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The Supervised practice framework, Supervision guidelines, FAQs, Fact sheet: Supervised practice – transition arrangements and Key steps – a summary when using the Supervised practice framework do not apply to:
The Medical Radiation Practice Board of Australia has separate Supervision guidelines in place.
1 February 2022
The primary roles of the National Boards and the Australian Health Practitioner Regulation Agency (Ahpra) include public protection and helping the public access safe health services.
National Boards work with Ahpra to implement the objectives of the National Registration and Accreditation Scheme (the National Scheme) under the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).
Supervised practice reassures the community, National Boards and Ahpra that a registered health practitioner whose practice is being supervised (the supervisee) is safe and competent to practise and is not putting the public at risk.
Download the Supervised practice framework
National Boards and Ahpra have developed the Supervised practice framework (the framework) to create a responsive and risk-based approach to supervised practice across the National Scheme. The framework supports consistency in processes and decision making and helps supervisees, supervisors and employers understand what is expected of them. The framework outlines the National Boards’ expectations, gives guidance on how to comply and explains what is necessary to effectively carry out supervised practice.
The framework applies to certain decisions made by National Boards or to meet National Board registration standards, eligibility or suitability requirements, or as required by the National Law.
The framework consists of the following core components; these components support the provision of high quality, safe and effective supervised practice:
The framework includes appendices and templates which also contain expectations for supervisees, supervisors and employers and outlines the process for progressing supervised practice. The appendices may be updated from time to time and these will be published on the relevant National Board website. The framework should be read together with the supervised practice arrangement.
In this framework a supervised practice arrangement means all the elements of supervised practice approved by the National Board. This includes the approved supervisor(s), supervised practice level, workplace and any other requirements documented in a supervised practice plan (where necessary) or as stated in a condition or undertaking, or registration standard.
The framework does not establish the requirements for supervised practice. These are established in the National Law, as specified in a condition or undertaking, or registration standard.
To comply with a condition, undertaking or a requirement of a registration standard, supervisors and supervisees must comply with the framework. A failure to comply with the framework or to provide the necessary evidence of compliance with the framework could result in a finding by the National Board that a condition, undertaking or requirement of a registration standard has not been met and result in regulatory action being taken by the National Board under the National Law.
The framework uses ‘patient’ to mean a person or persons accessing healthcare, which includes clients and healthcare consumers. These terms can also include families, carers, groups and/or communities. The meaning of patient for the purpose of this framework is set out in section 10. Definitions.
Supervised practice is used for three regulatory purposes across the National Scheme. Due to the profession specific uses of supervised practice, the examples below may not be relevant for all professions.
The three regulatory purposes are:
For some National Boards, some types of registration require supervised practice such as limited registration and provisional registration (such as for overseas qualified practitioners).
This may be due to:
Specific information on National Board standard requirements is provided in Appendix 1 – Links to relevant National Board material.
This will be in the form of a condition or undertaking imposed by a National Board, panel or tribunal as an outcome of a notification that requires the practitioner to complete a period of supervised practice.
If supervised practice is in place because of a complaint, a supervised practice plan is not needed.
The need for supervised practice is reflected by either one or a combination of the following a: registration requirement, notation, condition or undertaking recorded on a practitioner’s registration. This information is available on the public register of practitioners.
The framework does not override or replace any requirements specified in a condition or undertaking or registration standard or any other supervised practice requirement.
This framework does not apply to:
This framework does not apply to the following registrant groups because of profession-specific uses of supervised practice:
Some National Boards have extra requirements for supervised practice for a particular purpose (e.g. profession specific registration standards, capabilities, competencies, thresholds or standards for practice). While the core components of this framework apply, there may also be extra profession-specific documents that need to be considered.
Supervisees and supervisors need to check if there are profession-specific requirements that apply to the supervised practice arrangement. A summary of these profession-specific requirements is at Appendix 1 – Links to relevant National Board material.
2 Aspects of the framework may still apply as agreed by the National Board.
3 Due to other regulatory and/or profession-specific requirements the framework is not applicable to pharmacists or psychologists.
The framework should be used by:
Tribunals and panels considering matters arising from a notification about a registered health practitioner may decide to impose a period of supervised practice. A tribunal may refer to this framework in addition to the National Restrictions Library when drafting the supervised practice requirements.
4 Office of the Health Ombudsman, New South Wales Health Professional Councils.
This framework is underpinned by several principles that build on the Regulatory principles for the National Scheme and the guiding principles of the National Scheme set out under the National Law.
These principles are considered by National Boards when deciding the supervised practice arrangements and when ensuring monitoring and compliance with supervised practice. They also apply to the supervisees and supervisors, where relevant.
Patient care given during supervised practice must be safe and appropriate. This must be the overriding priority at all times.
