Improve Your Practice

Managing staff can be one of the most demanding responsibilities of a practice manager. However, minimising risk with staff is as much about communication and good relationships as with systems and good management.

In general, the employment of employees in the private sector is regulated by federal government legislation and industrial instruments (Federal Awards). There are a number of federal government agencies which provide information to small business operators about the rights and obligations of employers.

Staff are engaged as employees and medical practitioners tend to be independent contractors. You must make yourself aware of the differences in your obligations towards employees and contractors.

Human resources risks fall into a variety of areas. Better practice involves adopting all of the strategies listed. A practice manager with knowledge and experience in these areas, and given opportunities to remain up to date with changing requirements, will be invaluable to the practice with many of these tasks. 

To help you, Avant have prepared a Staff risk management checklist

First contact

1. Practice staff are the patient’s first contact with your practice, and their dealings with the patient can have     a dramatic impact on patient satisfaction.


Risks include poor public relations, poor practice experience for patients, rudeness or unhelpful staff.





Practitioners and managers must set a good example in their own conduct within the practice.

Have in place a practice code of conduct and/or code of ethics.

Develop a practice culture that embraces excellence in service to all parties – patients, families each other.

Create good staff conditions – facilities, work breaks, flexibility, opportunities for training and development and understanding with time off work etc.

Recruit staff with suitable temperament, skills and attitude.

Provide staff with clear appropriate position descriptions

Provide staff with customer service training.


Efficient operations

2. Staff are key to the smooth and efficient operation of your practice.


Risks include incorrect or inefficient performance of practice procedures, loss of intellectual capital when staff leave, workplace bullying or staff disharmony, theft and fraud, unauthorised internet activity and privacy breaches.




Have a staff induction program and conduct ongoing training about your organisation’s key policies and procedures. Ensure that training records are kept of attendance at training.

Have job descriptions, clear position responsibilities and an organisation chart.

Have clearly defined lines of communication

Have clearly defined authorities and limits to authority for all staff.

Ensure there is a policy and procedures manual that is indexed, signed as read and understood by all staff, has amendments dated and is made known to staff. The policy and procedures manual should be reviewed and amended as required.

Ensure that the manual includes a confidential complaint procedure and outlines the consequences of failing to adhere to acceptable standards of staff conduct.

Ensure that staff performance and conduct issues are dealt with in a timely and consistent way.

Hold regular staff meetings.

Have performance appraisals.

Provide positive and constructive feedback to staff. Praise in public, reprimand in private.

Avoid key person dependency by multi-skilling staff.

Have clear systems for checking finances (e.g. control of petty cash, practice banking, external bookkeeper).

Implement IT auditing processes (e.g. to detect unauthorised internet access and to mitigate fraud).


Staff’s duty of care

3. In a court judgement in Alexander v Heise & Anor [2001] NSWCA 422, practice staff were found to have a duty of care to patients. This case involved the receptionist deciding that an appointment was not urgent, and the patient died from an aneurysm before the appointment. In court the receptionist was found, however, not to have breached her duty of care on this occasion, as she based her assessment on the information given to her. This raises several risk management issues.


These include failure of practice staff to prioritise patients accurately



Instruct practice staff on the proper management of patients who present with symptoms or complaints that may warrant urgent attention.

Have guidelines in place so that if a staff member is unsure of the urgency of a condition, he or she consults the doctor.

Documented triage policy. A laminated triage flow sheet (e.g. POPGUNS ) visible near the telephone may assist staff in following triaging guidelines.

CPR training for all staff may be appropriate, depending on your location.

If the practice is open, you must ensure that there is appropriate clinical staff on duty to attend to patients if required. If this is not possible, have a policy in place to manage this situation.




4. As an employer you are vicariously liable for the actions of your employees.


These include performance of patient procedures by employees, employed health practitioners practising without registration or insurance, breach of confidentiality/privacy and unethical behaviour.




