Working together to ensure Aboriginal and Torres Strait Islander patient safety

AHPRA and the National Boards are committed to developing an Australia-wide Aboriginal and Torres Strait Islander health strategy for the National Scheme.

A key priority of 2016/17 was establishing a strategy group to lead this important work. A strategy group was formed in February 2017 and consists of Aboriginal and Torres Strait Islander health sector leaders and representatives from accreditation entities, National Boards, AHPRA and the Chair of AHPRA’s Agency Management Committee.

We are grateful for our partners’ commitment to the shared vision of patient safety for Aboriginal and Torres Strait Islander peoples in Australia’s health system as the norm, as defined by Aboriginal and Torres Strait Islander peoples.

The initial stages of the strategy will involve three major areas for action:

Find out more about this work and read the advisory group’s communiqués on the AHPRA website.

Focusing on practitioner health

In the past year, the two largest National Boards – the Medical Board of Australia (MBA) and the Nursing and Midwifery Board of Australia (NMBA) – funded and developed support services for their respective healthcare workforce.

The drs4drs services and Nurse & Midwife Support provide resources to support practitioners’ physical and mental wellbeing.

Ensuring the health workforce has the support it needs is an important step in ensuring the public is provided with safe and competent healthcare. For more information on these initiatives, see the MBA’s year in review on page 19 and the NMBA’s year in review on page 22 of the annual report.

Improving the practitioner experience

A priority for AHPRA and the National Boards this year was to make the registration process quicker and easier for practitioners.

We also continue to seek to understand and improve the experience of both notifiers and practitioners involved in the notifications process under the National Law.

In 2017, AHPRA began collecting data from notifiers and practitioners in the form of surveys and in-depth interviews. Initial responses showed that notifiers find it easy to locate and use our new online complaints portal. They also appreciate phone contact with us, as well as having a consistent case manager whenever possible. Some concerns were expressed about the involvement of notifiers in the notifications process and its transparency and timeliness.

Practitioner feedback highlighted satisfaction with initial communication, their opportunity to respond, the outcome of notifications and the content of letters explaining the reasons for decisions. They also highlighted areas for improvement – as with notifier feedback, practitioners said there could be greater transparency and improved timeliness.

For more information on the notifications process, see page 46 of the annual report or go to the Notifications page on the AHPRA website.

Enforcing the National Law

This year, a tougher stance was taken on those who do not comply with the National Law.

In February 2017, a landmark ruling saw a chiropractor convicted on criminal charges after he claimed to be able to prevent, treat and cure cancer in his advertising.

In April 2017, AHPRA successfully prosecuted a NSW man for knowingly and recklessly holding out as a medical practitioner by claiming to be a UK-based doctor. He received a criminal conviction and was fined $30,000 plus legal costs to AHPRA amounting to $22,000.

At its meeting of 24 March 2017, the Council of Australian Governments (COAG) Health Council discussed the adequacy of penalties under the National Law for individuals holding themselves out as health practitioners when they are not registered. Health Ministers agreed to consult on stronger penalties and increased prohibition powers, under the National Law.

Commitment to thorough investigations

AHPRA and the National Boards’ commitment to protecting the public means that we take the investigation of complaints and concerns seriously.

In the most complex of cases, dedicated investigations teams work tirelessly to get all the facts in establishing whether a registered health practitioner poses a risk to the public.

A National Board may decide to investigate a registered practitioner or student if it is concerned about potential risk to patients or the public because of a practitioner’s health or welfare, how the practitioner behaves or how the practitioner is treating patients.

To find out more about our investigations process, refer to the Investigations page on the AHPRA website.

Timeliness is also a priority in managing notifications. While this year saw an unprecedented amount of complaints and concerns lodged with AHPRA, we worked hard to close more notifications in the year than ever before.

For more information, see page 44 of the annual report.

Holding ourselves accountable

Like our international counterparts, AHPRA and the National Boards continue to face external scrutiny of our regulatory decision-making and performance.

We are committed to ensuring greater accountability and transparency of our work by:

This year, we continued to embed the recommendations of the 2014 independent review of the National Scheme, including preparing for the proposed amendments to the National Law, providing a joint submission to the accreditation systems review, and commissioning research into vexatious complaints.

In August 2016, AHPRA and the Medical Board of Australia (MBA) commissioned an independent review on the use of chaperoning restrictions as an interim measure for practitioners facing allegations of sexual misconduct. The review was handed down in April 2017, and AHPRA and the MBA accepted all the recommendations.

We also provided a submission to the Queensland Parliamentary Committee’s inquiry into the performance of the Queensland Office of the Health Ombudsman’s (OHO) functions, outlining our recommendations to ensure our regulatory expertise and that of the OHO as an ombudsman and health complaints authority is applied in the best possible way to protect the Queensland public.

Simplifying the notifications process

Improving the notifications experience for practitioners and the public remains a priority for AHPRA and the National Boards.