The National Board will consider several factors when taking a risk-based approach to supervised practice.
The risk associated with a particular purpose for supervised practice will be influenced by:
If the supervised practice is required in relation to an application or renewal of registration, the supervisee’s qualifications, skills, competence, years of practice and clinical experience will also be considered.
This risk associated with the purpose of supervised practice will inform the:
As a general principle, if the purpose for supervised practice is to address an assessed higher risk, the supervision will be more direct and reports will be more frequent and detailed.
Supervisees and supervisors must be accountable and transparent at all times in complying with their responsibilities for the supervised practice arrangement and in communication with Ahpra and the National Board. If the supervisee or supervisor does not act in good faith5 in their role, a National Board may take regulatory action.
By providing the framework and supporting documentation National Boards are being transparent about the approach to supervised practice in the National Scheme.
National Boards make decisions about supervised practice arrangements in different ways depending on the purpose of the supervised practice.
For notification matters, the National Board will impose supervised practice requirements to manage the risk identified.
For all other required supervised practice, the National Board will consider each proposed supervised practice arrangement on its individual merits and will only approve arrangements that it considers safe and fair. In these cases, supervised practice requirements need to be matched to the individual practitioner’s experience, needs and capabilities as well as their employment arrangement and/or practice environment.
Supervisors and supervisees have responsibilities to protect patient safety and improve healthcare quality for Aboriginal and Torres Strait Islander Peoples, contributing to improving their health wherever possible.
Supervisors and supervisees should recognise and consider the diverse and distinct needs of Aboriginal and Torres Strait Islander Peoples and their health and cultural safety, including the need to foster open and honest professional relationships. The National Scheme’s definition of cultural safety for Aboriginal and Torres Strait Islander Peoples is set out in section 10. Definitions.
Culturally safe and respectful practice requires supervisees and supervisors to have knowledge of how their own culture, values, attitudes, assumptions and beliefs influence their interactions with people and families, the community and colleagues. It is expected that supervisees and supervisors will practise in a culturally safe and respectful way as set out in the relevant National Board code of conduct and other relevant standards, codes or guidelines.
Objectivity from the supervisor is essential for the supervised practice arrangement to be effectively delivered.
The supervisory relationship between supervisor(s) and the supervisee must be professional.
Conflicts of interest may prevent objectivity and/or interfere with the supervised practice arrangement. Supervisors and supervisees must disclose potential or actual conflicts of interest to the National Board. The National Board will decide whether any conflicts disclosed show a potential or actual conflict of interest. Conflicts of interest must be avoided if possible and managed if not avoidable.
When supervised practice relates to a registration type or to meet suitability or eligibility for registration a National Board may refer to an independent measure such as entry-level competencies or equivalent (refer to Appendix 1 – Links to relevant National Board material) for the profession to describe the level of competence expected of the supervisee.
For further information about conflict of interest refer to:
The National Board may approve more than one supervisor for supervised practice. This allows for flexibility if a supervisor is not available to carry out the supervised practice. It also allows for each National Board to approve a relevant and suitable supervised practice arrangement with more than one approved supervisor.
The supervisor will usually be from the same profession as the supervisee. A National Board may approve a practitioner from another profession as a supervisor in exceptional circumstances. This is at the discretion of the National Board.
Supervised practice arrangements may need to change over time, subject to National Board-approval. This may be because of progress towards the purpose of the supervised practice or because of a change of circumstances, such as change in supervisor or workplace.
Supervised practice is most effective when supervisees and supervisors are prepared and supported. There needs to be a shared understanding of the supervised practice arrangements.
Supervisees should be given adequate orientation to any new supervised practice setting. Supervisors will need to meet any National Board-approved training requirements. This training may be counted as continuing professional development (CPD) if it meets the National Board’s requirements set out in the registration standard for CPD.
5‘Good faith’ has its ordinary meaning of being well-intentioned or without malice.
The levels of supervised practice are designed to make sure that the supervisee practises safely. There are four levels of supervised practice described in this framework. Not all levels will be used by all National Boards.
The definition of ‘consult’ for this framework is set out in section 10. Definitions.
More information about the supervised practice levels is available in Appendix 4 – Supervised practice levels.
The supervisor takes direct and principal responsibility for all individual patients receiving care from the supervisee.
The supervisee must consult with and follow the directions of the supervisor about the management of each patient, including the process of assessment, before care is given. The care provided must be directly observed by the supervisor who is physically present with the supervisee at all times.
The supervisee and the supervisor share responsibility for all individual patients receiving care from the supervisee.
The supervisee must consult with the supervisor who is always physically present in the workplace or practice environment and available to observe and discuss at agreed intervals and as necessary the:
The supervisee takes primary responsibility for their practice and the management of all individual patients receiving care from the supervisee under the supervisor’s general oversight.
