Registration - AHPRA Annual Report 2015/16

AHPRA Annual Report 2015/16

Registration

Performance snapshot

Note: Supplementary tables with registration data are available on the Downloads page.

Table R1: Registered practitioners by profession by principal place of practice1
Profession ACT NSW NT QLD SA TAS VIC WA No PPP2 Total 2015/16 Total 2014/15 % Change 2014/15-2015/16
Aboriginal and Torres Strait Islander Health Practitioner 4 106 210 103 52 3 11 98   587 391 50.13%
Chinese Medicine Practitioner 66 1,953 17 862 183 33 1,289 254 105 4,762 4,494 5.96%
Chiropractor 67 1,736 23 818 373 57 1,328 602 163 5,167 4,998 3.38%
Dental Practitioner 402 6,580 153 4,326 1,800 356 4,972 2,548 604 21,741 21,209 2.51%
Medical Practitioner 2,042 33,236 1,177 20,949 7,858 2,236 26,061 10,756 2,864 107,179 103,133 3.92%
Medical Radiation Practitioner 264 5,089 112 3,061 1,161 311 3,740 1,325 240 15,303 14,866 2.94%
Midwife 120 903 73 770 522 22 1,181 385 146 4,122 3,682 11.95%
Nurse 5,382 95,076 3,785 67,703 30,764 8,212 91,129 34,664 9,672 346,387 336,099 3.06%
Nurse and Midwife3 579 8,742 520 6,019 2,123 646 7,769 2,968 333 29,699 30,522 -2.70%
Occupational Therapist 335 5,167 175 3,544 1,430 285 4,521 2,626 221 18,304 17,200 6.42%
Optometrist 75 1,743 30 1,031 280 85 1,315 417 166 5,142 4,915 4.62%
Osteopath 34 572 3 190 37 42 1,109 62 45 2,094 2,000 4.70%
Pharmacist 516 9,171 217 5,843 2,142 701 7,360 3,163 604 29,717 29,014 2.42%
Physiotherapist 539 8,408 165 5,349 2,289 450 7,060 3,475 1,120 28,855 27,543 4.76%
Podiatrist and Podiatric Surgeon 61 1,268 24 780 427 104 1,481 442 68 4,655 4,386 6.13%
Psychologist 876 11,236 229 6,028 1,678 580 9,152 3,599 529 33,907 32,766 3.48%
Total 2015/16 11,362 190,986 6,913 127,376 53,119 14,123 169,478 67,384 16,880 657,621    
Total 2014/15 10,978 185,247 6,696 121,788 52,192 13,886 164,324 65,588 16,519   637,218

Notes:

  1. Data are based on registered practitioners as at 30 June 2016.
  2. No principal place of practice (No PPP) will include practitioners with an overseas address.
  3. Registrants who hold dual registration as both a nurse and a midwife.

For more detailed information about the professions that have divisions: Chinese medicine, dental, medical radiation practice, and nursing and midwifery - please refer to the list published on the Professions and Divisions page on AHPRA's website, and the individual profession summaries published on the Downloads page.

Renewals

AHPRA renewed registration for 608,711 health practitioners across Australia this year.

There are three main annual renewal periods every year: nurses and midwives by 31 May; most medical practitioners by 30 September; and other health practitioners by 30 November. This year, 98.07% of all eligible health practitioners renewed their registration online; an increase of 19,803 practitioners compared with last year (an increase of 3.43%).

The continued high rate of online renewals is a significant achievement. It enhances the practitioner experience, reduces the costs associated with sending hard-copy reminders and improves efficiency.

We are committed to continuously improving the systems and processes that make it easier for health practitioners to use our online services. One example of this is the significant effort that went into streamlining the registration renewal process for the nursing and midwifery renewal campaign between March and May 2016. AHPRA worked with the Nursing and Midwifery Board of Australia to:

The survey results were positive, with 95% of respondents saying the email reminder instructions were perfectly or mostly understood, and 85% saying they did not need to contact AHPRA for assistance while completing their renewal. Our customer service team recorded noticably fewer incoming telephone enquiries (17% less) and web inquiries (30% less) about the renewal process compared with last year. Over 98% of nurses and midwives renewed online and on time - the Board's highest ever online renewal rate.

Customer service team

AHPRA's customer service team manages telephone and online web enquiries from the community and health practitioners.

This year the team handled 382,207 phone and 44,603 web enquiries. Of the calls received, 75.47% were answered within 90 seconds and 92.74% were resolved on first contact, exceeding our service level agreement. In addition, 93% of callers responded with 'very satisfied' when asked to rate their interaction with our customer service team.

