September 2019

Issue 24 - September 2019


From the Chair

Kim Gibson

This year the Board has continued to engage with as many physiotherapists and stakeholders as it can. We recently presented a webinar on continuing professional development (CPD), which you can now view on our website. Read more below.

The Board also holds stakeholder breakfasts when it travels to meet in Australian capital cities. We know that not everyone can attend, so there are often opportunities to videoconference. Keep an eye out for an invitation from the Board to attend one of these events, which offer the chance to get to know your registration board, interact with board members and ask questions. We invite students, registrants and other stakeholders to attend.

We are embarking on two projects this year. The first relates to one of our main objectives: to facilitate a flexible workforce. With increasing numbers of physiotherapists coming to Australia from overseas, we want to understand the profile of these registrants, particularly limited registrants, better.

The other project will begin the long journey towards consideration for physiotherapist prescribing. Government and the Australian Health Practitioner Regulation Agency (AHPRA) have given us guidance and frameworks within which this work can be developed. We expect that the prescribing journey will take many years and broad consultation with all stakeholders. Read more below.

Kim Gibson 
Chair, Physiotherapy Board of Australia

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Board news

World Physical Therapy Day celebrates physiotherapists providing care to chronic pain patients

To celebrate World Physical Therapy Day (WPTD) on September 8, the Physiotherapy Board of Australia (the Board) and the Australian Physiotherapy Council (APC) recognised the important care given by physiotherapists to patients suffering from chronic pain.

The main focus for this year’s WPTD was chronic pain as a significant global health burden. Chronic pain causes more disability than any other condition.

The Board celebrates the critical contribution Australia’s 33,792 registered physiotherapists make to patients receiving safe and ethical care that helps keep people healthy, active, mobile and independent – what the World Confederation for Physical Therapy (WCPT) calls the Movement for Health campaign.

The World Health Organization’s Rehabilitation 2030 (Rehab 2030) initiative is also looking at the unmet need for rehabilitation and the important role physiotherapists play in providing quality, safe care to patients. Many Australians have been helped to overcome conditions including chronic pain without going to hospital, thanks to specialist care by rehabilitation teams that include physiotherapists.

Patients expect that every time they see a physiotherapist their practitioner is adhering to their obligations under the National Law.1 This means they can be safe in the knowledge that their practitioner will put their best interests first.

The Board also publishes codes and guidelines for physiotherapists and maintains the online national register of practitioners which can be accessed at www.physiotherapyboard.gov.au, along with the most up-to-date information for practitioners.

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1 Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).

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Important consultations now open – feedback invited

Three public consultations are now open asking for people to have their say on revised guidance to help practitioners and others understand their mandatory notification obligations, understand their obligations when advertising a regulated health service and to support a responsive and risk-based approach to supervised practice

Alongside other National Boards and AHPRA, the Board is conducting consultations on:

  • revised Guidelines for mandatory notifications
  • revised Guidelines for advertising a regulated health service
  • a proposed Supervised practice framework (excluding Psychology and Pharmacy Boards).

We invite physiotherapists and physiotherapy stakeholders to give feedback to these important public consultations. To ensure everyone has the chance to respond the closing dates for public consultation have been staggered as follows:

  • Guidelines for mandatory notifications − closes 6 November 2019
  • Guidelines for advertising a regulated health service − closes 26 November 2019
  • Supervised practice framework − closes 17 December 2019  

The consultation papers are available on the Consultations page of the Board’s website. To make it easier to participate, you can use the online survey option to send us your feedback.

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Australian Physiotherapy Council: new accreditation agreement and simulation assessments

We are pleased to announce that the Board, AHPRA and the Australian Physiotherapy Council (APC) have signed a new five-year accreditation agreement that started on 1 July 2019.

The APC plays a critical role in protecting the public through accrediting programs of study against the accreditation standards approved by the Board and ensures that when the Board approves these programs as qualifications for registration, it is confident that graduates have the knowledge, skills and professional attributes to practise as a physiotherapist.

