Annual Report 2017/18 The National Boards: protecting the public

What's on this page

Aboriginal and Torres Strait Islander Health Practice Board of Australia Chinese Medicine Board of Australia Chiropractic Board of Australia Dental Board of Australia Medical Board of Australia Medical Radiation Practice Board of Australia Nursing and Midwifery Board of Australia Occupational Therapy Board of Australia Optometry Board of Australia Osteopathy Board of Australia Paramedicine Board of Australia Pharmacy Board of Australia Physiotherapy Board of Australia Podiatry Board of Australia Psychology Board of Australia Board governance and secretariat

The National Boards work with the support of AHPRA to ensure safe, quality healthcare across Australia. Guided by the National Law, the Boards make decisions about registrants who practise the regulated health professions.

The National Boards protect the community by making sure that only those practitioners who are suitably trained and qualified are registered.

The Boards' responsibilities include:

• setting standards that practitioners must meet in order to be registered
• making policy decisions, and
• investigating complaints and concerns raised about registered health practitioners.

Chairs for each National Board in 2017/18 are listed below.

Detailed information about each of the National Boards will be progressively published on this site.

Aboriginal and Torres Strait Islander Health Practice Board of Australia in 2017/18

A snapshot of the profession

641 Aboriginal and Torres Strait Islander Health Practitioners Up 5.4% from 2016/17 0.1% of all registered health practitioners

490 registered students Up 9.4% from last year

4 notifications lodged with AHPRA about Aboriginal and Torres Strait Islander Health Practitioners

0.6% of all registered Aboriginal and Torres Strait Islander Health Practitioners had notifications made about them

4 notifications closed this year: 25% resulted in conditions being imposed on an Aboriginal and Torres Strait Islander Health Practitioner's registration 75% resulted in no further action being taken

Immediate action was taken once

2 mandatory notifications were made: both were about impairment

9 Aboriginal and Torres Strait Islander Health Practitioners were monitored by AHPRA for health, performance and/or conduct during the year

62 cases were being monitored by AHPRA as at 30 June 2018 4 on the grounds of health 2 for performance 1 prohibited practitioner/student 55 for suitability/eligibility for registration

No statutory offence complaints were made; one was closed

Key works of the Board

Growing appreciation of the profession

There is a growing appreciation of the vital role that all Aboriginal and Torres Strait Islander health workers and registered Health Practitioners play in their roles as cultural brokers of, and contributors to, health improvements and outcomes in their communities.

Registered Aboriginal and Torres Strait Islander Health Practitioners are one profession under the same roof as the many other Aboriginal and Torres Strait Islander health professions. Registered Health Practitioners are employed in many different ways and roles across the country – some practise in a clinical setting and some do not. A registered Aboriginal and Torres Strait Islander Health Practitioner's scope of practice is most often determined by the job they are employed in.

The Aboriginal and Torres Strait Islander Health Practice Board of Australia's (the Board) job does not include promoting the profession or advocating for jobs. The Board's role is to protect the people in our communities from harm when receiving health services from registered Health Practitioners, using the same regulatory system as for doctors, nurses, physiotherapists and the other regulated health professions.

Engaging with stakeholders

The Board continues to work closely with the National Aboriginal and Torres Strait Islander Health Workers Association (NATSIHWA), supporting its efforts to promote all of the Aboriginal and Torres Strait Islander health professions, including registered Aboriginal and Torres Strait Islander Health Practitioners.

During the year, the Board heard from its many stakeholders as it continued its review of five registration standards – the rules detailing the requirements for initial and ongoing registration with the Board.

Growing the profession

The registered Aboriginal and Torres Strait Islander Health Practice profession continues to be a fast-growing profession in the National Scheme. Registrant numbers are small but are steadily increasing, as more graduates of approved programs of study register and begin their professional careers including using the protected title of 'Health Practitioner'.

The Board's committee, the Aboriginal and Torres Strait Islander Health Practitioner Accreditation Committee, is appointed to carry out the accreditation function of the National Law. They do this at arm's length from the Board. This committee continues to work tirelessly and with great dedication to ensure that all eligible education providers and programs of study can be considered for accreditation at the earliest opportunity.

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Chinese Medicine Board of Australia in 2017/18

A snapshot of the profession

4,882 Chinese medicine practitioners Up 0.5% from 2016/17 0.7% of all registered health practitioners

1,220 registered students Down 19.5% from last year

43 notifications lodged with AHPRA about Chinese medicine practitioners

1.5% of all registered Chinese medicine practitioners had notifications made about them

30 notifications closed this year: 10% resulted in conditions being imposed on a Chinese medicine practitioner's registration 3.3% resulted in a Chinese medicine practitioner receiving a caution or reprimand by the Board 3.3% resulted in suspension or cancellation of registration 83.3% resulted in no further action being taken

Immediate action was taken 5 times

3 mandatory notifications were made: all about standards

22 Chinese medicine practitioners were monitored by AHPRA for health, performance and/or conduct during the year

887 cases were being monitored by AHPRA as at 30 June 2018 5 on the grounds of conduct 4 for performance 2 prohibited practitioners/students 876 for suitability/eligibility for registration (suitability includes competency in speaking or otherwise communicating in English)

31 statutory offence complaints were made; 32 were closed Over half of new matters related to title protection The majority of the remaining matters related to advertising breaches

Key works of the Board

Advertising

During the year, a main focus for the Chinese Medicine Board of Australia (the Board) was ensuring practitioners were aware of their legal obligations concerning advertising. The Board worked with the AHPRA policy team to develop internal guidance for assessing advertising complaints and Chinese medicine-specific external guidance materials to help practitioners comply. To inform practitioners about the Board's expectations, the Board issued a position statement.

Communicating

Communication with the profession has been a priority, with the Board conducting a series of presentations in major cities and leading a teleconference and meeting for practitioners in rural/regional areas. The Board draws inspiration from its Chinese Medicine Reference Group.

The profession is concerned about lack of access to therapeutically useful scheduled Chinese medicinal herbs. The Board requested and received a joint submission from the profession and is now taking the first step, scoping a potential project. The Board met with representatives of the Therapeutic Goods Administration to foreshadow various matters related to Chinese herbs, including scheduling issues. It also published an update of the herbal nomenclature compendium of commonly used Chinese herbal medicines.

Accreditation

The Chinese Medicine Accreditation Committee continues to independently exercise accreditation functions under the National Law. It monitors approved programs and educational institutions. During this reporting year, the Board approved the Bachelor of Health Science in Traditional Chinese Medicine/ Bachelor of Arts in International Studies and Bachelor of Health Science in Traditional Chinese Medicine from the University of Technology Sydney.

Cross-professional work

In 2017/18, the Board participated in cross-professional work to prepare for revision and consulting on:

• registration standards for professional indemnity insurance arrangements, continuing professional development and recency of practice
• review of accreditation arrangements
• supervised practice framework
• advertising guidelines, and
• a shared code of conduct.

The Board farewelled with gratitude Professor Craig Zimitat, who had served on the Board since 1 July 2011. It welcomed new community member Mr David Brereton.

Find out more about these initiatives on the Chinese Medicine Board website. Refer to Appendix 5 to view revised standards and guidelines that came into effect during the year.

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Chiropractic Board of Australia in 2017/18

A snapshot of the profession

5,420 chiropractors Up 2.6% from 2016/17 0.8% of all registered health practitioners

2,209 registered students Up 36.9% from last year

91 notifications lodged with AHPRA about chiropractors

2.4% of all registered chiropractors had notifications made about them

120 notifications closed this year: 11.7% resulted in accepting an undertaking or conditions being imposed on a chiropractor's registration 21.7% resulted in a chiropractor receiving a caution or reprimand by the Board 1.7% resulted in suspension or cancellation of registration 44.2% resulted in no further action being taken The remaining 20.8% were referred to another body

Immediate action was taken 6 times

6 mandatory notifications were made: all were about standards

47 chiropractors were monitored by AHPRA for health, performance and/or conduct during the year

40 cases were being monitored by AHPRA as at 30 June 2018 6 on the grounds of conduct 4 for health reasons 8 for performance 6 prohibited practitioners/students 16 for suitability/eligibility for registration

33 statutory offence complaints were made; 31 were closed Over half of new matters related to title and practice protection The majority of the remaining matters related to advertising breaches

Key works of the Board

Engaging with stakeholders

AHPRA and the National Boards held a successful multi-profession stakeholder forum on responsible advertising in healthcare. The forum provided the latest updates on the broader Advertising compliance and enforcement strategy for the National Scheme and the resources continually being developed to support practitioners to comply with advertising obligations. Stakeholders also debated issues with representatives from consumer organisations, professional associations, insurers and other regulators.

