Responding to the increasing pressure on Australia’s health workforce was a priority across much of our work.
We strengthened our engagement with employers to ensure registration requirements are clearly understood, improved timeframes to assess applications for registration, and created a new information hub for international applicants on our website.
The new hub and other changes are helping international applicants find information about getting registered in Australia quickly and easily.
These initiatives were well aligned to the findings from the interim report of the Independent review of overseas health practitioner regulatory settings (referred to as the Kruk review), which was released in April.
You can check our Register of practitioners to see if someone is registered and if there are any special requirements on their registration.
We have continued to improve the register to make it more accessible and easy to use. Changes include:
A total of 161 government departments, public and private hospitals, healthcare businesses, pharmaceutical companies, medical insurers, and nursing and aged care agencies subscribed to the Practitioner Information Exchange (PIE). The PIE is a secure web-based system that enables bulk checking of registration status, drawing on public information published on the Register of practitioners. This is an increase from 142 subscribers in 2021/22.
We check every applicant’s criminal history before they are registered.
The temporary pandemic response sub-register was established in April 2020 to enable a rapid return to the workforce of experienced and qualified health practitioners to assist in the COVID-19 pandemic.
These practitioners were selected because they had previously held general or specialist registration and had become unregistered or moved to non-practising registration in the previous three years.
Since then, there have been various adjustments to the sub-register to optimise Australia’s health workforce capacity. At its peak, there were more than 40,000 practitioners on the sub-register and around 1,000 have successfully applied to return to the main Register of practitioners.
The National Boards decided to close the sub-register in June 2023, and return the last 1,700 practitioners to the main register. These practitioners will be able to apply to renew their registration at the next scheduled renewal date for their profession.
After this transfer of the remaining practitioners, the sub-register was closed.
We finalised 96,136 applications for registration, an increase of 14.3% from last year.
We received 96,879 applications for registration. The largest number were from new graduates, followed by practitioners transitioning from provisional to general registration, and practitioners transitioning from general to non-practising registration.
We received 42,565 applications from new graduates, including 24,084 nursing applications.
The end-of-year graduate survey is a voluntary customer experience survey now in its fourth year. The results give us valuable insights about the graduate experience of joining the National Scheme as a qualified health practitioner.
This year we invited 29,059 new graduates to participate in the survey and 2,817 responded (a 9.7% participation rate). Overall, most measures improved when compared to last year.
This year saw the best result to date in how well we managed graduate applications, with 86.2% of respondents satisfied overall, compared to 83.1% last year.
This year, 19,288 overseas-qualified practitioners gained registration, a 92.5% increase from last year.
The Trans-Tasman Mutual Recognition Act 1997 (TTMR Act) allows for many types of health practitioners registered in either Australia or New Zealand to apply for registration in the other country through a streamlined registration process. The objective is to remove regulatory barriers and drive workforce mobility for health practitioners who hold current practising registration in either jurisdiction.
Registration in Australia will only be granted in the same category as the practitioner’s New Zealand registration. Any conditions, limitations or endorsements that apply in New Zealand may also apply to the practitioner’s registration in Australia. For most TTMR matters, a final registration decision must be made within 30 days of receipt of the application.
There has been a significant increase in TTMR applications in the past 12 months. Ahpra approved 3,562 TTMR applications in 2021/22 and 9,129 in 2022/23. The increase is most notable for nurses, occupational therapists, medical radiation practitioners and physiotherapists.
In September, National Cabinet commissioned the Independent review of overseas health practitioner regulatory settings to examine the entry of overseas-trained health professionals who want to work in Australia. The review considered ways to help ease health workforce shortages while maintaining high standards in healthcare quality and patient safety.
Ms Robyn Kruk AO was appointed to lead the review, which focused on five reform priorities:
In April, Ms Kruk released an interim report containing 56 recommendations across these five reform priorities. Ahpra and the National Boards have a significant program of work to improve the recognition of qualifications and assessment of skills for overseas-qualified practitioners, including:
Ms Kruk is expected to hand down her final report in late 2023.
Ahpra launched a new webpage to provide clear information to international applicants. A flyer was also developed which outlines what international practitioners must do before they can start practising in Australia. This includes advice on:
We implemented a new approach to assessing applications, which involves an initial risk assessment and more senior staff assessing applications at their earliest stage to reduce delays. This immediately improved the time it takes to make first contact with an applicant and reduced the average timeframe to assess applications from 29 days to 10 days.
We continue to work with jurisdictions and provide advice on improving the complex registration processes for overseas-qualified practitioners, including IMG pathways to registration and the internationally qualified nurse and midwife (IQNM) qualification assessment process. This supports employers who are seeking overseas-qualified practitioners to ease pressure on stretched local health services.
Ahpra delivered five virtual education sessions to employers and stakeholders who work with international applicants in every state and territory. The objective of the sessions was to increase understanding of complex IMG and IQNM registration processes. These sessions received very positive feedback from employers and resulted in more complete and accurate applications being submitted. This in turn reduced the time taken to finalise applications and improved the overall experience for applicants and employers.
IQNMs who wish to apply for registration in Australia are required to complete an online assessment of their qualifications. Those who hold qualifications that are substantially equivalent or based on similar competencies to an Australian graduate (and who meet the mandatory registration standards) progress to an application for registration.