The supervisee must consult with the supervisor who is accessible by telephone, video conference or other means of telecommunication and available to attend the workplace or practice environment to observe and discuss at agreed intervals and as necessary the:
This may be after the care is given to the patient.
The supervisee takes primary responsibility for their practice including the management of all individual patients receiving care from the supervisee under the supervisor’s general oversight.
The supervisee must consult with the supervisor, who is accessible by telephone, video conference or other means of telecommunication at agreed intervals and as necessary about the:
When supervised practice is required because of a notification, the supervised practice remains at the level outlined in the condition or undertaking.
Supervised practice may involve progression through levels when it is required for a registration type or to meet suitability or eligibility for registration. Progression can occur depending on the individual requirements of supervised practice as set out in the supervised practice arrangement, for example meeting the entry level competencies or equivalent.
For further information about the levels of supervised practice refer to:
National Boards expect that supervisees and supervisors comply with the framework. If the supervisee fails to comply with the framework it could result in a decision by the National Board that a condition, undertaking or requirement of a registration standard has not been met and may result in regulatory action being taken by the National Board.
The National Boards also expect supervisees and supervisors to comply with all the relevant National Board standards, guidelines, code of conduct and other codes.
The supervisee must not start practice, or restart practice, until the National Board has approved the supervisor(s) and the supervised practice arrangement, unless otherwise agreed by the National Board.
If the supervisee knows that their, or their supervisor’s, circumstances are going to change and they will not be able to comply with the approved supervised practice arrangement, they need to let Ahpra know as soon as possible and within seven (7) calendar days or as stated in the condition or undertaking.
The supervised practice approved by the relevant National Board will be documented in the supervised practice arrangement, which may also refer to a supervised practice plan. When supervised practice follows a notification, the requirements for supervised practice will be set out in the condition or undertaking in the supervised practice arrangement.
The supervisee must:
For further information about expectations of the supervisee and the practical steps to prepare for a period of supervised practice refer to:
A supervisor needs to have the qualifications, skills, knowledge, experience and availability needed for the role. These will vary according to the purpose of supervised practice and the risk associated with the role. The National Board will consider the supervisor’s experience and circumstances (including their qualifications, responsibilities, relevant scope of practice) when deciding the requirements of the supervised practice. Information on the nomination process for a supervisor is available in Appendix 2 – Information for supervisees.
Supervisors must hold general registration and, where relevant the appropriate specialist registration or endorsement with a National Board.
The supervisor’s registration must not be subject to any conditions or restrictions that could affect their effectiveness or suitability to successfully supervise another’s practice.
A supervisor’s required level of skills and the number of years of experience may vary according to the level of risk associated with the supervisee’s individual circumstances.
A supervisee must:
For further information about the expectations of the supervisor refer to:
An employer should think about the following factors in relation to supervised practice:
For further information about the expectations of the employer refer to:
It is important that the supervised practice arrangement manages the risk associated with the purpose of supervised practice.
Ahpra and National Boards monitor supervised practice. Monitoring will be proportional to the level of identified risk of harm and depending on the supervised practice purpose may include regular reporting, review of Medicare data, review of rosters or appointment diaries and/or employer reports.
If a supervisee does not practise in accordance with the supervised practice arrangement, this may pose a risk to the public and the National Board may take regulatory action under the National Law, including but not limited to investigation or immediate action for unprofessional conduct. A National Board may also take the necessary regulatory action required if a supervisee does not progress as expected.
If the supervisor does not, in good faith, supervise practice and carry out the role of the supervisor to the requirements outlined in the framework and appendices, the National Board may take regulatory action under the National Law, including but not limited to investigation or immediate action for unprofessional conduct.
Supervisees and supervisors are reminded to practise in accordance with the relevant National Board’s registration standards, guidelines, code of conduct and other codes.
The criteria for when supervised practice is successfully completed will depend on the purpose of supervised practice and profession specific uses of supervised practice. The criteria for successfully completing supervised practice will be set out in the supervised practice arrangement for each supervisee.
To meet a registration requirement or to meet suitability or eligibility for registration, the criteria for completing supervised practice includes when the supervisee has:
This information will be updated on the public register of practitioners.
Supervisees completing supervised practice as a requirement after a notification must apply for a review of the conditions or undertakings where they have successfully shown a period of competent and safe practice under supervised practice. Supervised practice will only be complete when the National Board decides the conditions or undertakings are no longer necessary.
The framework was issued on 1 February 2022.
It will be updated from time to time to support the implementation and understanding of supervised practice requirements across the National Scheme. This will generally be at least every five years.
Consult in this framework means the supervisee and supervisor must engage and interact with each other in a way that is consistent with the level of supervised practice required and appropriate for the relevant supervised practice arrangement.
