Australian Health Practitioner Regulation Agency - Annual report 2023/24 — Registration
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Annual report 2023/24 — Registration

ANNUAL REPORT 2023/24 Registration

Photo of two staff member sitting at their desk smiling while reviewing work on a laptop

Collaboration with stakeholders and continued streamlining of registration processes has been a focus this year.

  • In December, we changed the way overseas applicants verify their identity – they no longer need to present in person in Australia before being registered. The change has reduced travel costs and application assessment times, enabling practitioners to start work sooner.
  • In response to demand, a new nursing examination centre was opened for international applicants. All candidates are now able to sit an exam within eight weeks of us receiving their examination request.
  • Overseas midwives can now take their first exam online, reducing cost and time as they no longer need to travel to Australia or New Zealand.
  • We held education sessions for employers and stakeholders who work with international medical graduates, nurses and midwives to increase their understanding of the registration process. As a result, we saw more complete and accurate registration applications being submitted.
  • Subscriptions to the Practitioner Information Exchange (PIE) increased from 161 to 192. This secure web-based service enables government departments, hospitals, healthcare businesses, pharmaceutical companies, medical insurers and nursing and aged care agencies to do a bulk check of registration status and other information published in the Register of practitioners.

The year in summary

  • The number of registered health practitioners grew by 4.9% to 920,535.
  • 96.9% of all registered practitioners hold some form of practising registration.
  • 90,629 practitioners hold specialist registration in an approved specialty.
  • 28,922 practitioners hold endorsement to extend their scope of practice in a particular area because of an additional approved qualification.
tables

There are references to registration data tables throughout the text on this page. Download the registration tables (92 KB, XLSX).

You can check our online Register of practitioners to see if someone is registered and if there are any special requirements on their registration.

The register was again the most popular part of our website, with more than 8 million unique visits. More than 11 million searches were made, of which over half were for medical practitioners.

Following a redesign of our website, there was a 36% increase in register use compared with last year. Every page of the website now has a prominent button to ‘Look up a practitioner’; in the previous site design, most users navigated to the home page to access the register.

The website design improvements also resulted in more searches of the Register of cancelled practitioners: 121,427 searches were made and there was a 94% increase in unique visits since last year.

We received 105,382 applications for registration, of which 96,972 (92.0%) were for practising registration.

We finalised 106,236 applications for registration (see Table 8), an increase of 10.5% on last year.

More applications were finalised than received as some applications received in the previous year were finalised this year.

  • 1,675 (1.6%) of finalised applications were granted registration with conditions.
  • 105 (0.1%) were refused.
  • 3,407 (3.2%) applicants withdrew before a final decision was made on their application. This is a reduction on last year when there were 3,805 withdrawals. (The usual reason for withdrawal is the applicant not being able to provide the evidence necessary to complete their application.)

New graduate applications

We received 41,476 applications from new graduates, including 22,997 nursing applications. This is a decrease of 2.6% and 4.5%, respectively, from last year, and a second year of lower numbers following a big jump (6.2% increase) in 2021/22.

  • 30,185 of this year’s applications were received between mid-September and March, the peak registration period for new graduates.
  • Timeframes to assign, assess, make first contact and finalise when complete all improved on last year, and contributed to the improved results in our end-of-year graduate survey. The average time to assign and assess an application was down from seven days to six days.

End-of-year graduate survey

The end-of-year graduate survey is a voluntary applicant experience survey now in its fifth year. The results give us valuable insights into the graduate experience of becoming registered as a qualified health practitioner.

We invited 28,152 new graduates to participate in the survey and 2,843 responded (a 10.1% participation rate). Overall, most measures improved when compared to last year.

This year saw the best result to date in satisfaction with how well we managed graduate applications, with 86.8% of respondents satisfied overall, compared to 86.2% last year.

Criminal history checks

We check every applicant’s criminal history before they are registered.

  • 82,458 results were received from domestic and international criminal history checks of practitioners and/or applicants (Table 9). This is an increase on the 79,759 results received in 2022/23.

