March 2019

Issue 23 - March 2019

From the Chair
Board news
Registration
National Scheme news
Keep in touch with the Board

From the Chair

Kim Gibson

The Board met in March for the first time this year, alongside the National Registration and Accreditation Scheme (NRAS) Combined Meeting in Melbourne. It included all 15 National Boards and their stakeholders. For physiotherapy, this included colleagues from the Board’s appointed accreditation authority the Australian Physiotherapy Council (APC), the Australian Physiotherapy Association (APA), the Physiotherapy Board of New Zealand (PBNZ) and the NSW Physiotherapy Council (which, under the National Law, considers complaints raised in NSW). Apart from the opportunities for networking and cross-professional discussions, the plenary sessions and workshops illustrated the growing maturity of the Scheme as we strive to be world leaders in health practitioner regulation. For instance, as discussed further on in this newsletter, an example would be the release of a series of videos to support the public and registered health practitioners through the notifications (complaints) process. We’ve listened to people who have had a complaint made against them, and people who make complaints – to make the system easier to navigate and understand.

The National Board can only deal with complaints about conduct and health but we can also play a role in directing complainants to the right doorway. We also know from the data we’ve been able to collect across now 16 health professions that while the numbers of complaints are rising each year, they are very low for physiotherapists. We also know that around 70% of complaints result in no further action.

All physiotherapists should be prepared for a complaint being made about them at some time during their working careers. However our growing insights into the practitioner’s experience of the complaints process demonstrate that the terror and misgivings and feelings of helplessness are mostly not warranted thus we are working towards resources that are more educationally focused and will support and encourage practitioners to learn from the experience.

In other news, the Board was thrilled to learn of the appointment of Jayde Fuller to the position of AHPRA’s Aboriginal and Torres Strait Islander Program Manager. With the National Scheme’s focus on the Aboriginal and Torres Strait Islander Health Strategy, there’s been a lot of talk about cultural safety lately. This topic was covered in detail at the 2019 NRAS Combined Meeting by the Aboriginal and Torres Strait Islander Health Strategy Group’s Co-chairs, Professor Gregory Phillips and Ms Julie Brayshaw.

Their thought-provoking plenary session asked ‘How can cultural safety improve Aboriginal and Torres Strait Islander health outcomes?’

While there are many definitions of cultural safety, depending on context, we are working with the other National Boards and stakeholders to develop a shared definition – one that will be included in the revised draft Code of conduct, being readied for consultation later this year. The proposed draft definition is: ‘It is the individual and institutional knowledge, skills, attitudes and competencies needed to deliver optimal healthcare for Aboriginal and Torres Strait Islander Peoples.’ This is the same definition that National Boards, accreditation authorities, AHPRA and Aboriginal and Torres Strait Islander health leaders used in the National Scheme’s Statement of intent. The final definition will also be used as a baseline in the National Scheme.

Kim Gibson
Chair, Physiotherapy Board of Australia

Board news

Stakeholder engagement breakfasts

This year, the Board will continue its focus on engaging with registrants, beginning with a stakeholder breakfast held in Canberra on 29 March. All ACT physiotherapists (and those from neighbouring postcodes) and government and other stakeholders have been invited to meet the Board, enjoy a light breakfast, and learn about the Board’s work. If you are in Canberra and have not received an invitation, please get in touch using the number or the contact enquiry form at the bottom of this newsletter.

The next stakeholder breakfast will be in Brisbane on 26 September. Invitations will be sent to all Queensland physiotherapists and stakeholders, and people not able to travel to Brisbane may be able to join via videoconference.

Webinar

On 25 July, the Board is holding its first webinar. The event will be recorded so you can watch at a time that suits if you can’t attend in person. The theme is continuing professional development and we’ll issue a call for questions beforehand, so stay tuned to the news section on the Board’s website. We will also send out more information closer to the date.

Board presence at INPTRA and WCPT in May

Board members will be presenting and attending the International Network of Physical Therapy Regulating Authorities (INPTRA) conference which is being held alongside the biannual meeting of the World Confederation of Physical Therapists (WCPT) in Geneva.

INPTRA’s mission is to promote and contribute to the continuous development of leading regulatory practice through education, information sharing and other collaborative activities with key stakeholders worldwide.

As a member of INPTRA, the Board encourages regulators from around the world, particularly from the Pacific region, to join and take advantage of INPTRA’s scholarships.

The conference includes educational sessions and small group discussions on issues of healthcare regulation and physiotherapy regulation. The sessions are geared toward a range of regulatory experiences – from developing a regulatory system to challenges faced in other regulatory systems, like in Australia, which are well developed.

Conference themes cover regulatory board governance and effectiveness, mobility, workforce, technology, ethics, standards and scope of practice and regulator innovations/issues.

The conference gives a platform for health regulators, policymakers, and educators to come together and draw on the knowledge and shared experiences which, in turn, contributes to quality improvement in all our approaches.

The Board looks forward to sharing its story on what regulation means for physiotherapists in Australia and giving an update of its work with National Boards and the AHPRA.

Clear record keeping essential

Accurate and clear health records is essential for the continuing good care of patients and clients. The Board is reminding physiotherapists about their regulatory obligations to keep good clinical records as concerns can be raised if record keeping falls below par.

As registered health practitioners’ physiotherapists are expected to create and maintain clear, accurate and up-to-date clinical record for every patient. This is essential for the continuing good care of their patients. These records should contain enough detail to enable another practitioner to take over the care of the patient if necessary.