The Chiropractic Board of Australia (the Board) also hosted several educational forums in various cities to provide information on continuing professional development (CPD) and assessing formal learning activities, and further clarifying any issues about advertising. The presentations from these forums were published on the Board's website for those unable to attend in person.

Consultations and reviews

Together with other National Boards, the Board consulted on a draft revised CPD registration standard and guidelines, reviewed accreditation arrangements and consulted on a new draft guideline for informing a National Board about where practitioners practise.

Enforcing the National Law

AHPRA and the Board successfully prosecuted an individual for unlawful use of the title 'chiropractor'. The Board and AHPRA continue to seek the strongest possible penalties under the National Law against anyone who falsely claims to be a registered chiropractor.

The Board also took strong action against a number of chiropractors on matters ranging from misleading advertising, to boundary violation and sexual misconduct.

Evidence-based regulation

Research into complaints against practitioners, including a specific comparison of notifications about chiropractors, osteopaths and physiotherapists for the 2011 to 2016 period, was presented by Dr Anna Ryan (practitioner member of the Board) and Associate Professor Marie Bismark at a Research Day held in Melbourne by AHPRA and the Health and Care Professions Council (HCPC) United Kingdom. It was aimed at developing a collaborative research relationship to drive regulatory improvements in both countries and lead the way internationally.

Over 90% of chiropractors, osteopaths and physiotherapists had no complaints made against them during the period. However, chiropractors were found to be at higher risk of complaints than osteopaths and physiotherapists and, consistent with research in other health professions, older practitioners and male practitioners were at increased risk of complaints independent of their profession.

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Dental Board of Australia in 2017/18

A snapshot of the profession

23,093 dental practitioners Up 3.2% from 2016/17 3.3% of all registered health practitioners

3,731 registered students Down 21.2% from last year

539 notifications lodged with AHPRA about dental practitioners 1 notification was made about a student

3.7% of all registered dental practitioners had notifications made about them

554 notifications closed this year: 15.3% resulted in accepting an undertaking or conditions being imposed on a dental practitioner's registration 14.3% resulted in a dental practitioner receiving a caution or reprimand by the Board 0.2% resulted in suspension or cancellation of registration 66.4% resulted in no further action being taken The remaining 3.8% were referred to another body or retained by a health complaints entity

Immediate action was taken 10 times

31 mandatory notifications were made: 27 about standards 3 about impairment 1 about sexual misconduct

173 dental practitioners were monitored by AHPRA for health, performance and/or conduct during the year

123 cases were being monitored by AHPRA as at 30 June 2018 12 on the grounds of conduct 17 for health reasons 66 for performance 6 prohibited practitioners/students 22 for suitability/eligibility for registration

55 statutory offence complaints were made; 56 were closed Three-quarters of new matters related to title and practice protection The majority of the remaining matters related to advertising breaches

Key works of the Board

Scope of practice review

In 2017, the Dental Board (the Board) began its scheduled review of the registration standard and the guidelines that establish the requirements for scope of practice for all registered dental practitioners.

As part of this review and in line with its obligations, the Board has consulted widely with stakeholders. On 22 March 2018, the Board released a public consultation paper on a proposed revised Scope of practice registration standard, a proposed revised Guidelines for scope of practice, and a new Reflective practice tool for scope of practice. Public consultation concluded in May 2018, with an overwhelming response. More than 1,100 submissions were received with a variety of views expressed.

The Board is committed to delivering well-informed advice to the Ministerial Council and anticipates providing its proposal for consideration later in 2018.

Professional assurance for practitioners

In October 2017, the Board hosted a roundtable conversation with members of the profession and the community. While different aspects of revalidation for dental practitioners were discussed, the Board has not yet decided to adopt any specific approach to revalidation.

Over the next three years, the Board will explore ways to support practitioners to maintain and enhance their professional skills and knowledge, and remain fit to practise. The first stage will be to commission research to identify the characteristics of 'at risk' and poorly performing practitioners. This research will help inform the Board's future direction and decision-making about dental practitioner professional assurance, ensuring it is effective, evidence-based and practical.

Outcome-based assessment model for overseas-trained dental specialists

Last year, as part of the Board's work program on specialist registration pathways for overseas-trained dental specialists, the Board and AHPRA engaged the Australian Dental Council (ADC) to develop an outcome-based assessment model for overseas-trained dental specialists applying for specialist registration in Australia.

The ADC recommended an assessment model based on the entry-level competencies for the dental specialties, applicable for all of the recognised dental specialties in Australia. The ADC has also developed a framework to support the implementation of the assessment model.

Next year, the Board will consider the ADC's recommendations and any other requirements needed to support future registration pathways for overseas-trained dental specialists.

Refer to Appendix 5 to view revised standards and guidelines that came into effect during the year.

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Medical Board of Australia in 2017/18

A snapshot of the profession

115,113 medical practitioners Up 3.6% from 2016/17 16.4% of all registered health practitioners

20,272 registered students Up 1.1% from last year

3,749 notifications lodged with AHPRA about medical practitioners 10 notifications were made about students

5.1% of all registered medical practitioners had notifications made about them

3,703 notifications closed this year: 7.8% resulted in accepting an undertaking or conditions being imposed on a medical practitioner's registration 6.7% resulted in a medical practitioner receiving a caution or reprimand by the Board 1.0% resulted in suspension or cancellation of registration 0.2% resulted in a fine 80.2% resulted in no further action being taken The remaining 4.1% were referred to another body or retained by a health complaints entity

Immediate action was taken 148 times 32 resulted in suspension of registration

255 mandatory notifications were made: 188 about standards 43 about impairment 5 about alcohol or drugs 19 about sexual misconduct

890 medical practitioners were monitored by AHPRA for health, performance and/or conduct during the year

1,692 cases were being monitored by AHPRA as at 30 June 2018 100 on the grounds of conduct 205 for health reasons 230 for performance 85 prohibited practitioners/students 1,072 for suitability/eligibility for registration

176 statutory offence complaints were made; 191 were closed Almost two-thirds of new matters related to title and practice protection The majority of the remaining matters related to advertising breaches

Key works of the Board

Professional Performance Framework

In 2017, the Medical Board of Australia (the Board) designed the Professional Performance Framework (the Framework) to help ensure that all registered medical practitioners in Australia practise competently and ethically.

The Framework builds on the findings of the Expert Advisory Group (EAG) on revalidation, which was appointed to advise the Board on approaches to support practitioners to maintain and enhance their professional skills and knowledge, and remain fit to practise medicine.

In August 2017, the Board accepted the evidence provided by the EAG and its recommendations. The Framework is the Board's response to the EAG's final report.

The Framework is integrated, builds on existing initiatives and is evidence-based. It has five pillars:

1. strengthened continuing professional development (CPD) requirements
2. active assurance of safe practice
3. strengthened assessment and management of practitioners with multiple substantiated complaints
4. guidance to support practitioners – regularly updated professional standards that support good medical practice, and
5. collaborations to foster a culture of medicine that is focused on patient safety, based on respect and encourages doctors to take care of their own health and wellbeing.

The Board has started working with the profession and others in the health sector to implement the Framework. During 2017/18, the Board held two stakeholder workshops, first to announce the Framework and later to discuss implementation issues. The Board is committed to ongoing consultation about the various elements of the Framework, many of which will involve continuing partnerships and shared commitment to constructive change.

External review of specialist colleges

The Board and AHPRA commissioned an independent review of specialist medical colleges' assessment of international medical graduates (IMGs) for specialist recognition in 2016/17. This was in line with one of the recommendations of the Snowball review¹ of the National Scheme.

The independent review by Deloitte Access Economics, was designed to evaluate and report on the performance of specialist colleges in applying standard assessments of IMG applications and to see whether colleges are meeting benchmarks set by the Board for timeframes for completion of assessments. Deloitte's report, delivered in 2017/18, found areas of excellence, widespread compliance with guidelines set by the Board, and identified some areas for improvement.

The Board's response to the recommendations is published on the Guides and reports page on the Medical Board website.

National training survey

During 2018, the Board started work on the national training survey (NTS). The NTS is being designed to better understand and improve the quality of medical education in Australia. It will gather feedback from doctors in training in Australia to:

• better understand the quality of medical training in Australia
• identify how to improve medical training in Australia, and
• recognise and deal with potential issues in medical training that could impact on patient safety, including environment and culture, unacceptable behaviours and poor supervision.

The Board is working with experts in the medical education and training sector in Australia on this project.

The NTS will run annually from 2019.

Intern preparedness survey

In 2017/18, the Board and the Australian Medical Council partnered to conduct an intern preparedness survey. The survey examined whether medical school had prepared interns for the role and responsibilities of being an intern.

The findings of the first survey are published on the Medical Board website. Another survey is planned for 2018.

