectations of supervisors and supervisees. For most professions we have a common Supervised practice framework with extensive guidance and templates.
We have also published a frequently asked questions page on our website and continue to improve the language in our correspondence to make it clear to practitioners what they need to do next.
Each restriction on a practitioner’s registration is assigned a restriction category. Where a practitioner is subject to multiple restrictions they will have multiple restriction categories – this results in a greater number of total restrictions on practitioners than total cases being monitored.
The top 10 restriction categories by volume being monitored by Ahpra at 30 June contained 6,314 restrictions.
We close a monitoring case when the restrictions are no longer required.
When a practitioner has completed the requirements of the restrictions they can apply to the Board to remove the restrictions. The case is then closed.
When a practitioner's registration is not renewed we close the case but retain important information to ensure that we consider the practitioner’s regulatory history for any subsequent applications.
During the year we created 2,129 new monitoring cases and closed 2,037, leading to an increase in overall cases. Of the cases we closed:
We assessed 499 advertising complaints. Of these:
When we identify that advertising by registered health practitioners is not compliant with the Guidelines for advertising a regulated health service, we initially provide practitioners with an opportunity to correct their advertising and only take further regulatory action when this is unsuccessful.
Sometimes practitioners do not realise what they are not allowed to claim when they advertise. We provide information to help them. An example would be where a chiropractor claims that treatment can boost immune functions but there is no acceptable evidence to validate this claim. Removal of the claim would result in closure of the complaint.
Where practitioners fail to correct their advertising, we propose to take regulatory action by imposing conditions on the practitioner’s registration. There were 97 instances of practitioners correcting their advertising following a formal proposal to take regulatory action, and no instances where we needed to impose conditions.
See page 85 for action taken about advertising that is unlawful.
Work continued our two-year-long advertising audit of a random sample of 1,231 practitioners across 13 health professions.
We search for any advertising by each practitioner across the internet, including social media, and assess a sample of the content we find against our guidelines for advertising a regulated health service. This audit supplements our complaints-based approach to advertising breaches and helps us understand the rates of advertising in each profession along with the frequency of issues identified and any common themes. We use the information to improve our guidelines and website, and our engagement with practitioners.