June 2020

Issue 25 - June 2020

From the Chair
Board news
- Regulation and engagement in 2020 – webinar planned
- Get to know your colleagues – Aboriginal and Torres Strait Islander Health Practitioners
Get to know your Board
- Meet Lachlan Mortimer, practitioner member
Registration
- Workforce update – latest data
National Scheme news
Want more information?

From the Chair

What interesting times we find ourselves in. Since March, the Board has been meeting online each month, with much of its focus being on the COVID-19 response from a regulatory perspective. We have been responding to the needs of the profession, healthcare services and the public. This includes the creation of a pandemic sub-register, altering the registration requirements by moving to online applications, being flexible with CPD and supporting the Australian Physiotherapy Council to help the education programs minimise the impact of COVID-19 on student education. You can read more about that in this newsletter.

It has been a very challenging time for all, and the Board has been actively supporting the profession as much as it can. We thank you for all your hard work and being nimble in this changing landscape. We know physiotherapists have adapted the way they work to ensure adherence to public health guidelines.

Other important guidelines are discussed in this newsletter. The National Boards and the Australian Health Practitioner Regulation Agency (Ahpra) have published the revised mandatory notification guidelines and supporting resources. Please take the time to read these guidelines to understand when a notification needs to be made.

Kim Gibson
Chair, Physiotherapy Board of Australia

Board news

Regulation and engagement in 2020 – webinar planned

Outside of the pandemic response, the Board has been working on regulatory matters and participated in this year’s National Registration and Accreditation Scheme (National Scheme) combined meeting. This meeting brings together all National Boards, accreditation entities, Ahpra leaders and key professional stakeholders and is an opportunity for networking and cross-professional discussion on topics common in health practitioner regulation. The outcome of these discussions will help us all work together for consistency and alignment of policy in the work we do to protect the public.

Looking ahead towards the rest of 2020, while many face-to-face events will be postponed, we will continue to engage with practitioners on important policy items. We are planning a webinar and will update you about that soon – please keep an eye on our website.

Get to know your colleagues – Aboriginal and Torres Strait Islander Health Practitioners

Members of the the Aboriginal and Torres Strait Islander Health Practice Board (ATSIHPBA) recently gave an update to the Board about their Board, the profession and its practitioners.

The ATSIHPBA wants to help the physiotherapy profession understand the value that Aboriginal and Torres Strait Islander Health Practitioners can bring to Australian healthcare to make it culturally safe and help close the gap. Below are some facts about Aboriginal and Torres Strait Islander Health Practitioners and their profession to help physiotherapists know more.

Aboriginal and Torres Strait Islander Health Practitioners: fast facts

Programs of study that lead to registration as an Aboriginal and Torres Strait Islander Health Practitioner are the only ethnically based health training programs of this type in the world and have been recognised as such by the United Nations.
Aboriginal and Torres Strait Islander Health Practitioners work across organisations in many roles and act as cultural brokers and make healthcare settings, including hospitals, more culturally safe.
Aboriginal and Torres Strait Islander Health Practitioners are one profession under the same roof as many other Aboriginal and Torres Strait Islander health professionals and account for a small number of the Indigenous health workforce (e.g. Aboriginal Health Workers, Liaison Officers and so on).
They predominantly work for public hospitals and Aboriginal Community Controlled Health Organisations.
The National Aboriginal and Torres Strait Islander Health Worker Association (NATSIHWA) is the professional body which works hard to promote the profession.
Tasks Aboriginal and Torres Strait Islander Health Practitioners are qualified to perform include immunisations, screening of physical, social and emotional wellbeing, administering and supplying medications, advocating for clients, health promotion, and providing advice, support and training on culturally safe health services.
They complement the roles of other health practitioners, including physiotherapists. The cultural liaison and expertise they provide is invaluable. Their patient rapport and insight into culturally safe and responsive approaches to care helps non-Indigenous clinicians to achieve the best health outcomes for the patient.
New accreditation standards starting next year will enable programs offering qualifications higher than the current Certificate IV level to apply for accreditation.
Challenges to the profession include retention, lack of career mapping, employers not harnessing their full scope of practice, and completing their study in the time allowed (for cultural reasons and because of travelling distance). However, registrant numbers are steadily rising.

The ATSIHPBA would like to continue to work with Ahpra and the physiotherapy profession to help spread the word about the culturally safe workforce which is qualified, competent, registered and ready to go to work in both clinical and non-clinical roles.

What you can do to help and spread the word

Here are some things that you, as a physiotherapist, can do to help:

Ask a question: ask your health service, employer or other team members, ‘How many Aboriginal Health Practitioners do we employ?’ or ‘Did you know we could make our practice more culturally safe by employing an Aboriginal and/or Torres Strait Islander Health Practitioner, and do our bit towards closing the gap?’
Make them a priority: Prioritise the Aboriginal and Torres Strait Islander health workforce agenda.
Share the message: Distribute the Aboriginal and Torres Strait Islander Health Practice profession brochures explaining their role to employers.