The definition
Principles
The following principles inform the definition of cultural safety:
Definition
Cultural safety is determined by Aboriginal and Torres Strait Islander individuals, families and communities.
Culturally safe practice is the ongoing critical reflection of health practitioner knowledge, skills, attitudes, practising behaviours and power differentials in delivering safe, accessible and responsive healthcare free of racism.
How to
To ensure culturally safe and respectful practice, health practitioners must:
National Scheme means the National Registration and Accreditation Scheme for registered health practitioners of 16 health professions:
Patient in this framework means a person who has entered into a therapeutic and/or professional relationship with a registered health practitioner. The term ‘patients’ includes ‘clients’, ‘consumers’ and ‘women6’. It can also extend to their families and carers, and to groups and/or communities as users of health services, depending on context.
Practice means any role, whether remunerated or not, in which the individual uses their skills and knowledge as a health practitioner in the profession. Practice is not restricted to the provision of direct clinical care. It also includes using professional knowledge working in a direct non-clinical relationship with patients or clients, working in management, administration, education, research, advisory, regulatory or policy development roles, and any other roles that impact on safe, effective delivery of health services in the health profession.
Student in this framework means a student enrolled in a Board-approved program of study.
Supervised practice in this framework is a mechanism to give the National Board the assurance that the supervisee is practising safely, competently and ethically for a range of regulatory purposes. Supervised practice may be direct, indirect or remote according to the nature in which the practice is being supervised.
Supervisee is a registered health practitioner who is required to carry out a period of supervised practice. The supervisee practises under the supervision of a National Board-approved supervisor with a level of supervised practice outlined in the supervised practice arrangement or relevant condition or undertaking. Refer to Appendix 2 – Information for supervisees for further information.
Supervisor is a registered health practitioner who is approved by the relevant National Board to supervise another registered health practitioner for a specified period. The supervisor needs to have the qualifications, skills, knowledge, experience and availability required for this role. Refer to Appendix 3 – Information for supervisors for further information.
Supervised practice arrangement in this framework means all the elements of supervised practice approved by the National Board. This includes the approved supervisors(s), supervised practice level, objectives, workplace, and any other requirements documented in a supervised practice plan (where necessary) or as stated in a condition or undertaking or registration standard.
Supervised practice plan in this framework is the form approved by the National Board in which the supervisee and supervisor acknowledge and confirm they will carry out and comply with the requirements of supervised practice contained in the framework and reflected in the supervised practice arrangement.
Supporting documents in this framework includes the supervised practice plan, supervised practice report, correspondence from Ahpra, and National Board material set out in Appendix 1 – Links to relevant National Board material that form the framework and any documents relevant to the framework and updated by National Boards from time to time.
6Woman or women is used to refer to those individuals who have entered into a therapeutic and/or professional relationship with a midwife. The word woman in midwifery is generally understood to be inclusive of the woman’s baby, partner and family. Therefore, the words woman or women include all the women, babies, newborn, infants, children, families, carers, groups and/or communities, however named, that are within the midwife’s scope and context of practice.
National Boards have specific requirements for supervised practice for some regulatory purposes. It is important to check if there are profession-specific requirements that apply to the supervisee completing supervised practice. The National Board’s entry-level competencies or equivalent may need to be referred to if a detailed supervised practice plan is needed.
National Boards
National Board material
Hyperlinks
Aboriginal and Torres Strait Islander Health Practice Board of Australia
Registration standard – recency of practice
www.atsihealthpracticeboard.gov.au/Registration-Standards
Entry-level competencies
www.atsihealthpracticeboard.gov.au/Codes-Guidelines/Professional-capabilities
Chinese Medicine Board of Australia
www.chinesemedicineboard.gov.au/Registration-Standards
Registration standard – standards for limited registration
www.chinesemedicineboard.gov.au/Codes-Guidelines/Professional-capabilities-for-Chinese-medicine-practitioners
Chiropractic Board of Australia
www.chiropracticboard.gov.au/Registration-standards
www.chiropracticboard.gov.au/Accreditation
Dental Board of Australia
www.dentalboard.gov.au/Registration-Standards
www.dentalboard.gov.au/Accreditation
Medical Board of Australia
www.medicalboard.gov.au/Registration-Standards
Medical Radiation Practice Board of Australia
www.medicalradiationpracticeboard.gov.au/Registration-Standards
www.medicalradiationpracticeboard.gov.au/Registration-Standards/Professional-Capabilities
Nursing and Midwifery Board of Australia
www.nursingmidwiferyboard.gov.au/Registration-Standards/Recency-of-practice
Standards for practice
www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards
Occupational Therapy Board of Australia
www.occupationaltherapyboard.gov.au/Registration-Standards/Recency-of-practice
www.occupationaltherapyboard.gov.au/codes-guidelines/competencies
Optometry Board of Australia
www.optometryboard.gov.au/Registration-Standards/Recency-of-practice
www.optometryboard.gov.au/Registration-Standards/Limited-registration-for- postgraduate-training-or-supervised-practice
www.optometryboard.gov.au/Registration-Standards/Limited-registration-for-teaching-or-research
www.optometryboard.gov.au/policies-codes-guidelines
Osteopathy Board of Australia
www.osteopathyboard.gov.au/Registration-Standards
www.osteopathyboard.gov.au/codes-guidelines/capabilities-for-osteopathic-practice
Paramedicine Board of Australia
www.paramedicineboard.gov.au/Professional-standards/Registration-standards/Recency-of-practice
www.paramedicineboard.gov.au/Professional-standards/Professional-capabilities-for-registered-paramedics
Physiotherapy Board of Australia
www.physiotherapyboard.gov.au/Registration-Standards
www.physiotherapyboard.gov.au/accreditation
Podiatry Board of Australia
www.podiatryboard.gov.au/Registration-Standards
Professional capabilities
www.podiatryboard.gov.au/Registration-Endorsement/Podiatry-professional-capabilities
This information applies to all registered health practitioners who are required by the National Board to complete a period of supervised practice. It informs and forms part of the Supervised practice framework (the framework) and should be read together with relevant supporting documents.
