Twelve National Boards share a Code of conduct (the code) for the practitioners that they regulate.
The code describes the professional behaviour and conduct National Boards expect from registered health practitioners. By defining these expectations, the code supports good patient care and the delivery of services within an ethical framework, helping to keep the public safe.
Registered health practitioners have a responsibility to be familiar with and apply their relevant code.
The code has been revised so that it continues to be relevant and useful for practitioners, more accessible for health consumers and an effective and up-to-date regulatory tool.
The code applies to the practitioners regulated by the following National Boards:
The shared Code of conduct does not apply to the following professions:
Download the shared Code of conduct
Understanding the code’s principles and what they mean in practice is important for health practitioners.
Here you will find information to help you understand and apply the code.
Understanding the code helps the public know what to expect from their health practitioner.
Here you will find information to help you understand the code.
Ahpra acknowledges the Traditional Owners of Country throughout Australia and their continuing connection to
lands, waters and communities. We pay our respect to Aboriginal and Torres Strait Islander cultures and Elders
past, present and emerging.
The 15 National Boards regulating registered health practitioners1 in Australia are responsible for registering practitioners and students, setting the standards that practitioners must meet, and managing notifications (complaints/concerns) about the health, conduct or performance of practitioners.
The Australian Health Practitioner Regulation Agency (Ahpra) works in partnership with the National Boards to implement 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).
The core role of the National Boards and Ahpra is to protect the public.
The Code of conduct (the code) was developed by 12 National Boards under section 39 of the National Law to protect the public.
It sets out the standards of professional conduct the National Boards expect and is used by Boards to evaluate practitioners’ conduct. Practitioners have a professional responsibility to be familiar with and to apply this code.
If you are receiving care or treatment from a registered health practitioner covered by this code, it will help you understand the behaviour you can expect.
Any person or organisation can raise a concern about a registered health practitioner by contacting Ahpra. Ahpra’s website has more information about raising a concern about a health practitioner.
This code replaces the National Boards’ previous code.
This code uses ‘patient’2 to mean a person receiving healthcare from a registered health practitioner. The term ‘patient’ includes ‘clients’ and ‘consumers’. Depending on the context of practice3 and recognising the importance of patient-centred care, the term patient can also extend to families and carers (including kinship carers4), and to groups and/or communities as users of health services.
See also the Definitions section of this code.
This code has drawn on relevant aspects of the Medical Board of Australia’s Good medical practice and the Nursing and Midwifery Board of Australia’s codes of conduct. This code uses the definition of cultural safety developed for use in the National Scheme by the Scheme’s Aboriginal and Torres Strait Islander Health Strategy Group in partnership with the National Health Leadership Forum.
The following principles set out the National Boards’ expectations of the practitioners they regulate.
This code sets out National Boards’ expectations about professional behaviour and conduct for registered health practitioners. In the context of the practitioner-patient relationship, practitioners have a duty to put the care of patients first and to practise safely and effectively. Maintaining a high level of professional competence and conduct is essential for good care.
There are many ways to practise a health profession in Australia. Practitioners have critical roles in caring for people who are unwell, helping people to recover, and seeking to keep people well. This code covers these roles. For practitioners with roles that involve little or no contact with patients, not all of this code may be directly relevant, but the underpinning principles will still apply.
While individual practitioners have their own personal beliefs and values, there are certain professional values on which all practitioners are expected to base their practice. The professional values and behaviours in this code apply to practitioners’ conduct in every setting, including in-person, during technology-based consultations including online and remote prescribing, and electronically, e.g. social media5, digital health and so on.
The code includes 11 principles of conduct. Each principle is followed by practical information about how to apply it in practice. Underpinning the code is the expectation that practitioners will use their professional judgement to achieve the best possible outcomes in practice.
This code is a principles-based document that gives important guidance to practitioners about the National Boards’ expectations of their professional conduct and outlines the conduct that the public can expect from health practitioners. It is a key part of the regulatory framework that each National Board establishes for the profession(s) it regulates in order to protect the public and progress the other objectives of the National Law. By defining National Boards’ expectations of professional conduct, the code supports patients’ interests, good patient care and the delivery of appropriate, effective services within an ethical framework.
