Physiotherapy Board of Australia

2015/16 Annual Report Summary

At a glance: Regulating physiotherapists in 2015/16

This annual report summary provides a snapshot of our work regulating almost 29,000 registered physiotherapists in the financial year to 30 June 2016.

A more detailed profile, encompassing data relating to all 14 National Boards in Australia, is published in AHPRA and the National Boards’ 2015/16 annual report

About this report

This report provides a profession-specific view of the Physiotherapy Board of Australia’s work to manage risk to the public and regulate the profession in the public interest in 2015/16.

The Board has worked in close partnership with the Australian Health Practitioner Regulation Agency (AHPRA) to provide all Australians with a safe, qualified and competent workforce under the National Registration and Accreditation Scheme (the National Scheme).

Information included in this report is drawn from the data published in the 2015/16 annual report by AHPRA and the National Boards, and was correct as at 30 June 2016.

Whenever possible, historical data are provided to show trends over time, as well as comparisons between states and territories.

For a wider context, and to compare the profession against national data from all 14 professions regulated by National Boards under the National Scheme, this report should be read in conjunction with the 2015/16 annual report. Download the report.

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Message from the Presiding Member, Physiotherapy Board of Australia

During 2015/16, the Board continued to consolidate our role in protecting the public and carried out regulatory activities in accordance with the Health Practitioner Regulation National Law (the National Law) as in force in each state and territory.

We also continued to contribute to crossprofessional decision-making about issues that are common to registered health professions in the National Scheme.

My sincere thanks go to the Chair of the Registration and Notifications Committee, Fiona McKinnon, as well as the members of that important committee, which considers the individual matters of registrations and notifications on a monthly basis. These activities are time intensive and often complex, requiring careful and consistent consideration at an individual level.

The Board works collaboratively and effectively with AHPRA staff, from the National Executive through to the various registration and notification officers throughout the country.

Auditing of physiotherapists’ adherence to the registration standards is now considered ‘business as usual’ for the Board, and the results of these ongoing audits provide confidence that physiotherapists are aware of, and adhere to, their professional obligations as registered health practitioners.

The Board continues to contribute to early discussions about the possibility of prescribing for those professions in the National Scheme that do not already have prescribing rights. However, the Board acknowledges the complex issues that need to be worked through across all of the professions in order for Ministers to be able to consider approving the National Boards’ ability to endorse practitioners for prescribing.

Finally, I would like to thank AHPRA and particularly my fellow Board members for their contributions and continued dedication to the regulation of physiotherapists in Australia.

The Board’s Chair and Tasmanian practitioner member, Paul Shinkfield, resigned from his position during the year to take up a role with AHPRA. Paul led the Board very ably for over three years, and his clear thinking and collaborative manner were appreciated by the Board.

Dr Charles Flynn was elected by the Board as Presiding Member in December 2015, after the departure of Chair Mr Paul Shinkfield.

Members of the National Board in 2015/16

• Dr Charles Flynn (Presiding Member)
• Ms Alison Bell
• Mr Timothy Benson (until 30 August 2015)
• Mrs Janet Blake (from 31 August 2015)
• Mr David Cross (from 31 August 2015)
• Ms Anne Deans (until 30 August 2015)
• Ms Kim Gibson
• Mrs Lynette Green
• Mrs Kathryn Grudzinskas (until 30 August 2015)
• Ms Cherie Hearn (from 31 August 2015)
• Mr Peter Kerr AM
• Mrs Elizabeth Kosmala OAM
• Ms Karen Murphy (until 30 August 2015)
• Ms Philippa Tessmann
• Ms Elizabeth Trickett (from 31 August 2015)

During 2015/16, the Board was supported by Executive Officer Jill Humphreys.

More information about the work of the Board, including codes, guidelines and information on registration standards, can be found on the Board website.

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Message from the Agency Management Committee Chair and the AHPRA CEO

Since the National Scheme began six years ago, AHPRA has worked in partnership with the National Boards to ensure that the community has access to a safe and competent health workforce across 14 registered health professions Australia-wide.

We rely on the expertise and insights of the National Boards to make decisions about the 657,621 health practitioners currently registered in Australia in the interests of the Australian public. It’s a role that Board members commit to with dedication and passion, and the community can be assured that its safety is always their number-one priority.

As at 30 June 2016, there were 28,855 registered physiotherapists. Overseeing the registration and regulation of the profession is the Physiotherapy Board of Australia (the Board), with valuable input from professional and community groups.

The Board upholds the values of the National Scheme by taking a risk-based approach to regulatory decision-making and policy implementation, with a continued focus on finding ways to improve effectiveness, efficiencies and timeliness.

In 2015/16, the Board worked to ensure physiotherapists continued to understand their regulatory requirements after the publication of revised registration standards. Cross-profession consultation and collaboration has been a key focus for the Board, as has continued communication with the profession and its key stakeholders.

