Management and accountability - AHPRA Annual Report 2015/16

AHPRA Annual Report 2015/16

Management and accountability

Overview

AHPRA works with the National Boards to deliver five core regulatory functions.

Our work in the last year focused on three priority areas.

Financial management

The finance function ensures that our financial systems and records are well managed, accurate and compliant with legislation, and provide financial reporting and guidance to AHPRA and the National Boards. The Finance, Audit and Risk Management Committee (FARMC) is the principal committee of the Agency Management Committee that oversees finance, audit and risk management at the enterprise level. This committee reviewed the quarterly, halfyear and annual financial reports and projections with management, focusing on the integrity and clarity of disclosure, compliance with relevant legal and financial reporting standards, and the application of accounting policies and judgements.

AHPRA's income for the full financial year to 30 June 2016 was $170.9 million. Our income for the full year includes the following components, shown below in Table MA1.

Table MA1: Income type 2015/161
Income type Full year % Full year $'000
Registration income 88 151,172
Application income 5 8,482
Interest income 3 5,861
Legal fee recoveries 1 1,708
Exam fees 1 928
Late fees and fast-track fees 1 1,384
Certificates of registration status 1 464
Accreditation income   145
PESCI1 income   41
Application for registrar program   186
Other income   558
Total   170,929
  1. Pre-employment structured clinical interview.

AHPRA and the National Boards work in partnership to deliver financial performance. AHPRA and the National Boards recorded a net surplus of $1.8 million this year.

The financial statements section of the annual report describes our performance in more detail, including the net result and equity position for each National Board.

In 2015/16, fees for six National Boards were reduced, fees for three boards were frozen, and fees for five boards rose by no more than the national Consumer Price Index (CPI). See Table MA2 for National Board registration fees for each profession.

AHPRA's organisational structure and resources

AHPRA is led by a national Chief Executive Officer and is structured around three core directorates: Regulatory Operations, Strategy and Policy, and Business Services.

Regulatory Operations: Responsible for the efficient and effective delivery of AHPRA's core regulatory functions (registration, notifications, compliance and legal services) under the National Law. The directorate provides leadership and strategic direction to develop and embed operational policy and procedures that support decision-making across the regulatory functions. Offices in each capital city deal directly with local stakeholders, support decisionmaking by local Boards and committees and are responsible for operational performance.

Strategy and Policy: Responsible for engaging with national and international stakeholders, consumers, practitioners and partners in regulation of other regulatory bodies. The directorate coordinates and manages AHPRA inter-governmental relationships, communication and media services.

The directorate provides Boards and their committees with policy and governance advice and oversees accreditation activities. It delivers a program of research and analysis that provides an empirical basis for health practitioner regulation. It undertakes strategic analysis, planning and management, and supports community and professions reference groups established to engage with the community and the professions.

Business Services: Responsible for providing effective and efficient business and corporate support to deliver AHPRA's objectives. The directorate ensures regulatory functions and strategic research are supported by the most efficient and effective systems and processes. To successfully deliver this support, it manages and develops AHPRA's overall corporate and regulatory systems, provides high quality corporate functions, overall business plan, performance reporting, and maintains a transparent corporate risk profile to ensure the organisation manages risk well.

Figure MA2 outlines AHPRA's organisational structure.

Table MA2: National Board registration fees for each profession
Profession2010-112011-122012-132013-142014-152015-16
Aboriginal and Torres Strait Islander health practice  $100$100$100$100
Chinese medicine  $550$563$579$579
Chiropractic$495$510$518$530$545$552
Dentists & specialists$545$563$572$586$603$610
Dentists prosthetists$485$501$509$521$536$542
Dental hygienists and therapists$270$279$283$290$298$301
Medical$650$670$680$695$715$724
Medical radiation  $325$295$250$180
Nursing and midwifery$115$160$160$160$150$150
Occupational therapy  $280$230$160$130
Optometry$395$408$415$395$365$325
Osteopathy$480$496$504$516$416$386
Pharmacy$295$305$310$317$317$320
Physiotherapy$190$196$199$179$159$120
Podiatry$350$362$368$377$388$378
Psychology$390$403$409$419$431$436

Figure MA2: AHPRA's organisational structure 2015/16

AHPRA's full-time equivalent resourcing as at 30 June 2016 is detailed below.