The code is also a reference for co-regulatory authorities about the standards of professional conduct that National Boards expect.
Practitioners must understand their legal obligations and always act in accordance with the law in their personal and professional lives. The code is not a substitute for legislation and case law, e.g. privacy, child protection, medicines and workplace health and safety laws. If there is any conflict between the code and the law, the law takes precedence. Practitioners must also be aware of and meet the other standards, guidelines and policies of their National Board, which this code complements.
This code is not an exhaustive study of professional ethics or an ethics guide. It articulates the National Boards’ expectations about ethical and professional conduct, but not the standards of clinical practice within individual health professions or disciplines. These clinical standards are generally found in other documents issued by the relevant National Boards and/or professional bodies.
While good healthcare respects the rights of patients, this code is not a charter of rights.7 The focus of this code is on good practice and professional behaviour. It is not intended as a mechanism to address:
When providing care, practitioners have a duty to make patient care their first concern and to practise safely and effectively. Professionalism embodies all the qualities described below, including self-awareness and self-reflection. These qualities underpin and are further explained in the guidance provided throughout the code.
In this code, reference to ‘patients’ also includes substitute decision-makers e.g. for patients who do not have the capacity to make their own decisions. These can be parents, guardians, a person nominated by the patient or a legally appointed decision-maker. If in doubt, seek advice from the relevant guardianship authority.
Principle 1: Practitioners should practise safely, effectively and in partnership with patients and colleagues, using patient-centred approaches, and informed by the best available evidence to achieve the best possible patient outcomes.
Patient care is your primary concern in clinical practice. Providing good care includes that you:
Maintaining a high level of professional competence and conduct is essential for good care.
Good practice includes that you:
Your decisions about access to care must be free from bias and discrimination.10
Treating patients in emergencies requires practitioners to consider a range of issues, in addition to providing best care. Good practice means you should offer assistance in an emergency that takes account of factors such as your own safety, your skills, the availability of other options and the impact on any other patients under your care, and continue to help until your services are no longer needed.
Principle 2: Practitioners should consider the specific needs of Aboriginal and Torres Strait Islander Peoples and their health and cultural safety, including the need to foster open, honest and culturally safe professional relationships.
Aboriginal and Torres Strait Islander Peoples have inhabited and cared for the land as the First Peoples of Australia for millennia, and their diverse histories and cultures have uniquely shaped our nation. Aboriginal and Torres Strait Islander health means not just the physical wellbeing of an individual but refers to the social, emotional and cultural wellbeing of the whole community in which each individual is able to achieve their full potential as a human being, thereby bringing about the total wellbeing of their community. It is a whole-of-life view and includes the cyclical concept of life-death-life.11
Understanding and acknowledging factors such as colonisation and its impact on Aboriginal and Torres Strait Islander Peoples’ health, helps inform care. In particular, Aboriginal and Torres Strait Islander Peoples bear the burden of gross social and health inequity. It is for these reasons that cultural safety in the context of Aboriginal and Torres Strait Islander health needs to be specifically considered.
Supporting good practice and the health of Aboriginal and Torres Strait Islander Peoples also includes cultural safety. For Aboriginal and Torres Strait Islander Peoples, the National Scheme’s definition of cultural safety is as follows:
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.
To ensure culturally safe and respectful practice, you must:
See the Australian Government’s National Aboriginal and Torres Strait Islander Health Plan 2013-2023 and the National Safety and Quality Health Service Standards User guide for Aboriginal and Torres Strait Islander health.
Principle 3: Respectful, culturally safe practice requires practitioners to have knowledge of how their own culture, values, attitudes, assumptions and beliefs influence their interactions with people and families, the community and colleagues. Practitioners should communicate with all patients in a respectful way and meet their privacy and confidentiality obligations including when communicating online.
