August 2018

Issue 11

Message from the Chair
Board news
National Scheme news
Keep in touch with the Board

Message from the Chair

Welcome to our second newsletter for 2018 from the Occupational Therapy Board of Australia (the Board). You’ll notice a new look to our newsletter and we hope the new format is easier to read during your busy day.

We’ll be keeping you up to date with changes to standards and guidelines, public consultations, regulation and registration matters, Board projects and events. As always we welcome your feedback.

With the release of the Australian occupational therapy competency standards (AOTCS) 2018 on 20 February 2018, work is well underway to develop additional resources that will further support your understanding of the new competency standards. We welcome your initial thoughts on the new competency standards, including resources which you might find useful within your own practices.

The Board is in the final stages of its review, with a number of other National Boards, of the registration standards for continuing professional development, recency of practice and professional indemnity insurance. The Board is also working with a number of other National Boards to review the code of conduct for occupational therapists. Be sure to look on the Board’s website, communiqués and future newsletters for an update on this review process.

Since our last newsletter the membership on the Board has changed with the departure of Ms Louise Johnson who has been a member of the Board since 2012. On behalf of the Board I would like to thank her for her commitment, dedication and contribution to the work of the National Scheme. The Board greatly valued the skills and experience that Ms Johnson bought to the table, particularly in the early years of the transition of the profession to national registration. The Board wished her well for her future work in the National Scheme with the Victorian Board of the Medical Board of Australia. There was a call for applications in early 2018 to fill this vacancy and a new community member is expected to be announced later this year.

Ms Julie Brayshaw
Chair, Occupational Therapy Board of Australia

Board news

Australian occupational therapy competency standards (AOTCS) 2018 are published

On 20 February 2018 the Board published the new Australian occupational therapy competency standards (the competency standards) which take effect from 1 January 2019.

The new competency standards outline the professional behaviours that all occupational therapists should demonstrate to practise. These standards apply to all occupational therapists whether you are working in research, education, management or a role that may not involve direct care.

The Board has begun further promotional work to support the new competency standards when they take effect in January 2019. While this work is in its early stages, the Board is keen to engage with you all about the new competency standards and what they mean for you.

If you have any feedback on the new standards, please send your thoughts to otboardconsultation@ahpra.gov.au. Your feedback will further inform the Board’s work to help occupational therapists’ understand and adopt the new competency standards into their practice.

Practitioner audit has begun

All registered occupational therapists are required to comply with the Board’s registration standards and declare whether they were compliant when renewing their registration. We conduct regular audits to assess registrants’ compliance with the standards in order to provide assurance to the public and practitioners that the requirements of the National Law are understood and that practitioners are compliant. Registrants are selected at random for audit.

If you have been selected for audit, please access the Board's website which provides comprehensive information about the audit process including guidance on the audit notice and what it means for you, as well as contact details for the audit team and AHPRA customer service team who can assist you with any queries.

Practitioner audit results

For all audits completed in 2016 and 2017, 96% of occupational therapists audited were found to be in full compliance with the registration standards. Of the remainder:

1.8% became void as practitioners changed their registration type to non-practising or surrendered their registration after being advised that they were subject to the audit, and
0.7% were found to be non-compliant, with action being taken against some of those practitioners in the form of a caution or a condition on registration.

Overall the audits have found that there is a high level of compliance by occupational therapists with the Board’s registration standards.

The audit has shown that non-compliance with the Board’s registration standards tends to relate to false declarations being made about a practitioner satisfying the Board’s continuing professional development or professional indemnity insurance at renewal. We would like to remind you that you have an obligation to make truthful statements in relation to your compliance with these obligations.

Where appropriate, the Board has adopted an educational approach to conducting audits, seeking to balance the protection of the public with the use of appropriate regulatory force to manage those practitioners found to be non-compliant with the audited standards.