The new agreement provides a contemporary framework for addressing priority accreditation issues which will improve public protection as well as provide increased transparency and accountability.

New simulation laboratory is world-class

The APC also assesses the qualifications, skills and competencies of overseas-qualified physiotherapists for registration and migration purposes. When the APC hosted the Board's July meeting at their Richmond, Victoria office, we were given a tour of the new simulation laboratory (The Lab). This provides overseas-trained practitioners with an authentic and carefully controlled clinical environment to demonstrate their competence before qualifying to register and practise in Australia.

A growth in demand for physiotherapists in Australia a few years ago led to increased numbers of internationally qualified practitioners applying for assessments. Back then, assessments were carried out in real hospitals and with real patients. Patient availability was unreliable and there were understandable limitations to the scope of assessment. Supply was not meeting demand and waiting lists were becoming unreasonable.

In July 2017, the APC and Western Sydney University began a research trial to determine whether simulation would be as reliable as the single-event practical assessments that were being carried out with patients in hospitals and clinics, nationwide. The findings were extremely positive about simulated assessments using skilled actors in place of real patients. This led to the APC's relocation to new premises that have been carefully designed to accommodate the APC office function as well as The Lab.

The most impressive feature of the simulated assessment environment is its capacity to replicate a patient encounter in multiple environments (hospital, private practice and rehabilitation settings), on a set date and in one location. This has streamlined the assessment process for overseas-trained applicants, reduced wait times, and gives applicants a fairer opportunity to show their full range of clinical skills in a standard test environment, including taking a patient’s history, physical examination and communication and rapport building, before being registered in Australia.

APC simulation lab monitor screens

APC simulation lab clinical setting hospital

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Make sure you’re up to date with your CPD

Lifelong adult learning is a rewarding gift that health professionals should embrace. It sends a strong message to patients, the public and regulators that practitioners are maintaining the expected high standards of their professional practice.

Continuing professional development (CPD) is how physiotherapists maintain, improve and broaden their knowledge, expertise and competence, and develop the personal and professional qualities required throughout their professional lives, and it is a professional obligation of all registered physiotherapists. Make sure you are aware of and meet the requirements by reading the CPD registration standard. With registration renewal coming up, you need to ensure you have met your CPD goals for this year.

Physiotherapists doing CPD often combine a variety of learning methods, including self-directed learning, formal and informal learning. Keeping a logbook is a requirement of the registration standard that includes your CPD plan, your activities and a reflection on how these have affected your practice. Along with the registration standard itself, there is an example logbook and related FAQ on the Board’s website under CPD resources.

We have also published a recording of our recent webinar, CPD and you, as well as the questions that were asked during the session.

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Physiotherapist prescribing: where to from here?

Our new project, starting this year, heralds the beginning of the long journey towards consideration for physiotherapist prescribing.

The Board’s role

The Board seeks to have a contemporary and complete understanding of the international non-medical prescribing situation. It will carry out a gap analysis and publish a background document to form a view about the readiness of the profession to prescribe in Australia.

It is not the Board’s role to promote the profession, nor is it within the Board’s powers to endorse someone’s registration to prescribe without ministerial approval for every aspect from training, registration standards, to CPD and complaints handling.

The Board’s main purpose is to protect the public and to ensure that consumers receive contemporary and safe physiotherapy services. Every aspect of such a momentous change needs to be explored and understood. The Board’s role is in facilitating a case for prescribing for Health Ministers to consider.

The Australian Government and AHPRA have recently provided guidance and frameworks within which this work can be developed. We expect that the prescribing journey will take many years and broad consultation with all stakeholders.

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Get to know your Board

Kate Waterford, community member

Kate WaterfordWhat attracted you to the role of community member on the Board ?