Examinations

AHPRA delivers examinations to support the registration requirements of the Pharmacy Board of Australia, the Psychology Board of Australia and the Medical Radiation Practice Board of Australia.

This year, 1,802 oral examinations were held for pharmacy candidates and 507 computer-based examinations were held for eligible provisional psychologists. An additional eight computerbased examinations were held for eligible medical radiation practice candidates.

Grandparenting provisions

Grandparenting arrangements for the four professions that joined the National Scheme in 2012 ended from 30 June 2015. These provisions under the National Law provided a possible pathway to registration for existing practitioners who did not have contemporary, approved qualifications.

The four professions involved were Aboriginal and Torres Strait Islander health practice, Chinese medicine, medical radiation practice and occupational therapy. A significant number of complex applications for registration were received in the final month leading up to the end of the provisions, most notably for the Aboriginal and Torres Strait Islander health practice and Chinese medicine professions.

Registration teams in AHPRA's South Australia office (for Chinese medicine) and Northern Territory office (for Aboriginal and Torres Strait Islander health practice) provided additional support to the Aboriginal and Torres Straight Islander Health Practice Board of Australia and the Chinese Medicine Board of Australia, respectively, to manage the high volume of applications.

The number of registered Aboriginal and Torres Strait Islander health practitioners increased by over 50% - from 391 to 587 - by the end of 2015/16; our fastest growing health profession in the National Scheme this year.

Indigenous health professionals

Table R2: Indigenous status of registered health professionals across 13 professions1
Profession 2013 registrations Indigenous born Aus*2 2013 registrations % 2014 registrations Indigenous born Aus*2 2014 registrations % 2015 registrations Indigenous born Aus*2 2015 registrations %
Chinese medicine practitioners 13 0.3% 17 0.4% 19 0.4%
Chiropractors 12 0.3% 17 0.3% 17 0.3%
Dental practitioners 58 0.3% 68 0.3% 74 0.3%
Medical practitioners 244 0.3% 282 0.3% 302 0.3%
Medical radiation practitioners 46 0.3% 49 0.3% 64 0.4%
Nurses and midwives 2,887 0.8% 3,196 0.9% 3,428 1.0%
Occupational therapists 62 0.4% 67 0.4% 76 0.4%
Optometrists 7 0.1% 5 0.1% 16 0.3%
Osteopaths 10 0.5% 11 0.6% 16 0.8%
Pharmacists 46 0.2% 59 0.2% 68 0.2%
Physiotherapists 113 0.4% 123 0.5% 142 0.5%
Podiatrists 14 0.3% 66 1.5% 30 0.7%
Psychologists 137 0.4% 142 0.5% 167 0.5%
Total percentage of overall health workforce 3,649 0.6% 4,102 0.7% 4,419 0.7%

Notes:

  1. Aboriginal and Torres Strait Islander status is collected through the workforce survey completed by practitioners when they renew their registration. The workforce survey has very high response rates, making it a good source of information on the participation of Aboriginal and Torres Strait Islanders in the health workforce, however it should be noted that there are limitations associated with voluntary self-identification.

    It is also important to note that the data in this table indicate the proportion of Indigenous practitioners working in 13 of Australia's 14 regulated health professions. All of the practitioners registered with the Aboriginal and Torres Strait Islander Health Practice Board of Australia must be of Aboriginal or Torres Strait Islander origin to qualify for registration in that profession.
  2. Aboriginal or Torres Strait Islander rates shown in this table represent those practitioners who were born in Australia and identified themselves in the survey as being Aboriginal, a Torres Strait Islander, or both.

AHPRA and the National Boards recognise the importance of contributing to improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples, and the growth and development of the Indigenous workforce that provides health care within the community.

One way the National Scheme contributes to this is by facilitating the collection of data on the number of registered health practitioners who identify as being of Aboriginal and/or Torres Strait Islander origin. From 2015/16, we are reporting these data in our annual report.

This information is used for workforce policy and planning purposes. For example, it helps with implementing and measuring outcomes of the National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework (2011-2015), which prioritises Commonwealth, state and territory government initiatives to increase participation by Indigenous peoples in the health workforce.

In 2015, Australia's estimated resident Aboriginal and Torres Strait Islander population was 3% of the total population and 2.4% of those were aged 18 years and older. Table R2 indicates that Aboriginal and Torres Strait Islander participation in 13 of the health professions was 0.7% of the national health workforce in 2015, up 0.1% from 2013. The highest participation rate in 2015 was for Indigenous nurses and midwives, who comprised 1% of that workforce. The data do not reflect the 100% Indigenous status of practitioners registered with the Aboriginal and Torres Strait Islander Board of Australia. When these practitioners are included, the overall participation rate of Indigenous practitioners in the health workforce rises to 0.8%.