We encourage you to regularly review information on the Board’s website as we often make updates to guidelines or factsheets to help clarify our requirements and expectations in relation to the registration standards.

Interview with new Board members, Justin Scanlan and Areti Metuamate

Portrait of Justin Scanlan
Justin Scanlan, practitioner member

Justin Scanlan was born in Cloncurry and raised in other regional areas of Queensland (Rockhampton and Charters Towers). Justin completed his occupational therapy studies at The University of Queensland and graduated in 1998.

Like many others, Justin was infected by Jillian Gibson’s passion for mental health practice and forged a career in this area. He has worked in a range of community and inpatient mental health roles and has been working at The University of Sydney since 2012, where he is currently course director for the Bachelor of Applied Science (Occupational Therapy).

Justin enjoys watching Judge Judy, trashy horror movies and Come Dine With Me as well as doing cross-stitch.

Portrait of Areti Metuamate
Areti Metuamate, community member

Areti Metuamate is currently the Deputy Master and Director of Student Relations at St Albert’s College in Armidale NSW. He has worked in senior roles in policy, including Senior Manager (Governance) in the ACT’s teacher regulatory authority, Executive Officer to the Director General of ACT Education, Senior Advisor in the Cape York Institute for Indigenous Policy and Leadership, public relations roles, and roles in the Ministry of Justice and Parliament of New Zealand.

Areti is involved in Pacific Island and Maori communities in Australia and New Zealand, and through his wife, an Aboriginal scholar, he is also involved in Aboriginal communities in the ACT and NSW.

We asked Justin and Areti, ‘Why did you want to become a Board member?’

‘I just really wanted to support this profession that I love and help to ensure the quality and safety of all practitioners,’ Justin says. ‘I’m also really interested in developing my skills in the area of regulation of health practitioners.’

Areti is ‘passionate about ensuring diverse voices are reflected at every level of public decision-making, and given my background as a person with Pasifika and Maori heritage who is also married to an Aboriginal Australian, I felt that by becoming a Board member I could perhaps bring a voice from the community that might offer different insights to the Board’.

What are you looking forward to achieving in your role with the Occupational Therapy Board of Australia?

‘I am looking forward to supporting the Board in promoting culturally safe and respectful practice, and empowering OT practitioners across Australia to meet the needs of our increasingly diverse communities,’ Areti says.

For Justin, he wants to make sure that the public have confidence in the quality and safety of occupational therapy practitioners as well as continuing to support the development of the profession through high quality, risk-based regulation.

‘I am also excited by the release of the new competency standards, and I look forward to helping build the profession through integrating these new standards into the day to day practice of occupational therapists across Australia,’ Justin says.

Notifications trends and data

During 2016/17, AHPRA received 37 notifications about occupational therapists. This represents around 0.5% of the total number of notifications that were received by AHPRA during 2016/17 (6,898 total notifications across all professions).

Of all jurisdictions, Victoria and Queensland accounted for more than 56.8% of all notifications relating to occupational therapists in 2016/17.

The most common sources for notifications during 2016/17 were employers (34.8%), other practitioners (30.4%), government departments (13%) and patients, relatives or members of the public (4.3%).

For the 2016/17 financial year the top five categories of notifications received about occupational therapists related to clinical care, confidentiality, documentation, health impairment and other offences. What can be concluded from notifications data for occupational therapists is that practitioners can make appropriate changes to their practice behaviours in order to minimise the risks of a notification being made against them.

Further information about notifications received about occupational therapists by state and territory can be found on the AHPRA website.

It is important to note that while there is no statutory timeframe to lodge a complaint, it is usually better not to let a complaint get too old before reporting it to AHPRA. If a complaint is received many years after the event, it can be difficult to rely on people’s memories or to find all the relevant records.

