Are you immunised against Hepatitis B? Do you know your status in relation to blood-borne viral infections? Have you had any exposures since you were last tested? Do you perform exposure-prone procedures and if so, do you have annual tests?
Medical practitioners, along with other health practitioners, have a professional responsibility to protect the health and safety of their patients. This includes by preventing transmission of blood-borne viral infections. The 14 national health practitioner boards (the National Boards) have just released new guidelines in this area for consultation. The guidelines link to the Communicable Diseases Network Australia (CDNA) guidelines on prevention, detection and management of healthcare workers with blood-borne viral infections. CDNA is the body which coordinates Australia’s national public health efforts in relation to communicable diseases.
Under the National Boards’ proposed guidelines all registered practitioners are required to comply with the CDNA guidelines. The consultation document also outlines what is expected of treating practitioners and how the Board is likely to manage a notification about a practitioner who is infected with a blood-borne virus. Please let us know what you think.
Dr Joanna Flynn AM
Chair, Medical Board of Australia
Most medical practitioners are due to renew their registration by 30 September 2014. This is the renewal date for medical practitioners with general, specialist or non-practising registration. The Australian Health Practitioner Regulation Agency (AHPRA) will soon be starting the registration renewal campaign for medical practitioners.
The Board has set the fee for 2014/15 at $715, limiting the increase to the national consumer price index (CPI) of 2.9 per cent. The fee for NSW practitioners will be announced once it is approved by the NSW Minister. The annual renewal fee covers the registration period for most medical practitioners of 1 October 2014 to 30 September 2015.
AHPRA will send most renewal reminders by email and we encourage you to renew online.
The Board’s fees will be published in the fee schedule. More detailed information about the National Board’s financial operations will be outlined in the Health Profession Agreement between the National Board and AHPRA, which will be published on the Board’s website. This agreement sets out the services AHPRA will provide to support the National Board to regulate medical practice in Australia.
The National Registration and Accreditation Scheme (the National Scheme) is funded by practitioners’ registration fees and there is no cross-subsidisation between professions.
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On 1 July 2014, AHPRA and the National Boards marked the four-year anniversary of the National Scheme (Western Australia joined in October 2010). There are now more than 618,000 health practitioners registered nationally, regulated by 14 National Boards.
The National Scheme is underpinned by consistent national standards and the National Boards and AHPRA have this month released refreshed regulatory principles. The principles will inform the work of the Boards and AHPRA in regulating health practitioners and guide our decision-making. The principles encourage a responsive, risk-based approach to regulation across all professions in the National Scheme.
Regulatory decision-making is complex and contextual, requiring judgement, experience and common sense. The principles will further support decision-making which is consistent and balanced.
AHPRA and the Boards will consult on these principles later in 2014 and will review them based on feedback and 12 months’ experience.
The principles adopted by AHPRA and the National Boards are:
The Board has made changes to streamline the competent authority pathway and the specialist pathway for IMGs. The changes started on 1 July 2014.
Applicants for the competent authority pathway now apply directly to the Board for provisional registration, instead of applying for a Certificate of Advanced Standing through the Australian Medical Council (AMC). After the satisfactory completion of 12 months’ supervised practice, these practitioners will be eligible for general registration. They no longer need to be awarded the AMC certificate.
Applicants for the specialist pathway (specialist recognition or area of need) now apply directly to the relevant specialist medical college to be assessed for the specialist pathway, rather than applying through the AMC. The college and the specialist IMG will communicate directly with each other throughout the assessment process and the college, the AMC and AHPRA will use a secure portal to exchange key documents.
All international medical graduates must still apply to the AMC for verification of their medical qualifications.
Information for IMGs and employers is available on the website.
The Board has received feedback that there is some confusion about the use of the title ‘Doctor’. In particular, some medical practitioners who have retired and are no longer registered, or who are thinking about retiring, are concerned that they will not be able to use the title, after a lifetime of being a ‘doctor’.
The title of ‘Dr’ is not a protected title. Medical practitioners who are no longer registered can use the title ‘Dr’, as long they do not lead anyone to believe that they are a registered medical practitioner.
All 14 National Boards are inviting practitioners, members of the community and other stakeholders to provide feedback on guidelines that will determine how, from a regulatory perspective, health practitioners with blood-borne viruses should be managed.
Under the proposed guidelines, registered health practitioners with blood-borne viruses must comply with the Communicable Diseases Network Australia (CDNA) guidelines on this issue to ensure their practice does not compromise patient safety.
The CDNA offers strategic advice to governments and other key bodies on public health actions to minimise the impact of communicable diseases, and its Australian national guidelines for the management of health care workers known to be infected with blood-borne viruses are endorsed by the Australian Health Ministers' Advisory Council.
The National Boards’ proposed guidelines allow health practitioners infected with a blood-borne virus to practise their profession if they comply with the CDNA guidelines. However, they may have to modify their practice. For example, they will not be able to perform certain procedures such as exposure-prone procedures if the CDNA guidelines stop them from doing so.