Australia is a culturally and linguistically diverse nation. Section 2 (above) defines cultural safety for Aboriginal and Torres Strait Islander Peoples specifically for their status as First Nations Peoples. Culturally safe and respectful practice is important for all communities.
To ensure culturally safe and respectful practice, good practice includes that you:
Positive professional relationships are built on effective communication12 between a practitioner and the patient they are caring for.
You have ethical and legal obligations to protect the privacy of patients. Patients have a right to expect that you will hold information about them in confidence, unless the release of information is required or authorised by law15, or is required to facilitate emergency care.
To protect privacy and confidentiality, good practice includes that you:
You have a vital role in helping the community deal with the reality of death and its consequences.
In providing culturally safe end-of-life care17, good practice includes that you:
Principle 4: Basing relationships on respect, trust and effective communication enables practitioners to work in partnership with patients. Practitioners should maintain effective and professional relationships with their patients and provide explanations that enable patients to understand and participate in their care.
A good partnership between you and your patient requires high standards of personal conduct.
Informed consent is a person’s voluntary decision about healthcare that is made with knowledge and understanding of the benefits and risks involved.
Some patients have additional needs. These patients may include for example, children and young people, older people, those living with physical and/or cognitive disability, those with impaired decision-making capacity and those who are at higher risk, for example from family violence.
When a person is harmed19 by healthcare (adverse events), practitioners have a responsibility to be open and honest in communication with the patient to review what happened and to report appropriately.
When something goes wrong, good practice includes that you:
Patients have a right to raise concerns about their care.
When a concern or complaint is raised good practice includes that you:
For additional guidance see the Concerns about practitioners page on Ahpra’s website.
In some circumstances, the relationship between a practitioner and a patient may become ineffective or compromised and may need to end. Good practice involves ensuring that the patient is informed adequately of your decision to end the relationship and facilitating arrangements for the continuing care of the patient, including passing on relevant clinical information.
Good practice includes recognising the potential conflicts, risks and complexities of providing care23 to those in a close personal relationship. Providing care to anyone you have a close personal relationship with, for example close friends, work colleagues and family members, can be inappropriate because of the lack of objectivity, possible discontinuity of care and risks to the practitioner or patient.
If circumstances require you to provide care to someone in a close relationship, for example in an emergency, good practice requires that you:
Professional boundaries allow you and your patient to engage safely and effectively in a therapeutic relationship. Professional boundaries mean the clear separation that should exist between professional conduct aimed at meeting the health needs of patients and your own personal views, feelings and relationships which are not relevant to the therapeutic relationship.
Professional boundaries are integral to a good practitioner–patient relationship. They promote good care for patients and protect both parties.
You need to be aware of and comply with any guidelines of your National Board in relation to professional boundaries.
When you are considering treating multiple patients simultaneously in class or group work, or more than one patient at the same time, you should consider whether this mode of treatment is appropriate to the patients involved, including whether it could compromise the quality of care, whether it is culturally safe and whether confidentiality and privacy can be provided.
When closing or relocating a practice, or when you retire or move between practices, good practice includes that you:
Principle 5: Good relationships with colleagues and other practitioners strengthen the practitioner-patient relationship, collaboration and enhance patient care. Good relationships require healthcare to be free of discrimination, bullying and harassment.
Good care is enhanced when there is mutual respect and clear communication between all health professionals involved in the care of the patient.
Many practitioners work closely with a wide range of other practitioners, with benefits for patient care.
Effective collaboration is a fundamental aspect of good practice and teamwork. Good patient care requires coordination between all treating practitioners. Healthcare is improved when there is mutual respect and clear, culturally safe communication, as well as an understanding of the responsibilities, capacities, constraints and ethical codes of each other’s health professions. Working in a team or collaboratively does not alter your personal accountability for professional conduct and the care you provide.
When working in a team or collaboratively, good practice includes that you:
There is no place for discrimination24 (including racism), bullying and harassment, including sexual harassment,25 in healthcare in Australia. Practitioners are expected to contribute to a culture of respect and safety for all. Discrimination, bullying and harassment adversely affect individual health practitioners, increase risk to patients and compromise effective teamwork by healthcare teams. Respect is a cornerstone of good practice and of patient safety. It is a feature of constructive relationships between practitioners, their peers and colleagues on healthcare teams, and with patients.