Mandatory and voluntary notification requirements for students

An education provider is required under the National Law to make a mandatory notification if they reasonably believe:

a student enrolled in a program of study provided by the education provider has an impairment that, in the course of the student undertaking the clinical component as part of the program of study, may place the public at substantial risk of harm, or
a student for whom an education provider has arranged clinical training has an impairment that, in the course of the student undertaking clinical training, may place the public at substantial risk of harm.

Any entity (person or organisation) may make a voluntary notification about a student to AHPRA when they believe that the student:

has been charged with an offence, or has been convicted or found guilty of an offence, that is punishable by 12 months’ imprisonment or more, or
has, or may have, an impairment that they believe may harm the public, or
has, or may have, contravened a condition of the student’s registration or an undertaking given by the student to the National Board.

Further information on the notification process is available on the AHPRA website.

Reminder about your obligations to tell the Board about certain events

There are times when you are obliged to tell the Board that something has happened. These are called ‘relevant events’ and are detailed in section 130 of the National Law.

Some of the things you are obliged to tell us about within seven days include that:

you have been charged or convicted of certain offences
you no longer have appropriate professional indemnity insurance arrangements in place
your right to practice at a facility, your Medicare billing rights or your prescribing rights are withdrawn or restricted, and/or
your registration in another country is suspended, cancelled or restricted in any way.

If you are a student enrolled in an approved program of study, you must inform the Board if:

you have been charged or convicted of certain offences punishable by imprisonment, or
your registration in another country is suspended, cancelled or restricted in any way.

Within 30 days you are also required to advise us of any changes to your principal place of practice, contact address or name.
A full list of the relevant events that you are obliged to tell us about is included in the Notice of certain events form published on the AHPRA website. There are slightly different requirements for registered students.
To update your address and contact details log into your AHPRA account or if the change of personal details includes a name change, use the Request for change of personal details form on the website.

Occupational therapists pass the 21,000 mark as the profession continues to grow

The number of registered occupational therapists in Australia has hit the 21,000 mark, signalling that interest in the profession does not appear to be slowing.

The Board congratulated Shannon Kara of Canberra on 'a special 21st' ̶ becoming its 21,000th registrant ̶ following the Board’s approval of her registration earlier this month.

Ms Kara recently completed the Master of Occupational Therapy program at the University of Canberra. A ‘born-and-bred Canberran’, Ms Kara undertook training after more than 10 years working in web design and social media.

‘I was going through my own personal experience with an occupational therapist and realised I had been involved in OT most of my working life and as a parent,’ she said. ‘Occupational therapy is about making adaptations to the person or environment with the aim of achieving goals that are centred around the client.’

During her study Ms Kara discovered a passion for mental health care during a clinical placement and travelled to the City of Legazpi in the Philippines to develop the framework for a local wellness program. With plans to practise close to her ACT roots, she has already attracted the attention of employers and is looking forward to starting work as a mental health clinician soon, helping people in the community to recover from mental illness.

Since the National Registration and Accreditation Scheme (the National Scheme) began in 2010 the occupational therapy profession has grown year on year. Since 2012/13, when there were 15,101 registered occupational therapists in Australia, the profession has now grown to 21,000, an increase of 39%. The profession today is made up of 9% male practitioners and 91% female practitioners. The principal place of practice for the majority of the profession is in New South Wales, Victoria and Queensland and the majority of the profession is aged between 25 and 44.

When reflecting on how far the profession has come, Board Chair Ms Julie Brayshaw commented that she was pleased with how seriously registered occupational therapists take their legal obligations under the National Law.¹

‘I would like to congratulate Shannon on being our 21,000^th registrant. She joins her peers who make a significant contribution to the delivery of safe and quality care throughout Australia’s health system. This is a wonderful milestone for the profession. Occupational therapists are a pivotal part of the health services being delivered to healthcare consumers as they help clients become as independent as they can be in their daily lives,’ Ms Brayshaw said.

Once registered with their relevant National Board, health practitioners are able practise anywhere in Australia. Each year they have to meet their National Board’s standards, codes and guidelines.