I'm a personal injury lawyer, with a special interest in medical negligence. Over the years, I have acted for hundreds of people from all walks of life, with different injuries, conditions or disabilities, accessing a wide range of medical services. I see every day the devastating consequences on individuals and families of health services gone wrong.

I hoped that on a National Board, I would have an opportunity to contribute to making the healthcare sector safer for the Australian public. I also knew that I would enjoy working with health practitioners on the Board, just as I have learnt so much from the many medical professionals who have worked with me as expert witnesses over the years.

What are you passionate about?

Increasing quality in health practice. I love that as a Board member, I get a chance to draw from my experiences of health services at a local, individual level when looking at the bigger picture and discussing strategies for improving public safety at a national level. A special interest of mine is thinking about how to improve health services for people living in remote locations.

What is your vision for the profession?

Australia is lucky enough to have a highly qualified, high-performing physiotherapy profession, but there is always room for improvement. The country is growing, and its population is changing, so the profession will need to be able to rise to meet those new challenges, while maintaining its current high standards of professionalism and safety. We need to ensure that the newly trained or arrived physiotherapists who swell the ranks of the profession to meet the growing need, practise safely from the beginning. 

The profession doesn't exist in a bubble, rather it is part of our community as a whole. It is important that the community has the information and access to raise concerns with AHPRA, and that those concerns are dealt with promptly and effectively. 

What does it mean to be a community member? What role do you play?

The Physiotherapy Board of Australia benefits from the high-level clinical expertise of eight practitioners, from a range of backgrounds and locations. I always have a lot to learn from the physiotherapists, who know the needs of their own profession so intimately, but an outsider's perspective can enrich the discussion. As a community member, I often think about issues quite differently to practitioners, drawing on my legal and accounting training and my years of experience advising consumers. The participation of community members alongside practitioner members helps the Board to test its ideas and strategies from different angles, and to maintain high quality decision-making. 

I also sit on the Board's Continuous Improvement Committee, and I was part of a selection panel for AHPRA's Community Reference Group.

Want to know more?

Find out more about our current Board members on our updated About the Board page.

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Registration

Physiotherapist registration on the rise – latest update

Statistics on the numbers of physiotherapists in Australia are published quarterly on the Board’s website under Statistics. The most recent report covers 30 April to 30 June 2019. The profession has grown to 33,792 physiotherapists, of whom 66% (22,378) are female and the largest group (7,311) is aged 25–29 years.

The statistics also cover types of registration, breakdowns by age, gender and place of practice, and other details of the registered workforce.

Registration renewal reminder – keep an eye on your inbox

The National Law requires all registered health practitioners to renew their registration annually. Physiotherapists must renew their registration with the Board by 30 November each year – this is the annual renewal date for the profession.

Physiotherapists will be invited to renew their registration before 30 November 2019. AHPRA will start sending out information on renewal in September/October.

You must renew via the online portal. Look out for AHPRA’s email reminders to renew as confirmation that online renewal is open. Reminders will be emailed several times during the renewal period, so please make sure your contact details held by AHPRA are up to date.

Keep an eye on our website for further information.

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Regulation at work

Landmark decision sees a suspended physiotherapist convicted and receiving largest fine ever

Following criminal charges laid by AHPRA, a Tasmanian court imposed the largest fine against an individual for offences under the National Law in Australia with the conviction of a suspended physiotherapist, Mr Michael Sylvester Dempsey, for holding out.

On 19 February 2019, Mr Dempsey pleaded guilty to charges of holding out 11 people as registered physiotherapists or occupational therapists, when they were not. On 30 April, Mr Dempsey was convicted and fined $120,000.

Mr Dempsey admitted in the Tasmanian Magistrates’ Court in Launceston to knowingly holding people out as registered health practitioners, when they were not, at various aged care facilities in Tasmania.

AHPRA CEO Martin Fletcher said this outcome demonstrates the regulator’s determination to protect the Australian community from such unlawful and deceptive behaviour.