Health advisory and referral services

The Board has been funding a network of doctors' health advisory and referral services for the past three years. The funding is around $2 million annually and is derived from the registration fees of all medical practitioners.

This national network of services is run at arm's length from the Board and AHPRA, and is coordinated by Doctors' Health Services Pty Ltd, a wholly owned subsidiary of the Australian Medical Association (AMA). Doctors and medical students in all states and territories have access to help and support through this network of services.

AHPRA, on behalf of the Board, extended the contract with the AMA for a further three years, ensuring ongoing services to practitioners and students in need of this support.

Other codes and guidelines

The Board has continued to work on a number of codes and guidelines during the year:

• Good medical practice – a code of conduct for doctors in Australia was reviewed and the Board has started to consult with stakeholders on the revised version.
• Guidelines for regulating medical practitioners who provide complementary and unconventional medicine and emerging treatments – the Board has also been developing these guidelines and will be consulting on them in 2018/19.
• Guideline for informing a National Board about where you practise – this guideline responds to changes in the National Law.

Improvements in managing notifications

The majority (80%) of notifications end up with a decision to take 'no further action'. Despite this, most medical practitioners find it very stressful to be the subject of a notification. Many notifiers also find the process difficult and are often dissatisfied with the results. We know this anecdotally and from our research with people involved in the notifications process.

During 2017/18, the Board worked with AHPRA to introduce a range of measures to improve the management of notifications by reducing the time involved, closing matters early if they did not pose a risk to the public and concentrating resources on high-risk matters. This included:

• employing 13 medical practitioners part-time from a range of specialties to provide clinical advice to inform the management of notifications
• centralising the triage of notifications by establishing committees of Board members who consider all notifications as they arrive and decide whether investigation is necessary; the Board also established a Notifications Committee: Assessment, made up of Board members from all states and territories who will undertake this triage function from 1 July 2018
• introducing specialised case management of complex cases to provide input into the investigation
• establishing 'fast-track' teams that investigate matters that only need a small amount of additional information to complete the investigation
• starting work to better understand and quantify the risk associated with each notification, to inform the management of the notification
• supporting projects to gather feedback from notifiers and practitioners and making changes to our processes, documentation and communication to improve their experience, and
• commissioning research into vexatious complaints, which confirmed that these are very rare. For more information, refer to the AHPRA website.

Sexual boundaries

The Board and AHPRA have continued to implement the recommendations in the Independent review of the use of chaperones to protect patients in Australia.

The Board has established a Sexual Boundaries Notifications Committee, made up of community and practitioner members with training in sexual boundary violations and related issues. The committee also audited all practitioners with conditions imposed on their registration as a result of a notification alleging a sexual boundary violation.

Over the year, the Board also reviewed and consulted on Sexual boundaries: Guidelines for doctors. The revised guidelines describe the standards that doctors are expected to meet. It will be finalised in the year ahead.

Refer to Appendix 5 to view revised standards and guidelines that came into effect during the year.

¹Visit the COAG Health Council website.

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Medical Radiation Practice Board of Australia in 2017/18

A snapshot of the profession

16,257 medical radiation practitioners Up 3.7% from 2016/17 2.3% of all registered health practitioners

4,424 registered students Up 13.6% from last year

24 notifications lodged with AHPRA about medical radiation practitioners

0.2% of all registered medical radiation practitioners had notifications made about them

24 notifications closed this year: 25.0% resulted in conditions being imposed on a medical radiation practitioner's registration 16.7% resulted in a medical radiation practitioner receiving a caution or reprimand by the Board 58.3% resulted in no further action being taken

Immediate action was taken twice

8 mandatory notifications were made: 5 about standards 2 about impairment 1 about sexual misconduct

17 medical radiation practitioners were monitored by AHPRA for health, performance and/or conduct during the year

108 cases were being monitored by AHPRA as at 30 June 2018 1 for conduct 6 for health reasons 4 for performance 2 prohibited practitioners/students 95 for suitability/eligibility for registration

7 statutory offence complaints were made; 8 were closed 6 of the new matters related to title and practice protection 1 related to advertising breaches

Key works of the Board

Leveraging off work already being done by the profession, in coming years the Board will continue its focus on professional practice and the benefits this brings to patients and the overall safety of the public. Impressive results from the annual audit show that medical radiation practitioners understand and comply with their ongoing obligations.

Increasingly, practitioners recognise that regulation supports many of the aims of professional practice. Discussion about, and support shown for, elements of regulation are a regular feature at professional conferences and industry seminars. Professionalism in practice is fast becoming a defining feature of the medical radiation profession.

In 2017/18, the Board identified some work it would do over and above the multi-profession policy and systems work being done by AHPRA.

Commencing a review of capabilities

The Professional capabilities for medical radiation practice describe the minimum capabilities for a registered medical radiation practitioner and were first developed and implemented in late 2013. In the latter half of 2017, the Board engaged a project team to start a review of these capabilities.

The first phase of the project was timed to link in with the review of accreditation standards being carried out by the Medical Radiation Practice Accreditation Committee.

Work continued in 2018, with the Policy Committee meeting with the project team to provide advice, guidance and feedback on the work to date.

Reviewing examination performance

Since its launch in January 2016, an exam has served as a pathway for those overseas-qualified practitioners who do not hold a qualification substantially equivalent to an approved qualification for general registration.

The effectiveness of the exam relies on the ability of each exam question to provide a useful indicator of capability. Preliminary analysis shows that the overall performance of the exam is a stable predictor of cognitive capability for practice.

Cost of regulation

The Board is aware of the financial impact that regulation imposes on practitioners. The Board has maintained a cautious and conservative approach to expenditure, while maintaining an adequate equity position, including through an ongoing deficit budget.

The Board publishes its annual Health Profession Agreement with AHPRA to ensure that cost allocation and administrative expenditure are transparent, so that the public and practitioners can see where the costs of registration are distributed.

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Nursing and Midwifery Board of Australia in 2017/18

A snapshot of nursing

398,596 nurses Up 3.1% from 2016/17 56.7% of all registered health practitioners 28,277 also hold registration in midwifery The number of dual registered nurses and midwives is down 2.3% from last year

97,361 registered students Up 5.7% from last year

1,612 notifications lodged with AHPRA about nurses 21 notifications were made about students

0.5% of all registered nurses had notifications made about them

1,580 notifications closed this year: 18.3% resulted in accepting an undertaking or conditions being imposed on a nurse's registration 15.5% resulted in a nurse receiving a caution or reprimand by the Board 1.3% resulted in suspension or cancellation of registration 0.3% resulted in a surrender of registration 0.1% resulted in a fine 62.3% resulted in no further action being taken The remaining 2.2% were referred to another body or retained by a health complaints entity

Immediate action was taken 192 times 64 resulted in suspension of registration

467 mandatory notifications were made: 330 about standards 93 about impairment 31 about alcohol or drugs 13 about sexual misconduct

1,157 nurses were monitored by AHPRA for health, performance and/or conduct during the year

1,523 cases about nurses were being monitored by AHPRA as at 30 June 2018 85 on the grounds of conduct 281 for health reasons 161 for performance 178 prohibited practitioners/students 818 for suitability/eligibility for registration

74 statutory offence complaints were made; 90 were closed Most new matters related to title protection

A snapshot of midwifery

33,486 midwives Down 0.2% from 2016/17 4.8% of all registered health practitioners Of the 33,486 midwives, 5,209 hold registration as a midwife only The number of practitioners who are registered only as a midwife is up 12.7% from last year

3,495 registered students Down 12.3% from last year

72 notifications lodged with AHPRA about midwives 6 notifications were made about students

0.3% of all registered midwives had notifications made about them

80 notifications closed this year:21.3% resulted in accepting an undertaking or conditions being imposed on a midwife's registration 20.0% resulted in a midwife receiving a caution or reprimand by the Board 58.8% resulted in no further action being taken

Immediate action was taken 8 times

8 mandatory notifications were made: 6 about standards 2 about alcohol or drugs

31 midwives were monitored by AHPRA for health, performance and/or conduct during the year

155 cases about midwives were being monitored by AHPRA as at 30 June 2018 3 on the grounds of conduct 4 for health reasons 9 for performance 2 prohibited practitioners/students 137 for suitability/eligibility for registration

1 statutory offence complaint was made; 5 were closed The new matter related to title protection

Key works of the Nursing and Midwifery Board of Australia

New codes of conduct

New codes of conduct for nurses and midwives took effect on 1 March 2018, after being released publicly in September 2017. The codes set out the legal requirements, professional behaviour and conduct expectations for all nurses and midwives in all practice settings. The codes were developed by the Nursing and Midwifery Board of Australia (NMBA) through extensive consultation with stakeholders and the nursing and midwifery professions, as well as literature and evidence reviews.

