March 2020

Issue 14 – March 2020

Message from the Chair
Launch of national health and cultural safety strategy
- A strategy for embedding cultural safety into the health system
Board news
Alerts
- Vacancies on health profession national boards – lend your leadership and voice
- Victorian practitioners: information on the Voluntary Assisted Dying Act
National Scheme news
Keep in touch with the Board

Message from the Chair

Although it’s March already, I’d like to wish everyone a happy and prosperous year ahead. It’s hard to believe that our profession has been regulated in the National Registration and Accreditation Scheme (National Scheme) for eight years this year.

When I think back, we have achieved a great deal – we’re up to nearly 700 registrants across the country (see more under the Statistics tab on the Board’s website) and our hard-working accreditation committee has accredited every course that’s able to be accredited.However, in June 2020, a new accreditation standard will come into force. You can read about this in the article below.

This year, the Board will travel to Melbourne, Perth and Darwin for three of its four meetings. At each place we will try to get out to visit an Aboriginal healthcare provider nearby and spread the word about the value of employing registered Aboriginal and Torres Strait Islander Health Practitioners to make their services more culturally safe for our communities. Please read about the National Scheme's Aboriginal and Torres Strait Islander health and cultural safety strategy below.

Requirements for registration and accreditation for our developing profession can be confusing and hard to understand. You are welcome to contact us (see the details at the end of this newsletter) and let us help clarify anything you might not understand.

I look forward to working with the Board and our stakeholders again this year.

Renee Owen

Chair, Aboriginal and Torres Strait Islander Health Practice Board of Australia

Launch of national health and cultural safety strategy

A strategy for embedding cultural safety into the health system

An ambitious strategy from Aboriginal and Torres Strait Islander health experts, regulators and health organisations committed to embedding cultural safety into the health system has been released by 43 entities including the Australian Health Practitioner Regulation Agency (Ahpra) and the National Boards.

The National Scheme’s Aboriginal and Torres Strait Islander health and cultural safety strategy 2020-2025 is endorsed by organisations, academics and individuals, including the entities who set the education standards for the 183,000 students who are studying to become registered health practitioners and the regulators of Australia’s 750,000 registered practitioners.

The strategy focuses on achieving patient safety for Aboriginal and Torres Strait Islander Peoples as the norm and the inextricably linked elements of clinical and cultural safety. Development of the strategy was led by Aboriginal and Torres Strait Islander organisations and individuals via the Aboriginal and Torres Strait Islander Health Strategy Group, which represents all signatories to the strategy.

The launch of the strategy marks a change in leadership for the Strategy Group. Karl Briscoe, CEO of the National Aboriginal and Torres Strait Islander Health Worker Association (NATSIHWA) is the new Co-Chair, following on from Prof. Gregory Phillips and joining existing Co-Chair Julie Brayshaw, Chair of the Occupational Therapy Board of Australia. Jacqui Gibson-Roos, member of the Dental Board of Australia, has been appointed Deputy Chair of the Caucus (comprising all Aboriginal and Torres Strait Islander members of the Strategy Group).

Aboriginal and Torres Strait Islander health and cultural safety strategy 2020-2025

The vision

Patient safety for Aboriginal and Torres Strait Islander Peoples is the norm. We recognise that patient safety includes the inextricably linked elements of clinical and cultural safety, and that this link must be defined by Aboriginal and Torres Strait Islander Peoples.

The objectives

Cultural safety: A culturally safe health workforce through nationally consistent standards, codes and guidelines across all registered health practitioners in Australia.

Increased participation: Increased Aboriginal and Torres Strait Islander participation in the registered health workforce and across all levels of the scheme regulating registered practitioners nationally.

Greater access: Greater access for Aboriginal and Torres Strait Islander Peoples to culturally safe services from registered health practitioners.

Influence: Using the Strategy Group’s leadership and influence to achieve reciprocal goals. This includes developing a nationally consistent baseline definition to be used across the scheme regulating registered practitioners nationally, which has already been achieved in partnership with the National Health Leadership Forum.