‘The deliberate, intentional and deceptive behaviour uncovered as part of this case is of the most serious kind perpetrated on vulnerable people in aged care facilities. AHPRA will not hesitate to take action if we identify someone is practising as a registered practitioner when they are not registered,’ he said.

‘It also highlights the importance of the public and employers checking the online national register of practitioners to make sure services are being provided by a registered health practitioner. If you think someone is not registered – and they should be – tell AHPRA,’ he added.

AHPRA started its investigation after receiving a complaint from a registered chiropractor employed by Mr Dempsey’s company Libero Health Care Pty Ltd (Libero).

Following its investigation, AHPRA alleged that Libero was engaging unregistered people to provide regulated health services, specifically complex healthcare to residents at aged care facilities. AHPRA also alleged that the people held out by Libero to deliver services were not registered practitioners and had been instructed to falsely assume/sign the names of registered practitioners when giving treatment to residents in the aged care facilities they visited.

The people held out came from unrelated sectors including hospitality and transport. They were employed to provide pain management services to around 78 patients whose ages ranged from 67 to 99 across several aged care facilities in Tasmania.

On 21 January 2019, Libero was placed into liquidation and is no longer trading and on 27 September 2018 Mr Dempsey had his registration as a physiotherapist suspended by the Physiotherapy Board of Australia.

Physiotherapy Board of Australia Chair Ms Kim Gibson and Occupational Therapy Board of Australia Board Chair Ms Julie Brayshaw welcomed the court’s ruling as a strong deterrent.

‘To claim another person is registered, when they are not, is serious as it puts vulnerable people at risk and threatens patient safety. We expect registered practitioners to know better. This type of intentional, unlawful behaviour will not go unchecked. Together with AHPRA, we as National Boards will continue to ensure regulation of physiotherapists and occupational therapists to protect the public,’ they said.

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National Scheme news

Fake practitioners face jail and hefty fines as new regulatory powers come into force

Since 1 July 2019, the law has got tougher on people who pretend to be a registered health practitioner. The penalties for anyone prosecuted by AHPRA under the National Law for these offences now include bigger fines and the prospect of prison time.

The strengthened sanctions better protect the public. All Health Ministers recognise that penalties need to be tougher for serious cases. When someone pretends to be a registered health practitioner, they pose a significant risk to the public.

Since 2014, AHPRA has successfully prosecuted more than 50 cases where people were falsely claiming to be registered practitioners, including people pretending to be medical practitioners, physiotherapists, pharmacists, nursespsychologists

and dentists

 

Fake practitioners betray the trust that patients place in them. The amendments mean that offenders will face the possibility of a maximum term of three years’ imprisonment per offence. They also face an increase in the maximum fines from $30,000 to $60,000 per offence for an individual and from $60,000 to $120,000 per offence for a corporate entity.

Summary of the new laws

  • The amendments were passed in February 2019 by the Queensland Parliament under the Health Practitioner Regulation National Law and Other Legislation Amendment Act 2019 (Qld) (the Act).
  • The new offence provisions will apply in all states and territories, except Western Australia. The amendments to offence provisions do not apply to advertising offences under the National Law.
  • Under the National Law, anyone who uses any of the ‘protected titles’, such as ‘chiropractor’, ‘medical practitioner’, ‘psychologist’ or ‘paramedic’, must be registered with the corresponding National Board.
  • It is an offence to use one of the protected titles, and it is also an offence to knowingly or recklessly claim to be a registered practitioner when you’re not or use symbols or language that may lead a reasonable person to believe that an individual is a registered health practitioner or is qualified to practise in a health profession. These offences are known as ‘holding out’.

Members of the public can check the online national register of practitioners to make sure they are seeing a registered practitioner. The register assures patients that the practitioner is qualified and must meet national standards.

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Practitioners’ responsibility to support public health programs

Australia’s health regulators have reminded health practitioners about their responsibility to support public health programs, including vaccination. Regulators have spoken out to support public safety, given mounting concerns about a five-year high in measles cases and an early spike in flu cases this year.