During public consultations on the notifications process, it was identified that the term ‘notification’ is not commonly understood by the broader community. In response to this, we simplified our online content, with the phrase ‘complaint or concern’ replacing the word ‘notification’ across the website.

In January 2017, an online portal was launched on the AHPRA website to simplify the process involved in making a complaint or raising a concern about a health practitioner or student. An online form now guides each user through the process, including instructions on how to provide information that will best enable efficient assessment of their concern. After making a complaint, an automated correspondence is issued to the user with a copy of their complaint or concern and advice that they will be contacted by a member of the AHPRA team within four days.

The portal also contains information about the way AHPRA manages complaints and concerns, which is aimed at those who make the complaint and those who have had a complaint made about them. This includes information to help ensure the user understands the types of complaints or concerns that AHPRA can deal with and where to go if their complaint cannot be managed by AHPRA. We have also included a short online survey to ensure the online portal is meeting the needs of our users.

The complaints portal is among the first in a range of digital initiatives being developed and implemented to improve the efficiency of processes across the National Scheme.

The complaints portal can be found on the Make a complaint page of the AHPRA website.

For more information about notifications, see page 44 of the annual report.

Embedding a multi-profession approach to regulation

During the year, the National Boards have collaborated on a range of multi-profession initiatives to progress nationally consistent approaches to regulation, supported by a policy team working with the Boards and working groups across AHPRA.

Key projects included the development and implementation of a strategy to support improved compliance with advertising requirements under the National Law; the early stages of a review of the Code of conduct shared by seven National Boards and used by an additional four (with some profession-specific modifications); and coordinating a review of core registration standards for a number of National Boards.

These initiatives are paralleled by multi-professional initiatives in regulatory decision-making. In December 2016, a Multi-Profession Immediate Action Committee (MPIAC) was formed, consisting of three community members and practitioner members from nine participating boards (Aboriginal and Torres Strait Islander Health Practitioner, Chinese Medicine, Chiropractic, Medical Radiation Practice, Occupational Therapy, Optometry, Osteopathy, Physiotherapy and Podiatry). It is intended that the MPIAC will build expertise in these areas to be a more effective decision-making body.

Engaging with international regulatory partners

In September 2016, AHPRA and the Medical Board of Australia co-hosted the 12th International Conference on Medical Regulation and the International Association of Medical Regulatory Authorities (IAMRA).

The event took place in Melbourne over four days and attracted more than 490 delegates from more than 40 countries. International and Australian speakers discussed and workshopped IAMRA’s theme for the year: Medical Regulation – Making a Difference.

AHPRA presented three sessions at the CLEAR 2016 Annual Education Conference, in conjunction with the Nursing and Midwifery Board of Australia. The Council on Licensure, Enforcement and Regulation (CLEAR) is an association of individuals, agencies and organisations that comprise the international community of professional and occupational regulation. The conference was attended by more than 600 members from across North America, Europe, Australia and New Zealand.

AHPRA is set to host CLEAR’s International Congress on Professional and Occupational Regulation in Melbourne in November 2017. For more information, visit the CLEAR website.

National Boards also had a presence at a number of international regulatory meetings within their profession.

Listening to community feedback

In 2013, AHPRA established a Community Reference Group (CRG), made up of 10 community members and a Chair, who give feedback on AHPRA’s regulatory operations and other relevant issues from the perspective of members of the general public.

Over the past year, the CRG cemented itself as a trusted source of advice and a community perspective on health regulation. Members of the group provided detailed feedback to AHPRA and the National Boards on such works as improvements to our notifications (complaints) process and the new complaints portal. They also advised on consultations on revalidation, codes of conduct for nurses and midwives, and the Occupational Therapy Board of Australia’s review of competency standards. Members also provided a community perspective at National Board workshops and events – including for the Medical, Chiropractic and Dental Boards.

The CRG is not only called upon to give advice to AHPRA and the Boards. In 2016/17, members of the group were also asked to provide feedback on a senate inquiry into the complaints mechanism administered under the National Law, and the Independent review of the use of chaperones to protect patients in Australia.

For information on the activities of the CRG and other reference groups, such as the Professions Reference Group (PRG), who advise AHPRA and the Boards, visit the Advisory groups page on the AHPRA website.

Adding paramedicine to the National Scheme

On 24 March 2017, Health Ministers met as the Australian Health Workforce Ministerial Council (AHWMC) to consider an amendment to the National Law that will see the regulation of paramedics under the National Scheme.

If passed, paramedics will be able to register nationally for the first time in Australia, the title ‘paramedic’ will be protected nationally, and paramedicine will become a registered health profession.

AHPRA has been tasked with implementing the decision of the Ministers and, to that end, the first call for applications to the Paramedicine Board of Australia was advertised in April 2017. If the amendment bill is passed, Health Ministers will make appointments in September 2017 and the national regulation of paramedics is expected to start in the second half of 2018.

For more information, visit the Paramedicine Board of Australia website.