As part of the strategy, we have already reached some goals:

partnering with the National Health Leadership Forum (the forum for national Aboriginal and Torres Strait Islander health peak organisations) to develop, consult and finalise a baseline definition of cultural safety for the scheme for regulating health practitioners
commissioning high-quality cultural safety training to ensure that the regulation of health practitioners, including the development of standards practitioners must meet and the handling of notifications (concerns about registered health practitioners), is culturally safe
recommending and advocating for changes to the Health Practitioner Regulation National Law to ensure consistency in cultural safety for Aboriginal and Torres Strait Islander people.

For more information, please read the media release.

There is also a new podcast about the strategy, featuring Karl Briscoe and Prof. Greg Phillips. See Ahpra's 'Taking care' series of podcasts.

L to R: Karl Briscoe, Co-Chair, Aboriginal and Torres Strait Islander Health Strategy Group; Julie Brayshaw, Chair of the Occupational Therapy Board of Australia and Co-Chair, Health Strategy Group; Prof. Greg Phillips, immediate past chair, Health Strategy Group; Gill Callister, Chair, Agency Management Committee (Ahpra); Martin Fletcher, CEO, Ahpra.

Board news

New accreditation standard coming soon

Big changes are coming in our new Accreditation standard, due to take effect in June this year. Not only will all the Certificate IV in Aboriginal and Torres Strait Islander Health Care Practice courses be able to apply for accreditation, any course that is of a higher qualification (such as a diploma course) can also apply for accreditation.

However, all courses that seek to be accredited must meet the requirements of the standard. Just because someone holds a qualification doesn’t mean that they qualify to be registered. The qualification that someone holds must be listed on the Board’s website as an approved program of study. If it’s not listed on the website, it is not a qualification that satisfies the requirements of the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).

Revised registration standards are in effect

The Board’s revised registration standards¹ came into effect on 1 December 2019. These are:

Aboriginal and Torres Strait Islander Health Practitioners
English language skills
Recency of practice
Professional indemnity insurance arrangements
Continuing professional development.

The revised registration standards were published on 31 July 2019 to give practitioners time to understand the revised requirements. Make sure you have read and understand the revised registration standards and know what you need to do to meet them. Some of the main changes are outlined below and you can read the registration standards in full on the Registration standards page of the Board’s website.

When applying for registration for the first time you need to meet the Aboriginal and Torres Strait Islander and English language skills registration standards. Every time you renew your registration you must declare you meet recency of practice, professional indemnity insurance arrangements and continuing professional development registration standards.

Aboriginal and Torres Strait Islander

To meet the standard, you must be and identify as an Aboriginal and/or Islander Strait Islander person. The first time you apply for registration you need to provide a letter from a recognised Aboriginal and/or Torres Strait Islander organisation stating that you are an accepted Aboriginal and/or Torres Strait Islander in the community in which you live or lived. The letter needs to be on official letterhead, signed by an authorised person and include the official seal if the organisation has one.

English language skills

The first time you apply for registration you need to show your English language competency by giving evidence of your successful completion of an approved program of study. You can also show your competency through any qualifications you hold at the level of Certificate IV or higher.

Recency of practice (ROP)

The revised registration standard requires you to have practised 450 hours over the last three years, or 150 hours over the last year. You will also need to submit a professional development plan to the Board for approval if you are making a substantial change to the scope of your practice, for example from an administrative role to providing clinical care.

Professional indemnity insurance arrangements (PII)

The revised registration standard has been made easier to read and understand. To meet the registration standard, you need to have appropriate insurance. It’s likely your employer has PII cover for you, but you should still check. If you work for yourself make sure you have the correct insurance in place.

Continuing professional development (CPD)

The revised registration standard requires you to do 20 hours of CPD each year and five of these must be interactive. You no longer have three years to complete 60 hours and you don’t need to maintain an up-to-date first aid certificate to meet the registration standard.

More information

You can find more information about the revised CPD registration standard in the CPD guidelines on the Codes and guidelines webpage. The Board will be publishing more information about all the revised registration standards in the FAQ section of that webpage in coming weeks.
________________________________________
¹ Registration standards define the requirements that applicants and registrants in the regulated professions need to meet to be registered.

