We monitor five streams: 

• conduct 
• health 
• performance 
• prohibited practitioner/student 
• suitability/eligibility. 

When we receive a notification that raises serious concerns about a practitioner’s conduct or performance, Boards consider whether there are additional things that a practitioner can do, or if there are checks and balances that can be put in place so that they can practise safely. 

Only a small number of notifications are so serious that the practitioner is not permitted to practise. 

Where a Board needs additional assurance, it may impose restrictions on the practitioner’s registration. For example, a practitioner who is the subject of an allegation of sexual misconduct for conducting a physical examination that is not clinically indicated, or that the patient has not consented to, may be prohibited from contact with patients of a particular assigned sex or gender. 

A practitioner with this restriction must not practise until we determine that there are systems in place at their practice location that will ensure their compliance. The restrictions are published on the Register of practitioners. The practitioner must report regularly about all the patients they have had contact with. We then monitor the practitioner’s compliance by checking that the: 

• practice location is suitable and has sufficient systems in place to monitor compliance 
• practice staff and a senior person at each practice location understand the requirements of the restriction 
• practitioner’s information about the practice location is accurate; for example, by visiting practice locations 
• practitioner has not had prohibited contact with patients of the assigned sex or gender. 

Where applicable, we also receive reports from Services Australia and the Pharmaceutical Benefits Scheme about patients seen by the practitioner. 

We recognise that having to comply with restrictions can be confusing and stressful for practitioners. We publish additional guidance to help practitioners understand our processes.

Conditions, undertakings and restrictions

Where a Board imposes the requirements, we use the term ‘conditions’.

In other cases, 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.

How we monitor

We gather information to monitor health practitioners and students with restrictions on their registration or whose registration has been suspended or cancelled.

Our monitoring activities are guided by the requirements of the restrictions on each individual practitioner’s registration. We gather information to confirm that the practitioner has complied with the requirements. We place greater weight on independent sources of information and avoid relying on self-reported compliance.

We provide practitioners with a monitoring plan that outlines how we will monitor their compliance and what they need to provide us with and when.

Updating our National Restrictions Library

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, that they are understood by practitioners and that we monitor restrictions consistently.

We launched an updated library in September, which aims to:

• reduce the complexity and length of restrictions 
• improve information for practitioners about what the restrictions require them to do or not do 
• improve information for the public and employers about what restrictions mean 
• remove unnecessary barriers to practitioners complying with the requirements. 

For the most commonly imposed types of restrictions, there is now a protocol that supports the restriction wording and contains detailed information to help the practitioner understand: 

• what they are required to do 
• how we will assess any nominations they provide 
• what information we will gather to confirm they are complying. 

Only practitioners who have had restrictions imposed since the launch of the updated library have the newly formulated restrictions published on the Register of practitioners. Until practitioners achieve unrestricted registration, or their restrictions are replaced, their restrictions will continue to reflect the previous library wording. This means that, over time, the register will become more consistent and easier to understand.

Managing non-compliance

Where a practitioner does not do what the restrictions require, we first seek an explanation from them. The Board that placed the restrictions may choose to take additional action, such as issuing a caution or imposing further restrictions, to ensure the public remains protected. 

Prohibited practitioners

We also monitor practitioners who are not permitted to practise because they have had their registration cancelled or suspended, have surrendered their registration, or are otherwise restricted from practising.

We may ensure that practitioners have ceased practising by: 

• informing the practitioner’s employer that the practitioner is not permitted to practise 
• accessing information from Services Australia or the Pharmaceutical Benefits Scheme 
• visiting the practitioner’s known practice locations. 

If a practitioner is found to have practised while they were not permitted to do so, the Board may choose to take further regulatory action. This can include referring the practitioner to a tribunal or commencing criminal proceedings against the practitioner.

Case study: Failure to nominate education

The Medical Board of Australia imposed conditions on a practitioner requiring them to undergo further education on prescribing drugs of dependence and managing challenging patient behaviours. The practitioner was required to nominate education of a minimum of six hours and tell us within 60 days. The education was required to be completed within six months of the conditions being imposed. 

Despite repeated requests, the practitioner failed to nominate education within 60 days. In their response to Ahpra about the failure to comply, the practitioner said that they were not able to find appropriate education due to their time commitments managing a busy general practice. 

The Board proposed to take regulatory action by cautioning the practitioner. The practitioner made submissions in response to the proposed caution, stating that they had already learned from their mistakes and that they had been too busy. The Board did not find this to be a sufficient reason for not complying with the conditions. It cautioned the practitioner and directed them to nominate appropriate education within 30 days.

Most common restrictions

Each restriction on a practitioner’s registration is assigned a restriction category. The most common restriction categories are in line with previous years, and include: 

• a requirement that a practitioner is supervised 
• restrictions on a practitioner’s practice or scope of practice 
• a requirement to complete further education 
• a prohibition from practising 
• a requirement to attend a treating practitioner due to a health condition. 

A majority of restrictions relate to suitability or eligibility for registration rather than coming from a notification. Around 70% of restrictions in the most common categories are imposed following an assessment of a practitioner’s application for registration or a renewal of their registration. The remaining restrictions are imposed because of a finding made by a National Board, panel or tribunal about a practitioner’s health, performance or conduct.

Outcomes from monitoring cases

When a practitioner has completed the requirements, the Board can decide that the restrictions are no longer needed or the practitioner can apply to the Board to remove the restrictions. The case is closed when the Board removes the restrictions. Monitoring cases may also be closed because the practitioner is no longer registered, or for other reasons, such as transferring monitoring for practitioners located in New South Wales to the HPCA.

When we close the case, we retain important information to ensure that we consider the practitioner’s regulatory history for any subsequent applications for registration and notifications we may receive.

During the year, we closed 2,148 monitoring cases.