In this framework, a supervised practice arrangement means all the elements of supervised practice approved by the National Board. This includes the approved supervisor(s), supervised practice level, workplace and any other requirements documented in a supervised practice plan (where necessary) or as stated in a condition or undertaking or registration standard.
There are three regulatory purposes that supervised practice is used for across the National Registration and Accreditation Scheme (National Scheme). Check section 2. Purpose and scope to see if the framework applies to you.
Some National Boards require supervised practice for some types of registration such as limited registration and provisional registration (such as for overseas qualified practitioners).
This may be because you:
This may be in the form of a condition or undertaking imposed by a National Board, panel or tribunal that requires you, the practitioner, to complete a period of supervised practice.
The reasons for your supervised practice will be given to you in writing by the Australian Health Practitioner Regulation Agency (Ahpra) on behalf of the National Board. Ahpra will be your contact point with the National Board.
You must wait until the supervised practice arrangement is approved, including the approval of a supervisor by the National Board, before you start or restart practice.
Any practice that occurs outside the approved supervised practice arrangement will be considered a breach of the supervised practice arrangement and may result in the National Board taking regulatory action.
If you are carrying out supervised practice because of a registration type or eligibility/suitability requirement you will usually need to nominate a supervisor and prepare a proposed supervised practice arrangement including a plan. The details of the documentation you need to complete will be outlined in the application form, and/or in communication from Ahpra following your application.
If you are carrying out supervised practice because of a complaint (notification) the details of the supervised practice will be set out in the condition or undertaking. Ahpra will communicate with you about actions you need to take to prepare for supervised practice, which may include nominating a supervisor.
You must also give your employer or senior person at your workplace (for example a CEO, medical/clinical director or head of department) a copy of the supervised practice arrangement. If you are completing supervised practice because of a notification the senior person you must give a copy of the arrangement to will be stated in the condition/undertaking.
You may need to find and nominate your own supervisor depending on the purpose for the supervised practice. If nominating a supervisor, you need to consider the information in this appendix and the information in Appendix 3 – Information for supervisors.
If you are required to nominate a supervisor, it is recommended that you nominate more than one. Then, if the primary supervisor is no longer available, any other approved supervisor in the supervised arrangement can take on the role of supervisor and you can continue to practise. The National Board must approve all supervisors. They may approve someone other than your nominee(s).
If you are an employee, you need to make sure your employer agrees with your nominated supervisor(s).
When selecting and approaching potential supervisors, you should check they meet the following requirements:
While your supervisor will usually be from the same profession as you, a National Board may approve practitioners from another profession as your supervisor(s) in exceptional circumstances. This will be at the discretion of the National Board.
When identifying a potential supervisor, you may wish to seek advice from:
A supervisor must be able to give an independent report of supervised practice results and be willing to report to Ahpra if your practice places the public at risk or you are not compliant with the supervised practice arrangement.
You must declare any actual or perceived conflicts of interest that may undermine the supervisor’s role. The National Board will decide whether any conflict declared shows a potential or actual conflict of interest. Disclosure of the actual or perceived conflicts of interest does not necessarily mean that the supervisory relationship will be prevented.
Some examples of situations that may result in a conflict of interest and that you must declare are:
If a potential or actual conflict of interest arises during the supervised practice arrangement, you should contact Ahpra to notify them as soon as possible and within seven (7) calendar days.
As the supervisee, you are responsible for bearing any costs associated with the supervised practice arrangement.