Table MA3: Full-time equivalent resourcing (FTE) in 2015/16
DirectorateFTE
Strategy and Policy86.9
Regulatory Operations645.1
Business Services (including CEO office)138.5
Total870.5

Enterprise agreement

AHPRA is moving toward a single national enterprise agreement by consolidating our existing five enterprise agreements, which expired on 30 June 2016, into one nationally consistent agreement to cover all AHPRA staff nationwide. The enterprise bargaining meetings began in February 2016 and have been conducted within all AHPRA's offices. The aim of this bargaining round is to achieve common employment standards and conditions for all AHPRA staff. Once the negotiations are complete, voting invitations will be issued to all staff and a vote will be taken. After voting, if the new enterprise agreement receives majority staff support, it will be sent to the Fair Work Commission for approval.

Statutory appointments

The Statutory Appointments Unit (SAU) provides strategic and compliance advice and support across AHPRA in relation to statutory appointments. The unit works closely with internal stakeholders across the organisation to deliver a professional service to the National Boards and governments.

During 2015/16, the SAU managed recruitment to fill approximately 480 vacancies on National Boards and committees, state, territory and regional boards, local committees, advisory panels, assessors' panels, and list of approved persons appointments. This involved coordinating several large campaigns covering over 100 vacancies for National Boards.

Getting value from our data

The National Scheme represents a significant statistical asset that can be leveraged to inform policy, planning and research. In addition to the valuable information on the public register, each year AHPRA administers a workforce survey in conjunction with the National Boards, made available to all practitioners at the time of renewal. This year, 94% of practitioners who received a survey during renewal responded. These data are critical to support workforce policy and planning through the National Health Workforce Dataset.

Data access and research

AHPRA collects comprehensive national data on health practitioner regulation. While these data have registration, workforce planning, demographic, commercial and research value, the National Law, as in force in each state and territory, and the Privacy Act 1988 (Cth) impose strict limits on their use.

Our Data access and research policy assists researchers and other interested parties to better understand the framework for considering requests for data and research. In addition, following amendments to the Privacy Act, we have developed more robust processes on data governance, access and release of National Scheme data.

Table MA4: Data access requests by type in 2015/16
Request typeNumber of requests received
Contact or survey practitioners19
Copies or extracts of the National Register18
Quantitative statistics37
Other2
Total76

Practitioner information exchange program

AHPRA receives requests from employers wanting to participate in our practitioner information exchange (PIE) program. PIE provides information to employers about the registration of the health practitioners they employ, including any restrictions that a Board might have placed on a person's registration, which are published on the national register.

PIE is a secure web-based system. It can assist employers with connecting human resources, clinical management, risk management, IT security and customer management systems into a secure and effective health practitioner registration data source. Further details about the PIE program can be found on PIE page.

This year, there were 60 subscribers to the PIE service from government departments, public and private hospitals, and the educational and research sector. The subscriber base almost doubled in 2015/16 from last year's 32.

Legal services

AHPRA's legal advisers operate in two broad streams:

Overall leadership is provided by the National Director of Legal Services. AHPRA's lawyers work closely and cooperatively to ensure that decisions are made under the National Law effectively and efficiently, and consistently with legal requirements. The legal advisers manage legal risks relating to the administration of the National Law and the complex business of operating a number of entities (including AHPRA and the National Boards) that operate nationally under the National Law.

AHPRA's legal advisers, in conjunction with our panel of external legal services providers, conduct matters relating to decisions under the National Law and the performance of functions under the National Law.