To help nurses and midwives understand the requirements in the codes, the NMBA launched its first video promoting the values and principles of the codes, and a vodcast presentation explaining the conduct expectations. Other resources were also developed by the NMBA, including conduct case studies and a fact sheet.

One critical element of the codes is the inclusion of 'Principle 3: Cultural practice and respectful relationships', with a domain dedicated to Aboriginal and Torres Strait Islander Peoples' health. The NMBA worked closely with the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives to develop this principle, which was further supported by a joint statement on culturally safe care, released on 1 February 2018. A second joint statement, the Joint statement on cultural safety: Nurses and midwives leading the way for safer healthcare, was released on 5 April 2018. It is endorsed by more than 25 leading nursing and midwifery organisations.

Adoption of international codes of ethics

The International Council of Nurses (ICN)'s ICN code of ethics for nurses and the International Confederation of Midwives (ICM)'s International code of ethics for midwives took effect as the guiding documents for ethical decision-making for nurses and midwives in Australia on 1 March 2018. The NMBA, Australian College of Midwives, Australian College of Nursing and Australian Nursing and Midwifery Federation agreed to adopt the ICN and ICM codes of ethics jointly, based on evidence from an academic literature review on ethical guiding documents and the mapping and analysis of the previous codes of ethics.

New midwife standards for practice: enabling midwifery care

The new Midwife standards for practice (the standards) were released on 1 May 2018 and replace the National competency standards for the midwife on 1 October 2018. The standards provide a framework for midwifery practice in all contexts. The standards are evidence-based and have been tested across a broad range of midwifery settings, including clinical, community and education, which means they are enabling and suitable for all midwives in all practice settings.

Seven interrelated standards are framed within a woman-centred approach and contain criteria that specify how the standard can be demonstrated. The standards reflect the midwife's continuous woman-centred professional relationship that may extend from preconception to the postnatal period, and acknowledge the role midwives play across the health system.

Successful audit of privately practising midwives

In late 2017, at the request of the Ministerial Council, the NMBA carried out an audit of privately practising midwives (PPMs) providing homebirth services against the NMBA's Safety and quality guidelines for privately practising midwives (SQG). PPMs providing homebirth services need to meet the requirements of the SQG to be exempt from holding professional indemnity insurance for homebirths under the National Law.

The outcomes of the audit show that the 101 PPMs who responded to the audit met all the audit requirements.

The audit demonstrates that an overwhelming majority of PPMs comply with all elements of the SQG in their private practice.

Consulting on prescribing

The NMBA worked with the Australian and New Zealand Council of Chief Nursing and Midwifery Officers (ANZCCNMO) to explore potential models of prescribing for nurses and midwives.

The Commonwealth Chief Nursing and Midwifery Officer held the Registered Nurse/Midwife Prescribing Symposium on 21 March 2017. From this symposium, a joint working group was established by the NMBA Board and ANZCCNMO, which released a discussion paper for public consultation in October 2017.

The consultation feedback supported the NMBA's current approach to autonomous midwifery prescribing and indicated there was no need to establish another pathway.

There was support for a supervised/designated prescribing model for registered nurses – with the preferred term being 'partnership'. It was also clear from feedback that the use of protocols and standing orders for the supply of medicines is captured at the undergraduate level of registered nurse education.

The NMBA is now consulting on a proposed Endorsement for scheduled medicines for registered nurses to prescribe in partnership.

Outcomes-based assessment of overseas-qualified nurses and midwives

In 2017/18, the NMBA continued its work to develop a new approach to the assessment of internationally qualified nurses and midwives (IQNM). Monash University was awarded the tender to develop an objective structured clinical examination (OSCE) for registered nurses and enrolled nurses. The NMBA is also undertaking a joint project with the New Zealand Midwifery Council to develop a multi-choice examination and OSCE for midwives.

The NMBA plans to begin the new model for the assessment of IQNMs in 2019.

Refer to Appendix 5 to view revised standards and guidelines that came into effect during the year.

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Occupational Therapy Board of Australia in 2017/18

A snapshot of the profession

20,975 occupational therapists Up 7.5% from 2016/17 3.0% of all registered health practitioners

8,079 registered students Up 2.0% from last year

34 notifications lodged with AHPRA about occupational therapists

0.3% of all registered occupational therapists had notifications made about them

34 notifications closed this year: 5.9% resulted in conditions being imposed on an occupational therapist's registration 26.5% resulted in an occupational therapist receiving a caution or reprimand by the Board 2.9% resulted in a fine 55.9% resulted in no further action being taken The remaining 8.8% were referred to another body or retained by a health complaints entity

Immediate action was taken 3 times

7 mandatory notifications were made: 4 about standards 1 about impairment 2 about alcohol or drugs

7 occupational therapists were monitored by AHPRA for health, performance and/or conduct during the year

57 cases were being monitored by AHPRA as at 30 June 2018 4 for health reasons 1 prohibited practitioner/student 52 for suitability/eligibility for registration

14 statutory offence complaints were made; 16 were closed All of the new matters related to title protection

Key works of the Board

New competency standards

The release of the new Australian occupational therapy competency standards (AOTCS) 2018 is a significant milestone for the Occupational Therapy Board of Australia (the Board). The new competency standards outline the professional behaviours all occupational therapists should demonstrate to practise safely and ethically.

The competency standards focus on four conceptual areas of occupational therapy practice:

• professionalism
• knowledge and learning
• occupational therapy process and practice, and
• communication.

They are supported by a number of practice behaviours that address specific core competencies.

Return to practice pathways project

At the start of 2017/18, the Board undertook to improve explanatory material on the Board's website. This review was done to provide greater guidance to practitioners on how they can meet the Board's Recency of practice registration standard. The guidance material includes new FAQ, a fact sheet and a diagram to help illustrate the material that practitioners need to submit with their application when there are questions as to whether they have adequate recent practice.

Stakeholder engagement

With the release of the new competency standards in early 2018, the Board has engaged with the profession, educators, the professional associations and its accreditation authority on what the new competency standards mean for them. The Board also met with heads of occupational therapy schools in June 2018 to discuss the use of the competency standards to ensure new graduates are meeting the standards expected of their peers.

Board members presented at forums hosted by Occupational Therapy Australia in May and June 2018. The Board continued its engagement program with education providers with a meeting in Perth to discuss student notifications and new graduate registration processes.

Registration standards review

During 2017/18, the Board continued to work with six other National Boards in reviewing core registration standards. The Board undertook public consultation on a draft revised Profession indemnity insurance arrangements registration standard, Continuing professional development registration standard and guideline and Recency of practice registration standard. The feedback received informed the final shape of the registration standards, which will be submitted for ministerial approval during 2018/19.

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Optometry Board of Australia in 2017/18

A snapshot of the profession

5,532 optometrists Up 3.5% from 2016/17 0.8% of all registered health practitioners

1,936 registered students Up 27.7% from last year

35 notifications lodged with AHPRA about optometrists

1.2% of all registered optometrists had notifications made about them

32 notifications closed this year: 21.9% resulted in accepting an undertaking or conditions being imposed on an optometrist's registration 12.5% resulted in an optometrist receiving a caution or reprimand by the Board 65.6% resulted in no further action being taken

No immediate action was taken

2 mandatory notifications were made: Both were about standards

14 optometrists were monitored by AHPRA for health, performance and/or conduct during the year

22 cases were being monitored by AHPRA as at 30 June 2018 2 on the grounds of conduct 1 for health reasons 6 for performance 1 prohibited practitioner/student 12 for suitability/eligibility for registration

6 statutory offence complaints were made; 7 were closedHalf of the new matters related to title protection Half related to advertising breaches

Key works of the Board

Engagement with stakeholders and the profession

The Optometry Board of Australia (the Board) hosted its annual Optometry Regulatory Reference Group meeting in October 2017, covering topics of mutual interest between education providers, accreditation bodies and regulators in both Australia and New Zealand.

In November 2017, the Board's Chair presented at the South Australia Blue Sky Congress 2017 on the current work of the Board. During the event, optometrists took the opportunity to meet Board members, asking them questions at their exhibition space.

The Chair attended the Optometrist and Dispensing Opticians Board of New Zealand's meeting in May 2018 in Wellington, New Zealand. This was an opportunity to share information and strengthen Trans Tasman relationships. In June, the Chair also attended the Association of Regulatory Boards of Optometry's (ARBO) Annual Meeting in Denver, Colorado, USA, providing an overview of Board activity and exchanging global ideas with other regulators.

Policy updates

In March 2018, National Boards consulted on the draft revised Registration standard for continuing professional development (CPD) and related guidelines. The Chair facilitated a CPD stakeholder information forum with the professional association, accreditation body and education providers in March 2018. The forum was an opportunity for stakeholders to learn about the public consultation and the proposed changes to the current registration standard for CPD.