Before the supervised practice arrangement starts you need to make sure that you have the necessary professional indemnity insurance (PII) arrangements in place. You should refer to your National Board’s PII registration standard and check with your insurance provider (or employer/other entity arranging cover) to make sure you meet the minimum requirements and to confirm that your supervised practice arrangement meets the requirements of your insurance cover.
You may need to seek advice from your employer if your PII is given under an organisational policy.
You will need to complete some documentation before the supervised practice arrangement is approved.
The purpose of the supervised practice will determine what information you need to give and when you need to give it.
For example, if the supervised practice relates to an application for registration or renewal of registration then you need to give information with your application.
If the supervised practice is because you do not meet recency of practice requirements, you may need to describe the learning you need to complete before you return to independent practice.
If the supervised practice is because of a complaint (notification) then the information will need to be given once the relevant conditions are imposed or undertakings are accepted.
The supervised practice arrangement approved by a National Board must be in place at all times when you are practising. You must not start practice until the supervised practice arrangement is approved by the National Board, unless otherwise agreed by the National Board.
As the supervisee you are responsible for ensuring that all reports are completed and submitted by the due dates.
You also need to:
In the event you need to change your supervisor, you must:
Each National Board has information on its website about how you can do this. If you do not have an approved supervisor in place and you are not able to comply with the supervised practice arrangement, you must not practise.
If you cannot practise according to the approved supervised practice arrangement you must stop practising.
If you know your circumstances or your supervisor’s circumstances are going to change and you will not be able to comply with the approved supervised practice arrangement, you need to let Ahpra know as soon as possible and within seven (7) calendar days or as stated in the condition or undertaking.
If you do not practise in accordance with the framework and the National Board-approved supervised practice arrangement, the National Board may take regulatory action against you under the National Law. The circumstances in which you practised outside of the supervised practice arrangement will be considered by the National Board when making this decision. Any provision of care, including in an emergency should be given in accordance with the relevant National Board’s code of conduct.
This information applies to all National Board-approved supervisors of registered health practitioners required by the National Board to complete a period of supervised practice (supervisees). It outlines the National Board’s expectations of an approved supervisor. This appendix informs and forms part of the Supervised practice framework (the framework) and should be read together with the relevant supporting documents.
The National Board relies on you, as the supervisor, to determine if the supervisee is practising safely, competently and ethically under the National Registration and Accreditation Scheme (National Scheme), and to monitor the supervised practice arrangement.
In this framework a supervised practice arrangement means all the elements of supervised practice approved by the National Board. This includes the approved supervisor(s), supervised practice level, workplace and any other requirements documented in a supervised practice plan (where necessary) or as stated in a condition or undertaking or registration standard.
When considering if you can be a supervisor, you should check if you meet the following requirements:
While a supervisor will usually be from the same profession as the supervisee, a National Board may approve practitioners from another profession as the supervisor(s) in exceptional circumstances. This will be at the discretion of the National Board.
A supervisor must be able to give an independent report of supervised practice results and be willing to report to the Australian Health Practitioner Regulation Agency (Ahpra) if the supervisee’s practice places the public at risk or is not compliant with the supervised practice arrangement.
You must declare any actual or perceived conflicts of interests that may undermine your role as a supervisor. The National Board will decide whether any conflict declared shows a potential or actual conflict of interest. Disclosure of the actual or perceived conflicts of interest does not necessarily mean that the supervisory relationship will be prevented.
You need to read the framework and this appendix, so you understand the:
If you are an employee, you need to make sure your employer agrees with you being a supervisor.
If you are not an employee, the setting within which you work (for example a hospital or practice) may still need to approve you being a supervisor.
Before you start as a supervisor you need to make sure you have the necessary professional indemnity insurance (PII) arrangements in place. You should refer to your National Board’s PII registration standard and check with your insurance provider (or employer/other entity arranging cover) to make sure you meet the minimum requirements and to confirm that your supervised practice arrangement meets the requirements of your insurance cover.
This depends on the purpose and level of supervised practice required for the supervisee(s). It is important that you have adequate time to carry out the role of supervisor.
It is the supervisee’s responsibility to bear any costs associated with the supervised practice arrangement, such as payment to a supervisor, if applicable.
You may need to carry out training developed by the National Board before you can start in your role as a supervisor.
As a supervisor you will have responsibilities in relation to the clinical/non-clinical aspect of supervised practice which includes, to:
As a supervisor you will also have responsibilities in relation to the reporting aspect of supervised practice which includes:
If you are approved as a supervisor, you will be contacted by Ahpra on behalf of the National Board. Ahpra will continue to be your contact point for the duration of the supervised practice arrangement.