Concerns about disrespectful behaviour are often best handled locally, however when discrimination, bullying and harassment is affecting public safety there may be grounds for regulatory action by the National Board, such as imposing conditions or accepting an undertaking from the practitioner.
For additional guidance see the Australian Human Rights Commission Fact sheet.
Principle 6: Practitioners have a responsibility to contribute to the effectiveness and efficiency of the healthcare system and use resources wisely.
It is important to use healthcare resources wisely.
There are significant disparities in the health status of various groups in the Australian community. These disparities result from social, cultural, historic, geographic, environmental, physiological, psychological and other factors. Some groups who experience health disparities include Aboriginal and/or Torres Strait Islander Peoples; people with disabilities; those who are gender or sexuality diverse; and those from socially, culturally and linguistically diverse backgrounds including asylum seekers and refugees.
In advocating for community and population health, good practice includes that you use your expertise and influence to protect and advance the health and wellbeing of individuals, as well as communities and populations.
Practitioners have a responsibility to promote the health of the community through infection and disease prevention and control, education and, where relevant, screening.
Principle 7: Good practice involves putting patient safety, which includes cultural safety, first. Practitioners should minimise risk by maintaining their professional capability through ongoing professional development and self-reflection and understanding and applying the principles of clinical governance, risk minimisation and management in practice.
Good practice in relation to risk management includes that you:
The welfare of patients may be put at risk if a practitioner is performing poorly.
If there is a risk, good practice includes that you:
Maintaining and developing appropriate and current knowledge, skills and professional behaviour are core aspects of good, culturally safe practice, requiring self-reflection and participation in relevant professional development, practice improvement and performance-appraisal processes to continually develop professional capabilities. These activities must continue through a practitioner’s working life as science and technology develop and society changes.
Development of knowledge, skills and professional behaviour must continue throughout a practitioner’s working life. Good practice involves you keeping knowledge and skills up to date to ensure that you continue to work within your competence and scope of practice. The National Law requires practitioners to do CPD.31
Principle 8: Practitioners must display a standard of professional behaviour that warrants the trust and respect of the community. This includes practising ethically and honestly.
Practitioners have statutory responsibility under the National Law to report certain matters to the National Boards/Ahpra: please refer to the Board’s guidelines on mandatory notifications and Sections 130 and 141 of the National Law. Practitioners also have professional obligations to report to the National Boards/Ahpra and their employer/s if they have had any limitations placed on their practice.
For additional information see Making a mandatory notification on Ahpra’s Concerns about practitioners webpage.
A vexatious notification32 (complaint/concern)is one without substance, made with an intent to cause distress, detriment or harassment to a practitioner named in the notification. Legitimate notifications (complaints/concerns) are motivated by genuine concerns about patient safety.
Maintaining clear and accurate health records is essential for the continuing good care of patients. You should be aware that some National Boards have specific guidelines in relation to records.
You have a statutory requirement to ensure that you have appropriate professional indemnity insurance (PII) arrangements in place when you practise (see your National Board’s Professional indemnity insurance arrangements registration standard).
Advertisements for services can provide useful information to patients. However, advertising should not be false, misleading or deceptive, use testimonials about clinical aspects of a regulated health service, create an unreasonable expectation of benefit or encourage the indiscriminate or unnecessary use of regulated health services. Advertising that offers a gift, discount or other inducement to attract someone to use the regulated health service or business must state the offer’s terms and conditions in plain language.
Good practice involves complying with the advertising requirements of the National Law (explained in the National Boards’ Guidelines for advertising a regulated health service) and relevant Commonwealth, state and territory legislation on consumer protection, fair trading and therapeutic goods advertising, and ensuring that any promotion of therapeutic products is ethical.