During 2016/17, AHPRA and the National Boards will consider additional ways to ensure that the health and cultural needs of Indigenous peoples are addressed through the policies, standards and operation of the National Scheme.

Student registration

Registration data supplied by accredited education providers indicate that 153,710 students were studying in Australia to be health practitioners during 2015/16.

Under the National Law, a National Board must decide whether students who are enrolled in an approved program of study or undertaking clinical training should be registered. A student does not need to apply for registration, as education providers are responsible for arranging the registration of all their students with AHPRA. Student registration is free and the register is not made public. All National Boards have decided to register students, with the exception of the Psychology Board of Australia, which requires provisional registration.

The accuracy of the student registration information AHPRA receives depends on the quality of data supplied to us by education providers. We continue to work with more than 120 education providers to improve the exchange of information and identify the status of students to ensure that information is accurate, particularly in relation to completion/ cessation of students who may have otherwise remained on the student register.

Table R3: Student registration numbers1
Profession Approved program of study2 students by expected completion date Clinical training3 students by expected completion date Total 2015/16 Total 2014/15
Aboriginal and Torres Strait Islander Health Practitioner 260 32 292 140
Chinese Medicine Practitioner 1318   1318 1481
Chiropractor 796 444 1240 1894
Dental Practitioner 4796 14 4810 4710
Medical Practitioner 19184 576 19760 18680
Medical Radiation Practitioner 3223 224 3447 4088
Midwife 3949   3949 3703
Nurse 88919 701 89620 77974
Occupational Therapist 7921 1 7922 8234
Optometrist 1652   1652 1590
Osteopath 1759   1759 1189
Pharmacist 7277 3 7280 7389
Physiotherapist 8283 660 8943 9097
Podiatrist and Podiatric Surgeon 1718   1718 1782
Total 2015/16 151,055 2,655 153,710  
Total 2014/15 138,212 3,739   141,951

Notes:

  1. These student figures are based on the number of students reported as undertaking an approved program of study/clinical training program within the relevant financial year. This may include ongoing students or students with a completion date falling within the period. It is important to note that this information is reliant on the data provided by education providers. AHPRA continues to work both internally and with the 120+ education providers to improve the exchange of information and accurately identify the status of students to ensure that information is accurate, particularly in relation to completion/cessation of students who may have remained on the student register.
  2. Approved programs of study refer to those students enrolled in a course that has been approved by a National Board and leads to general registration. These courses can be found on the Approved Programs of Study page on the AHPRA website.
  3. Clinical training has been defined as any form of clinical experience (also known as clinical placements, rotations, etc) in a regulated health profession that does not form part of an approved program of study AND the student does not hold registration under division 6 of the National Law in the health profession in which the clinical training is being undertaken. This obligation is imposed by section 91 of the National Law and may apply for example:
    1. when an overseas student arranges a clinical placement as part of the course requirements set out by the education provider in their home country
    2. when an education provider is running a course that is accredited by an accreditation authority but has not yet been approved by a National Board, or
    3. when an education provider is running a course that has not yet been accredited by an accreditation authority or approved by a National Board.

A clinical training education provider could be a university, registered training organisation, hospital, health facility, private practice or retail outlet (e.g. retail pharmacy). Because of this, exact numbers of clinical training providers are largely unknown to AHPRA and we are reliant on the clinical training figures reported to us under section 91(1) of the National Law. Due to the nature of the clinical training provisions within the National Law, the student numbers reported may fluctuate significantly each year.

Criminal history checks

AHPRA requested 66,698 domestic and international criminal record checks of practitioners this year, an increase of 28.4%.

While there has been a moderate increase in domestic criminal record checks, most of the increase is due to a new approach to checking international criminal history, which was introduced in 2014/15. Of all criminal record checks obtained in 2015/16:

Overall, 4.9% (3,275) of the results indicated that the applicant had a disclosable court outcome. All disclosable outcomes are assessed in accordance with the criminal history standard, which is common across all 14 National Boards. In the majority of cases, the applicant was granted registration because the nature of the individual's disclosable court outcome had little relevance to their ability to practise in their profession safely and competently.

One applicant was refused registration due to their disclosable court outcome. A further 10 practitioners had conditions imposed on their registration.

How we check criminal history

Under the National Law, applicants for initial registration must undergo criminal history checks.