Aboriginal and Torres Strait Islander Health Practice regulation at work: Protecting the public in 2018/19

A profession-specific statistical summary and a report from the Chair that covers the work of the Aboriginal and Torres Strait Islander Health Practice Board of Australia over the 12 months to 30 June 2019 is now available on our website.

The summary draws on data from the 2018/19 annual report of Ahpra and the National Boards, which you can read in full.

The summary provides a snapshot of the profession as at 30 June 2019, and includes the number of applications for registration, outcomes of practitioner audits and segmentation of the registrant base by gender and age.

The summary also includes extensive notifications information, including numbers, types and sources of complaints, mandatory notifications, criminal offence complaints and more.

Profession-specific data tables are also available for downloading.

Alerts

Vacancies on health profession national boards – lend your leadership and voice

Practitioner and community member vacancies are arising on the following health profession National Boards:

Aboriginal and Torres Strait Islander Health Practice Board of Australia
Chinese Medicine Board of Australia
Chiropractic Board of Australia
Medical Radiation Practice Board of Australia
Occupational Therapy Board of Australia
Osteopathy Board of Australia
Paramedicine Board of Australia
Psychology Board of Australia.

The National Scheme has a commitment to increasing Aboriginal and/or Torres Strait Islander Peoples’ leadership and voices. Aboriginal and/or Torres Strait Islander people are strongly encouraged to apply, as are people from rural or regional areas in Australia.

Appointments are made by the Ministerial Council under the Health Practitioner Regulation National Law, as in force in each state and territory. Appointments can be for up to three years, with eligibility for reappointment.

More information about the vacancies, roles of National Board Chairs and members, and eligibility requirements can be found on Ahpra's Board member recruitment page.

Applications will close on 30 March 2020 at 5:00pm AEST.

Victorian practitioners: information on the Voluntary Assisted Dying Act

On 1 July 2019, the Voluntary Assisted Dying Act 2017 (Vic) began operation in Victoria. The Board draws specific attention to section 8 of the Act, which states that a registered health practitioner who provides health services or professional care services to a person must not, in the course of providing those services to the person:

initiate a discussion that is, in substance, about voluntary assisted dying (s 8(1)(a))
in substance, suggest voluntary assisted dying to that person (s 8(1)(b)).

A breach of this requirement is deemed to be unprofessional conduct for the purposes of the National Law (s 8(3)). It is noted, however, that section 8 does not prevent a health practitioner providing information about voluntary assisted dying to a person at that person’s request (s 8(2)) (emphasis added).

We encourage Victorian health practitioners who have not already done so, to review the Act and familiarise themselves with its requirements.

If you need further information, we encourage you to contact your professional association or professional indemnity insurer. Information about the Act, published by the Victorian Department of Health and Human Services, is available on the DHHS website.

National Scheme news

The role of accreditation in improving health outcomes for Aboriginal and Torres Strait Islander Peoples

A new report, The role of accreditation in improving Aboriginal and Torres Strait Islander health outcomes, was recently published by the Health Professions Accreditation Collaborative Forum, which is made up of the accreditation authorities for the health professions regulated in the National Scheme. The forum wanted to better understand and address the role accreditation plays in improving health outcomes for Aboriginal and Torres Strait Islander Peoples.

Achieving equity in health outcomes for Aboriginal and Torres Strait Islander Peoples and other Australians is a shared commitment led by the National Scheme’s Aboriginal and Torres Strait Islander Health Strategy Group and outlined in the Statement of Intent.

The project collected and analysed data from accredited health practitioner programs across Australia, to inform a collective strategy. This will involve accreditation authorities promoting quality education of health practitioners to improve Aboriginal and Torres Strait Islander health outcomes and produce a culturally safe workforce.

To access the report, please visit the Accreditation publications webpage.

For more information on the forum, please visit the Health Professions Accreditation Collaborative Forum website.

Ahpra and National Boards welcome policy directions

Ahpra and the National Boards have welcomed two new policy directions from the COAG Health Council which reinforce that Ahpra and National Boards are to prioritise public protection in the work of the National Scheme.

The two directions state that public protection is paramount and require consultation with patient safety and health care consumer bodies on any new and revised registration standards, codes and guidelines, as well as other considerations.