IQNMs who hold relevant but not equivalent qualifications must successfully complete an outcomes-based assessment before being eligible to apply. These IQNMs complete two exams:
The MCQ examinations are:
This year, 1,489 internationally qualified registered nurses participated in the registered nurse OSCE. The midwife OSCE was held three times throughout the year.
Ahpra coordinated the following exams:
Ahpra renewed registration for 800,943 health practitioners. This is an increase of 4.7% from last year.
Each year when they renew, practitioners must confirm they continue to meet their National Board’s mandatory registration standards. They must also let us know if there’s been any change to their criminal history or any health impairment that may negatively affect their ability to safely practise. This year we revised communications to practitioners about what they need to tell us at renewal, which reduced the number of unnecessary disclosures.
This year, health practitioners across all professions were expected to fully meet their continuing professional development requirements – some expectations had been reduced or paused during the first years of the COVID-19 pandemic. Practitioners who hadn’t met the requirements had to let us know.
We continued to transition all renewals to online, phasing out hard-copy forms. To accommodate practitioners who were unable to access the online platform for renewal, a verbal submission process was implemented. Only 11 health practitioners accessed this service, and all successfully finalised their application for renewal.
From time to time, we are challenged to respond quickly and decisively to ensure positive health outcomes.
We registered a specialist plastic surgeon under urgent circumstances this year, which resulted in positive health outcomes for his patients. A children’s hospital called to advise that a specialist surgeon needed to be registered so he could treat 30 children who required his expertise. Eight of the children needed operations for craniofacial deformities that had to be precisely timed with their developmental requirements, so registering the surgeon in a timely manner was crucial.
Our team worked out of hours to ensure the right information reached the Medical Board of Australia delegate committee at short notice, liaised within Ahpra to ensure the importance of the situation was understood and the case given priority, and ensured the Register of practitioners was updated without delay.
The team’s quick work meant the specialist plastic surgeon was registered in time to start reviewing cases and operating within a week, in time for the first scheduled surgery.
In late 2022 our international registration team was delighted to play a part in enabling Australia’s first-ever uterine transplant operation.
The surgery was part of a research trial at the Royal Hospital for Women in Sydney.
After receiving several limited registration applications for the specialists from Sweden on 13 December, our team worked throughout the Christmas period to prepare papers and liaise with the MBA delegate committee, to finalise registration in time for the operation on 10 January.
The life-changing surgery was a success, and a thank you letter from hospital staff confirmed it could not have happened without the efforts of our dedicated regulatory officers.
It was an outstanding achievement for all involved and our team was proud to help this landmark surgery occur in Australia.
Aboriginal and Torres Strait Islander Peoples are under-represented in our health workforce. Increasing participation in the registered health workforce is a goal of our Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy.
Ahpra and the National Boards ask about Aboriginal and/or Torres Strait Islander cultural identity in application and renewal processes. This enables us to understand workforce trends and the proportion of registered health practitioners who identify as Aboriginal and/or Torres Strait Islander.
At 30 June:
A new Aboriginal and Torres Strait Islander Engagement and Support team was established in July to better support Aboriginal and Torres Strait Islander applicants, registrants and stakeholders to engage with Ahpra’s registration processes.
Supporting Aboriginal and Torres Strait Islander health practitioners (across all professions) to join the health workforce and helping them have a positive and culturally safe experience is the Engagement and Support team’s core purpose.
The team initially focused on supporting Aboriginal and/or Torres Strait Islander graduates with their registration applications (especially with any issues that arose or disclosures they needed to make), before expanding the support service to the nursing and midwifery renewal campaign. The team will continue to use feedback obtained from the new graduate survey, relevant stakeholders, and directly from the applicants and registrants they support, to improve the services provided by Ahpra to Aboriginal and/or Torres Strait Islander applicants and registrants.
Students are the health practitioners of the future.
Education providers supply student information so students can be registered.
All National Boards except the Psychology Board register students. Psychology students receive provisional registration.
The student register is not open to the public.
We audit practitioners to check that they comply with registration standards. Our approach to audits is designed to be educative and ensure that practitioners understand and meet the requirements of their profession’s registration standards.
Auditing provides additional assurance to the public, Boards and practitioners that practitioners are meeting required standards.
Since we began conducting audits, in 2012, the overwhelming majority of audited practitioners have been found to comply with registration standards.
In 2022/23, we did not complete as many audits as in previous years because we transferred resources to focus on assessing more applications for registration.
We completed 2,956 audits with a compliance rate of 95.8%.
Of the 81 (2.7%) matters with no audit action:
Of the 40 (1.4%) practitioners found to be non-compliant:
A further 928 audits were initiated but not completed. Due to the timing of these audits, we expect to complete these matters in parallel with the practitioners’ next renewal application.
Audits ensure that a practitioner’s disclosures at renewal are accurate. During an audit, a practitioner is required to provide evidence to support the declarations made in the previous year’s renewal of registration.
The standards that may be audited are:
When an audit finds that a practitioner has not complied with standards audited, Boards identify the risks that need to be considered. Practitioners who are found to have not quite met the registration standard but who are able to provide evidence of achieving full compliance during the audit period are managed through education to achieve full compliance. These practitioners are recorded as being ‘compliant through education’.
All matters that involve issuing a caution or placing conditions on a registration are subject to a ‘show cause’ process. This process alerts the practitioner to the intended action and gives them an opportunity to respond before a decision is made.