Welcome to the August edition of Registrant update from the Physiotherapy Board of Australia (the Board). As with previous editions, I am pleased to provide the following key messages on behalf of the Board:
Over the next few months you will receive an electronic survey from the Board. The purpose of this email survey is to improve the Board’s understanding of registrants’ knowledge and awareness of their obligations as health practitioners under the National Law. As mentioned in the April Registrant update, the survey will not be a test, nor have any impact on your ongoing registration as a physiotherapist. The results will assist the Board to develop more targeted guidance and advice to registrants about specific areas or obligations that may be unclear. I encourage you to participate in this important activity.
As reported in recent communications, this collaborative project with the Physiotherapy Board of New Zealand will replace the existing Australian Standards for Physiotherapy and the Physiotherapy Competencies for Physiotherapy Practice in New Zealand. An Expert Reference Group has been appointed to provide advice to the Project Manager and Steering Committee. This group contains representatives of physiotherapy stakeholders, including the respective professional associations, education providers and accreditation entities from both countries.
A first draft is expected for delivery later this month, following a series of focus groups and workshops with clinical stakeholders across Australia and New Zealand. A wide-ranging public consultation process will then be undertaken on this document from October to December. The Board will keep registrants informed on this project via its regular communiqués, further editions of this newsletter and in media releases.
Further to my advice in the last edition on developing scope of practice, I highlight another key element of good care as outlined in the Board’s Code of conduct.
Providing good physiotherapy care involves maintaining a high level of professional competence and conduct. It includes ‘…practising in accordance with the current and accepted evidence base of the health profession, including clinical outcomes’. The Board has recently become aware of a number of physiotherapists who purport to be practising techniques for which there is very little current and accepted evidence within the profession.
The Board will take appropriate action against any registered physiotherapist whose practice poses a significant risk of harm to the public. I remind registrants that the Code of conduct is admissible in proceedings under the National Law, or the law of a co-regulatory jurisdiction, as evidence of what constitutes appropriate practice for the profession of physiotherapy.
Registrants may be aware of the Health Professionals Prescribing Pathway that was endorsed by Health Ministers in 8 November 2013. In light of this, the Board has recently begun discussions with a number of its key stakeholders to explore the potential for a case to be submitted to the Ministerial Council for approval of an endorsement on physiotherapist registration to prescribe scheduled medicines. If approved by the Council, this will result in eligible physiotherapists being able to apply to the Board for an endorsement and for it to be published on the public register with their other registration details.
However, it is important to note that whether such physiotherapists could then prescribe in Australia would still be dependent on a range of other factors, including the relevant drugs or poisons legislation in their jurisdiction and any relevant policies or other requirements of their workplace.
Recent data collected across the National Registration and Accreditation Scheme (the National Scheme) demonstrate that physiotherapy continues to have one of the lowest rates of notifications (complaints) of all the registered professions in Australia. In addition, a majority of these notifications are resolved with no further action taken by the Board and only a very small percentage are serious enough to progress to panels or tribunals for hearing.
Despite this, the Board has noted a significant increase in the number of notifications last financial year compared to recent years, with the majority related to professional conduct or performance. A recent decision of the South Australian Health Practitioners Tribunal also demonstrates the potential for physiotherapists to cause significant harm to the public. Amongst other things, this case is a salient reminder of the trust the public places in the profession and the importance that physiotherapists in clinical practice do not abuse the relationship of trust with their patients and its inherent power imbalance.
Chair, Physiotherapy Board of Australia
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The National Board has analysed its registration data and produced a number of statistical breakdowns about registrants to share with the profession and the community.
The table below shows there are 26,123 registered physiotherapists in Australia as of June 2014. The number of registered physiotherapists has increased by 208 since the previous update published in March 2014.
Of this total, 766 are non-practising and 264 have some form of limited registration.
Physiotherapists: state and territory by registration type (June 2014)
The data published by the National Board also contain information on physiotherapists by principal place of practice, gender by state and territory and endorsement type by state and territory.
For further details, visit the Statistics section of the Board’s website.
All 14 National Boards are inviting practitioners, members of the community and other stakeholders to provide feedback on guidelines that will determine how, from a regulatory perspective, health practitioners with blood-borne viruses should be managed.
Under the proposed guidelines, registered health practitioners with blood-borne viruses must comply with the Communicable Diseases Network of Australia (CDNA) guidelines on this issue to ensure their practice does not compromise patient safety.
The CDNA offers strategic advice to governments and other key bodies on public health actions to minimise the impact of communicable diseases, and its Australian national guidelines for the management of health care workers known to be infected with blood-borne viruses are endorsed by the Australian Health Ministers Advisory Council.
The National Boards’ proposed guidelines allow health practitioners infected with a blood-borne virus to practise their profession if they comply with the CDNA guidelines. However, they may have to modify their practice. For example, they will not be able to perform certain procedures such as exposure-prone procedures if the CDNA guidelines stop them from doing so.