Engaging the Aboriginal and Torres Strait Islander health workforce to work in partnership with physiotherapists is a key opportunity to improve health outcomes for Aboriginal and Torres Strait Islander people.

If you would like to find out more about the profession, please contact Executive Officer Jill Humphreys at jill.humphreys@ahpra.gov.au.

Get to know your Board

Meet Lachlan Mortimer, practitioner member

Lachlan Mortimer, Physiotherapy Board member

What is your experience and background?

I studied at the University of Queensland and have worked as a physiotherapist since 2006 in a mixture of public and private roles. I'm currently working in the Royal Hobart Hospital (RHH) Emergency Department and dabbling in private practice − with a particular interest in dizziness. I also sit on the APA Emergency Department group as the Tasmanian rep. I've been involved in management advisory groups within the RHH Physiotherapy Department, but before joining the Board I had no experience with regulation.

What attracted you to the role of practitioner member on the Board?

I was looking for something a bit different from my other roles − an opportunity to see the profession from another perspective. To be honest, I didn't really know what I was getting myself into and it's been a steep learning curve, but worthwhile. I've always thought that it was important to give back to the profession and be involved at a wider level, but this has really helped me broaden my perspective and think about physiotherapy from a public/community perspective.

What contribution do you think the Board and regulation of physiotherapists make to patient safety?

There is a broad perception that regulation is required to take care of the few physiotherapists who contravene the Code of conduct and put the public at risk. Realistically this represents a very small percentage of the workforce. I think that some of the major work of the Board is in helping ensure our workforce can meet the needs of our population. A scheme-wide example of this is the work occurring around building a culturally safe workforce, increasing Indigenous representation within our health workforce and making a culturally safe experience of healthcare the norm.

What is the main focus of the Board for 2020?

Other than ensuring we pull our weight in terms of the National Scheme’s Aboriginal and Torres Strait Islander health and cultural safety strategy 2020-2025, the Board will continue to modify its regulatory approach to support the profession through the COVID-19 pandemic. Another major goal is to arrive at a well-informed stance on prescribing. I think we need to keep an eye out to the future and make sure that our regulatory system is nimble enough to serve the needs of the public in this time of rapid change.

What are you passionate about?

I wouldn’t say that I am passionate about regulation, but it is certainly interesting. From a professional perspective, I’m into vestibular physiotherapy because it can really change people's lives, and it has such a strong evidence base for effectiveness. From a personal perspective, I am passionate about responding to climate change and am committed to making simple changes to my life to reduce my footprint such as choosing to eat less meat, fly less, eat local ... And of course, my family, mountain biking, rock climbing − and my partner is concerned that I have a growing obsession with indoor plants …

Registration

Workforce update – latest data

The Board’s registration data report for the period 1 January to 31 March 2020 shows there are 35,392 registered physiotherapists, 33,299 of whom have general registration. There are 1,455 physiotherapists with non-practising registration, and 638 with limited registration (postgraduate training or supervised practice, teaching or research).

For more information on registration by principal place of practice, age group, gender and registration type, visit our Statistics page.

National Scheme news

Podcasts on the pandemic and beyond

Ahpra has released podcasts on areas of interest to all health professionals in the Taking care podcast series. The topics covered in the podcasts include pandemic and non-pandemic-related issues.

In a recent episode on Health practitioner wellbeing in the pandemic era and beyond, psychiatrist Dr Kym Jenkins, clinical psychologist Margie Stuchbery and Dr Jane Munro, a rheumatologist, share personal and professional insights on practitioner wellbeing. They discuss practical and evidence-based strategies to safeguard and support practitioners and teams through the COVID-19 pandemic and beyond.

Ahpra releases a new episode every fortnight. You can download on the Ahpra website or listen and subscribe on Spotify, Apple Podcasts and by searching ‘Taking care’ in your podcast player. Podcasts include:

Professor Valerie Braithwaite on the importance of trust
Health practitioner wellbeing in the pandemic era and beyond
Telehealth in the pandemic era
Introducing the COVID-19 pandemic sub-register
Dr Gerald Hickson on patient safety and high-risk practitioners
Eliminating racism from the health system is a team effort
A new look at mandatory notifications
Ahpra’s role in the health system
A view of mental health from both sides
The practitioner experience of a notification
Safe, competent and ethical health practitioners
Vexatious notifications.