‘Occupational therapists have engaged really well with their responsibilities under the National Scheme. As with everything there is still more we can do to ensure that we are practising competently. The new Australian occupational therapy competency standards, launched in February this year, outline the professional behaviours all occupational therapists should demonstrate to practise safely and ethically. It is important that practitioners, employers, education providers and consumers engage with the standards. They determine the expected behaviours for a registered occupational therapist.’

Photo of Shannon Kara
OTBA's 21,000^th registrant, Shannon Kara

For more information about the new competency standards, including resources that can be used within practice settings, please visit www.occupationaltherapyboard.gov.au/competencies.

Members of the public can check the registration status of Australia’s registered health workforce using the national online Register of practitioners, with details of registered practitioners updated several times each day across Australia. The national register is a great resource to help keep the public safe.

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

National Scheme news

Self-assessment tool launched to help health practitioners and advertisers

A new tool to help practitioners and advertisers understand their obligations about using testimonials and reviews to advertise regulated health services is now available.

Within 30 days you are also required to advise us of any changes to your principal place of practice, contact address or name.

A full list of the relevant events that you are obliged to tell us about is included in the Notice of certain events form published on the AHPRA website. There are slightly different requirements for registered students.

To update your address and contact details log into your AHPRA account or if the change of personal details includes a name change, use the Request for change of personal details form on the website.

The testimonial tool is the latest in a series of resources and support materials developed by the Australian Health Practitioner Regulation Agency (AHPRA) and National Boards to help health practitioners, healthcare providers and other advertisers of regulated health services to comply with the National Law.

The tool includes information and flow charts to help practitioners and advertisers understand why testimonials are not allowed and which reviews or feedback can be used in advertising.

Under section 133(1) of the National Law a person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that uses testimonials or purported testimonials about the service or business.

In the context of the National Law, advertising includes any public communication that promotes a regulated health service such as all forms of printed and electronic media and a testimonial includes recommendations or statements about the clinical aspects of a regulated health service.

AHPRA CEO Martin Fletcher said advertising had changed dramatically in the last decade.

‘Websites and social media have increasingly evolved into major marketing tools,’ he said.

‘The National Boards and AHPRA recognise that these sites provide opportunities for patient feedback but advertisers have a legal and professional responsibility to make sure they don’t use testimonials unlawfully in advertising.’

Using testimonials to advertise regulated health services is prohibited under the National Law because they are not usually a balanced source of information, and typically include a narrow selection of positive comments about patient experiences. Also the outcomes experienced by one patient do not necessarily reflect the likely outcomes for others, so a testimonial doesn’t tell the whole story.

Read more about why testimonials can’t be used in advertising.

‘Our law bans using testimonials to advertise but there are ways advertisers can use positive patient reviews and feedback,’ Mr Fletcher said.

‘Comments about friendly staff, plenty of parking or extended opening hours, for example, can be used to advertise a regulated health service but under the law advertising cannot include testimonials about clinical care.

‘I encourage practitioners and advertisers to use the testimonials tool to help them get it right. This means not encouraging patients to leave testimonials and removing testimonials published on websites or other online platforms which they control or administer.’

Advertising compliance strategy

An Advertising compliance and enforcement strategy for the National Scheme was launched in April 2017. The strategy has met a number of its targets since its launch including clear, concise and helpful correspondence about advertising complaints and new resources such as a summary of advertising obligations, frequently asked questions, tips on words to be wary about, examples of compliant and non-compliant advertising and a self-assessment tool.

The testimonial tool is available in the Advertising resources section on the AHPRA website.

Closing the gap by 2031: a shared commitment

A landmark commitment was launched recently to help achieve equity in health outcomes between Aboriginal and Torres Strait Islander Peoples and other Australians to close the gap by 2031.