When you are contracted by a third party to provide a legal, insurance or other assessment of a person who is not your patient, the usual therapeutic practitioner–patient relationship does not exist. In this situation, good practice includes that you:
The community places a great deal of trust in registered health practitioners. Consequently, some practitioners have been given the authority to sign documents such as sickness or fitness for work certificates on the assumption that they will only sign statements that they know, or reasonably believe, to be true.
When providing information about your work history, good practice includes that you:
Also see Section 10.2 Assessing colleagues in relation to providing references for colleagues.
Practitioners have responsibilities and rights relating to any legitimate investigation of their practice or that of a colleague. In meeting these responsibilities, it is advisable to seek legal advice or advice from a professional indemnity insurer.
Patients rely on the independence and trustworthiness of practitioners for any advice or treatment offered. A conflict of interest in practice arises when a practitioner, entrusted with acting in the interests of a patient, also has financial, professional or personal interests or relationships with third parties which may affect or be perceived to affect their care of the patient.
Multiple interests are common. They require identification, careful consideration, appropriate disclosure and accountability. When these interests compromise or might reasonably be perceived by an independent observer to compromise the practitioner’s primary duty to the patient, practitioners must recognise and resolve this conflict in the best interests of the patient.
Practitioners must be honest and transparent in financial arrangements with patients.
Principle 9: It is important for practitioners to maintain their health and wellbeing. This includes seeking an appropriate work–life balance.
Health practitioners have a responsibility to help their colleagues maintain good health.
Principle 10: Practitioners should support the important role of teaching, supervising and mentoring practitioners and students in order to develop the health workforce.
In teaching and supervision roles, good practice includes that you:
Assessing colleagues is an important part of making sure that the highest standards of practice are achieved.
Students are learning how best to care for patients. Creating opportunities for learning improves their clinical practice and nurtures the future workforce.
Principle 11: Practitioners should recognise the vital role of ethical and evidence-based research to inform quality healthcare and policy development, conduct research ethically and support the decision-making of research participants.
Research involving humans, their tissue samples or their health information is vital to improve the quality of healthcare and reduce uncertainty for patients now and in the future, and to improve the health of the population as a whole. Research in Australia is governed by guidelines issued in accordance with the National Health and Medical Research Council Act 1992 (Cth) and any other legislative requirements. If you are carrying out research, you should familiarise yourself with and follow these guidelines.
Research involving animals is governed by legislation in states and territories and by guidelines issued by the National Health and Medical Research Council (NHMRC).
Being involved in the design, organisation, conduct or reporting of health research involving humans brings responsibilities for practitioners. These responsibilities include that you:
Refer to the NHMRC, including the publications listed above, for more guidance including about ethical conduct in research with Aboriginal and Torres Strait Islander Peoples and communities.
When you are involved in research that involves patients, good practice includes that you:
The Australian Commission on Safety and Quality in Health Care provides guidance on a range of safety and quality issues. Information of relevance to health practitioners includes:
The National Health and Medical Research Council provides information on informed consent and research issues.
The Therapeutic Goods Administration provides information on therapeutic goods.
Bullying is when people repeatedly and intentionally use words or actions against someone or a group of people to cause distress and risk to their wellbeing. These actions are usually done by people who have more influence or power over someone else, or who want to make someone else feel less powerful or helpless (Australian Human Rights Commission – What is bullying?: Violence, harassment and bullying fact sheet).
Clinical governance describes a systematic approach to maintaining and improving the quality of patient care within a clinical setting. It ensures that everyone – from frontline clinicians to managers and members of governing bodies, such as boards – is accountable to patients and the community for assuring the delivery of safe, effective and high-quality services.
Complaint is a way to raise a concern about a registered practitioner. Ahpra and the National Boards’ main role is to protect the public by ensuring that only health practitioners who are suitably trained and qualified, and who practise in a competent and ethical manner, are registered. This means that we can only investigate the concern if there may be a risk to the public. Other organisations have a different purpose and are set up to resolve a dispute or complaint between a health service user (such as a patient) and a health service provider (such as a hospital, clinic or a health practitioner). More detailed information is published on Ahpra’s Concerns about practitioners page.
