We monitor five streams:

• conduct
• health
• performance
• prohibited practitioner/student
• suitability/eligibility.

When we receive a notification that raises serious concerns about a practitioner’s conduct or performance, Boards consider whether there are additional things that a practitioner can do, or if there are checks and balances that can be put in place so that they can practise safely.

Only a small number of notifications are so serious that the practitioner is not permitted to practise.

Where a Board needs additional assurance, it may impose restrictions on the practitioner’s registration. For example, a practitioner who is the subject of an allegation of sexual misconduct for conducting a physical examination that is not clinically indicated or that the patient has not consented to may be prohibited from contact with patients of a particular assigned sex or gender.

A practitioner with this restriction must not practise until we determine that there are systems in place at their practice location that will ensure their compliance. The restrictions are published on the Register of practitioners. The practitioner must report on all the patients they have had contact with on a regular basis.

We then monitor the practitioner’s compliance by checking that the:

• practice location is suitable and has sufficient systems in place to monitor compliance
• practice staff and a senior person at each practice location understand the requirements of the restriction
• practitioner’s information about the practice location is accurate; for example, by visiting practice locations
• practitioner has not had prohibited contact with patients of the assigned sex or gender.

Where applicable, we also receive reports from Medicare and the Pharmaceutical Benefits Scheme about patients seen by the practitioner.

We recognise that having to comply with restrictions can be confusing and stressful for practitioners. We publish additional guidance to help practitioners understand our processes.

Conditions, undertakings and restrictions

Where a Board imposes the requirements, we use the term ‘conditions’.

In other cases, a practitioner is aware of what they need to do and provides an enforceable ‘undertaking’ that they will meet additional requirements.

We use the term ‘restrictions’ to include both conditions and undertakings.

How we monitor

We gather information to monitor health practitioners and students with restrictions on their registration or whose registration has been suspended or cancelled. Monitoring plans guide our monitoring and compliance activities, and help practitioners understand what is required of them.

We have a National Restrictions Library and we use the same wording about restrictions for similar cases. This ensures that the restrictions are achieving the desired outcome, are understood by practitioners and that we develop consistent monitoring plans.

Where a practitioner does not do what the restrictions require, we first seek an explanation from them. The Board that placed the restrictions may choose to take additional action, such as issuing a caution or imposing further restrictions, to ensure the public remains protected.

Prohibited practitioners

We also monitor practitioners who are not permitted to practise because they have had their registration cancelled or suspended, have surrendered their registration or are restricted from practising.

• Tribunals have the power to cancel a practitioner’s registration – these practitioners can reapply for registration after an imposed minimum period.
• Tribunals and panels can suspend a practitioner’s registration – these practitioners have their registration reinstated at the completion of the suspension period.
• In cases of high risk, Boards are able to suspend a practitioner through an immediate action while awaiting completion of an investigation or an assessment.
• Boards can impose conditions or accept undertakings that restrict the practitioner from practising until a particular requirement is met.
• Some practitioners who are subject to a notification may surrender their registration or request a non-practising form of registration.

Most common restrictions

Each restriction on a practitioner’s registration is assigned a restriction category. A practitioner can have multiple restriction categories – this results in a greater total number of restrictions on practitioners than total cases being monitored.

The top 10 restriction categories by volume being monitored by Ahpra at 30 June contained 5,579 restrictions (see Table 27).

• 69.9% (3,900) of restrictions in the top 10 restriction categories were imposed following assessment of an application for registration or renewal of registration.
• 30.1% (1,679) of the restrictions in the top 10 restriction categories were imposed because of a finding made by a National Board, panel or tribunal about a practitioner’s health, performance or conduct.

Outcomes from monitoring cases

When a practitioner has completed the requirements, the Board can decide that the restrictions are no longer needed or the practitioner can apply to the Board to remove the restrictions. The case is closed when the Board removes the restrictions.

When we close the case, we retain important information to ensure that we consider the practitioner’s regulatory history for any subsequent applications for registration and notifications we may receive.

During the year, we created 2,302 new monitoring cases and closed 2,591, leading to a decrease in overall cases. Of the cases we closed:

• 1,584 cases were closed because the restrictions were removed
• 907 were closed because the practitioner was no longer registered
• 100 were closed for other reasons, such as transferring monitoring for New South Wales practitioners to the HPCA.

We assessed 667 complaints about advertising. Of these:

• 140 were complaints about corporate entities or unregistered persons, or assessed as serious-risk complaints
• 446 were lower-risk complaints about registered health practitioners
• 81 cases had no breach identified.

We continued our targeted audit of advertising about cosmetic surgery and assessed the advertising for 72 practitioners and health services.

When we identify that advertising by registered health practitioners is not compliant with the Guidelines for advertising a regulated health service, we first provide practitioners with an opportunity to correct their advertising and only take further regulatory action when this is unsuccessful.

Sometimes practitioners do not realise what they are not allowed to claim when they advertise. We provide information to help them.

Where practitioners fail to correct their advertising, Boards may impose a caution or conditions on the practitioner’s registration.

National Boards took regulatory action in response to 19 audits:

• 10 resulted in conditions imposed on the practitioner’s registration
• 9 resulted in a formal caution.

Ahpra may also prosecute advertisers for breaching the National Law (see Legal action).