During the period of supervised practice it is the responsibility of the supervisor to notify Ahpra immediately if:
Any practice that occurs outside the approved supervised practice arrangement will be considered a breach of supervised practice and may constitute behaviour for which the National Board may take regulatory action.
As a registered health practitioner, you have an obligation under the National Law to make a mandatory notification to Ahpra in certain circumstances. Depending on the type of concern and risk of harm to the public you must notify Ahpra about another practitioner’s impairment, intoxication, departure from accepted professional circumstances and sexual misconduct. Further information about mandatory reporting is available on the Ahpra website.
The supervisor needs to contact Ahpra as soon as possible and within seven (7) calendar days or as stated in the condition or undertaking if changes are necessary to the approved supervised practice arrangement. Examples of when this may occur include if there are changes to your or the supervisees’ employment, the supervisee is absent or has ceased practice or you intend to withdraw from the supervisor role.
Supervisors should also notify Ahpra as soon as possible and within seven (7) calendar days, if during the period of supervised practice, following a complaint (notification) their practice is subject to a condition or undertaking.
If you do not carry out your role according to the framework and supporting documents and in accordance with the approved supervised practice arrangement, the National Board may take regulatory action against you under the National Law.
This applies to supervisees and supervisors.
The National Board may approve more than one supervisor for the purpose of supervised practice.
When more than one supervisor is approved by a National Board, the alternate supervisor(s) is expected to take on the role of the primary supervisor when they are not available.
The alternate supervisor(s) is expected to give feedback to the primary supervisor about the supervisee’s practice during the absence of the primary supervisor.
The alternate supervisor(s) may need to complete the supervised practice report in the absence of the primary supervisor. Alternate supervisors must follow the framework and other relevant supporting documents.
This information supports and informs the Supervised practice framework (the framework) and gives further information about the levels of supervised practice.
The levels of supervised practice are designed to ensure the supervisee practises safely, competently and ethically.
Not all levels of supervised practice will be used when supervised practice is required, and progression from one level to the next level may also not be required. For example, some supervisees will stay at the same level of supervised practice for the whole period.
There are four levels of supervised practice. The supervised practice level of the supervisee will be set out in the approved supervised practice arrangement. The decision about the starting level for a supervisee will depend on several factors that may include:
If supervised practice is required because of the registration type (e.g. provisional or limited registration) or eligibility and suitability requirements, then in most cases the supervised practice level, the frequency of reporting and any other specific requirements will be set out in the approved supervised practice arrangement. If the supervisee is required to submit a proposal for the supervised practice arrangement, the National Board may approve the proposed arrangement or an alternative arrangement, including a different level than proposed by a supervisee.
If supervised practice is required because of a condition or undertaking following a complaint (notification) the requirements for supervised practice, such as the level of supervised practice, the frequency of reporting, and any other specific requirements will be set out in the condition or undertaking.
The framework informs the supervised practice arrangement and the supervised practice plan (where available) and gives guidance on how to comply and outlines the National Board’s expectations and what is necessary to effectively carry out supervised practice.
Some types of supervised practice involve progression through levels. In most cases, the National Board will need to approve the change in levels.
The purpose and underlying risk for supervised practice will sometimes allow for a progression through levels to be planned. It may also be appropriate at times for progression to be at the discretion of the supervisor if a National Board agrees to do so through the approved supervised practice arrangement.
A National Board will take the necessary regulatory action required if a supervisee does not progress as expected.
When supervised practice is required following a notification the supervised practice remains at the level outlined in the condition or undertaking.
Further guidance on what is required in each supervised practice level is set out in the table below. The descriptions of each level aim to accommodate the different approaches including practice in clinical or nonclinical settings for the professions using this framework.
The supervised practice arrangement will specify the workplace(s) or practice environment(s) where the supervised practice is to take place.
The definition of ‘consult’ for the purposes of this framework is set out in section 10. Definitions.
What does this mean?
This appendix is to help employers understand information about the Supervised practice framework (the framework) that applies to supervisees and supervisors. This appendix should be read together with the framework and relevant supporting documentation.
Employers make an important contribution to the risk-based approach of the National Registration and Accreditation Scheme (National Scheme) supervised practice process by giving supervisees an opportunity to practise while under supervised practice and/or allowing a supervisor to supervise another health practitioner at a health service or private practice.
Supervised practice is used for three regulatory purposes across the National Scheme. Employers can check section 2. Purpose and scope to see when the framework applies to their employees.
Some types of registration require supervised practice such as limited registration and provisional registration for some National Boards (such as for overseas qualified practitioners).
This may be the result of:
This may be in the form of a condition or undertaking imposed by a National Board, panel or tribunal that requires the practitioner to complete a period of supervised practice.
Before any supervised practice can take place, the supervisee must:
A supervisee must stop practising if they cannot practise in accordance with the approved supervised practice arrangement.