This definition of cultural safety was developed for use in the National Scheme by the Scheme’s Aboriginal and Torres Strait Islander Health Strategy Group in partnership with the National Health Leadership Forum.
The following principles inform the definition of cultural safety:
Delegation involves one practitioner asking another person or member of staff to provide care on behalf of the delegating practitioner, while that practitioner retains overall responsibility for the care of the patient.
Discrimination occurs when a person, or a group of people, is treated less favourably than another person or group because of their background or certain personal characteristics (Australian Human Rights Commission).
Electronic means any digital form of communication, including email, online meeting technologies, internet, social media, etc.
Handover is the process of transferring all responsibility for a patient’s care to another practitioner.
Harassment – to treat a person less favourably on the basis of certain personal characteristics, such as race, sex, pregnancy, marital status, breastfeeding, age, disability, sexual orientation, gender identity or intersex status (Australian Human Rights Commission).
Kinship care is family-based care within the child’s extended family or with close friends of the family known to the child, whether formal or informal in nature (United Nations, 2010).
Notification is the way to raise a concern about a registered practitioner’s professional conduct, performance, or health. Ahpra and National Boards’ main role is to protect the public by ensuring that only health practitioners who are suitably trained and qualified, and who practise in a competent and ethical manner, are registered. This means that we can only investigate the concern if there may be a risk to the public. We call these concerns notifications. Other organisations have a different purpose and are set up to resolve a dispute or complaint between a health service user (such as a patient) and a health service provider (such as a hospital, clinic or a health practitioner). More detailed information is published on Ahpra’s Concerns about practitioners page.
Providing care includes, but is not limited to, any care, treatment, examination, advice, service or goods provided in respect of the physical or mental health of a person, whether remunerated or pro bono.
Practice means any role, whether remunerated or not, in which the individual uses their skills and knowledge as a practitioner in their regulated health profession. For the purposes of this code, practice is not restricted to the provision of direct clinical care. It also includes using professional knowledge in a direct non-clinical relationship with patients, working in management, administration, education, research, advisory, regulatory or policy development roles and any other roles that have an impact on safe, effective delivery of health services in the health profession.
Patient means a person who has entered into a therapeutic and/or professional relationship with a registered health practitioner. The term ‘patient’ includes ‘clients’ and ‘consumers’. It can also extend to their families and carers (including kinship carers), and to groups and/or communities as users of health services, depending on context.
Practitioner means registered health practitioner (see below).
Racism includes prejudice, discrimination or hatred directed at someone because of their colour, ethnicity or national origin.
Referral involves one practitioner sending a patient to obtain an opinion or treatment from another practitioner. Referral usually involves the transfer (in part) of responsibility for the care of the patient, usually for a defined time and a particular purpose, such as care that is outside the referring practitioner’s expertise or scope of practice.
Registered health practitioner (practitioner) means an individual who is registered under the National Law to practise a health profession, other than as a student; or who holds non-practising registration in a health profession under the National Law.
Sexual harassment is broadly defined as unwelcome sexual conduct that a reasonable person would anticipate would offend, humiliate or intimidate the person harassed (Australian Human Rights Commission, 2014).
Social media describes the online and mobile tools that people use to share opinions, information, experiences, images, and video or audio clips, and includes websites and applications used for social networking. Common sources of social media include, but are not limited to, social networking sites such as Facebook and LinkedIn, blogs (personal, professional and those published anonymously), business search and review sites such as Word of Mouth and True Local, microblogs such as Twitter, content-sharing websites such as YouTube and Instagram, and discussion forums and message boards. For the purposes of this code, practice is not restricted to the provision of direct clinical care. For more information see Social media: How to meet your obligations under the National Law.
Vexatious notification is a notification without substance, made with an intent to cause distress, detriment or harassment to a practitioner named in the notification. Vexatious notifications can come from anyone including patients, members of the public and other practitioners.
Date of issue: June 2022
Date of review: This Code of conduct will be reviewed from time to time as needed. This is generally at least every five years.