In June 2018, the Board published the revised Endorsement for scheduled medicines registration standard and Guidelines for use of scheduled medicines, which came into effect on 10 September 2018. The registration standard and guidelines were updated as a result of a scheduled review, following wide-ranging public consultation in 2017. As part of the review, the Chair consulted with the peak eye healthcare professional bodies, Optometry Australia and the Royal Australian and New Zealand College of Ophthalmologists in October 2017. At this meeting, the Board clarified aspects of potential patient safety issues and the process for future changes to the list of medications that endorsed optometrists are qualified to prescribe.

Refer to Appendix 5 to view revised standards and guidelines that came into effect during the year.

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Osteopathy Board of Australia in 2017/18

A snapshot of the profession

2,389 osteopaths Up 7.1% from 2016/17 0.3% of all registered health practitioners

1,456 registered students Down 24.5% from last year

17 notifications lodged with AHPRA about osteopaths

1.4% of all registered osteopaths had notifications made about them

17 notifications closed this year: 17.6% resulted in accepting an undertaking or conditions being imposed on an osteopath's registration 5.9% resulted in an osteopath receiving a caution or reprimand by the Board 76.5% resulted in no further action being taken

Immediate action was taken once

1 mandatory notification was made About impairment

6 osteopaths were monitored by AHPRA for health, performance and/or conduct during the year

9 cases were being monitored by AHPRA as at 30 June 2018 1 for health reasons 3 for performance 1 prohibited practitioner/student 4 for suitability/eligibility for registration

5 statutory offence complaints were made; 7 were closed 2 of the new matters related to title protection 2 to advertising breaches 1 to an 'other' offence

Key works of the Board

Advertising

In response to the increase in the number of advertising complaints about osteopaths received in the last financial year, the Osteopathy Board of Australia (the Board) and AHPRA have an advertising compliance and enforcement strategy for managing complaints about advertising regulated health services. During the year, resources were developed including osteopathy-specific examples and a self-assessment tool. This approach helped osteopaths to be compliant with advertising.

International stakeholder relations

The Chair, several members and the Executive Officer attended the Osteopathic International Alliance conference in Auckland, New Zealand, in September 2017 and met with international regulators in osteopathy to share ideas, initiatives and research. The conference focused on osteopathy regulation, education, research and association leadership. At the conference the Chair presented on the challenges of delivering healthcare in a commercial environment. It was also an opportunity to discuss issues of mutual interest with other regulatory entities and stakeholders.

Capabilities for osteopathic practice

The Board is revising the current Capabilities for osteopathic practice. This is a major regulatory initiative for the Board for the current and following year. After preliminary consultation with targeted stakeholders in early 2017, the Board sought a provider to amend the draft revised Capabilities for osteopathic practice to address the feedback received in preliminary consultation and to finalise the document after public consultation. The Southern Cross University is the successful provider to develop the revised Capabilities for osteopathic practice.

A document for public consultation was drafted by the provider, which incorporated the preliminary consultation feedback.

Accreditation

In April 2018, the Board conducted public consultation on the future accreditation arrangements from mid-2019, when the current term of assignment of accreditation functions ends. In June 2018, the Board decided that the Australasian Osteopathic Accreditation Council (AOAC) should continue to exercise accreditation functions for the osteopathy profession. The Board looks forward to continuing the excellent working relationship with the AOAC.

Consultations

In April 2018, the Board published a public consultation paper on the draft guideline for informing the Board about where practitioners practise and it released a public consultation paper on the draft revised Professional capabilities for osteopathic practices seeking views on the knowledge, skills and professional attributes identified by the Board as entry-level capabilities.

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Paramedicine Board of Australia in 2017/18

Key works of the Board

The Paramedicine Board of Australia (the Board) was established under the National Law on 19 October 2017 and met for the first time on 30 October 2017. This was a critical step in bringing the paramedicine profession into the National Scheme with the start of regulation of the profession proposed to occur late in 2018.

As the paramedicine profession was not previously regulated in any jurisdiction, significant work was required to develop and implement the necessary regulatory infrastructure. The Board embarked on a rigorous program of work to achieve this, engaging extensively with stakeholders to ensure the smoothest possible transition of the profession into regulation.

With the support of Ministers, stakeholders and AHPRA, the Board developed a set of mandatory registration standards along with a registration standard to support the grandparenting of paramedics into the scheme. The Board also worked closely with AHPRA to develop detailed budget modelling and forecasting to support and sustain the regulation of paramedics in the National Scheme.

The Board adopted a number of interim codes and guidelines necessary to support regulation while simultaneously participating in cross-profession projects relating to the shared code of conduct, a revised supervision framework and registration standards for limited registration, revised guidelines for the advertising of health services and the National Scheme Aboriginal and Torres Strait Islander health strategy statement of intent.

None of this could have been achieved without the support and enthusiasm of a hardworking and cohesive Board and AHPRA staff, particularly Project Manager Deborah Tapping and Executive Officer Paul Fisher.

Posters for paramedics about the National Scheme

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Pharmacy Board of Australia in 2017/18

A snapshot of the profession

31,108 pharmacists Up 2.5% from 2016/17 4.4% of all registered health practitioners

6,487 registered studentsDown 14.0% from last year

451 notifications lodged with AHPRA about pharmacists 2 notifications were made about students

1.9% of all registered pharmacists had notifications made about them during the year

411 notifications closed this year:14.1% resulted in accepting an undertaking or conditions being imposed on a pharmacist's registration 29.7% resulted in a pharmacist receiving a caution or reprimand by the Board 0.2% resulted in suspension of registration 0.2% resulted in a fine 54.7% resulted in no further action being taken The remaining 1% were referred to another body or retained by a health complaints entity

Immediate action was taken 15 times

44 mandatory notifications were made:36 about standards 7 about impairment 1 about sexual misconduct

163 pharmacists were monitored by AHPRA for health, performance and/or conduct during the year

172 cases were being monitored by AHPRA
as at 30 June 201817 on the grounds of conduct 19 for health reasons 32 for performance 11 prohibited practitioners/students 93 for suitability/eligibility for registration

19 statutory offence complaints were made; 22 were closedOver half of the new matters related to title protection 8 related to advertising breaches

Key works of the Board

This year, the work of the Pharmacy Board of Australia (the Board) has built on key initiatives from 2016/17.

Pharmacy prescribing forum

Following the completion of a project on the mapping of the National Prescribing Service prescribing competencies framework against the learning outcomes of current pharmacy programs and the competency standards for pharmacists, the Board arranged a prescribing forum. A range of stakeholders attended and included representation from hospital and community pharmacy practice, government health departments, professional associations, state and territory pharmacy authorities, consumer organisations, education providers, the Board and AHPRA. The forum enabled attendees to consider the need and opportunities for expanding pharmacist involvement in prescribing that could be implemented and sustained as part of a broader range of health services that meet the health needs of the community effectively. The Board will publish a report outlining discussions on the day and next steps during the next reporting period.

Competency tools

To assist pharmacists to engage with the revised National competency standards framework for pharmacists in Australia 2016, the Board funded the development of tools which were published this year. The tools will assist pharmacists to plan their continuing professional development and meet their obligations, which are outlined in the Board's Registration standard: Continuing professional development.

Research and analysis

An Intern Year Blueprint was developed by the Australian Pharmacy Council (APC) with funding from the Board. The blueprint will become the framework used to determine future options for assessing pharmacy interns against the revised competency standards for pharmacists. The next steps in its implementation will be developing a strategy to determine the most appropriate and effective type of assessment for each competency from the range of choices described in the blueprint and to identify the organisation with the prime responsibility to develop and administer the assessment. This work will be carried out by a joint Board and APC working party next year.

Following a pilot survey of interns and preceptors conducted last year to investigate issues relevant to the quality of the intern training experience, the Board conducted a large-scale survey. The results of the survey will be analysed in the next year and are anticipated to guide policy development about future arrangements for supervision and are also likely to provide useful insights to be taken into account in reviewing assessment processes for interns.

Refer to Appendix 5 to view revised standards and guidelines that came into effect during the year.

