Australian Health Practitioner Regulation Agency - Restriction: Supervised practice for defined concerns/areas of care
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Restriction: Supervised practice for defined concerns/areas of care

National Restrictions Library 2.0: This restriction applies to restictions imposed or accepted from 16 September 2024. For restrictions imposed or accepted before this date please see the National Restrictions Library 1.0.

Restriction description

These conditions apply to performance and conduct, excluding psychology and pharmacy.

A practitioner with this restriction must not practise in the defined areas unless another registered health practitioner supervises them. For the areas this applies to, read the restrictions on the practitioner’s registration record. The supervisor must have the training, experience or qualifications needed to provide the required supervision.

Supervision involves overseeing some or all of the practitioner’s practice to ensure that they are practising safely.

This type of restriction usually applies to practitioners who apply for registration but don’t quite meet the standard for recency of practice. Rather than refusing the application, we require the practitioner to only practise under supervision.

We must approve the practitioner’s supervised practice plan, outlining:

  • what level of supervision the supervisor will provide
  • where the practitioner will practise
  • how the practitioner will meet each supervision requirement. 

We monitor compliance by checking that:

  • the practitioner meets all required timeframes
  • the supervisor supervises as required
  • the supervisor does not have any concerns about the practitioner’s health, conduct or performance
  • the practitioner keeps a logbook of the procedures they perform in the areas listed in the restriction if the restriction states this is needed. 

The following definitions of the level of supervision apply to this condition.

Direct: Before delivering care, the practitioner must consult the supervisor and follow their directions about patient management. The supervisor must always do both of the following:

  • be physically present at the workplace 
  • observe the practitioner directly.

Indirect 1 (present): The practitioner must consult the supervisor about patient management. The supervisor must always be physically at the workplace and be available to observe patient management. 

Indirect 2 (accessible): The practitioner must consult the supervisor about patient management. The supervisor must be available both:

  • by telephone or other means of telecommunication
  • to attend the workplace to observe the practitioner.

Remote: The practitioner must consult the supervisor about patient management. The supervisor must be available by telephone or other means of other means of telecommunication.

Full text of restriction

  1. From #start date#, the practitioner must not practise in relation to the area(s) defined below other than under supervision by an approved #registered health practitioner/profession# (the supervisor): #concerns#. 
    #A supervisor was approved on #date#. / No supervisor is currently approved#.
    The level of supervision required is #direct/indirect 1/indirect 2/ remote#. 
  2. The practitioner must comply with the Supervised practice framework in force at the date these conditions are imposed and then as updated from time to time
  3. The practitioner must provide the following, using the approved forms:  
    1. acknowledgement that they have read and understood the requirements of this condition within #timeframe# of the # start date# 
    2. nomination for a supervisor 
    3. acknowledgement from each nominated supervisor 
    4. nomination of a senior person at each practice location 
    5. acknowledgement from each nominated senior person  
  4. <include if required> The practitioner must meet #in person# with the supervisor at no less than #frequency# intervals. 

INDIRECT 2 / REMOTE:

  1. The practitioner must cease practice in relation to the area(s) above if no supervisor is approved, the approval of a supervisor is not published above or, is not available to provide the required level of supervision at any time on or after #start date#.

DIRECT / INDIRECT 1:

  1. The practitioner must cease practice in relation to the areas above if no supervisor is approved, the approval of a supervisor is not published above or, is not available to provide the required level of supervision at any time.
  2. After a supervisor has been approved and the approval has been published, the practitioner must: 
    1. provide supervisor and senior person reports, in the format required, and on a #timeframe# basis or as otherwise advised. 
    2. <delete if not required> maintain a log (the log), in the format required, and detailing every case they have practised in relation to the area(s) above and provide the log on a #timeframe# basis or as otherwise required. 
  3. <include if required> For the purposes of this condition, the requirement to be supervised does not include #consultating/interviewing/examining/assessing/prescribing/providing post-operative care/transfer of care to another registered health practitioner#.