The current CDNA guidelines define an exposure-prone procedure as a procedure where there is a risk of injury to the healthcare worker resulting in exposure of the patient’s open tissues to the blood of the worker. These procedures include those where the worker’s hands (whether gloved or not) may be in contact with sharp instruments, needle tips or sharp tissues (spicules of bone or teeth) inside a patient’s open body cavity, wound or confined anatomical space where the hands or fingertips may not be completely visible at all times.
The National Boards have published a consultation paper to support the draft guidelines, accessible under Current consultations on the Board’s website. The consultation is open until 26 September 2014.
The Physiotherapy Board of Australia, along with the other National Boards, has acted on feedback received about the Guidelines for advertising regulated health services (Advertising guidelines) that were released in March and has published an update. The updated guidelines, FAQ and a fact sheet are published under Codes and guidelines on the Board’s website.
Anyone who advertises a regulated health service must meet the requirements of the National Law. This includes registered health practitioners, individuals who are not health practitioners and businesses.
No new requirements have been added.
The updated Advertising guidelines were edited to make them clearer, particularly that:
The National Boards would like to thank everyone who provided feedback on the guidelines. Whenever possible, this feedback was taken into account and used to update the guidelines.
Much of the feedback was about the ban on using testimonials in advertising a regulated health service. This is a requirement of the National Law, which is something National Boards are obliged to implement. The terms of reference for the scheduled review of the National Scheme (the scheme regulating registered health practitioners in Australia) include a point relating to advertising, and interested health practitioners and members of the public are encouraged to provide feedback about the legislation. See more below.
Australia’s health ministers have announced the terms of reference for the scheduled review of the National Registration and Accreditation Scheme (the National Scheme). The review – to be led by independent reviewer, Mr Kim Snowball – was built into the intergovernmental agreement that set up the framework and governance arrangements for the National Scheme. The agreement stated that the Australian Health Workforce Ministerial Council (Ministerial Council) will initiate an independent review after three years of the National Scheme’s operation.
The terms of reference for the review are published at Australian Health Ministers’ Advisory Council website under ‘media releases’ on the right-hand tab.
The independent reviewer, Mr Snowball, has held a variety of senior leadership roles in both the public and private health sectors. He was previously the Director General of WA Health and has also served as the Chair of the Australian Health Ministers’ Advisory Council (AHMAC).
The National Board will be participating in the review process and will keep stakeholders informed of opportunities to provide comment and consultation timelines.
The National Boards and AHPRA have launched refreshed regulatory principles that will underpin the work of the Boards and AHPRA in regulating Australia’s health practitioners in the public interest.
The principles are endorsed by all National Boards and the AHPRA Agency Management Committee and will guide Boards and AHPRA when they are making decisions. The principles encourage a responsive, risk-based approach to regulation across all professions within the National Scheme.
Regulatory decision-making is complex and contextual, requiring judgement, experience and common sense. The principles will further support consistent, balanced decision-making.
AHPRA and the National Boards will be seeking feedback on the principles in a formal consultation later in 2014 and will review them based on this feedback and 12 months’ experience. You can read the regulatory principles in a media release on the AHPRA website.
One of the objectives of the National Scheme is to protect the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered. To achieve this objective AHPRA and the National Boards are increasing the use of data and research to inform policy and regulatory decision-making. Specifically, we’re building organisational capacity for analysis, supporting external collaboration on regulatory research, and conducting or supporting high value regulatory research and analysis.
To do this well, we must effectively govern access to data generated by the National Scheme. We can provide access to de-identified data, as governed by the National Law and the relevant privacy laws and policies, but strict limits exist. These limitations are explained on the AHPRA website, which also includes a downloadable data access and research application form (1.11 MB,PDF) for interested researchers.
AHPRA and the National Boards encourage applications from researchers whose projects aim to deliver regulatory improvement and health workforce reform.
July marks the four-year anniversary of the National Scheme (with Western Australia joining in October 2010). Reflecting on the past four years, AHPRA Chair, Mr Michael Gorton AM, said the National Scheme had delivered important benefits for the quality and safety of the health system in each state and territory and for health practitioners and the community.
The National Scheme was the product of an important national health workforce reform, which was internationally significant in its scale and ambition.
Headline achievements in the last four years include:
We are changing the homepages of the AHPRA and National Boards’ websites, to make them easier to use and make it easier for users to find what they need.
The designs aim to make searches easier and more accurate and promote consultations and AHPRA’s social media channels to make it easier for users to find the information they are looking for. The new designs are based on analytics data on how people use the sites as well as feedback from staff (including our customer service teams who receive calls from our stakeholders on where to find information on the sites) as well as members from our community reference group.
With the new homepages, users will be able to:
While the new homepages will make an immediate improvement on the usability of the sites, there is still more work to follow. Work on the rest of the sites will begin later this year, which will include extensive consultation with a range of user groups, including practitioners, employers and members of the community.