AHPRA and the National Boards have urged more than 740,000 registered health practitioners to take seriously their responsibilities for public health, including by helping patients to be protected from preventable illnesses. Supporting public health programs, including vaccination and immunisation, and not promoting anti-vaccination views are regulatory responsibilities.

National Boards set codes, standards and guidelines, including about protecting and promoting the health of individuals and the community, which they expect registered health practitioners to meet. If practitioners do not comply and meet the professional standards set by their National Board, regulators can and do take action.

National Boards and AHPRA have acted to manage risk to the public, in response to concerns raised about practitioners (including medical practitioners, nurses and chiropractors) who have advocated against evidence-based vaccination programs. This has included restricting practitioners’ practice pending further investigation, when there was a serious risk to the public.

Read the media release on the AHPRA website. 

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Safety of older Australians at centre of new regulatory agreement

 Older Australians will be better protected as the result of a new memorandum of understanding (MOU) signed by the Australian Health Practitioner Regulation Agency (AHPRA) and the Aged Care Quality and Safety Commission (the commission).

The MOU underpins the positive and collaborative working relationship that already exists between AHPRA and the commission. It will ensure that information can be appropriately shared between the two agencies where there may be concerns in aged care.

It will support the commission in raising concerns about the health, performance or conduct of registered health practitioners working in aged care. In a reciprocal arrangement, AHPRA will disclose information to the commission if it has concerns about the care and safety of someone receiving Commonwealth-funded aged care services.

AHPRA will also work with the commission to ensure that all aged care employers use the online national register to check that health practitioners working in aged care are appropriately registered and meet required registration standards and codes of conduct.

Read more in the news item.

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Keeping the notification process in perspective – a practitioner view

Earlier this year, AHPRA launched a series of new videos to support the public and registered health practitioners as they go through the notification process. The video series, called ‘Let’s talk about it’, explains what happens when concerns are raised with the regulator, gives easy-to-follow information about the notification process and addresses common questions, so members of the public and health practitioners know what to expect when they interact with AHPRA and National Boards.

Two practitioner experience videos have been added to the series, to help tackle the fear of notifications: A notification was made about me: A practitioner’s experience (from a GP) and Putting it in perspective: A practitioner’s experience (from a surgeon).

Many practitioners have told us that they would have benefited greatly from hearing the voice of other practitioners who had gone through this experience – and come out the other side. They have also told us that when they are the subject of a notification, they immediately think they will lose their registration and their livelihood – that it’s a catastrophe.

However, our data show a different story. While we have a clear focus on patient safety, many notifications end without the need for regulatory action and are often closed following initial assessment, without the need for an extended investigation.

The medical practitioners featured agreed to share their experience and reflections with other practitioners in their situation. In particular, they wished they had reached out for help sooner, and emphasise that a good support network is essential. Talking to family, friends and having the ongoing support your own trusted health professionals – your GP, for example – can help you maintain a realistic perspective.

There are now five videos:

The videos sit alongside other written resources available on our website, including information about understanding the notification experience. See: www.ahpra.gov.au/Notifications.

You can view the videos on the AHPRA and National Board websites or from our YouTube and Vimeo channel, and join the conversation by following AHPRA on Facebook, Twitter or LinkedIn: use the hashtag #letstalkaboutit and tag @AHPRA.

My expereince: receiving a notification

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Want more information?

  • Visit the Board’s website for the mandatory registration standards, codes, guidelines and FAQ.
  • Lodge an online enquiry form.
  • For registration enquiries, call 1300 419 495 (from within Australia) or +61 3 9275 9009 (for overseas callers).
  • Address mail correspondence to: Kim Gibson, Chair, Physiotherapy Board of Australia, GPO Box 9958, Melbourne, VIC 3001.

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Page reviewed 16/09/2019