May 2017

• Latest tribunal decisions 
  • Recent decisions have been published online
• Improving complaints management
  • Workshop with the AMA 
• Assessing specialist IMGs 
  • AHPRA appoints reviewer of specialist medical college IMG assessment  
• Senate inquiry
  • Senate Committee publishes report on complaints inquiry
• News and alerts
  • Vaccination information resources for doctors
  • Media statements
• Contacting the Board 

Recent decisions have been published online

There are important lessons for registered medical practitioners from tribunal decisions. The Board refers the most serious concerns about medical practitioners to tribunals in each state and territory. Cases published recently have included:

• Professional boundaries (Medical Board of Australia v Linde)

The Court of Appeal in Western Australia upheld the Medical Board of Australia’s appeal and set aside a tribunal’s decision in a case about:

• Inadequate training and false representation (Medical Board of Australia v Woollard)

Publication of panel, court and tribunal decisions

The Australian Health Practitioner Regulation Agency (AHPRA), on behalf of the 14 National Boards, publishes a record of panel, court and tribunal decisions about registered health practitioners.

When investigating a notification, the Medical Board may refer a medical practitioner to a health panel hearing, or a performance and professional standards panel hearing. Under the National Law¹, panel hearings are not open to the public. AHPRA publishes a record of panel hearing decisions made since July 2010. Practitioners’ names are not published, consistent with the requirements of the National Law.

Summaries of tribunal or court cases are published at Tribunal decisions on the AHPRA website. The Board and AHPRA sometimes choose to not publish summaries, for example about cases involving practitioners with impairment.

In NSW and Queensland, different arrangements are in place. More information is available on AHPRA’s website under Notification outcomes and hearing decisions.

¹The Health Practitioner Regulation National Law, as in force in each state and territory

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Workshop with the AMA

Senior leaders from the Board, AHPRA and the Australian Medical Association (AMA) met in May for the third annual workshop on complaints management.

Discussions focused on ways to reduce timelines in an environment of increasing numbers of complaints, and the group considered how to improve the experience of practitioners who have a notification made about them.

Over the last 12 months, AHPRA and the Board have increased completion rates of cases by 34 per cent despite an 18 per cent increase in notifications. We have done this by reducing the time that a case spends in both the assessment and investigation phases. To achieve this, we are now triaging notifications early and concluding matters that pose less risk more swiftly, and ensuring there is early clinical input to shape the ongoing management of each matter.

The workshop also focused on the gap between practitioner’s views about being the subject of a complaint, and actual regulatory outcomes. Many practitioners regard being the subject of a notification as a catastrophic event, despite the fact that about 70 per cent of notifications result in no regulatory action. While there is a clear need for the Board and AHPRA to take steps to improve practitioners’ experience of the notifications process, there is also work to do in educating practitioners about likely outcomes and reducing often misplaced anxiety about what is likely to happen as a result of a complaint. It may be helpful for practitioners who are the subject of a complaint to talk with their insurer about likely regulatory outcomes for the type of complaint that has been made about them.

AHPRA has started surveying practitioners and notifiers at the end of the notification process, to better understand their experience and make improvements. Early results suggest that providing regular updates on the progress of each matter will improve the experience of both notifiers and doctors.

The AMA raised the issue of vexatious complaints. The Board and AHPRA have committed to commissioning further research, although evidence to date indicates that there are very, very few clearly vexatious complaints made.

Mandatory notifications, particularly in relation to impairment, were also discussed. AHPRA and the Board reported having no evidence that mandatory notifications are being made inappropriately.

The AMA commended the Board and AHPRA on their willingness to listen to concerns and take action. There have been many initiatives over the past 12 months that have reduced notification timelines, but we recognise we need to do more. The Board is grateful to the AMA for sharing their ideas and working together to make improvements. A joint communiqué from the meeting is published on the Board’s website.

For more information about notifications, AHPRA has published guides for practitioners on the notifications process.

For more data on the outcome of notifications, see the 2016 Annual report and the 2016 medical profession summary.