Physiotherapists have obligations under the National Law¹ to maintain good clinical records whether in electronic or paper form. Poor record keeping is often a component of complaints raised with the Board about a physiotherapist.

The professional obligations for physiotherapists are set out in the Physiotherapy Board of Australia’s Code of Conduct (the Code) in section 8.4, which states:

Maintaining clear and accurate health records is essential for the continuing good care of patients or clients. Practitioners should be aware that some National Boards have specific guidelines in relation to records. Good practice involves:

keeping accurate, up-to-date, factual, objective and legible records that report relevant details of clinical history, clinical findings, investigations, information given to patients or clients, medication and other management in a form that can be understood by other health practitioners
ensuring that records are held securely and are not subject to unauthorised access, regardless of whether they are held electronically and/or in hard copy
ensuring that records show respect for patients or clients and do not include demeaning or derogatory remarks
ensuring that records are sufficient to facilitate continuity of care
making records at the time of events or as soon as possible afterwards
recognising the right of patients or clients to access information contained in their health records and facilitating that access, and
promptly facilitating the transfer of health information when requested by patients or clients.

The Board does not stipulate how physiotherapists keep records; however, they must adhere to the Code which provides a framework for professional and ethical practice. It is against the Board’s registration standards, codes and guidelines that physiotherapists are measured if a concern is raised about them with the regulator. The Board will be seeking the views of practitioners as part of a scheduled review of its Code of conduct.

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

Registration

Statistics on the numbers and breakdown of physiotherapists in Australia are updated quarterly on the Board’s website. The most recent data are from the end of December where it is reported that the profession has grown to 33,188 physiotherapists, of whom 67% are female and the largest group is aged between 25–29 years.

National Scheme news

National Boards and AHPRA host research summit

The National Registration and Accreditation Scheme 2019 Research Summit took place on 27 February 2019 at the Melbourne Convention and Exhibition Centre.
The summit asked how research can be harnessed to strengthen regulation and improve patient safety to contribute to improved health outcomes.

Led by AHPRA and the National Boards, the all-day Research Summit hosted 17 speakers and drew more than 300 participants from national, state and territory board and committee members, AHPRA staff, co-regulatory bodies, representatives from accreditation authorities and key partners.

With the theme ‘Optimising research for regulatory effectiveness’, the Research Summit explored the National Scheme’s evolving approaches to risk assessment, lessons from research into notifications, and future opportunities to use smart data. At the heart of discussions was asking how we can use data and research to improve regulatory processes and, ultimately, contribute to safer care for patients.

Professor Zubin Austin from the University of Toronto, Canada, was a keynote speaker. His stirring address highlighted that competency assessment has emerged as a dominant issue for regulators, educators and employers worldwide. Professor Austin called for more attention to be focused on notions of teamwork, emotional intelligence, and genuine practitioner engagement as important concepts in defining and evaluating competency.

Read more in the media release about the summit.

'Let's talk about it' videos launched

AHPRA has 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 notifications process and addresses common questions, so consumers and health practitioners know what to expect when they interact with AHPRA and National Boards.

There are three videos:

A notification has been made about me features five health practitioners who work within the National Scheme and is directed at health practitioners who have had a notification made about them.
I have a concern, am I in the right place? is targeted at members of the public who have a concern but aren’t yet sure whether AHPRA is the right place in which to raise it.
I have raised a concern with AHPRA provides information for individuals who have just raised a concern with AHPRA.

The videos sit alongside other written resources available on our website.

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.

Legislative amendments on mandatory reporting and fake practitioners

The Health Practitioner Regulation National Law and Other Legislation Amendment Act 2019 (Qld) (the Act) has been passed by the Queensland Parliament. The amendments include revisions to the mandatory reporting requirements for treating practitioners and an extension of sanctions for statutory offences.

The changes to the National Law² intend to support registered practitioners to seek help for a health issue (including mental health issues). They will also increase the penalties (and introduce custodial sentences) for some offences under the National Law, including where a person holds themselves out to be a registered health practitioner when they are not.

AHPRA and National Boards will now work to implement these amendments. This will require working closely with professional bodies, employers and state and territory health departments to spread the message that practitioners should be supported to seek help about their health issues.

The passing of the Act in Queensland marks the second set of legislative amendments to the National Law since the start of the National Scheme in 2010.

When they take effect, the amendments will apply in all states and territories except Western Australia, where the mandatory reporting requirements will not change.

Practitioners can read a news item about the amendments on the AHPRA website or the Act on the Queensland Legislation website.

²The Health Practitioner Regulation National Law (the National Law), as in force in each state and territory.

Health Ministers announce review of the practice of spinal manipulation

An independent expert review on the practice of spinal manipulation for infants and young children was announced by Health Ministers following COAG Health Council’s March meeting.

The review will be carried out by Safer Care Victoria, the review will focus on risk of harm and adverse events, and the current best evidence for the efficacy of spinal manipulation to treat childhood illnesses or health concerns in infants and young children.

National Boards do not define the types of treatments in which a registered health practitioner may choose to be qualified and competent to carry out in their chosen scope of practice.

Under the National Law, only registered chiropractors, medical practitioners, osteopaths and physiotherapists are permitted to manipulate the cervical spine when treating patients.

The National Law says that manipulation of the cervical spine means ‘moving the joints of the cervical spine beyond a person’s usual physiological range of motion using a high velocity, low amplitude thrust’.

AHPRA and the National Boards regulating the professions able to undertake cervical spinal manipulation support the independent review and await its outcome and recommendations with keen interest.

Read more in the COAG Health Council March communique.

Keep in touch with the Board

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.