International applicants

This year, 28,617 overseas-qualified practitioners gained registration, a 48.4% increase from last year.

  • We registered 5,431 international medical graduates, a 29.0% increase on last year.
  • We registered 351 internationally qualified midwives and 16,622 internationally qualified nurses, an increase of 28.6% and 48.6%, respectively.
  • We registered 6,213 overseas-qualified practitioners across the other health professions, an increase of 71.8% from last year.

We focused on improving the process and timeframes for overseas applicants, including reducing the time to finalise applications. It took 44.9% less time to finalise ‘complete’ applications (those that included all the necessary information): 33 days this year, down from 60 days last year.

Mutual recognition with New Zealand

The Trans-Tasman Mutual Recognition Act 1997 (TTMR Act) allows for many types of health practitioners registered in either Australia or New Zealand to apply for registration in the other country through a streamlined registration process. The objective is to remove regulatory barriers and drive workforce mobility for health practitioners who hold current practising registration in either jurisdiction.

Registration in Australia will only be granted in the same category as the practitioner’s New Zealand registration. Any conditions, limitations or endorsements that apply in New Zealand may also apply to the practitioner’s registration in Australia.

There has been a significant increase in approved TTMR applications: 14,452 this year and 9,129 last year, a 58.3% increase (Table 10). The increase is most notable for nurses and physiotherapists.

Changes to verification of identity

We have changed the way overseas applicants prove their identity, aligning it with the Attorney-General’s Department’s National identity proofing guidelines. The new requirements mean applicants no longer need to present in person in Australia before being registered. Instead, they can provide identity evidence while still overseas, which can enable them to be registered before coming to work in Australia.

This reduces the uncertainty for applicants and employers and significantly decreases application assessment times, thus enabling practitioners to start work sooner. Once overseas practitioners are registered and have moved to Australia, they must provide further proof of identity.

Supporting employers

Ahpra delivered eight virtual education sessions in every state and territory to employers and stakeholders who work with international applicants. This was to support employers seeking overseas-qualified practitioners to ease pressure on stretched local health services. The objective of the sessions was to increase understanding of registration processes for international medical graduates (IMGs) and internationally qualified nurses and midwives (IQNMs).

These sessions received very positive feedback from employers and resulted in more complete and accurate applications being submitted. This in turn reduced the time taken to finalise applications and improved the overall experience for applicants and employers.

Some applicants sit an exam

The number of international applicants sitting an exam increased by 28.6% from last year.

Nursing and midwifery exams

IQNMs are required to complete a self-check of their qualifications before applying for registration. Those who hold qualifications that are substantially equivalent or based on similar competencies to an Australian graduate (and who meet the mandatory registration standards) progress to an application for registration. Some IQNMs will need to pass an outcomes-based assessment before being eligible to apply. The examination process for these IQNMs consists of:

  • a multiple-choice question (MCQ ) examination (knowledge test)
  • an objective structured clinical examination (OSCE) (knowledge, skills and competence test).

The MCQ examinations:

  • Enrolled nurse – a paper-based exam coordinated by Ahpra and held at our offices around Australia. Two exams were conducted this year.
  • Registered nurse – the National Council of State Boards of Nursing’s online National Council Licensure Examination – Registered Nurse (NCLEX-RN) held at Pearson VUE testing centres in more than 20 countries, including Australia. This year, 9,859 exams (including re-sits) were conducted, an increase from 8,077 last year.
  • Midwife – an online exam held at Aspeq-managed facilities. There were 38 exams (including re-sits) conducted this year in Australia and New Zealand. Overseas midwives who are required to sit this exam are now able to do so from their overseas base. This reduces the candidate’s cost and time significantly as they no longer need to travel to Australia or New Zealand to take the exam in person.

The OSCEs:

  • 2,333 internationally qualified registered nurses participated in the registered nurse OSCE.
  • The midwife OSCE was held twice during the year, with 21 midwives (including re-sits) participating in the exam.

