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This is the phone call you don’t want to receive. Or is it?
The number of notifications made to Ahpra about doctors has increased by 42% over the last three years.* While most complaints end in no further action, Ahpra and the Medical Board will assess all notifications.
In the financial year 2019-20, Ahpra introduced a new risk assessment approach. Doctors are now being contacted directly by telephone and earlier in the process, by Ahpra staff. We are seeing this in the assessment phase and will soon see it when a notification is being formally investigated.
A new framework
The previous notification process often involved Ahpra undertaking a lengthy investigation before seeking the doctor’s response, typically in writing. It was a process geared more towards proving or disproving allegations in the notification. Ahpra’s new framework aims to focus more on the individual and organisational risk controls that affect the doctor and to do this earlier in the process.
When Ahpra receives a notification, it carries out a risk assessment of the practitioner, considering the circumstances of the notification in relation to the practitioner’s broader clinical setting, context of practice and the relevant standards, codes and guidelines. Ahpra will also consider the historical regulatory data about the doctor and any risk controls or protections which may apply to the doctor’s practise. Where Ahpra identifies sufficient risk controls, there is less likelihood of further disciplinary action.*
In the past, Ahpra usually sent a letter to the doctor informing them of the notification and asking for a written response. In most cases, doctors respond in a way that gave Ahpra and the Medical Board confidence no further action was needed.
Ahpra now aims to contact doctors by telephone in the first instance on matters it considers lower-risk (typically performance-based matters). The calls are to assess the doctor’s insights and risk profile earlier in the process. High-risk and more serious conduct matters will be managed in line with the previous process, which typically involves a letter from Ahpra outlining in detail the circumstances of the notification.
Getting on the front foot
Under these new processes for assessment and investigation, Ahpra wants to see that doctors have recognised and responded promptly to the issues raised, in the interests of the public. Ahpra wants doctors to have frank discussions about the notification, their reflections on it and any changes they have implemented to protect the public.
When doctors can show they operate in a safe environment and are responding to the issue accordingly, it is far more likely no regulatory action will be taken. Even if you don’t think there is merit in the patient’s complaint, Ahpra is inviting you to reflect upon the experience with the patient and consider any learning opportunities. Reflection helps a doctor consider opportunities for improvement.
Doctors usually respond very well when things go wrong. Often members complete Avant’s education courses to demonstrate they have considered the notification, upskilled themselves on the issues raised, and reflected on how to improve their practice.
How to respond
If you do receive a call from Ahpra, or you are contacted by any other regulatory agency about a notification, our advice is:
For members currently involved in an investigation, if you are invited to a discussion with Ahpra, have Avant representation with you, rather than speaking with an investigator on your own.
*This figure was amended in May 2021 based on figures from the Australian Health Practitioner Regulation Agency 2019/20 Annual Report (excluding OHO in QLD).
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