No place for racism in healthcare

In April, the Australian Indigenous Doctors’ Association (AIDA) issued a media release detailing occasions of medical practitioners denying Aboriginal and Torres Strait Islander people access to culturally safe healthcare. They were seeking testing for COVID-19. These cases in rural New South Wales and Western Australia involved refusal of care on the grounds of patient identity and racist stereotypes of Aboriginal and Torres Strait Islanders not practising self-hygiene.

Racism from registered healthcare professionals will not be tolerated, particularly given the vulnerability of Australia’s Aboriginal and Torres Strait Islander Peoples to the virus. They continue to experience prejudice and bias when seeking necessary healthcare. Discrimination in healthcare contributes to health inequity.

We encourage Aboriginal and Torres Strait Islander people who have experienced culturally unsafe incidents of care or refusal of care by a registered health practitioner to submit a notification or complaint to Ahpra.

In February 2020, the National Scheme’s Aboriginal and Torres Strait Islander health and cultural safety strategy 2020-2025 was released, proving our commitment to achieving patient safety for Aboriginal and Torres Strait Islander Peoples as the norm and the inextricably linked elements of clinical and cultural safety. The strategy strives to achieve the national priority of a health system free of racism.

We remind all registered health practitioners that they are required to comply with their profession’s Code of conduct, which condemns discrimination and racism in health practice.

False and misleading advertising on COVID-19 – what is acceptable evidence?

Ahpra and National Boards recognise the vital role of registered health practitioners in treating and containing the COVID-19 emergency. We know you are working hard to keep people safe in a demanding and fast-changing environment.

A consequence of the current situation is greater public awareness of individual health and wellbeing, leading to many questions about treating and containing the disease. People are likely to seek reassurance and answers about COVID-19 from their trusted health professional. While most health practitioners are responding professionally to the COVID-19 emergency and focusing on providing safe care, we are seeing some examples of false and misleading advertising about COVID-19.

It is vital that health practitioners only provide information about COVID-19 that is scientifically accurate and from authoritative sources, such as a state, territory or Commonwealth health department or the World Health Organization (WHO). According to these sources, there is currently no cure or evidence-based treatment or therapy which prevents infection by COVID-19 and work is underway on a vaccine.

Other than sharing health information from authoritative sources, you should not make advertising claims about preventing or protecting people from contracting COVID-19 or accelerating recovery from COVID-19. To do so involves risk to public safety and may be unlawful advertising. For example, we are seeing some advertising claims that spinal adjustment/manipulation, acupuncture and some products confer or boost immunity or enhance recovery from COVID-19 when there is no acceptable evidence to support this.

We will consider action against anyone found to be making false or misleading claims about COVID-19 in advertising. Breaching advertising obligations is also a professional conduct matter which may result in disciplinary action, especially where advertising is clearly false, misleading or exploitative. There are also significant penalties for false and misleading advertising claims about therapeutic products under the Therapeutic Goods Act 1989.

New resources to help practitioners assess whether claims made in advertising are supported by accepted evidence

To help you understand what is and is not acceptable evidence, new resources have been published. The approach taken to assessing evidence to support claims is consistent with the wider scientific and academic community. However, there is an important difference between acceptable evidence for claims made in advertising and the evidence used for clinical decisions about patient care.

When treating patients, practitioners must obtain informed consent for the care they provide and are expected to discuss the evidence for different treatment options. In advertising, the claims are generic, and practitioners are not available to clarify whether a treatment is appropriate for an individual patient.

The evidence base for clinical practice is constantly developing so it is important to make sure that the evidence you rely on is current. See the resources on acceptable evidence in health advertising and further information on COVID-19 advertising under Advertising resources on the Ahpra website.

Protecting our health practitioners of the future: clinical education principles during COVID-19

National Boards, accreditation authorities and Ahpra, with the Australian Government through the Health and Education portfolios, have issued national principles for clinical education during the COVID-19 pandemic.

This unique multi-sector collaboration to protect Australia’s future health workforce is helping students learning to become health practitioners during the COVID-19 pandemic continue their studies and graduate.

Some student placements have been paused, cancelled or otherwise modified as health services respond to the pandemic. This has led to uncertainty and change for students and educators as education providers, accreditation authorities, clinical supervisors and others explore alternative options for students to progress towards graduation.

The principles aim to provide helpful guidance about how placements can occur safely, taking into account the significant changes across the health and education sectors due to COVID-19. Visit the National principles for clinical education during COVID-19 to find out more.

Changes to mandatory notifications requirements are now in effect

On 1 March 2020 the amendments to the National Law in relation to mandatory notifications took effect.

The amendments apply in all states and territories except Western Australia and affect the mandatory reporting obligations for treating practitioners.

The threshold for reporting a concern about impairment, intoxication and practice outside of professional standards has been raised. The threshold is now reached when there is a substantial risk of harm to the public.