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Physiotherapy Board of Australia in 2017/18

A snapshot of the profession

31,995 physiotherapists Up 5.4% from 2016/17 4.6% of all registered health practitioners

8,472 registered students Up 1.4% from last year

98 notifications lodged with AHPRA about physiotherapists

0.5% of all registered physiotherapists had notifications made about them during the year

82 notifications closed this year: 24.4% resulted in accepting an undertaking or conditions being imposed on a physiotherapist's registration 17.1% resulted in a physiotherapist receiving a caution or reprimand by the Board 56.1% resulted in no further action being taken The remaining 2.4% were retained by a health complaints entity

Immediate action was taken 5 times

17 mandatory notifications were made 12 about standards 2 about impairment 1 about alcohol or drugs 2 for sexual misconduct

47 physiotherapists were monitored by AHPRA for health, performance and/or conduct during the year

58 cases were being monitored by AHPRA as at 30 June 2018 9 on the grounds of conduct 3 for health reasons 10 for performance 3 prohibited practitioners/students 33 for suitability/eligibility for registration

37 statutory offence complaints were made; 47 were closed Over three-quarters of the new matters related to title protection 8 related to advertising breaches

Key works of the Board

As part of the Board's strategy to ensure every Australian has access to safe and reliable physiotherapy services, the Board has contributed to AHPRA's work occurring in partnership with Aboriginal and Torres Strait Islander health experts, to better health outcomes for Indigenous people.

Advertising

Seventy per cent of Australian physiotherapists work in private practice, so they often advertise the services they provide to the public. The National Law governs the advertising of regulated health services by all advertisers, including registered health practitioners. This year the Board, working with AHPRA and the other National Boards, developed a suite of tools to assist physiotherapists and all advertisers of regulated health services in ensuring that their advertising meets the requirements of the National Law.

Audits

No matter what context a physiotherapist works in, they must meet their professional obligations as set out in the National Law. Audits conducted by AHPRA happily indicate that physiotherapists are generally compliant with their professional obligations. Audits are conducted at random during the year and serve to validate physiotherapists' declarations, made when they renew their registration each year.

Engaging with stakeholders

This year, the Board worked closely with two of its important stakeholders – the Australian Physiotherapy Association (APA) and the Australian Physiotherapy Council. With the APA, the Board has clarified that physiotherapists who work with animals must meet the requirements based on their work with humans (not animals).

During the year, the Board worked with AHPRA to simplify the registration and registration renewal process for practitioners, trialling online registrations for new graduates.

The Board helped organise and presented at the International Physical Therapy Regulatory Authorities conference in South Africa, offering an opportunity to engage with international physiotherapy regulatory partners, to explain how health regulation works in Australia, compare data and discuss shared regulatory challenges. The shared Physiotherapy practice threshold statements developed by the Board and the Physiotherapy Board of New Zealand in 2015 and free for use worldwide are of interest and value to emerging regulators from other countries.

The Board held two successful stakeholder engagement breakfasts this year, in Darwin and Perth. These events help explain the role and work of the Board to physiotherapists and other stakeholders and are being rolled out across the country.

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Podiatry Board of Australia in 2017/18

A snapshot of the profession¹

5,155 podiatrists Up 4.7% from 2016/17 0.7% of all registered health practitioners

1,482 registered students Down 4.9% from last year

61 notifications lodged with AHPRA about podiatrists 2 notifications were made about students

1.6% of all registered podiatrists had notifications made about them during the year

41 notifications closed this year: 14.6% resulted in conditions being imposed on a podiatrist's registration 17.1% resulted in a podiatrist receiving a caution or reprimand by the Board 65.9% resulted in no further action being taken The remaining 2.4% were retained by a health complaints entity

No immediate action was taken

5 mandatory notifications were made: 2 about standards 2 about impairment 1 about alcohol or drugs

13 podiatrists were monitored by AHPRA for health, performance and/or conduct during the year

17 cases were being monitored by AHPRA as at 30 June 20183 for health reasons 3 for performance 1 prohibited practitioner/student 10 for suitability/eligibility for registration

5 statutory offence complaints were made; 9 were closed 2 of the new matters related to title protection 2 to advertising breaches 1 related to an 'other' offence

Key works of the Board

New registration standard

A highlight for the Podiatry Board of Australia (the Board) this year was receiving Ministerial Council approval for the Board's revised endorsement for scheduled medicines registration standard.

The revised registration standard, which comes into effect on 1 August 2018, expands the options for practitioners to have their registration endorsed for scheduled medicines by introducing a new contemporary pathway to endorsement. This pathway enables future graduates, from an accredited and approved program of study that has prescribing theory and practice integrated throughout the curriculum, to qualify for endorsement.

By introducing this new pathway to endorsement, the Board is putting the enabling infrastructure in place for reform of the podiatry curriculum. The Australian and New Zealand Podiatry Accreditation Council (ANZPAC) progressed work on developing accreditation standards that will set the requirements that education providers will need to meet to ensure their graduates have the necessary knowledge, skills and attributes to be safe and effective prescribers.

The Board hosted breakfast forums at association conferences in Melbourne, Sydney and the Gold Coast to inform practitioners about the requirements of the new registration standard and associated guidelines.

Infection prevention and control

The Board published a video on infection prevention and control for patients to help them understand what infection prevention and control measures to expect when visiting their podiatrist or podiatric surgeon. It was launched to coincide with International Infection Prevention Week and shows the key aspects of infection prevention and control practices that a podiatrist follows during a routine podiatry service.

Engaging with stakeholders

During the year the Board hosted a forum for practitioners in Hobart on themes identified through an analysis of complaints and/or concerns about podiatrists and podiatric surgeons. Other activities included meeting with:

• stakeholders in Hobart and Melbourne
• the President of the Podiatry Council of NSW
• the Podiatrists Board of New Zealand; and
• the Health and Care Professions Council (HCPC), the Professional Standards Authority and the Society of Chiropodists and Podiatrists in London.

Board representatives attended the CLEAR (Council on Licensure Enforcement and Regulation) International Congress in Melbourne and the World Health Professions Regulation Conference in Geneva, Switzerland.

Refer to Appendix 5 to view revised standards and guidelines that came into effect during the year.

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Psychology Board of Australia in 2017/18

A snapshot of the profession

36,376 psychologists Up 4.0% from 2016/17 5.2% of all registered health practitioners

437 notifications lodged with AHPRA about psychologists

1.9% of all registered psychologists had notifications made about them during the year

381 notifications closed this year: 11.5% resulted in accepting an undertaking or conditions being imposed on a psychologist's registration 10.2% resulted in a psychologist receiving a caution or reprimand by the Board 1.3% resulted in suspension or cancellation of registration 76.4% resulted in no further action being taken The remaining 0.5% were retained by a health complaints entity or referred to another body

Immediate action was taken 18 times

52 mandatory notifications were made 35 about standards 11 about impairment 6 about sexual misconduct

156 psychologists were monitored by AHPRA for health, performance and/or conduct during the year

140 cases were being monitored by AHPRA as at 30 June 2018 35 on the grounds of conduct 12 for health reasons 23 for performance 15 prohibited practitioners/students 55 for suitability/eligibility for registration

117 statutory offence complaints were made; 145 were closed Over 89% of the new matters related to title protection 12 related to advertising breaches

Key works of the Board

Approval of accreditation standards

In August 2017, the Psychology Board of Australia (the Board) approved revised Accreditation standards for psychology programs. The Australian Psychology Accreditation Council is appointed as an external accreditation entity under the National Law to develop accreditation standards and recommend them to the Board for approval.

The new standards will be used to assess whether a program of study, and the education provider that provides the program of study, equips graduates of the program with the knowledge, skills and professional attributes to practise in the profession.

Education and training reform

This year the Board completed the first stage of its education and training reform agenda and finalised its proposal to retire the 4+2 Internship program.

Over the year, the Board consulted extensively with major employers of 4+2 interns, government, education providers, health services, students and members of the profession.

The Board also hosted a forum in Sydney and a national webinar to talk about its proposal. These events were collectively attended by over 600 participants.

Reviews of standards, codes and guidelines

In addition to project work, the Board undertook a number of scheduled reviews of its standards, codes and guidelines.

The Board completed a review of the Guidelines for supervisor and supervisor training providers, as well as a cross-profession review of the Professional indemnity insurance arrangements registration standard. The Board continues to consult on the Guidelines on area of practice endorsements, which were impacted by the release of the new accreditation standards.

The Board is also participating in a review of the Australian Psychological Society code of ethics, which the Board has adopted for the profession.

Regulation and collaboration

In August 2017, the Board hosted an All Psychology Boards meeting in Sydney. This was the second time the National Board and regional boards have met as a group since the Scheme began in 2010. The first All Psychology Boards meeting was in 2014. All national and regional board members participated, along with members of the Psychology Council of NSW and senior AHPRA staff.

The meeting focused on the work of the national and regional boards in regulating the psychology profession and provided an opportunity to reflect on the Board's role, approach to regulation, and major strategic projects.

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Board governance and secretariat

Supporting Boards

AHPRA provides policy advice and executive and secretariat support to all 15 National Boards, state, territory and regional boards and national committees, and the Agency Management Committee and its committees. The tools in ensuring that Board and committee operations remain effective, efficient and support good decision-making under the National Law include:

• the Board members' manual, a guide for all members to assist them in understanding their roles and discharging their regulatory responsibilities, and which outlines key policy, procedural and administrative arrangements for the calling, conduct and management of meetings
• standard formats for key Board and committee documentation and meeting papers, and
• consistent procedural arrangements for secretariat and meeting management processes.