Launched on Thursday 5 July, the National Registration and Accreditation Scheme Statement of Intent is signed by 37 health organisations, including leading Aboriginal and Torres Strait Islander health organisations and entities working to implement Australia’s regulation scheme for health practitioners; AHPRA, all National Boards and all accreditation authorities.

The work to develop the Statement of Intent and its associated work is being led by the National Scheme Aboriginal and Torres Strait Islander Health Strategy Group and coordinated by AHPRA on behalf of the National Scheme. It has been developed in close partnership with a range of Aboriginal and Torres Strait Islander organisations and experts.

The group shares a commitment to ensuring that Aboriginal and Torres Strait Islander Peoples have access to health services that are culturally safe and free from racism so that they can enjoy a healthy life, equal to that of other Australians, enriched by a strong living culture, dignity and justice.

To help achieve this, the group is focusing on:

a culturally safe health workforce supported by nationally consistent standards, codes and guidelines across all professions in the National Scheme
using our leadership and influence to achieve reciprocal goals
increased Aboriginal and Torres Strait Islander Peoples’ participation in the registered health workforce
greater access for Aboriginal and Torres Strait Islander Peoples to culturally safe services of health professions regulated under the National Scheme, and
increased participation across all levels of the National Scheme.

AHPRA and the National Boards also launched our first Reconciliation Action Plan (RAP). The RAP is an important formal statement of our commitment to work in partnership with Aboriginal and Torres Strait Islander Peoples to achieve patient safety for all Australians.

AHPRA’s RAP is another key initiative under the overall Aboriginal and Torres Strait Islander health strategy developed in partnership with Aboriginal and Torres Strait Islander health sector leaders, National Boards and accreditation authorities. Our shared vision is:

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
this link must be defined by Aboriginal and Torres Strait Islander Peoples.

The National Scheme is uniquely placed in being able to directly contribute to, and significantly influence, real change to improve patient safety for Aboriginal and Torres Strait Islander Peoples in Australia’s health system. This is also true for all of us working within the Scheme, including AHPRA, the 15 National Boards and accreditation authorities.

This RAP outlines what AHPRA will do to start addressing the imbalance in health outcomes between Aboriginal and Torres Strait Islander Peoples and other Australians.

You can read more about the Statement of Intent and the RAP on the AHPRA website.

New research framework launched to improve patient safety

In January, National Boards and AHPRA published a research framework to help transform health practitioner regulation to improve patient safety.

A research framework for the National Scheme: Optimising our investment in research sets out the research priorities and principles for National Boards and AHPRA to focus their research efforts.

The framework includes the priority research areas of: defining harms and risks related to the practice of regulated health professions, regulatory taxonomy or classification scheme, risk factors for complaints and/or poor practitioner performance, evidence for standards, codes and/or guidelines, evaluating regulatory interventions, stakeholder satisfaction and engagement, work readiness and workforce capacity and distribution.

It has been published to provide a solid base to facilitate risk-based research and evaluation activities, with a clear focus on translating the outcomes of research into initiatives that will inform regulatory policy development and decision-making to maximise the public benefit.

Research finds truly vexatious complaints are very rare

New independent research commissioned by AHPRA has looked internationally at vexatious complaints, finding these are very rare and that there is more risk from people not reporting concerns than from making complaints in bad faith.

The report found that the number of vexatious complaints dealt with in Australia and internationally is very small, less than one per cent, but they have a big effect on everyone involved. The research also confirms that the risk of someone not reporting their concerns is greater than if the complaint turns out to be vexatious.

Most of Australia’s 700,000 registered health practitioners provide great care, but patients also have the right to make a complaint when things don’t go so well.

The best available evidence suggests that truly vexatious complaints are very rare, and that under-reporting of well-founded concerns is likely a far greater problem.

There is a common misconception that a complaint must have been vexatious if it resulted in no regulatory action. However, a decision by a National Board not to take regulatory action does not mean that the complaint was unfounded or made in bad faith. For example, a risk to the public may have been adequately addressed between the time the complaint was made and when the investigation concluded.