The first policy direction outlines the consideration that National Boards and Ahpra must give to the public (including vulnerable people in the community) when determining whether to take regulatory action about a health practitioner. It also authorises limited sharing of information with employers and state/territory health departments about serious matters involving the conduct of a registered health practitioner.

As the national regulators, it is Ahpra and the National Boards’ responsibility to protect the public and prevent harm. However, most health practitioners practise safely and well. In 2018/19 around 98 per cent of all registered practitioners did not have any concerns reported about their conduct, health or performance.

The second policy direction requires National Boards to consult with patient safety bodies and consumer bodies on registration standards, codes and guidelines when these are being developed or revised. It also provides that National Boards and Ahpra must:

consider the impacts of the new or revised registration standard on vulnerable members of the community and Aboriginal and Torres Strait Islander people, and
prepare and publish a ‘patient health and safety impact statement’ with each new or revised registration standard, code or guideline.

In implementing these policy directions, Ahpra and National Boards will continue to ensure fairness for health practitioners in regulatory processes. The policy directions can be viewed on the Ahpra and National Board websites.

Taking care: a podcast of conversations about public safety and healthcare

Ahpra launched its podcast channel in 2019. ‘Taking care’ is a series of podcasts that highlight Ahpra and the National Boards’ commitment to public safety and the ongoing conversation about the work of health practitioner regulation in Australia.

‘Taking care’ features a broad range of conversations and interviews with experts from the community, health professions, people from health, regulation and the broader community. Ahpra hosts an intentionally diverse list of guests to address myths and common questions about public safety in healthcare, to offer professional and consumer perspectives on current issues.

The podcast channel and the video series it follows provide opportunities for significant discussions about health, and the essential role of regulation in protecting the public and supporting the safe delivery of healthcare in Australia.

These conversations highlight what’s important in healthcare. People want to feel like they are being seen and heard when they consult with a health practitioner, and that they’re in safe hands. Practitioners are telling us how it feels from their perspective, including difficulties associated with self-care and what makes it harder for them to do their job.

Ahpra and the Boards are listening and committed to doing whatever they can improve the experience for the public and registered health practitioners, with public safety at the forefront.

Find out more

Find out more about safe healthcare in Australia by by downloading the podcasts:

Launching the National Scheme's Aboriginal and Torres Strait Islander health and cultural safety strategy 2020-2025
A new look at mandatory notifications
Ahpra's role in the health system
A view of mental health from both sides
The practitioner experience of a notification
Safe, competent and ethical health practitioners: a public perspective
Vexatious notifications: a practitioner perspective

Subscribe to Ahpra’s ‘Taking care’ podcast channel for access to interesting conversations about the latest issues affecting safe health care in Australia. New episodes released fortnightly. Available on Spotify, Apple Podcasts and the ‘Taking care’ show page on Whooshka.

Comments about the ‘Taking care’ podcast channel, or any of the downloadable episodes, are welcome via email at communications@ahpra.gov.au. Email the team if you are interested in hosting the podcast on your website or social media.

Changes to mandatory notifications requirements are now in effect

On 1 March 2020 the amendments to the National Law in relation to mandatory notifications took effect.

The amendments apply in all states and territories except Western Australia and affect the mandatory reporting obligations for treating practitioners.

The threshold for reporting a concern about impairment, intoxication and practice outside professional standards has been raised. The threshold is now reached when there is a substantial risk of harm to the public.

The National Boards and Ahpra have jointly revised the mandatory notifications guidelines to reflect these amendments. The guidelines are relevant to all registered health practitioners and registered students in Australia.

The guidelines are relevant to all registered health practitioners and registered students in Australia. They aim to explain the mandatory notifications requirements in the National Law clearly so that practitioners, employers and education providers understand who must make a mandatory notification about a practitioner or student and when they must be made. They also aim to make it clearer when a notification does not need to be made.