Applicants seeking registration must disclose any criminal history information when they apply for registration, and practitioners renewing their registration are required to disclose if there has been a change to their criminal history status within the preceding 12 months.

International applicants seeking registration in Australia and certain registered health practitioners, including those registered under Trans-Tasman mutual recognition arrangements, need to obtain an independent international criminal history check from an AHPRA-approved supplier, who will provide the report to them as well as directly to us. A check is required when an applicant or health practitioner declares an international criminal history and/or has lived, or been primarily based, in any country other than Australia for six consecutive months or more when aged 18 years or over.

AHPRA may also seek a report from a police commissioner or an entity in a jurisdiction outside Australia that has access to records about the criminal history of people in that jurisdiction. The criminal history reports are used as one part of assessing an applicant's suitability to hold registration. There is a common criminal history standard across all 14 National Boards.

While a failure to disclose a criminal history by a registered health practitioner does not constitute an offence under the National Law, such a failure may constitute behaviour for which a National Board may take health, conduct or performance action.

Table R4: Domestic and international criminal history checks by profession, state or territory and cases where a criminal history check resulted in or contributed to imposition of conditions or undertakings1
Profession ACT Number of CHCs2 ACT Number of DCOs3 ACT Conditions/undertakings resulting from CHCs NSW Number of CHCs NSW Number of DCOs NSW Conditions/undertakings resulting from CHCs NT Number of CHCs NT Number of DCOs NT Conditions/undertakings resulting from CHCs QLD Number of CHCs QLD Number of DCOs QLD Conditions/undertakings resulting from CHCs SA Number of CHCs SA Number of DCOs SA Conditions/undertakings resulting from CHCs TAS Number of CHCs TAS Number of DCOs TAS Conditions/undertakings resulting from CHCs VIC Number of CHCs VIC Number of DCOs VIC Conditions/undertakings resulting from CHCs WA Number of CHCs WA Number of DCOs WA Conditions/undertakings resulting from CHCs No PPP4 Number of CHCs No PPP4 Number of DCOs No PPP4 Conditions/undertakings resulting from CHCs Total 2015/16 Number of CHCs Total 2015/16 Number of DCOs Total 2015/16 % of DCOs resulting from CHCs Total 2015/16 Conditions/undertakings resulting from CHCs Total 2014/15 Number of CHCs Total 2014/15 Number of DCOs Total 2014/15 % of DCOs resulting from CHCs Total 2014/15 Conditions/undertakings resulting from CHCs
Aboriginal and Torres Strait Islander Health Practitioner 1 1   95 29   65 37   97 30   32 23   0 0   10 5   96 67 1 0 1   396 193 48.74% 1 266 111 41.73% 1
Chinese Medicine Practitioner 6 1   361 25   1 0   173 15   31 4   3 0   272 8   54 6   32 1   933 60 6.43% 0 1,187 78 6.57% 1
Chiropractor 10 1   268 25   1 0   118 14   41 5   3 1   233 11   102 8   11 1   787 66 8.39% 0 664 62 9.34% 2
Dental Practitioner 22 2   511 26   9 0   416 18 1 171 10   19 10   555 17   212 12   77 1   1,992 96 4.82% 1 1,764 106 6.01% 4
Medical Practitioner 217 1   2,774 86   150 8   2,028 51   692 23   218 28   4,387 31   1,191 35   234 4   11,891 267 2.25% 0 9,298 320 3.44% 6
Medical Radiation Practitioner 26 1   615 20   12 1   255 14   99 3   18 7   453 9   158 5   92 1   1,728 61 3.53% 0 1,989 102 5.13% 0
Midwife 32 3   179 15   18 2   152 15   83 4   3 2   244 3   81 7   67 1   859 52 6.05% 0 1,422 55 3.87% 0
Nurse 557 23   9,491 490   383 13   6,444 408 1 2,731 233   574 291   10,567 261   3,354 236 5 2,039 22   36,140 1,977 5.47% 6 24,328 1,738 7.14% 21
Occupational Therapist 43 1   672 15   9 0   425 11   156 7   19 9   641 8   310 14   13 1   2,288 66 2.88% 0 1,626 60 3.69% 0
Optometrist 5 0   122 1   0 0   65 0   38 2   0 0   144 2   24 0   10 0   408 5 1.23% 0 618 32 5.18% 1
Osteopath 0 0   51 9   0 0   19 3   2 1   0 0   108 2   3 0   2 0   185 15 8.11% 0 266 21 7.89% 0
Pharmacist 48 1   776 23   19 1   525 14 1 187 6   56 16   648 14   237 11   20 0   2,516 86 3.42% 1 2,264 105 4.64% 0
Physiotherapist 52 2   884 28   11 0   492 14   195 12   23 5   672 14   312 19   61 0   2,702 94 3.48% 0 2,645 96 3.63% 0
Podiatrist and Podiatric Surgeon 8 2   260 20   2 0   128 6   61 8   19 6   268 4   52 7   16 1   814 54 6.63% 0 738 55 7.45% 0
Psychologist 56 2   1,037 56   26 2   540 38   124 5   40 13   844 34 1 361 32   31 1   3,059 183 5.98% 1 2,872 159 5.54% 1
Total 2015/16 1,083 41 0 18,096 868 0 706 64 0 11,877 651 3 4,643 346 0 995 388 0 20,046 423 1 6,547 459 6 2,705 35 0 66,698 3,275 4.91% 10        
Total 2014/15 723 58 3 14,302 887 8 488 79 0 9,547 541 11 3,994 298 4 819 336 0 16,337 425 2 5,737 476 9               51,947 3,100 5.97% 37