The report will be used to inform best practice for reducing, identifying, and managing vexatious complaints and helps to identify opportunities to work with others to help reduce their frequency and adverse consequences.

The report is available on the AHPRA website under Published research.

Consultation paper on the draft guideline for informing a National Board about where you practice

The Board has published a consultation paper on the draft guideline for informing a National Board about where you practise.

In September 2017, the Queensland Parliament passed the Health Practitioner Regulation National Law and Other Legislation Amendment Bill 2017. The Bill contained a set of amendments to the Health Practitioner Regulation National Law (the National Law), as in force in each state and territory except Western Australia. Corresponding legislation has also been passed in Western Australia. These amendments include changes to the information a registered health practitioner is required to provide about their practice arrangements when requested by the National Board (referred to as ‘practice information’).

National Scheme, and
increased participation across all levels of the National Scheme.

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
this link must be defined by Aboriginal and Torres Strait Islander Peoples.

This RAP outlines what AHPRA will do to start addressing the imbalance in health outcomes between Aboriginal and Torres Strait Islander Peoples and other Australians.

You can read more about the Statement of Intent and the RAP on the AHPRA website.

700,000^th practitioner registered

AHPRA and the National Boards have welcomed the 700,000^th health practitioner to be registered in Australia since the start of national regulation in 2010, Victoria-based enrolled nurse Alison Tregeagle.

Ms Tregeagle graduated in March 2018 as a mature-aged nursing graduate. Her registration with the Nursing and Midwifery Board of Australia was confirmed and published this month on the national Register of practitioners. While Alison was studying for her Diploma in Nursing, she was working in part-time and casual jobs at an aged care facility, a hospital and a pharmacy and is excited about embarking on her new career as an enrolled nurse.

Reaching the 700,000^th registered practitioner milestone comes almost eight years after the launch of the National Scheme on 1 July 2010, when AHPRA and the National Boards for 10 health professions began their regulatory partnership governed by a nationally consistent National Law.

In 2010, the registration of over half a million health practitioners transferred to the new National Scheme, with a further four health professions joining in 2012 and growing the number of registered health practitioners to more than 590,000 for the year to 30 June 2013. This year the number will grow further as paramedics join the National Scheme in late 2018.

AHPRA’s first annual report showed there were slightly more than 530,000 registered health practitioners across Australia as at 30 June 2011 so hitting 700,000 represents significant growth over that time. It demonstrates that regulation is enabling the growth and mobility of a registered health workforce to support the delivery of health services to Australians.

AHPRA designated a WHO Collaborating Centre for health workforce regulation across the Western Pacific

AHPRA’s commitment to best practice and learning from others has received a boost, with an official designation from the World Health Organization (WHO) as a Collaborating Centre for health workforce regulation. This designation means that AHPRA, in partnership with National Boards, will work with WHO and its Member States in the Western Pacific to strengthen regulatory practice across the region.

Crucial to the work of the Collaborating Centre is establishing a network of regulators across South East Asia and the Western Pacific. The network is expected to work on improving regulatory standards.

The designation as a Collaboration Centre is timely, with the Australian Government Department of Health and WHO recently beginning a four-year Cooperation Strategy. Strengthening regulation in health services, health workforce, radiation, food safety and health products is an identified priority for the joint work in this Cooperation Strategy. You can access the Cooperation Strategy on WHO’s information-sharing site. Queries about AHPRA’s work as a Collaboration Centre can be directed to WHO_CC_HWR@ahpra.gov.au.

Keep in touch with the Board

Visit our website for news about the profession and for registration standards, codes, guidelines, policies and fact sheets.
Lodge an online enquiry form.
For registration enquiries call 1300 419 495 (from within Australia).
Address mail correspondence to: Julie Brayshaw, Chair, Occupational Therapy Board of Australia, GPO Box 9958, Melbourne VIC 3001.