In response to demand, a new examination centre in Melbourne was opened for nurse and midwife objective structured clinical examinations (OSCEs), and we can now run up to 20 exam weeks each year across Adelaide and Melbourne. Each exam week has capacity for 240 candidates.

At 30 June, all candidates had been offered an exam date.

Pharmacy, psychology, medical radiation practice and Chinese medicine exams

Ahpra coordinated the following exams:

  • 2,331 pharmacy interns were assessed in the oral examination (practice) in October, February and June. All these exams used a hybrid online and face-to-face model.
  • 112 oral exams were held for pharmacy practitioners holding limited or general registration with conditions on their registration that required the completion of an examination in practice, or in law and ethics. These exams were offered monthly.
  • 2,270 candidates sat the quarterly national psychology examination. Candidates could choose to sit the exam in a test centre or online.
  • 102 candidates sat the quarterly national medical radiation practice examination. These exams were also offered in a test centre or online.
  • 19 candidates sat the scenario-based multiple-choice exam for Chinese medicine. Again, candidates could choose to sit the exam in a test centre (where available) or by online supervision.
  • 20 candidates sat the OSCE for Chinese medicine over two examination periods.
  • 12 candidates sat the paramedicine competency assessment.

Ahpra renewed registration for 840,816 health practitioners. This is an increase of 5.0% from last year.

Each year when they renew, practitioners must confirm they continue to meet their National Board’s mandatory registration standards. They must also let us know if there’s been any change to their criminal history or any health impairment that may negatively affect their ability to practise safely.

Ahpra has continued to provide help to practitioners who were not able to renew their registration online. Only nine practitioners took up this option.

Aboriginal and Torres Strait Islander Peoples are under-represented in our health workforce. Increasing participation in the registered health workforce is a goal of our Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy. 

Ahpra and the National Boards ask about Aboriginal and/or Torres Strait Islander cultural identity in application and renewal processes. This enables us to understand workforce trends and the proportion of registered health practitioners who identify as Aboriginal and/or Torres Strait Islander. At 30 June:

  • Aboriginal and/or Torres Strait Islander Peoples’ participation in the regulated health professions was 1.2%. This rate has remained the same for several years – the number of Aboriginal and/ or Torres Strait Islander practitioners is growing steadily but is increasing at the same rate as the total number of registrants.
  • The participation rate is well short of the 3.8% Aboriginal and Torres Strait Islander representation in the general population.
  • 100% of Aboriginal and Torres Strait Islander Health Practitioners are Aboriginal and/or Torres Strait Islander. It is a requirement for registration in that profession. Paramedicine had the second-highest representation with 2.1% of its workforce identifying as Aboriginal and/or Torres Strait Islander. 
  • Midwifery (including dual-registered midwives and nurses) had the third-highest representation with 1.6%, followed by nursing (including dual-registered) with 1.5%.
  • During the end-of-year new-graduate registration campaign, an additional 540 health practitioners who identified as Aboriginal and/or Torres Strait Islander joined the workforce.

Support for registrants

The Aboriginal and Torres Strait Islander Engagement and Support team was established last year to better support Aboriginal and Torres Strait Islander applicants, registrants and stakeholders to engage with our registration processes.

The team continued to support Aboriginal and/or Torres Strait Islander graduates with their application for registration (especially with any issues that arose or disclosures they needed to make). The team also supported practitioners who were renewing their registration, providing guidance and support across a range of issues and individual circumstances.

The team continues to use feedback from the new graduate survey, from stakeholders, and directly from the applicants and registrants they support to better understand the barriers to getting registered and renewed, and to improve the services we provide to Aboriginal and Torres Strait Islander applicants and registrants.

Students are the health practitioners of the future.

  • 182,647 students were studying to be health practitioners through an approved program of study or clinical training program (Table 12).

Education providers supply student information so students can be registered.

All National Boards except the Psychology Board register students. Psychology students receive provisional registration. 

The student register is not open to the public.

 
 
 
Page reviewed 12/11/2024