Changes to the guidelines include:

a new, higher reporting threshold for when treating practitioners must make a notification about their practitioner-patients. This is to give a practitioner-patient the confidence to seek help if they need it without undue concern about a mandatory notification
two separate guidelines now in place. One is for mandatory notifications about practitioners, and one for mandatory notifications about students. As there are only limited circumstances when a mandatory notification must be made about a student it was decided to develop a separate guideline that is only about students
restructuring of the guidelines for practitioners according to notifier type (that is, treating practitioner, non-treating practitioner, employer) so that relevant information for each notifier group is easier to find
updated flowcharts to help potential notifiers assess whether they need to make a mandatory notification, and
introduction of risk charts that highlight risk and mitigating factors that may be relevant to deciding if a mandatory notification is required.

Read the revised guidelines for practitioners and for students and the additional resources developed to help explain mandatory notifications. There is also a new podcast on this topic.

Statement by Ahpra and the National Boards on the misuse of protected titles

Protected titles are an important public safety measure and we take their misuse seriously.

While we are unable to talk about individuals, we would like to thank everyone who has helped to promote a greater community understanding of the importance of protected titles and their appropriate use.

We have recently been working with media organisations to ensure they understand their legal obligations when using titles such as ‘nurse’, ‘medical practitioner’ or ‘psychologist’.

In Australia, titles that relate to a registered health profession are protected by law. You must be registered with a national health practitioner board (National Board) to use a protected title. To be registered, you must be suitably trained, qualified and satisfy the National Board’s requirements for continuing professional education, professional indemnity insurance and recency of practice.

To use a protected title when you’re not registered, or to hold someone else out as registered when they’re not, breaches the trust the public has in their registered health practitioners. That’s because when the public sees a protected title, they trust that they’ll be receiving safe and professional healthcare and advice.

We have written to media organisations to remind them of their obligations under the National Law, and to advise that the easiest way to check if someone is registered to practise and entitled to use a protected title in Australia, is by checking our online register of practitioners. The register, which contains the most up-to-date information about a practitioner’s registration status, is available to members of the public, employers and third-parties. It’s free, available 24/7, with updates made daily.

If you are concerned that someone might be holding themselves out to be a registered practitioner when they’re not, call 1300 419 495 or notify us via the Ahpra website.

Tougher penalties for offences committed after 1 July 2019

In February 2019, the Health Practitioner Regulation National Law and Other Legislation Amendment Act 2019 (Qld) was passed by the Queensland Parliament.

The amendments included increased penalties and introduced an imprisonment term of up to three years for offences against the National Law. The penalties apply to offences committed after 1 July 2019 and some offences will automatically become indictable offences in all states and territories (except Western Australia).

Social media guide for health practitioners

Ahpra and National Boards have published a new guide to help registered health practitioners understand and meet their obligations when using social media.

The guide reminds practitioners that when interacting online, they should maintain professional standards and be aware of the implications of their actions, just as when they interact in person.

The guide does not stop practitioners from engaging online or via social media; instead, it encourages practitioners to act ethically and professionally in any setting.

To help practitioners meet their obligations, the guide also outlines some common pitfalls practitioners may encounter when using social media.

Community trust in registered health practitioners is essential. Whether an online activity can be viewed by the public or is limited to a specific group of people, health practitioners have a responsibility to behave ethically and to maintain professional standards, as in all professional circumstances.

In using social media, health practitioners should be aware of their obligations under the National Law, their Board’s Code of conduct, the Advertising guidelines and other relevant legislation, such as privacy legislation.

This guide replaces the Social media policy on Boards’ codes, guidelines and policies pages and is available in the Advertising resources section of Ahpra’s website. The guide will be updated as needed.

Understand your obligations. New guide on use of social media. Avoid the pitfalls.

Keep in touch with the Board

Call Ahpra on 1300 419 495 or 08 8901 8527 if you:

have any questions
need help filling in forms, or
are having trouble explaining to your employer about requirements. You can ask your employer to call this number.

The Board’s website has information on registration forms, registration standards, codes and guidelines, and news. If you have already lodged your application, you may call the registration officer responsible for Aboriginal and Torres Strait Islander Health Practitioner applications directly on 08 8901 8527.

To contact the Board, please call Jill Humphreys on 03 8708 9066 or send an email to jill.humphreys@ahpra.gov.au.