We’d like to thank Board members for their continued commitment to ensuring a competent and flexible health workforce that meets the current and future health needs of the community.

We look forward to continuing to work in partnership with the Board.

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Year in review: Physiotherapy Board of Australia

In 2015/16, the Physiotherapy Board of Australia worked with its appointed accreditation authority, the Australian Physiotherapy Council, to embed the physiotherapy practice thresholds, which were developed and launched in 2014/15 in conjunction with co-authors, the Physiotherapy Board of New Zealand.

The Board continued to refine its regulatory approach, working closely with stakeholders to ensure clarity of regulatory requirements, particularly as it rolled out revised registration standards for professional indemnity insurance, continuing professional development and recency of practice.

The Board’s focus in 2015/16 was to think scheme-wide, seeking consistency, efficiency and effectiveness in undertaking its regulatory role. It took part in cross-professional work within the National Scheme, such as the review of supervision guidelines. This work is ongoing and a framework is being developed to cover all situations in which supervision is a requirement for registration.

The Board has been involved in early conversations with the profession about non-medical health practitioner prescribing. This is cross-professional work with other relevant National Scheme professions. Whether physiotherapist prescribing becomes a reality will depend on many factors, including the clear and unequivocal safety of the community, and the value proposition to the health system and community as a whole. The conversation is expected to continue for some time.

As part of its statutory role, the Board is currently conducting a scheduled review of its Approved accreditation standard. In regards to improving health outcomes for Indigenous people, the Board will work with the Australian Physiotherapy Council to ensure that the culturally appropriate educational aspects are broadly consulted upon and included before finalising.

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Data snapshot: Regulation at work in 2015/16

The profession in brief

• Physiotherapy registrants increased by 4.8% year on year, to 28,855 in 2015/16.
• New South Wales (NSW) was the principal place of practice for most of these practitioners (8,408); the Northern Territory (NT) was home to the least (165).
• The age bracket with the most practitioners was 25–29 (at 6,187 registrants).
• 2,385 practitioners were under 25 years of age; 19 were aged 80 or over.
• Women comprised 68% of the profession.

About our data

Data in this Board summary are drawn from the 2015/16 annual report, published by AHPRA and the National Boards. Data relating to physiotherapists have been extracted from national source data that include all 14 health professions currently regulated under the National Law.

In the following pages you’ll find registration data, including registrant numbers by age, gender and principal place of practice, and data about notifications (complaints or concerns) received about physiotherapists in the year to 30 June 2016. Statutory offence data are also included.

For a further breakdown of data from the 2015/16 annual report by AHPRA and the National Boards, including data relating to other professions and summary reports by state and territory.

Notifications data

Notifications are complaints or concerns that are lodged with AHPRA about registered health practitioners or students practising in Australia.

Our data generally excludes complaints handled by co-regulatory jurisdictions, such as in:

• NSW, where complaints about health practitioners with this state as their principal place of practice (PPP) are not managed by the Board and AHPRA, unless the conduct occurred outside NSW. Complaints about health practitioners where the conduct occurred in NSW are handled by the Health Professional Councils Authority (HPCA) and the Health Care Complaints Commission (HCCC), and
• Queensland, where complaints are received and managed by the Office of the Health Ombudsman (OHO) and may be referred to AHPRA and the relevant National Board. We are not able to report on all complaints about health practitioners in Queensland because we only have access to data relating to matters referred to us by OHO.

Note that some NSW regulatory data published in this report may vary from data published in the HPCA’s annual report. This is due to subsequent data review by the HPCA after submission of initial data to AHPRA. For more information about how complaints about health practitioners are managed in NSW, and for data about complaints made in the state, please refer to the HPCA website.

For data relating to complaints in Queensland that have not been referred to AHPRA, please refer to the OHO website.

Registration of physiotherapists

There were 28,855 physiotherapists registered across Australia as at 30 June 2016. This represents a national increase of 4.8% from the previous year.

Physiotherapists made up 4.4% of all registered health practitioners across the National Scheme. Of the registrant base:

• 95.9% held general registration to practise physiotherapy, with this cohort of registrants increasing by 4.6% year on year
• 1.2% held limited registration, which allows internationally qualified physiotherapists to provide physiotherapy services under supervision while undertaking the overseas trained physiotherapist assessment process conducted by the Australian Physiotherapy Council, and
• 2.9% held non-practising registration and could not practise physiotherapy. This category of registrants increased by 2% from 2014/15.

There were 8,943 registered physiotherapy students at 30 June 2016, a decrease of 1.7% from 2014/15.

The Board received 2,505 new applications for registration, 1.4% fewer than 2014/15. Of these, 83.9% were for general registration and 6.4% were applications to move to the non-practising register.

