Understanding people’s experiences with us

We know that one of the most significant ways that practitioners and members of the public engage with us is through our notifications process, so we continue to be interested in the notifier and practitioner experience. Each year we interview people who have recently been through our processes so we can understand what went well and what could have been better. We also survey people about those experiences.

We use the themes that come up in the interviews and surveys for our quality improvement work and to help our staff and the National Boards understand the things that are important for a notifier or practitioner to have a good experience.

We have just begun to survey people who are currently going through our monitoring and compliance process to understand what is working well for them and what is not. We look forward to collecting this feedback and using it to further improve.

Strengthening consumer voices

We are focusing on building stronger community engagement and connecting with a broad range of people, and the Community Advisory Council (CAC) continued to be the primary source of consumer and community representation. The CAC advises us on how and where consumer and community voices are needed, and how best to consult, especially with underserved consumers and communities.

CAC members actively participated in the National Scheme Combined Meeting and were especially interested in the discussion on how to include the voices of patients and the community in regulation. This was flagged in a frank panel session in which members of the CAC and the community critiqued the current representation of their perspectives within the scheme.

The CAC provided feedback on Ahpra and National Board strategies, standards, codes, guidelines, policies and publications. For the first time, the CAC was part of the panels for recruiting community members to the National Boards. CAC members participated on committees, reference groups and working groups, and supported several National Board stakeholder events.

Members individually and collectively engaged with the following issues and activities:

• desired attributes of community members appointed to decision-making committees
• the consumer complaints reference group led by the Australian Commission on Safety and Quality in Health Care
• Ahpra’s relaunched webpage about how to raise a concern and videos about the notifications process
• review of the criminal history and English language standards for registration
• the annual Medical Training Survey consultative forum
• pathways for specialist international medical graduates
• the Independent review of Australia’s regulatory settings relating to overseas health practitioners
• a range of reforms to keep patients safe.

The CAC met seven times and was chaired by Ms Patricia Hall. Communiqués of its meetings are published on our website.

Consulting the professions

The Professions Reference Group (PRG) met six times. It was chaired by Ms Julianne Bryce from the Australian Nursing and Midwifery Association. The PRG brings together professional associations for each of the regulated health professions. It provided feedback on the development of our strategies to proactively respond to emerging public safety concerns such as prescribing via telehealth, our work to improve the assessment and registration of internationally qualified health practitioners, our reforms to improve the safety of cosmetic surgery and procedures, and practical implementation of amendments to the National Law.

Ahpra updated PRG members on our work to identify and minimise distress for practitioners involved in a notifications process, the development of National Law amendments, the Business Transformation Program, graduate registration and practitioner renewal campaigns, and our accreditation work.

Patient safety partnership

Our work with the Australian Commission on Safety and Quality in Health Care (the Commission) to improve the experience of making a health complaint resulted in the production of several important resources for health practitioners and consumers over the past 12 months:

• A checklist tool for practitioners managing feedback and complaints, to support them to resolve a complaint that is made directly to them.
• Changes to our webpage on how to raise a concern to simplify information for consumers and practitioners who are considering raising a concern with Ahpra. Since this redesigned page was launched in November, it has had an 89% increase in unique views, a higher rate of user interaction on the page (74% engagement rate) and a 50% increase in traffic from Google.
• Three short video animations for consumers, which explain patients’ healthcare rights and that it is okay to make a complaint, contain tips for a consumer making a complaint directly to their health provider, and explain how to make a complaint to health complaints organisations and Ahpra.

In 2021, Ahpra and the Commission set up a reference group to guide this joint work, which brought together consumer and health profession perspectives. The project focused on ensuring that the consumer experience is better understood, and involved wide-ranging consultation, including with consumers with a lived experience of making a health complaint and key professional groups. Because Ahpra is only one of many bodies responding to consumer health complaints, there was ongoing engagement with other health complaints bodies throughout the project.

A final report was published by Ahpra and the Commission, which highlights the key findings from the project and areas for continued work. 

