AHPRA Annual Report 2015/16

Monitoring and compliance

Performance snapshot

• There were 4,963 cases actively monitored by AHPRA in 2015/16.
• A National Restrictions Library was launched, currently containing 73 restrictions (conditions and undertakings) used across all regulatory functions.
• A strengthened compliance framework was implemented, which categories cases and assigns each monitoring case to one of five streams: health, performance, conduct, suitability/eligibility and prohibited practitioner/student.
• Risk-based reporting was introduced for National Boards. New reports provide data on the monitoring of registrant compliance with conditions or undertakings on their registration and include a summary of actions being undertaken by AHPRA when compliance is being assessed and where non-compliance is being managed.

Monitoring compliance with restrictions on registration

On behalf of the National Boards, AHPRA monitors health practitioners and students with restrictions (conditions or undertakings) placed on their registration, or with suspended or cancelled registration. By identifying any noncompliance with restrictions and acting swiftly and appropriately, AHPRA supports Boards to manage risk to public safety.

Table MC1 reports on active monitoring cases by state and territory. Table MC2 reports on these cases by each profession.

Restrictions are placed on registration through a number of mechanisms, including as an outcome of a notification, application for registration or renewal of registration. This year, a strengthened compliance framework was introduced as a way to categorise restrictions, and each monitoring case is assigned to one of the following five streams:

Health: The practitioner or student is being monitored because they have a physical or mental impairment, disability, condition or disorder (including substance abuse or dependence).

Performance: The practitioner is being monitored to ensure they practise safely and appropriately while demonstrated deficiencies in their knowledge, skill, judgement or care in the practice of their profession are addressed.

Conduct: The practitioner is being monitored to ensure they practise safely and appropriately following consideration of their criminal history, or they have demonstrated a lesser standard of professional conduct than expected.

Suitability/eligibility: The practitioner is being monitored because they:

• do not hold an approved or substantially equivalent qualification in the profession
• lack the required competence in the English language
• do not meet the requirements for recency of practice, or
• do not fully meet the requirements of any other approved registration standard.

Prohibited practitioners/student: The practitioner/ student is being monitored because they:

• are subject to a cancellation order, suspension or restriction not to practise, or
• have surrendered registration or changed to nonpractising registration, in lieu of further action, under Part 8 of the National Law or suspension.

This year, the number of monitoring cases in the health, performance and conduct streams have all seen a slight decrease, the majority of these being due to closures associated with a comprehensive review of all active cases and re-allocation to the prohibited practitioners/student stream. There was a slight increase in monitoring cases associated with suitability/eligibility restrictions.

We have maintained our focus on service improvement with the introduction of compliance performance reporting. This has created opportunities to improve the quality, timeliness and accuracy of our compliance work. Performance was strong across all key performance indicators in all quarters.

Launch of the National Restrictions Library

This year, AHPRA developed and implemented a National Restrictions Library which will aid decisionmaking and improve national consistency. The library provides a best practice approach and consolidated structure for common restrictions used across regulatory functions, ensuring consistency in:

• recommendations made by AHPRA to the Boards, delegates, panels, tribunals and other decision-makers under the National Law
• how restrictions appear on the national register, and
• how a practitioner’s compliance with restrictions is monitored.

The National Restrictions Library currently includes standardised wording for the health, performance and conduct streams. Work has commenced on expanding the library across the remaining compliance streams. The library content was also shared externally with co-regulatory entities in New South Wales and Queensland, State and Territory tribunals and published on our online National Restrictions Library.

Introducing risk-based reporting for National Boards

This year, new reporting for local and regional boards and national committees was introduced to assist National Boards in overseeing AHPRA’s monitoring of conditions, undertakings and suspensions that are imposed on practitioners’ and students’ registration.

The reports provide data on the monitoring of registrant compliance with conditions or undertakings on their registration and include a summary of actions being undertaken by AHPRA when compliance is being assessed and where non-compliance is being managed. The reports enable the boards and committees to manage risks and quickly respond to non-compliance. Reporting is underpinned by a set of critical compliance events endorsed by the National Boards. Critical compliance events describe those issues of noncompliance which must be escalated to a Board or committee for review and action as required.

Table MC1: Active monitoring cases at 30 June 2016 by state or territory (including HPCA¹)

Stream	AHPRA ACT	AHPRA NSW3	AHPRA NT	AHPRA QLD	AHPRA SA	AHPRA TAS	AHPRA VIC	AHPRA WA	AHPRA No PPP4	AHPRA Subtotal 2015/16	HPCA	Total 2015/16	2014/15 AHPRA	2014/15 HPCA	2014/15 Total
Conduct	10	5	4	141	55	11	132	42	2	402	307	709	482	293	775
Health	25	12	18	284	111	17	125	64	7	663	337	1,000	826	327	1,153
Performance	24	10	10	173	55	26	171	75	6	550	127	677	600	91	691
Prohibited Practitioner/student	8	5	-	43	39	9	79	35	1	219		219
Suitability/eligibility2	50	1,349	23	437	192	42	525	419	92	3,129		3,129	3,083		3,083
Total 2015/16	117	1,381	55	1,078	452	105	1,032	635	108	4,9635	771	5734
Total 2014/15	155	1,412	74	1,186	472	101	948	554	89				4,991	711	5,702

Table MC2: Active monitoring cases at 30 June 2016 by profession and stream

Profession	Conduct AHPRA	Conduct HPCA	Health AHPRA	Health HPCA	Performance AHPRA	Performance HPCA	Prohibited practitioner/student AHPRA	Suitability/eligibility1 AHPRA	Total 2015/16 AHPRA	Total 2015/16 HPCA	Total 2014/15 AHPRA	Total 2014/15 HPCA
Aboriginal and Torres Strait Islander Health Practitioner	0		3		1		0	69	73	0	6	0
Chinese Medicine Practitioner	5	1	0		1	1	1	947	954	2	882	1
Chiropractor	12	7	1		9	1	3	21	46	8	60	8
Dental Practitioner	24	28	23	10	64	15	6	24	141	53	165	46
Medical Practitioner	164	171	244	119	232	30	52	1,075	1,767	320	1,697	323
Medical Radiation Practitioner	1		6	1	1		2	99	109	1	533	2
Midwife	5		10	4	14	4	2	113	144	8	108	9
Nurse	111	47	327	166	154	52	129	553	1,274	265	1,013	232
Occupational Therapist	1		2	2	1		3	29	36	2	71	2
Optometrist	0		1	1	1	1	0	15	17	2	15	1
Osteopath	2	1	0		0		0	7	9	1	15	1
Pharmacist	26	37	17	11	39	10	12	84	178	58	187	51
Physiotherapist	6	3	6	3	6	3	0	42	60	9	75	7
Podiatrist and Podiatric Surgeon	1	1	4		4	2	0	12	21	3	14	1
Psychologist	44	11	19	20	23	8	9	39	134	39	150	27
Total 2015/16	402	307	663	337	550	127	219	3,129	4,9632	771
Total 2014/15	482	293	826	327	600	91		3,083			4,991	711