See Tables 1–3 for segmentation of registration data about physiotherapists.

As a standard part of the registration process, applicants for initial registration as a health practitioner in Australia must undergo a criminal record check. AHPRA requested 66,698 domestic and international criminal history checks for practitioners across all professions in 2015/16. Of these, 2,702 checks were carried out for practitioners wanting to register as physiotherapists. The checks resulted in 94 disclosable court outcomes. No conditions or undertakings were imposed on any practitioner’s registration as a consequence.

For source data on domestic and international criminal history checks, as well as more registration information across all regulated health professions, please refer to the 2015/16 annual report by AHPRA and the National Boards.

Regulation of physiotherapists

In 2015/16, there were 102 notifications received nationally about physiotherapists (including HPCA data). This represents an increase of 5.2% from the previous year. AHPRA received and managed 66 matters (excluding HPCA). Notifications about physiotherapists represent 1.1% of all notifications received by AHPRA (excluding HPCA) in 2015/16.

On a national basis, the percentage of registered health practitioners with notifications received during the year was 1.5%. The percentage of all registered physiotherapists with notifications received was 0.4%.

A total of 55 notifications relating to a registered physiotherapist were closed during the year (excluding HPCA). This represents 1.1% of all matters closed across all professions. Of the closed notifications:

• 18.2% resulted in conditions being imposed or an undertaking accepted by the Board
• 16.4% resulted in the practitioner receiving a caution or reprimand by the Board
• none resulted in suspension or cancellation of registration, and
• 65.4% resulted in no further action being taken by the Board (no further action is taken when, based on the available information, the Board determines there is no risk to the public that requires regulatory action).

At the end of the year, there were 49 open notifications about registered physiotherapists (excluding HPCA).

There were 69 active monitoring cases (including HPCA). The majority of these (42 cases) related to suitability/eligibility for registration. For example, they may not have held an approved or equivalent qualification; lacked English-language skills; did not meet requirements for recency of practice; or did not meet registration standards.

Immediate action was taken on matters relating to physiotherapists six times in 2015/16 (compared with four instances in 2014/15). A National Board has the power to take immediate action in relation to a health practitioner’s registration at any time, if it believes this is necessary to protect the public. Immediate action limits a practitioner’s registration by suspending or imposing conditions on it, or accepting an undertaking or surrender of the registration from the practitioner or student. This is an interim step that Boards can take while more information is gathered or while other processes are put in place.

To take immediate action, the Board must reasonably believe that:

• because of their conduct, performance or health, the practitioner poses a ‘serious risk to persons’ and that it is necessary to take immediate action to protect public health or safety, or
• the practitioner’s registration was improperly obtained, or
• the practitioner or student’s registration was cancelled or suspended in another jurisdiction.

AHPRA received 66 new complaints about possible statutory offences relating to physiotherapy. These complaints constitute 4.9% of all statutory offence matters received in 2015/16. Almost all the new matters related to the use of protected titles or advertising concerns. Forty statutory offence matters were considered and closed in 2015/16.

Statutory offences are breaches of the National Law, committed by registered health practitioners and unregistered individuals. There are a number of offences created under the National Law, including the following:

• unlawful use of a protected title
• performing a restricted act
• holding out (claims by individuals or organisations as to registration), and
• unlawful advertising.

See Tables 4–11 for segmentation of notifications and statutory offence complaints data relating to physiotherapists.

Want to know more?

For more data and analysis relating to physiotherapy or any regulated health profession, please refer to the full 2015/16 annual report and supplementary data tables published by AHPRA and the National Boards.

Segmentation of data by state and territory is also available on the AHPRA website.

For more information on the National Law as it applies to each state and territory, see AHPRA's legisltaion.

Table 1: Registrant numbers at 30 June 2016¹

Physiotherapists	ACT	NSW	NT	QLD	SA	TAS	VIC	WA	No PPP2	Total
2015/16	539	8,408	165	5,349	2,289	450	7,060	3,475	1,120	28,855
2014/15	511	7,943	168	5,097	2,234	439	6,744	3,344	1,063	27,543
% change from 2014/15	5.50%	5.90%	-1.80%	4.90%	2.50%	2.50%	4.70%	3.90%	5.40%	4.80%

Table 2: Registrants by age

Physiotherapists	U-25	25-29	30-34	35-39	40-44	45-49	50-54	55-59	60-64	65-69	70-74	75-79	80+	Not available	Total
2015/16	2,385	6,187	5,000	3,804	2,939	2,505	2,103	2,017	1,146	510	178	62	19		28,855
2014/15	2,365	5,851	4,676	3,573	2,910	2,375	2,086	1,993	1,008	459	173	53	20	1	27,543