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AHPRA appoints reviewer of specialist medical college IMG assessment

Specialist colleges have previously been appointed to assess the training, assessment, experience, recent practice and continuing professional development completed by a specialist international medical graduate (IMG) to determine whether the IMG can practise at a level comparable to the standard expected of an Australian trained specialist starting in the same field of practice. This is commonly known as the ‘specialist pathway’.

AHPRA, on behalf of the Board, has appointed Deloitte Access Economics to review specialist medical colleges’ performance in relation to assessments of IMGs.

The review will examine each college’s current performance against benchmarks for the specialist pathway the Board has set. It will review the extent to which college processes align with the Board’s Good practice guidelines for the specialist international medical graduate assessment process. These guidelines define good practice in the assessment of specialist IMGs, including in relation to:

• how colleges assess comparability
• college committee structures
• interview and assessment procedures and processes
• fees, and
• appeals processes.

The review will also consider whether elements of the current specialist IMG assessment process can be improved, evaluate current performance benchmarks and recommend methods for future monitoring of colleges’ performance.

Deloitte Access Economics will seek input from external stakeholders including specialist IMGs and employers.

The Snowball review of the National Registration and Accreditation Scheme recommended that the Medical Board ‘evaluate and report on the performance of specialist colleges in applying standard assessments of IMG applications and apply benchmarks for timeframes for completion of assessments’.

Australia’s health ministers accepted this recommendation and the Board committed to appointing an external reviewer. The Board selected Deloitte Access Economics after an open competitive tender process.

The review will continue throughout 2017 and the Board will consider the report in early 2018.

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Senate Committee publishes report on complaints inquiry

The Senate Community Affairs References Committee has tabled its report of the inquiry into the Complaints mechanism administered under the Health Practitioner Regulation National Law.

The committee made a number of recommendations about how AHPRA and the Medical Board can improve notifications management, including improving communication with practitioners and notifiers, identifying and dealing with vexatious complaints, ensuring early clinical input into complaints management, appropriate selection of clinical experts and training for AHPRA staff and Board members.

The report is available on the Senate Committee webpage.

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Vaccination information resources for doctors

General practitioners have an important role in guiding parents about child vaccination issues.

The Australian Child Health Poll, conducted on behalf of Royal Children’s Hospital, Melbourne, found that more than 25 per cent of Australian parents had some concerns about vaccination, although most still vaccinate.

General practitioners are a trusted and frequently accessed resource about vaccine concerns. There are resources available to help doctors skilfully address parent’s worries, including the following:

• Commonwealth Department of Health – Immunise Australia Program - Resources for health professionals.
  
  
• The National Centre for Immunisation Research and Surveillance - Available resources include fact sheets addressing the five concerns most commonly expressed by Australian parents, including How are vaccines shown to be safe? What is in vaccines?, available at the
  Support And Resources to Assist Hesitant parents with vaccination (SARAH project).
  
  
• Most states and territories have a specialist immunisation service available to health practitioners and parents, including immunisation recommendations and advice for children with complex medical problems or who have previously experienced an adverse event following immunisation. For example, Melbourne Vaccine Education Centre, New South Wales Specialist Immunisation Service, and Queensland Specialist Immunisation Service.

Media statements

AHPRA has made media statements about the following matters during the last month:

• AHPRA and Medical Board note Senate report 
  
  
• Update on the investigations into chemotherapy underdosing in South Australia – A number of notifications about chemotherapy underdosing in South Australia were received and nine matters about four medical practitioners and five pharmacists have been completed.

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Contacting the Board

• The Medical Board of Australia and AHPRA can be contacted by phone on 1300 419 495.
• For more information, see the Medical Board of Australia website and the AHPRA website.
• Lodge an enquiry form through the website under Contact us at the bottom of every web page.
• Mail correspondence can be addressed to: Dr Joanna Flynn AM, Chair, Medical Board of Australia, GPO Box 9958, Melbourne, VIC 3001.

More information

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 newsletters@ahpra.gov.au.

For registration enquiries or contact detail changes, call the AHPRA customer service team on 1300 419 495 (from within Australia).

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