The current CDNA guidelines define an exposure-prone procedure as a procedure where there is a risk of injury to the healthcare worker resulting in exposure of the patient’s open tissues to the blood of the worker. These procedures include those where the worker’s hands (whether gloved or not) may be in contact with sharp instruments, needle tips or sharp tissues (spicules of bone or teeth) inside a patient’s open body cavity, wound or confined anatomical space where the hands or fingertips may not be completely visible at all times.
The National Boards have published a consultation paper to support the draft guidelines, accessible under Current consultations on the Board website. The consultation is open until 26 September 2014.
New co-regulatory arrangements in Queensland started on 1 July 2014 with the introduction of the Office of the Health Ombudsman.
The Office of the Health Ombudsman is Queensland's independent health complaints agency. It replaces the Health Quality and Complaints Commission (HQCC) and has taken on certain functions previously undertaken by AHPRA.
The Office of the Health Ombudsman deals with complaints about both registered and unregistered health practitioners, and health service organisations.
The Health Ombudsman of Queensland oversees the Office of the Health Ombudsman, receives health service complaints and decides what action should be taken. Mr Leon Atkinson-MacEwen is the Health Ombudsman of Queensland. He was previously Tasmania’s Ombudsman and Health Complaints Commissioner.
Under the new arrangements, anyone with a complaint about a health practitioner in Queensland should contact the Office of the Health Ombudsman directly.
The Health Ombudsman is responsible for managing serious complaints relating to the health, conduct and performance of health practitioners, and will determine which complaints go to AHPRA and the National Boards after assessing their severity.
The mandatory notification requirements in Queensland under the Health Practitioner Regulation National Law remain. However, notifications are now made to the Office of the Health Ombudsman, rather than to AHPRA.
Complaints about Queensland health practitioners that were made to AHPRA or National Boards before 1 July 2014 will generally continue to be managed by AHPRA on behalf of the National Boards.
Any health complaints and other matters that were active with the HQCC on 30 June 2014 were transferred to the Office of the Health Ombudsman.
Anyone with a complaint about a health practitioner in Queensland should contact the Office of the Health Ombudsman (OHO) on telephone 133 OHO (133 646).
The Medical Board of Australia has established state and territory boards to make decisions about individual medical practitioners in each jurisdiction. This includes all registration and notification decisions. The National Board has delegated many of its powers so that local decision-makers can respond effectively and in a timely way to local matters, working within a national policy framework.
The state and territory boards are made up of practitioner and community members and are appointed by the Minister for Health in each jurisdiction. Appointments are for up to three years and members are eligible for reappointment.
A number of board members’ appointments expired on 30 June 2014 and a number of appointments have been announced. The current members of state and territory boards can be found on the website at About us.
The Medical Board of Australia thanks the state board members who recently finished their terms on state boards and welcomes all the members appointed.
Dr Laurie Warfe and Associate Professor Peter Sexton both finished their terms as Chairs of the Victorian and Tasmanian boards respectively. Dr Warfe and Associate Professor Sexton, both general practitioners, have provided leadership to their boards, including through the transition to the National Scheme. They have worked tirelessly in medical regulation for many years to advocate for high standards of medical practice in their communities. The Medical Board of Australia thanks them both for their dedication and wishes them well in their future endeavours.
Dr Peter Dohrmann, a neurosurgeon, and Dr Andrew Mulcahy, an anaesthetist, have been appointed to chair the Victorian and Tasmanian boards respectively. Both are experienced board members with wide-ranging clinical and regulatory experience. The Medical Board welcomes them to their new role.
AHPRA on behalf of the 14 National Boards publishes a record of panel, court and tribunal decisions about registered health practitioners. Summaries are published when there is clinical and educational value.
Under the National Law, the Board must refer a matter about a registered medical practitioner or student to a tribunal if the Board reasonably believes that the practitioner has behaved in a way that constitutes professional misconduct; or the practitioner’s registration was improperly obtained because the Board was given false or misleading information. The Board must also refer the matter to a tribunal if a panel established by the Board requires the Board to do so.
Medical practitioners may also appeal certain decisions of the Board to a tribunal, or court.
AHPRA publishes summaries of selected tribunal or court cases from time to time. These can be sourced at Publications>Tribunal decisions on the AHPRA website. A full library of published hearing decisions from tribunals or courts relating to complaints and notifications made about health practitioners or students is available on the Austlii website.
When investigating a notification, state and territory committees of the Medical Board of Australia may refer a medical practitioner to a health panel hearing, or a performance and professional standards panel hearing.
Under the National Law, panel hearings are not open to the public. AHPRA publishes a record of panel hearing decisions made since July 2010. Summaries have been provided when there is educational and clinical value. These summaries are accessible from hyperlinks within the table. Practitioners' names are not published, consistent with the requirements of the National Law. This table does not include summaries of panel decisions made under previous legislation, even if these were held after July 2010.
Please note: Practitioners are responsible for keeping up to date with the Board’s expectations about their professional obligations. The Board publishes standards, codes and guidelines as well as alerts in its newsletter. If you unsubscribe from this newsletter you are still required to keep up to date with information published on the Board’s website.
Comment on the Board newsletter is welcome and should be sent to email@example.com.
For registration enquiries or contact detail changes, call the AHPRA customer service team on 1300 419 495 (from within Australia).