Health practitioners encouraged to seek advice about their own health

04 Dec 2019

Mandatory notifications are an important part of patient safety. We need to know when patients may be at substantial risk of harm from a registered health practitioner.

We also want to ensure that practitioners with health issues feel safe to seek treatment without fear of an unnecessary mandatory notification being made about them. A practitioner with a health issue, on its own, does not require a mandatory notification.

New resources have been published to explain mandatory notifications and when they do and do not need to be made, in preparation for new requirements that take effect in early 2020. Produced by Ahpra and the National Boards regulating Australia’s health practitioners, the resources aim to support practitioners to understand changes to the law about mandatory notification requirements which were made by Health Ministers.

‘Healthy practitioners are good for patient safety. We want all registered practitioners to know what the changes mean for them and to seek advice and support for their own health and wellbeing, without fear of an unnecessary mandatory notification,’ said Ahpra CEO Mr Martin Fletcher.

The resources explain that there are very specific circumstances when a treating practitioner needs to report: when an impairment, intoxication at work or practice that departs significantly from accepted standards places the public at substantial risk of harm.

Mr Fletcher said it has been essential to hear directly from treating health practitioners to understand their concerns and address barriers to people seeking help when they need it.

‘After listening to practitioners, we understand their fears about mandatory notifications and the changes to the legislation. When a practitioner has a health issue, people want to know what is, and what is not, a trigger for a mandatory notification,’ he added.

‘We want to work together, to address any confusion and create the culture and leadership needed to support practitioners and make mandatory notifications easier to understand. These resources aim to both ensure patient safety and support practitioner wellbeing,’ he said.

Medical Board of Australia Chair Dr Anne Tonkin said the resources aimed to reduce practitioners’ anxiety about mandatory notifications.

‘Some practitioners are really worried about seeking care for a health issue, because of unnecessary concerns about mandatory reporting,’ Dr Tonkin said.

‘I would hate any doctor to hesitate to seek help because of this worry. We only need to know about a practitioner’s health issue when there is a substantial risk to the public and this is very rare,’ she said.

Chair of the Nursing and Midwifery Board of Australia, Associate Professor Lynette Cusack, said that health practitioners need to know that they can take care of their own health as part of their professional life.

‘Australia’s 411,216 nurses and midwives are relied on to take care of the health of others and need to take care of their own health in the same way other Australians do. As the regulator, we want to bust the myth that a practitioner will lose their registration for seeking advice about their own health.’

Federal Secretary of the Australian Nursing and Midwifery Federation, Ms Annie Butler, said ‘I welcome the progress we are seeing to help practitioners understand how mandatory notifications work. It benefits all of us when practitioners are supported, and Ahpra and ANMF state and territory branches are working hard to provide that support. We all want practitioners to feel that they can seek help for their health when they need to, so they can continue to provide patients with safe and effective care.’

President of the Federal Australian Medical Association, Dr Tony Bartone, said ‘the health of our colleagues is, and will always be, of paramount concern. Any barrier to a doctor who is unwell seeking help must be overcome and should be a continuing focus for all of us. These resources will help to overcome some of the fear and confusion about mandatory reporting.’

The new resources are available on a hub on the Ahpra website and include a resource kit with two videos, social media posts and graphics that can be shared. Additional resources will be added to the hub in advance of the changes coming into effect in early 2020. This includes the revised Guidelines on mandatory notifications, which were recently consulted on.

What are the legal changes to mandatory notifications?

The changes only apply to when a treating practitioner must make a mandatory notification. They do not affect the obligations of other registered practitioners, employers or education providers.

The threshold for a mandatory notification by treating practitioners has been raised, so the circumstances for when they need to make a mandatory notification are more limited than for other types of notifiers. A mandatory notification by a treating practitioner about their practitioner-patient is now only required when there is a substantial risk of harm to the public. This is a very high threshold for reporting and will rarely apply.

There is no change to the reporting threshold for when non-treating practitioners or employers or education providers must make a mandatory notification.

Background

• Ahpra works in partnership with 15 National Boards to regulate Australia’s 740,000 registered health practitioners across 16 professions. Their primary role is to protect the public through the National Registration and Accreditation Scheme, a national system of regulation that sets national standards that all registered practitioners must meet. All registered practitioners are listed on an online register.
• The regulated, or registered, health professions in Australia that are regulated under the National Registration and Accreditation Scheme are: Aboriginal and Torres Strait Islander Health Practice, Chinese medicine, chiropractic, dental, medical, medical radiation practice, midwifery, nursing, occupational therapy, optometry, osteopathy, paramedicine, pharmacy, physiotherapy, podiatry, and psychology.
• The proportion of mandatory notifications made to National Boards and Ahpra is small. Data from 2018/19 shows that out of a total of 15,858 notifications, 1,807 mandatory notifications (11%) were made across Australia. Of the 1,749 mandatory notifications received by Aphra and the Health Professional Councils Authority (HPCA) in NSW, only 419 mandatory notifications (24%) were made about impairment. This is just under 3% of notifications received by those organisations for the year. The remainder of the mandatory notifications related to other notifiable conduct such as intoxication, sexual misconduct or substandard practice.
• While registered health practitioners and employers have mandatory reporting obligations under the National Law, many of the concerns received by Ahpra and National Boards are made voluntarily by patients or their families.
• The new resources being released today were developed from discussions and focus groups with treating health practitioners, registered students, professional associations, indemnity insurers, jurisdictions and others.
• The National Law amendments to mandatory notifications have not yet commenced – they are expected to take effect in early 2020 and will apply in all states and territories except Western Australia, where mandatory notification requirements will not change.  

For further information

Visit the new mandatory notifications resource hub 

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