Administrative complaints

Anyone can make a complaint about AHPRA, the Agency Management Committee or a National Board. A complaints form is available on AHPRA's website, along with AHPRA's Complaint handling policy and procedure.

If anyone believes that they have been treated unfairly in our administrative processes or in our handling of Freedom of Information (FOI) processes, a complaint can also be lodged with the independent National Health Practitioner and Privacy Ombudsman (NHPO), who will receive complaints and help people who believe they have been treated unfairly by the bodies within the National Scheme. The NHPO will usually only deal with complaints that have already been lodged with AHPRA, and when AHPRA has been given a reasonable opportunity to resolve the complaint.

AHPRA is committed to resolving complaints and to learning from what has happened and making improvements to services. Complaints are considered at a senior level in AHPRA, in recognition of their importance. There is a designated complaints officer in each AHPRA office. A database records all complaints received by AHPRA and all complaints directed to AHPRA from the NHPO.

AHPRA regularly liaises with the NHPO to address, wherever possible, issues and concerns raised by complaints lodged with their office.

In the year ending 30 June 2016, AHPRA received a total of 378 administrative complaints, a reduction from 2015 (when we received 469 complaints). Of the 378 received, 266 were received directly by AHPRA and 112 formal complaints were received from the NHPO. Issues raised in complaints included:

See Table MA5 for a breakdown of the nature of complaints by profession.

Table MA5: Nature of complaint by profession in 2015/16
Nature of complaint categorised by profession (YTD)MedicalChiropracticNursing/MidwiferyPharmacyPsychologyDentalOptometryPhysiotherapyOsteopathyPodiatryChinese MedicineMedical RadiationAboriginal and Torres Strait Islander Health PracticeOccupational TherapyTotal
Board complaint5000420000000011
Registration complaint37177121560303151313186
Notification complaint93022211421000004139
Other complaint000000000000000
Campaign90101000002400035
Privacy complaint302000000100017
Total14711021431122404391318378

This year, 11 complaints were received about Board matters (policy-related issues), five less than last year. For the year, 186 registration complaints were received (a reduction from the 216 registrationrelated complaints received last year). Of these, 91 complaints were about the period taken to process a new registration application. There were 57 complainants who were unhappy about the registration requirements not being clearly conveyed to them. There were 11 registration renewal-related complaints that were concerned with the time taken to finalise a registration renewal application (an identical number of complaints were received last year expressing a similar concern), and seven complainants were concerned with the time taken to register an overseas applicant (again an identical number of similar complaints were received last year).

There were 139 notification-related complaints received this year (a reduction from the 173 received last year). The overwhelming majority of the complainants expressed dissatisfaction with Boards deciding to take no further action in relation to their notification. No further action is taken when, based on the available information, the Board determines there is no risk to the public that requires regulatory action.

The drop in notification-related complaints can be partly explained by more detailed and explanatory decision letters being provided to notifiers once a Board has made a decision.

There were 35 campaign-related complaints received, the majority of which were in response to announcements about changes to the policies of some National Boards.

Freedom of information

Section 215 of the National Law provides that the Commonwealth Freedom of Information Act 1982 (FOI Act) applies to the National Law, as modified by regulations made under that Law.

In the year to 30 June 2016, AHPRA received 176 FOI applications, slightly more than we received in the previous financial year. During the 2015/16 reporting period, 175 applications were finalised.

Approximately 53% of applications that received a ‘refused access' decision were from applicants seeking practitioner contact details under the FOI Act. During the year there were 15 applications for internal review and four for tribunal/court review of these decisions. Of these 19 decisions, four were amended after review and granted in part, and 15 decisions to refuse access were affirmed.

In total, 33,932 pages were assessed in responding to FOI applications. We also removed application fees during the financial year. A summary of FOI decisions is provided in Table MA6.