‘#concerns#’ are defined as: #definition#.

‘senior person’ is defined as another person senior by position or experience. Where possible a senior person should be another registered health practitioner. 

For the purposes of this condition, 'practise/practising' and the level of supervision are defined in the Board's Supervised practice framework.

You will receive a monitoring plan that details contact information, due dates, and the information you will need to provide to show that you are complying with your restrictions.

Forms

Please contact your case officer for more information. 

For general information see our Frequently asked questions about Monitoring and compliance page

If you have not yet received contact details for your case officer, please email your enquiry.

We are here to support and guide you through your compliance. 

The contact details for your case officer are included on all our correspondence with you.

We also encourage you to use independent support services, including those provided on our Practitioner support services page.

You can also contact your legal representative or professional union to support you.

Generally, we will provide a further opportunity to nominate a different supervisor, or to address any shortfalls in the nomination. 

If the commencement date for the requirement for supervision has passed and you have no approved supervisors, and/or the approval date of supervisors has not been published on the public register you must cease practice and must not recommence practice until such times as the approval of a supervisor has been published on the public register. 

Direct and Indirect 1

You will be required to nominate a new supervisor. If you have an alternate supervisor approved, you will be able to continue to practise while your new nomination is assessed. If you have no available alternate supervisors, you must cease practice and must not recommence practice until such times as the approval of a new supervisor has been published on the public register.

Indirect 2

You will be required to nominate a new supervisor. If you have another supervisor approved, you will be able to continue to practise while your new nomination is assessed.

If you have no available alternate supervisors and, the date of commencement for the restrictions has passed, you must cease practice and must not recommence practice until the approval of a new supervisor has been published on the public register. 

If you have no available alternate supervisors, but the date of commencement for the restrictions has not passed, you may continue practising until the date of commencement for the restrictions.

After this time, you must cease practice, and must not recommence practice until such times as the approval of a new supervisor has been published on the public register. 

The senior person may be the practice principal, practice manager or other person senior by position. Where possible your senior person should be another registered health practitioner. 

Senior persons will provide information such as rosters, pay slips, appointment diaries, billing information and the like and may, on request from us provide copies of clinical records, audit logs, appointment and billing data and the equivalent to provide independent evidence of your compliance.

If there is no one more senior than you at your practice location, you should let us know. It may be that either another registered health practitioner, practice manager or other third party may be able to provide the required information.

If the commencement date in the restrictions has passed and you do not have an approved supervisor published on the public register you must cease practising and not practise. 

For indirect 2 and remote supervision: 

If the commencement date provided in the restriction has not passed you may practise whilst your nomination is considered. If the commencement date has passed you must cease practice, and must not recommence practice until such times as the approval of a supervisor has been published on the public register. 

For Direct and Indirect 1 supervision:

You must not recommence practice until such times as the approval of a supervisor has been published on the public register.

You must notify your case officer or team as soon as possible of any incident where, due to a medical emergency, you are unable to comply with the condition requiring supervised practice. We will assess whether the circumstances were such that compliance with the condition would directly affect your ability to provide care that would have a direct benefit to a patient in a medical emergency.

A medical emergency is defined as an event where it is not possible or reasonable to have a patient with a serious or life-threatening condition seen by another practitioner or transferred to the nearest hospital.

We will treat any failure to notify of non-compliance in the circumstances of a medical emergency as a breach of the condition and may take further action in relation to a breach of conditions.

We will consider any breaches of the supervised practice restriction and may decide to take further regulatory action in circumstances where:

  • you fail to notify Ahpra within [timeframe] of any incidents where you were not able to comply due to a medical emergency, or
  • the circumstances did not meet the definition of a medical emergency as stated above.

Contact us using the details provided in your monitoring plan. You may be able to apply for a change in your restrictions, or an extension of the date of commencement of the requirement for supervision. Circumstances are considered on a case-by-case basis.

 
 
 
Page reviewed 13/09/2024