Shared policy issues

The National Boards and Ahpra regularly collaborate on shared policy issues that affect the health professions similarly. This supports effective interprofessional care, helps to simplify regulation, and makes it easier for the public, practitioners and employers to know what to expect of registered health practitioners.

Our areas of focus this year expanded to respond to the changing healthcare landscape and evolving consumer expectations of health practitioners and regulators. They included:

• developing resources to support professional practice, such as information for practitioners and the public about virtual care (telehealth), which provided guidance to practitioners about how to use virtual care safely and effectively and guidance for the public on how to access safe virtual care
• setting up new governance arrangements and other systems to give us the ability to respond rapidly to emerging issues, which can help us act earlier to strengthen public protection
• supporting workforce capability by addressing the recommendations of the Independent review of Australia’s regulatory settings relating to overseas health practitioners (Kruk review)
• strengthening our focus on health consumers, including consulting on a revised criminal history registration standard.

So that the National Boards’ regulatory requirements remain contemporary and relevant, we developed and reviewed a suite of other policies across multiple professions, including:

• draft guidelines for registered health practitioners (except medical practitioners, nurses and midwives) who perform non-surgical cosmetic procedures, completing public consultation in early 2024
• a joint review of the English language skills registration standards for 14 professions, completing public consultation on two further possible changes to revised draft standards in August and September and submitting revised standards to health ministers which were approved in June 2024.

Policy consultations

Throughout the year, the National Boards and Ahpra together provided input to the following external policy consultations and reviews:

• Australian Bureau of Statistics comprehensive review of the Australian and New Zealand Standard Classification of Occupations (ANZSCO) to reflect the contemporary labour market and better meet stakeholders’ needs (Consultation round 2)
• Australian Commission on Safety and Quality in Health Care consultation on draft Chronic obstructive pulmonary disease clinical care standard
• Australian Government Department of Employment and Workplace Relations draft Best practice principles and standards for skilled migration assessing authorities
• Australian Government Department of Health and Aged Care consultations on:
  • Intellectual disability health capability framework
  • Unleashing the potential of our health workforce – Scope of practice review and issue papers 1 and 2
• Australian Government Department of Industry, Science and Resources consultation on safe and responsible artificial intelligence
• Australian Government Department of the Prime Minister and Cabinet COVID-19 response inquiry
• Australian Government Minister for Health on family, domestic and sexual violence training in the registered health practitioner workforce
• Australian health ministers consultation on three proposed reforms to the National Law:
  • Part 1: Expansion of the information available on the Register of practitioners
  • Part 2: Introduction of nationally consistent reinstatement orders
  • Part 3: Stronger protections for notifiers and prospective notifiers
• Jobs and Skills Australia 2024 Skills Priority List stakeholder survey
• Victorian Department of Families, Fairness and Housing consultation on Social services regulations 2023: Regulatory impact statement
• Victorian Department of Health review of the Health Services (Health Service Establishments) Regulations 2013.

Government relations

Ahpra maintains a strong working relationship with the Australian, state and territory health departments, including through its Jurisdictional Advisory Committee, which meets quarterly.

We continued to appear by invitation at Senate budget estimates hearings. This is an opportunity to provide senators with information about our work and performance and address any queries and concerns.

In April, the Department of Health and Ageing announced the Independent review of complexity in the National Registration and Accreditation Scheme. We are engaging with the independent reviewer, Ms Sue Dawson, and look forward to contributing to this important review.

National Law amendments

Protection of the title ‘surgeon’ when used by medical practitioners was an important element of new cosmetic surgery reforms agreed by health ministers. This change was enacted by the Health Practitioner Regulation National Law (Surgeons) Amendment Act 2023 and came into use on 20 September.

We also finished implementing the final group of changes arising from the Health Practitioner Regulation National Law and Other Legislation Amendment Act 2022. This last group of 30 reforms started on 1 July 2024.

On 14 May, Western Australia passed the Health Practitioner Regulation National Law Application Act 2024, moving to an applied-laws model and bringing WA into line with other Australian states and territories. All of the National Law amendments have also begun in that state.