Table MA6: Finalised FOI applications in 2015/16
FOI applicationNumber
Granted in full25
Granted in part65
Access refused163
Access request was transferred in whole to another agency0
Access request was transferred in part to another agency0
Access request withdrawn22
Total175

Note:

  1. Approximately 53% of applications that received a ‘refused access' decision were from applicants seeking practitioner contact details under the FOI Act.

Information governance

AHPRA has continued to advance its information governance during the reporting period, making significant progress. This included finalising outcomes of the privacy impact assessment performed by the Australian Government Solicitor (AGS) on AHPRA's behalf.

Our Information Governance and Assurance Group was also responsible for:

AHPRA has also been active in the area of information security during the reporting period. We commissioned a number of information security reviews to understand AHPRA's current compliance level and identify the risks/issues we are facing. The reviews have generally noted that AHPRA has made significant improvement over the past five years, but given the increased activity in this area and therefore inherent risk, needs to continue these efforts. As a result, AHPRA has developed an improvement program designed to maintain a high level of risk mitigation and compliance and increase our security.

Risk management

AHPRA's Agency Management Committee, together with the National Boards, determines the appetite for risk, after taking into account the strategic objectives and other factors including community expectations, financial and reporting requirements, and legal and regulatory obligations.

The Agency Management Committee and the National Boards are jointly responsible for ensuring material risks have been identified. The Agency Management Committee is responsible for ensuring that appropriate and adequate control, monitoring and reporting mechanisms are in place.

AHPRA's corporate assurance framework provides the structures and processes to influence behaviour within the organisation, designed to facilitate achievement of the corporate objectives through the effective management of both opportunities and adverse effects encountered in the environment in which AHPRA operates. AHPRA aims to maximise the impact of its operations within the resources available to it. In doing so it aims to manage and minimise risks at all levels of the organisation from the top strategic level to the operations/project levels without dampening innovation. This requires consideration of a full cross-section of risks to the organisation's objectives, including reputation, organisational, operational and financial risks.

Compliance with state and territory laws

AHPRA is subject to a wide range of Commonwealth, state and territory legislation and subordinate rules made under that legislation such as regulations, as well as obligations under the general law. AHPRA is committed to constantly testing, reviewing and improving its procedures and activities to comply with these laws and to promote a culture of compliance. In particular, AHPRA has undertaken a range of activities, described below, to instil the principles set out in Australian standard 3806-2006: compliance programs into AHPRA's everyday activities.

AHPRA has compiled a register of Commonwealth, state and territory legislation that applies to it and the National Boards. Responsibility for compliance with particular legal obligations has been allocated to relevant AHPRA staff, who have been advised of their compliance responsibilities. AHPRA has tested legislative compliance with those staff members by asking them to advise on whether AHPRA is fully compliant with relevant legislation or not, and has put in place a program to continue to regularly test compliance.

When compliance concerns have been identified in legislative compliance tests, relevant staff have been allocated responsibility to take practical steps to ensure compliance. These staff members regularly report to AHPRA's senior executives and the Finance, Audit and Risk Management Committee on the compliance steps they propose to take or have taken.

AHPRA engages a number of contractors to assist with administering the National Law. AHPRA's standard contract terms require contractors to comply with applicable legislation and policies, including confidentiality, privacy, employment law and proper record-keeping obligations. Where it is appropriate, AHPRA requires contractors to permit AHPRA audits to ensure their compliance. An online contract register has been maintained, designed to assist with monitoring contractor performance.

Requests for telecommunications data

Until mid-October 2015, AHPRA was an enforcement agency for the purposes of the Telecommunications (Interception and Access) Act 1979 (Cth) (the TI Act).

In previous years AHPRA has accessed information or documents about telecommunications data under the TI Act to enforce the National Law. However, the TI Act was amended, with effect from 13 October 2015, to significantly narrow the definition of ‘enforcement agency', and that definition does not currently cover AHPRA.

This year, before this change, AHPRA issued four requests for access to telecommunications data under the TI Act.