Ensure that nurses only perform procedures they are trained and competent to perform. Such training should be up to date and ongoing.

Ensure nurses are properly supervised when performing medical procedures.

Have indemnity insurance policies for staff where applicable (seek advice from your Avant portfolio service officer).

Develop a routine pre-employment checklist, including such things as evidence of current registration and right to work in Australia. For particular positions this may require police checks and/or a Working With Children Check.

Confidentiality agreement signed by staff.

Ensure performance appraisals, job descriptions and documented lines of authority.

Ensure that employment contracts include reference to dismissible offences such as breach of patient confidentiality.

Ensure all staff receive regular training in key policies and procedures. Document attendance at the training and maintain those records.

Ensure the practice manager is familiar with employment requirements and employee conditions of employment.

Practice managers and practice nurses may hold their own professional indemnity policies and this should be recorded and you practice insurer notified.


Workplace health and safety legislation

5. Workplace safety is the responsibility of many parties, including the employer and anyone carrying on a           business. Your practice must comply with workplace health and safety legislation.


These include staff injury, staff off work on workers’ compensation and management of return to work, increased workers’ compensation premiums and prosecution.




Know the workplace health and safety legislation that applies in your state.

Have workers’ compensation insurance.

Have a nominated workplace safety officer and that person must maintain their knowledge of the requirements of the relevant legislation.

Know the requirements for reporting incidents and claims to your workers’ compensation insurer and the authority responsible for workplace health and safety.

Provide and explain to staff your practice workplace health and safety policy.

Have processes in place for staff to raise safety issues and report injuries.

Assess and minimise safety risks in the practice.

Include Work Health and Safety as an agenda item at all staff meetings.

Subscribe to electronic information update service/s.



Industrial relations laws

6. You must comply with industrial relations laws regarding recruitment, offers and contracts of employment, probation periods, conditions for permanent and casual employees, awards, pay slips, superannuation, PAYG tax, leave entitlements, dispute resolution procedures, termination and record keeping.


These include employee dissatisfaction, employee disputes and legal action.



Be familiar with legislative requirements, including award rates and pay slip information requirements.

Attend industrial relations training courses.

Subscribe to electronic update service/s.

Adopt effective recruitment procedures to try to eliminate the stress and business disruption of dealing with an unsuitable employee.

Use probation periods to assess employee performance and suitability.

Keep records of employment details for tracking leave entitlements.

Have dispute resolution procedures in place.

Seek advice to follow correct procedure for redundancies or terminations.


Working with children

7. In some states, staff in contact with children must undergo a ‘working with children’ check. This involves applying to the relevant government agency to register for the program, and staff signing a declaration.


Next page

HR manual and staff recruitment
  • Why you need an HR manual
  • What’s in an HR manual?
  • Recruiting staff

This publication is proudly brought to you by Avant Mutual Group. The content was authored by Brett McPherson, reviewed by Colleen Sullivan and Avant Mutual Group.

This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practice proper clinical decision making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgment or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published. © Avant Mutual Group Limited 2014.

IMPORTANT: Professional indemnity insurance products and Avant’s Practice Medical Indemnity Policy are issued by Avant Insurance Limited, ABN 82 003 707 471, AFSL 238 765. The information provided here is general advice only. You should consider the appropriateness of the advice having regard to your own objectives, financial situation and needs before deciding to purchase or continuing to hold a policy with us. For full details including the terms, conditions, and exclusions that apply, please read and consider the policy wording and PDS, which is available at or by contacting us on 1800 128 268. Practices need to consider other forms of insurance including directors’ and officers’ liability, public and products liability, property and business interruption insurance, and workers compensation and you should contact your insurance broker for more information. Cover is subject to the terms, conditions and exclusions of the policy. Any advice here does not take into account your objectives, financial situation or needs. You should consider whether the product is appropriate for you before deciding to purchase or continuing to hold a policy with us.