A supervisee and supervisor must comply with the requirements and responsibilities specified in the framework and Appendix 2 – Information for supervisees, and Appendix 3 – Information for supervisors.
A supervisee may be required to nominate a supervisor to carry out the supervised practice. It is recommended that a supervisee nominate more than one supervisor so that if the primary supervisor is not available the alternate supervisor can carry out the supervised practice. The National Board must approve the supervisor(s). They may approve someone other than the practitioners nominated by the supervisee.
A supervisee may contact you for advice about identifying potential supervisor(s) at the workplace.
Alternatively, an employee may contact you for advice about being nominated as a potential supervisor at the workplace. A supervisor should make sure you, as the employer, agree with any proposed supervised practice arrangement.
The supervisee must give their employer or senior person at their workplace(s) (for example a CEO, medical/clinical director or head of department) a copy of the supervised practice arrangement. If the supervisee is completing supervised practice because of a notification the senior person they must give a copy of the arrangement to will be stated in the condition or undertaking.
A supervisor needs to have the qualifications, skills, knowledge, availability and experience required for the role. These will vary according to the purpose for supervised practice and the risk associated with this role.
This will generally mean that the supervisor will have enough experience in the relevant clinical area and relevant qualifications, responsibilities and scope of practice. The requirements to be a supervisor include that they:
While the supervisor will usually be from the same profession as the supervisee, a National Board may consider approving a practitioner from another profession as a supervisor in exceptional circumstances. This will be at the discretion of the National Board.
The supervisor will also need to meet any National Board-approved training requirements.
A supervisor must be able to give an independent report of supervised practice outcomes and be willing to report to Ahpra if a supervisee’s practice places the public at risk or if they are not compliant with the supervised practice arrangement.
The supervisee and supervisor must declare any actual or perceived conflicts of interest that may undermine the supervisor’s report. The National Board will decide whether any perceived conflict declared shows a potential or actual conflict of interest. Disclosure of the actual or perceived conflicts of interest does not necessarily mean that the supervisory relationship will be prevented.
Some examples of situations that may result in a conflict of interest and that supervisees and supervisor must declare are:
Employers in a health service, public or private, will need to think about the following possible conflicts of interest about supervised practice arrangements between two employees:
Employers in a private practice will need to think about the following possible conflicts of interest about a supervised practice arrangement if the employer is also the supervisor:
Employers have an obligation to make sure that the employment arrangements support a supervisee to complete their period of supervised practice. This can include facilities, scope of practice and supervised practice arrangements.
Employers also have a responsibility to advise Ahpra as soon as possible and within seven (7) calendar days, of any concerns about the supervisee if they form the opinion that there is a risk to the public.
Employers may also have responsibilities in relation to professional indemnity insurance (PII) as set out below.
Employers have mandatory notification responsibilities under the National Law. If an employer forms a reasonable belief that a registered health practitioner has behaved in a way that meets the threshold for notifiable conduct, they must notify Ahpra. Further information about mandatory notifications is available on the Ahpra website.
It is the responsibility of the supervisor and supervisee to check they have the required PII arrangements in place before the supervised practice arrangement starts.
The National Board’s PII registration standard sets out the requirements for registered health practitioners to have appropriate PII arrangements in place.
Supervisees and/or supervisors may be covered by either individual or third party PII arrangements, such as via a health service and/or employer’s overall insurance arrangement. Employers should check with the insurance provider to make sure the supervisor and supervisee, if covered by a third party PII arrangement, meet the minimum requirements and to see if the supervised practice arrangement affects their coverage.
This depends on the purpose and level of supervised practice required for the supervisee(s). It is important that the supervisor has enough time to carry out the role of supervisor and that the supervisee receives the level of support as detailed in the supervised practice arrangement.
It is the supervisees responsibility to bear any costs associated with the supervised practice arrangement.
The need for supervised practice is reflected by either one or a combination of the following a: registration requirement, notation, condition or undertaking recorded on a practitioner’s registration. This information is available on the public register.
An employer needs to contact Ahpra as soon as possible and within seven (7) calendar days if the:
If circumstances change and the supervisor is not able to comply with the approved supervised practice arrangement the supervisor should let Ahpra know as soon as possible and within seven (7) calendar days or as stated in the condition/undertaking.
A supervisee cannot practise without the approved supervised practice arrangement in place at all times.
If the supervisor or supervisee does not, in good faith7, practise in accordance with the supervised practice arrangement or in accordance with the requirements contained in the framework and appendices, the National Board may take disciplinary action under the National Law, including but not limited to immediate action and/or investigation for unprofessional conduct.
The alternate supervisor(s) may need to complete the supervised report in the absence of the primary supervisor.
7 ‘Good faith’ has its ordinary meaning of being well-intentioned or without malice.