Table 3: Registrants by gender

Physiotherapists	ACT	NSW	NT	QLD	SA	TAS	VIC	WA	No PPP1	Total
Total 2015/16	539	8,408	165	5,349	2,289	450	7,060	3,475	1,120	28,855
Female	368	5,684	116	3,580	1,486	326	4,825	2,477	777	19,639
Male	171	2,724	49	1,769	803	124	2,235	998	343	9,216
Total 2014/15	511	7,943	168	5,097	2,234	439	6,744	3,344	1,063	27,543
Female	356	5,417	121	3,463	1,474	318	4,617	2,399	746	18,911
Male	155	2,526	47	1,634	760	121	2,127	945	317	8,632

Table 4: Notifications received by state or territory¹

Physiotherapists	ACT	NSW2	NT	QLD3	SA	TAS	VIC	WA	No PPP4	Subtotal	HPCA5	Total
2015/16 (PPP)6	2	1	3	23	5	2	20	10		66	36	102
2014/15 (PPP)	1		3	7	10	1	25	8	2	57	40	97
2014/15 (Responsible Office)7	1		4	8	10	1	25	8		57	40	97

Table 5: Percentage of registrant base with notifications received, by state or territory

Physiotherapists	ACT	NSW (including HPCA complaints)1	NT	QLD	SA	TAS	VIC	WA	No PPP2	Total
2015/16 (PPP)3	0.40%	0.40%	1.80%	0.40%	0.20%	0.40%	0.30%	0.30%		0.40%
2014/15 (PPP)	0.20%	0.50%	1.80%	0.10%	0.40%	0.20%	0.40%	0.20%	0.20%	0.40%
2014/15 (Responsible Office)4	0.20%	0.50%	2.40%	0.20%	0.40%	0.20%	0.40%	0.20%		0.40%

Table 6: Immediate action cases by state or territory (excluding HPCA)

Physiotherapists	ACT	NSW	NT	QLD	SA	TAS	VIC	WA	No PPP1	Total 2014/15
Total 2015/16 (PPP)2			2				3	1		6
Total 2014/15 (PPP)			1	2	1					4
Total 2014/15 (Responsible Office)3			1	2	1					4

Table 7: Notifications closed, by state or territory

Physiotherapists	ACT	NSW1	NT	QLD	SA	TAS	VIC	WA	No PPP2	Subtotal	HPCA3	Total
2015/16 (PPP)4	1	1	6	15	5	1	21	4	1	55	38	93
2014/15 (PPP)	1	4	7	13	12	2	32	8	4	83	32	115
2014/15 (Responsible Office)5	1		9	18	13	2	32	8		83	32	115

Table 8: Notifications closed, by stage at closure (excluding HPCA)¹

Stage at closure	Total 2015/16	Total 2014/15
Assessment2	31	41
Health or performance assessment3	6	5
Investigation	16	30
Panel hearing	1	1
Tribunal hearing	1	6
Total	55	83

Table 9: Notifications closed, by outcome at closure (excluding HPCA)¹

Outcome at closure	Total 2015/16	Total 2014/15
No further action2	36	47
Health complaints entity to retain	0	4
Caution	9	15
Accept undertaking	0	5
Impose conditions	10	8
Suspend registration	0	2
Not permitted to reapply for registration for 12 months or more	0	2
Total	55	83

Table 10: Active monitoring cases at 30 June 2016, by stream (including HPCA)¹

Physiotherapists	Total 2015/16	Total 2014/15
Conduct	9	11
Health	9	17
Performance	9	9
Prohibited practitioner/student	0	0
Suitability/eligibility2	42	45
Total	69	82

Table 11: Statutory offence complaints received and closed, by type of offence and jurisdiction¹

Offence	ACT	NSW	NT	QLD	SA	TAS	VIC	WA	No PPP2	Total 2015/16	Total 2014/15
Title protections (s.113-120): Received		6	2	2				3	6	19	12
Title protections (s.113-120): Closed		6	4	1	1			1	3	16	19
Practice protections (s.121-123): Received				1						1	0
Practice protections (s.121-123): Closed										0	0
Advertising breach (s.133): Received		4	1	15			1	3	20	44	19
Advertising breach (s.133): Closed	1	6		4	2		1	4	6	24	18
Directing or inciting unprofessional conduct/professional misconduct (s.136): Received										0	0
Directing or inciting unprofessional conduct/professional misconduct (s.136): Closed										0	0
Other offence: Received				2						2	0
Other offence: Closed										0	1
Total 2015/16 (PPP)3: Received	0	10	3	20	0	0	1	6	26	66
Total 2015/16 (PPP)3: Closed	1	12	4	5	3	0	1	5	9	40
Total 2014/15 (PPP)3: Received	1	5	0	6	3	0	3	1	12		31
Total 2014/15 (PPP)3: Closed	0	2	0	6	1	0	6	16	7		38