The National Boards and Ahpra have jointly revised the mandatory notifications guidelines to reflect these amendments. The guidelines are relevant to all registered health practitioners and registered students in Australia.

Changes to the guidelines include:

a new, higher reporting threshold for when treating practitioners must make a notification about their practitioner-patients. This is to give a practitioner-patient the confidence to seek help if they need it without undue concern about a mandatory notification
two separate guidelines now in place. One is for mandatory notifications about practitioners, and one for mandatory notifications about students. As there are only limited circumstances when a mandatory notification must be made about a student it was decided to develop a separate guideline that is only about students
restructuring of the guidelines about practitioners according to notifier type (that is, treating practitioner, non-treating practitioner, employer) so that relevant information for each notifier group is easier to find
updated flowcharts to help potential notifiers assess whether they need to make a mandatory notification, and
introduction of risk charts that highlight risk and mitigating factors that may be relevant to deciding if a mandatory notification is required.

Please read the revised guidelines for practitioners and students and the additional resources developed to help explain mandatory notifications.

A strategy for embedding cultural safety into the health system

An ambitious strategy from Aboriginal and Torres Strait Islander health experts, regulators and health organisations committed to embedding cultural safety into the health system was released earlier this year by 43 entities including Ahpra and the National Boards.

The National Scheme’s Aboriginal and Torres Strait Islander health and cultural safety strategy 2020-2025 is endorsed by organisations, academics and individuals, including the entities who set the education standards for the 183,000 students who are studying to become registered health practitioners and the regulators of Australia’s 750,000 registered practitioners.

The strategy focuses on achieving patient safety for Aboriginal and Torres Strait Islander Peoples as the norm and the inextricably linked elements of clinical and cultural safety. Development of the strategy was led by Aboriginal and Torres Strait Islander organisations and individuals via the Aboriginal and Torres Strait Islander Health Strategy Group, which represents all signatories to the strategy.

Aboriginal and Torres Strait Islander health and cultural safety strategy 2020-2025

The vision

Patient safety for Aboriginal and Torres Strait Islander Peoples is the norm. We recognise that patient safety includes the inextricably linked elements of clinical and cultural safety, and that this link must be defined by Aboriginal and Torres Strait Islander Peoples.

The objectives

Cultural safety: A culturally safe health workforce through nationally consistent standards, codes and guidelines across all registered health practitioners in Australia.

Increased participation: Increased Aboriginal and Torres Strait Islander participation in the registered health workforce and across all levels of the scheme regulating registered practitioners nationally.

Greater access: Greater access for Aboriginal and Torres Strait Islander Peoples to culturally safe services from registered health practitioners.

Influence: Using the Strategy Group’s leadership and influence to achieve reciprocal goals. This includes developing a nationally consistent baseline definition to be used across the scheme regulating registered practitioners nationally, which has already been achieved in partnership with the National Health Leadership Forum.

As part of the strategy, we have already reached some goals:

partnering with the National Health Leadership Forum (the forum for national Aboriginal and Torres Strait Islander health peak organisations) to develop, develop, consult and finalise a baseline definition of cultural safety for the scheme for regulating health practitioners
commissioning high-quality cultural safety training to ensure that the regulation of health practitioners, including the development of standards practitioners must meet and the handling of notifications (concerns about registered health practitioners), is culturally safe
recommending and advocating for changes to the Health Practitioner Regulation National Law to ensure consistency in cultural safety for Aboriginal and Torres Strait Islander people.

For more information, read the media release.

Ahpra and National Boards welcome policy directions

Ahpra and the National Boards have welcomed two new policy directions from the COAG Health Council which reinforce that Ahpra and National Boards are to prioritise public protection in the work of the National Scheme.

The two directions state that public protection is paramount and require consultation with patient safety and healthcare consumer bodies on any new and revised registration standards, codes and guidelines, as well as other considerations.

The first policy direction outlines the consideration that National Boards and Ahpra must give to the public (including vulnerable people in the community) when determining whether to take regulatory action about a health practitioner. It also authorises limited sharing of information with employers and state/territory health departments about serious matters involving the conduct of a registered health practitioner.

The second policy direction requires National Boards to consult with patient safety bodies and consumer bodies on registration standards, codes and guidelines when these are being developed or revised. It also provides that National Boards and Ahpra must:

consider the impacts of the new or revised registration standard on vulnerable members of the community and Aboriginal and Torres Strait Islander people, and
prepare and publish a ‘patient health and safety impact statement’ with each new or revised registration standard, code or guideline.

In implementing these policy directions, Ahpra and National Boards will continue to ensure fairness for health practitioners in regulatory processes. The policy directions can be viewed on the Ahpra and National Board websites.

Want more information?

Visit the Board’s website for the mandatory registration standards, codes, guidelines and FAQs.
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.