The Board services unit has portfolio responsibility for the development and oversight of the orientation and professional development program for Board and committee members, and for Board effectiveness reviews.

All new National Board members are provided with an orientation to the National Scheme and to the Board(s) to which they have been appointed, usually before they attend their first meeting. This is a full-day session aimed at giving members an overview of the National Scheme, its legislative and governance frameworks, the interplay between the entities in the National Scheme and the role of regulatory boards in that environment. This is complemented by further Board-specific orientation activities and briefings, coordinated through the Board's Executive Officer (employed by AHPRA to act as liaison to the Board).

In 2017/18, orientation sessions were delivered to 22 new National Board members who took up their appointments during that period. We were pleased to welcome nine members of the newly constituted Paramedicine Board of Australia as part of this cohort.

With the assistance of external provider Effective Governance, a customised two-day professional development program, Governance and decision-making in the National Scheme, has been developed and is now offered and delivered to members, usually within 6–12 months of their appointment. Key AHPRA staff engaged in working with Boards are also invited to attend to further strengthen our collaboration and partnership.

In 2017/18, 16 National Board members and senior AHPRA staff attended the two sessions offered.

2017/18 also saw the development and piloting of a one-day version of this program specifically tailored to the needs of our regulatory decision-makers on state and territory boards. In collaboration with the Medical Board of Australia, this program has been made available to members of three of the state and territory boards, with delivery to the remaining five boards scheduled for early 2018/19.

A key achievement in 2017/18 was the roll-out of Diligent Boards, a secure, robust, reliable electronic meeting document delivery platform, to replace the previous system. Implementation was concluded on schedule in October 2017, with training conducted for over 40 staff and 250 Board members nationally. The Diligent platform now supports over 750 Board member and staff users.

Secretariat support for Boards and committees

Board Services staff across Australia are responsible for the provision of secretariat and governance support to the National Boards, their committees and other delegates to enable robust, harmonised decision-making aligned with agreed approaches to risk-based regulation and the regulatory principles. Timely, complete and accurate meeting support and record-taking services are provided for all meetings.

To deliver this service, Board Services works closely with all Executive Officers and National Board and committee Chairs, and liaises closely with staff across all directorates to ensure that members are supported in undertaking their decision-making roles under the National Scheme.

Looking to the future

To find out more about the National Boards' structure, meetings of Boards and committees and National Board consultations in 2017/18, refer to the appendices.

Appendices

Appendix 1: Structure of the National Boards

National Board	National committees	Regional boards	State and territory boards	State and territory/regional committees
ATSIHPBA	Immediate Action Committee1 Registration and Notifications Committee	N/A	N/A	N/A
CMBA	Immediate Action Committee1 Policy, Planning and Communications Committee Registration and Notifications Committee	N/A	N/A	N/A
ChiroBA	Immediate Action Committee1 Registration, Notifications and Compliance Committee When required: Accreditation, Assessment and Education Working Group Communications and Relationships Working Group CPD Working Group Governance, Finance and Administration Working Group Regulatory Policy and Standards Working Group Statutory Offences Unit Liaison Group	N/A	N/A	N/A
DBA	Accreditation Committee Conscious Sedation Advisory Panel Equivalence Assessment Panel for overseas-trained dental specialists Expert Reference Group – Specialist Recency of Practice Advisory Panel	N/A	N/A	Immediate Action Committee (excluding NSW) Registration Committee (NSW only) Registration and Notifications Committee (excluding NSW)
MBA	Finance Committee Queensland Triage and Assessment Committee Western Triage and Assessment Committee National Training Survey Advisory Group National Training Survey Steering Committee Professional Performance Framework Implementation Working Group Sexual Boundaries Notifications Committee (commenced 6 July 2017)	N/A	All states and territories	Health Committee in Vic and WA Immediate Action Committee (excluding NSW) Notifications Committees (excluding NSW) Registration Committee (all jurisdictions)
MRPBA	Immediate Action Committee1 National Examination Committee Overseas Qualifications Assessment Committee (until December 2017) Registration and Notifications Committee Strategy and Policy Committee	N/A	N/A	N/A
NMBA	Finance, Governance and Communications Committee Program Approval Committee Registration and Notifications Committee State and Territory Chairs' Committee	N/A	All states and territories	Immediate Action Committee (excluding NSW) When required: Notifications Committee (excluding NSW) Registration Committee
OTBA	Accreditation and Assessment Working Group Communications and Relationships Working Group Finance and Governance Working Group Immediate Action Committee1 Registration and Notifications Committee	N/A	N/A	N/A
OptomBA	Finance and Risk Committee Immediate Action Committee1 Policy and Education Committee Registration and Notifications Committee Scheduled Medicines Advisory Committee Statutory Offences Unit Liaison Group	N/A	N/A	N/A
OsteoBA	Immediate Action Committee1 Registration and Notifications Committee Statutory Offences Unit Liaison Group	N/A	N/A	N/A
ParaBA (from October 2017)	N/A	N/A	N/A	N/A
PharmBA	Finance, Risk and Governance Committee Immediate Action Committee Notifications Committee Policies, Codes and Guidelines Committee Registration and Examinations Committee	N/A	N/A	N/A
PhysioBA	Continuous Improvement Committee Immediate Action Committee1 Registration and Notifications Committee	N/A	N/A	N/A
PodBA	Immediate Action Committee1 Registration and Notifications Committee Strategic Planning and Policy Committee	N/A	N/A	N/A
PsyBA	Examination Committee Governance Working Group (including Finance) Psychology Immediate Action Committee (from February 2018) Regulatory Risk Working Group	ACT, Tas and Vic NT, SA and WA	NSW Qld	ACT/Tas/Vic Immediate Action Committee (until February 2018) NT/SA/WA Immediate Action Committee (until February 2018) Qld Immediate Action Committee (until February 2018)

Appendix 2: Meetings of Boards and committees

The table below details the number of National Board, national committee, state/territory board and committee meetings held during 2017/18. Each Board has different committee structures to support their day-to-day regulatory decision-making and policy work, largely determined by both the volume and risk profile of the tasks (see Appendix 1).

The purposes of committees vary, and include decision-making about individual practitioners (e.g. registration, notifications, immediate action and compliance matters) and policy-oriented committees looking at standards, codes and guidelines for the profession.

All of the meetings listed below as either state/territory board or state/territory committee, along with the majority of national committee meetings, were engaged in regulatory decision-making affecting individual practitioners. Numbers include out-of-sessions and immediate action committee meetings where those occurred.

National Board	National Board meetings	National committee meetings	Total national meetings	State/territory board meetings	State/territory committee meetings	Total state/territory meetings	Total
ATSIHPBA	5	13	18				18
CMBA	12	47	59				59
ChiroBA	15	45	60				60
DBA	13	22	35		116	116	151
MBA	17	63	80	130	707	837	917
MRPBA	11	29	40				40
NMBA	19	50	69	116	482	598	667
OTBA	13	34	50				50
OptomBA	12	27	39				39
OsteoBA	14	21	35				35
ParaBA	14	N/A	14				14
PharmBA	12	109	121				121
PhysioBA	12	66	78				78
PodBA	15	23	38				38
PsyBA	11	18	29	67	32	99	128
Total	198	567	765	313	1,337	1,650	2,415

Appendix 3: Attendance at meetings of the Agency Management Committee and its subcommittees

The table below sets out how many meetings of the Agency Management Committee and its subcommittees each member attended in the 2017/18 financial year, compared with the total number of meetings those members were eligible to attend. Agency Management Committee members who left or joined during the financial year have a smaller number of meetings that they were eligible to attend. Not all Agency Management Committee members are members of each subcommittee. Non-Agency Management Committee members have also been appointed to its subcommittees, including National Board Chairs and members.