Notes:

  1. For 2015/16, figures are reported by principal place of practice. For 2014/15, figures are reported by the state/territory location of the preferred address as advised by the applicant/registrant. Where this can’t be identified, the location of the office assessing the application is used.
  2. Criminal history checks. Refers to both domestic and international criminal history checks submitted. International criminal history checks started in 2014/15.
  3. Disclosable court outcomes.
  4. No principal place of practice (No PPP) will include practitioners with an overseas address.

Auditing compliance with registration standards

AHPRA conducts regular audits of health practitioners on behalf of the National Boards. Audits provide assurance that practitioners understand the registration standards for their profession and are meeting these obligations. During an audit, a practitioner is contacted and required to provide evidence in support of the declarations made in their previous year's registration renewal application.

Since we began conducting audits in 2012, the vast majority of practitioners audited have been found to comply with registration standards. In that time, 3% of those audited have either surrendered their registration or moved to non-practising registration while being audited. Analysis of the circumstances of those practitioners demonstrates two clear groups: practitioners residing overseas and those no longer practising but maintaining registration.

In 2015/16, AHPRA audited 6,125 practitioners across all 14 professions. All National Boards audited compliance with one or more of the registration standards.

For all audits initiated and completed this year, 93% of practitioners were found to be in full compliance with the registration standards being audited. While this is a 3% decrease from 2014/15, when 96% were found to be fully compliant, less than 1% of all audited practitioners were formally cautioned in 2015/16 - the same as last year. We analysed the audit outcomes to better understand the reasons for this change. In some professions, practitioners were not always fully aware of specific requirements for continuing professional development. This is being addressed through increased communication about what is required to comply with professional development standards.

Audit outcomes for 2015/16:

Notes:

  1. 'No audit action required' refers to practitioners who changed registration type (became non-practising) or surrendered their registration after being advised that they were subject to an audit.

How our audit process works

All registered practitioners are required to comply with a range of national registration standards. Each time a practitioner applies to renew their registration they must make a declaration that they have met the registration standards for their profession.

Our auditing function provides additional assurance to the public, Boards and practitioners that the requirements of the National Law are understood and that practitioners are compliant with their Board's registration standards. During an audit a practitioner is required to provide evidence of the declarations they made in the previous year's renewal of registration.

The standards that may be audited are continuing professional development, recency of practice, professional indemnity insurance arrangements and criminal history.

All Boards have adopted an educational approach to conducting audits, seeking to balance the protection of the public with the use of appropriate regulatory force to manage those practitioners found to be less than fully compliant with the audited standards. Practitioners who are found to have 'not quite' met the registration standard but are able to provide evidence of achieving full compliance during the audit period, are managed through education to achieve full compliance.

For example, we may encounter a number of practitioners across different professions who have gaps in compliance with continuing professional development, most commonly by being one or two hours/units short of the required amount. In these instances, all Boards have accepted that the practitioner can complete the required hours before the closure of the audit. These practitioners are recorded as being 'compliant (education)' and this year represent 3% of all completed audits across the 14 professions.

What if a practitioner is non-compliant?

When an audit finds that a practitioner has not met the requirements of the registration standards, all Boards follow an approach consistent with the regulatory principles, which aims to work with the practitioner to ensure compliance before the next period of renewal.

This may include formally cautioning the practitioner about the importance of complying with registration standards. All matters that involve issuing a caution or placing conditions on a registration are subject to a 'show cause' process. The show cause process alerts the practitioner of the Board's intended action and gives the practitioner an opportunity to respond before a final decision is made.