Further changes are on the horizon, with health ministers agreeing in April to ensure that proven allegations of sexual misconduct remain on a health practitioner’s record in perpetuity. We are working with governments as a legislative bill of amendments is being drafted for introduction into the Queensland Parliament by the end of 2024.

Contributing internationally

As a World Health Organization (WHO) Collaborating Centre for Health Workforce Regulation, Ahpra works in partnership to strengthen the capacity and skills of regulators in the Western Pacific Region of WHO. As part of this work, we lead the Western Pacific Regional Network of Health Workforce Regulators, with members from approximately 20 countries. We held four regional network webinars on important health workforce regulation topics.

We also continued our partnership work with other international regulatory bodies, including the International Association of Medical Regulatory Authorities and the Council of Licensure, Enforcement and Regulation.

Projects

Our research, evaluation and data analytics work is integral to examining, assessing and projecting trends related to health workforce regulation and patient safety. We established a regulatory intelligence function to identify and address emerging regulatory challenges and developed a four-year Research and Evaluation Strategy for the National Scheme. We focused on sharing our work with different groups, using a range of approaches including webinars, conferences and peer-reviewed publications, and we developed a presentation series around one of our evaluations.

Our research and evaluation projects (with information on Human Research Ethics Committee approvals) included:

• exploring factors associated with the retention and attrition of nine health professions and analysing workforce demographic snapshots (Metro North Health, approved)
• exploring factors associated with the retention and attrition of physiotherapists in Australia (Metro North Health, approved)
• identifying and improving stakeholder access and use of the Medical Training Survey (Metro North Health, approved)
• exploring notifier and practitioner experiences with Ahpra regulatory processes over time (Metro North Health, approved)
• exploring trends in communication-related notifications (ACT Health, exempted)
• evaluating the Notifier Support Service (Metro North Health, approved)
• evaluating the impact of the Health Management Team (Metro North Health, approved)
• evaluating the response to the pandemic sub-registers (Metro North Health, approved)
• evaluating Operation Reset (Metro North Health, approved)
• evaluating the retirement of Guidelines on infection control (ACT Health, exempted)
• conducting literature reviews on:
  • health practitioner communication and patient outcomes and safety
  • the history of the Community Advisory Council.

Publications

We wrote or contributed to three publications in peer-reviewed health journals:

• Biggar S, Van der Gaag A, Maher P et al (2023) ‘”Virtually daily grief” – understanding distress in health practitioners involved in a regulatory complaints process: a qualitative study in Australia’, International Journal for Quality in Health Care, doi.org/10.1093/intqhc/mzad076
• Mahat A, Dhillon IS, Benton DC et al (2023) ‘Health practitioner regulation and national health goals’, Bulletin of the World Health Organization, doi.org/10.2471%2FBLT.21.287728
• Van der Gaag A, Jago R, Gallagher A et al (2023) ‘Artificial intelligence in health professions regulation: an exploratory qualitative study of nurse regulators in three jurisdictions’, Journal of Nursing Regulation, doi.org/10.1016/S2155-8256(23)00087-X

Access to data for research

The comprehensive national data that Ahpra collects have demographic, commercial and research value and value for workforce planning. Our data access and research policy and the information on our website set out the data already available and how to access them, and the processes for requesting data that are not publicly available. We are not able to meet all requests for information, as both the National Law and the Privacy Act 1988 (Cth) impose strict limits on the use of our data.

We also provide a data-matching service to Australian universities wishing to track graduate outcomes. Ahpra can match a graduate’s student number to their registration number so the university does not have to manually search the Register of practitioners. This enables universities to determine whether they are meeting their funding requirements and the intended outcomes of their rural training programs by determining how many of their health students are working in regional and rural locations. Some universities also use the register to assess graduate outcomes more broadly in metropolitan and rural areas. We received and fulfilled seven requests for student data matching in 2023/24.

Each year Ahpra provides an extract of medical practitioner data from the Register of practitioners to Medical Deans, who combine it with their own data from surveys of final-year medical students. Including Ahpra’s data with their own allows Medical Deans to display information about medical practitioners that is broken down by a range of demographic factors, such as gender, rurality, specialty, and graduates’ preferred versus actual work locations.