Meeting attendance

Name	Number of meetings attended/eligible to attend
Agency Management Committee
Mr Michael Gorton AM, Chair	10/11
Ms Philippa Smith AM	09/11
Adjunct Prof. Karen Crawshaw PSM	10/11
Ms Jenny Taing	09/11
Ms Barbara Yeoh AM	10/11
Mr Ian Smith PSM	09/11
Dr Susan Young	11/11
Dr Peggy Brown AO	10/11
Regulatory Performance Committee (formerly the Performance Committee)
Dr Peggy Brown AO, Chair	02/02
Dr Susan Young	02/02
Adjunct Prof. Karen Crawshaw PSM	02/02
Ms Philippa Smith AM	01/02
Dr Joanna Flynn AM	02/02
Assoc. Prof. Lynette Cusack	02/02
Mr William Kelly	02/02
Dr John Lockwood AM	02/02
Prof. Brin Grenyer	02/02
Mr Ian Bluntish	02/02
Mr Mark Bodycoat	01/02
Finance, Audit and Risk Management Committee
Ms Barbara Yeoh AM, Chair	05/05
Mr Ian Smith PSM	03/05
Ms Jenny Taing	02/02
Mr David Balcombe	05/05
Ms Kim Jones	05/05
Ms Allyson Warrington	02/02
Mr Anthony Evans	01/02
Remuneration Committee
Mr Michael Gorton AM, Chair	02/02
Adjunct Prof. Karen Crawshaw PSM	02/02
Mr Ian Smith PSM	02/02
Ms Jenny Taing	02/02
Dr John Lockwood AM	02/02
Performance Committee (superseded)
Mr Michael Gorton AM, Chair	02/02
Dr John Lockwood AM	02/02
Dr Peggy Brown AO	01/02
Mr Ian Bluntish	02/02
Dr Joanna Flynn AM	01/02
Ms Jenny Taing	01/02

Appendix 4: National Board consultations

National Board	Consultations completed July 2017–June 2018
All National Boards	Review of accreditation arrangements – assignment of accreditation functions Released: 17 April 2018 Closed: 14 May 2018 Draft guideline for informing a National Board about where you practise Released:13 April 2018 Closed: 25 May 2018
ATSIHPBA	Changes to the rules for being a registered Aboriginal and/or Torres Strait Islander Health Practitioner Draft revised registration standards for professional indemnity insurance arrangements, continuing professional development and recency of practice and guidelines for continuing professional development Released: 13 March 2018 Closed: 4 May 2018
CMBA	Draft revised registration standards for professional indemnity insurance arrangements, continuing professional development and recency of practice and guidelines for continuing professional development Released: 13 March 2018 Closed: 4 May 2018
ChiroBA	Draft revised registration standard and guidelines for continuing professional development Released: 13 March 2018 Closed: 4 May 2018
DBA	Proposed revised scope of practice registration standard and guidelines for scope of practice Released: 22 March 2018 Closed: 14 May 2018
MBA	Consultation on proposed changes to sexual boundaries guidelines Released: 29 January 2018 Closed: 29 March 2018 Consultation on good medical practice – a code of conduct for doctors in Australia Released: 13 June 2018 Closed: 3 August 2018
MRPBA	Nil
NMBA	Midwife standards for practice Released: 3 July 2017 Closed: 25 August 2017 Registered nurse and midwife prescribing – discussion paper Released: 30 October 2017 Closed: 22 December 2017 Decision-making framework – benchmarking consultation survey Released: 23 January 2018 Closed: 9 March 2018 Re-entry to practice policy – practitioner consultation survey Released: 11 April 2018 Closed: 25 April 2018 Re-entry to practice policy – Government and health consultation service survey Released: 15 May 2018 Closed: 10 June 2018
OTBA	Draft revised registration standards for professional indemnity insurance arrangements, continuing professional development and recency of practice and guidelines for continuing professional development Released:13 March 2018 Closed: 4 May 2018
OptomBA	Draft revised registration standard and guidelines for continuing professional development Released: 13 March 2018 Closed: 4 May 2018
OsteoBA	Nil
PharmBA	Nil
ParaBA	Proposed registration standards – English language skills, criminal history, professional indemnity insurance arrangements, continuing professional development (and supporting guidelines), recency of practice, grandparenting arrangements Released: 19 December 2017 Closed: 8 February 2018
PhysioBA	Nil
PodBA	Nil
PsyBA	Proposal to retire the 4+2 internship pathway to general registration Released: 29 March 2018 Closed: 1 June 2018 Review of professional indemnity insurance arrangements registration standard Released: 13 March 2018 Closed: 4 May 2108 National psychology examination curriculum review Released: 7 July 2017 Closed: 1 September 2017

Appendix 5: Approved registration standards, codes and guidelines

For the reporting period 1 July 2017 to 30 June 2018, a number of registration standards for the 16 health professions in the National Scheme were submitted for approval by the Ministerial Council in accordance with the National Law.

Codes and guidelines were also developed and approved by the relevant National Boards.

Prior to approval, there must be public consultation on the proposed registration standards, codes and guidelines.

Registration standards, codes and guidelines are developed by the relevant National Board in accordance with the National Law and AHPRA's Procedures for the development of registration standards, codes and guidelines. You can find out more about these procedures on the Procedure page of the AHPRA website.

Chinese Medicine Board of Australia

Registration standard, code or guideline	Approved by	Date of approval	Status
Guidelines for safe practice of Chinese herbal medicine	CMBA	2015	Effective from 12 November 2017

For more information about codes, guidelines and policies for Chinese medicine, visit the Codes and Guidelines page on the Chinese Medicine Board website.

Dental Board of Australia

Registration standard, code or guideline	Approved by	Date of approval	Status
Dental list of recognised specialties, related specialist titles and definitions	Ministerial Council	11 July 2017	Effective from 1 October 2017

For more information about policies, codes and guidelines for the dental profession, visit the Codes and Guidelines page on the Dental Board website.

Medical Board of Australia

Registration standard, code or guideline	Approved by	Date of approval	Status
Granting general registration to medical practitioners who hold an Australian Medical Council certificate registration standard	MBA	1 September 2017	Effective from 15 February 2018
Registration standard for specialist registration	MBA	1 September 2017	Effective from 1 June 2018

For more information about registration standards for the medical profession, visit the Registration Standards page on the Medical Board website.

For more information about codes, guidelines and policies for the medical profession, visit the Codes, Guidelines and Policies page on the Medical Board website.

Nursing and Midwifery Board of Australia

Registration standard, code or guideline	Approved by	Date of approval	Status
Code of conduct for nurses	NMBA	27 July 2017	Effective from 1 March 2018
Code of conduct for midwives	NMBA	27 July 2017	Effective from 1 March 2018
Midwife standards for practice	NMBA	22 March 2018	Effective from 1 October 2018

For more information about codes and guidelines for nursing and midwifery, visit the Professional Codes and Guidelines page on the Nursing and Midwifery Board website.

Optometry Board of Australia

Registration standard, code or guideline	Approved by	Date of approval	Status
Endorsement for scheduled medicines registration standard	Ministerial Council	31 May 2018	Effective from 10 September 2018
Guidelines for use of scheduled medicines	OptomBA	31 May 2018	Effective from 10 September 2018

For more information about codes, guidelines and policies for optometry, visit the Codes, Guidelines and Policies page on the Optometry Board website.

Paramedicine Board of Australia

Registration standard, code or guideline	Approved by	Date of approval	Status
Continuing professional development registration standard	Ministerial Council	13 April 2018	Effective from 17 May 2018
Criminal history registration standard	Ministerial Council	13 April 2018	Effective from 17 May 2018
English language skills registration standard	Ministerial Council	13 April 2018	Effective from 17 May 2018
Professional indemnity insurance arrangements registration standard	Ministerial Council	13 April 2018	Effective from 17 May 2018
Recency of practice registration standard	Ministerial Council	13 April 2018	Effective from 17 May 2018
Grandparenting registration standard	Ministerial Council	13 April 2018	Effective from 17 May 2018
Code of conduct for paramedics (interim)	ParaBA	15 June 2018	Effective from 15 June 2018
Guidelines for mandatory notifications (interim)	ParaBA	15 June 2018	Effective from 15 June 2018
Guidelines for advertising regulated health services (interim)	ParaBA	15 June 2018	Effective from 15 June 2018
Guidelines for continuing professional development	ParaBA	17 May 2018	Effective from 17 May 2018
Social media policy (interim)	ParaBA	15 June 2018	Effective from 15 June 2018

For more information about registration standards for paramedicine, visit the Registration standards page on the Paramedicine Board website.

For more information about codes, guidelines and policies for paramedicine, visit the Codes, guidelines and policies page on the Paramedicine Board website.

Pharmacy Board of Australia

Registration standard, code or guideline	Approved by	Date of approval	Status
Section 6.2 – Compounding of sterile injectable medicines of the Guidelines on compounding of medicines	PharmBA	23 June 2017	Effective from 1 February 2018

For more information about codes, guidelines and policies for pharmacy, visit the Codes, Guidelines and Policies page on the Pharmacy Board website.

Podiatry Board of Australia

Registration standard, code or guideline	Approved by	Date of approval	Status
Registration standard: Endorsement for scheduled medicines	Ministerial Council	2 February 2018	Effective from 1 August 2018
Guidelines: Endorsement for scheduled medicines	PodBA	28 July 2017	Effective from 1 August 2018

For more information about policies, codes and guidelines for podiatry, visit the Policies, Codes and Guidelines page on the Podiatry Board website.