July 2020

Issue 20 - July 2020


Chair’s message

Murray Thomas

The challenging times we find ourselves in mean this is the Dental Board of Australia’s first newsletter for 2020.

Since March, together with the Australian Health Practitioner Regulation Agency (Ahpra) and other National Boards, we have been focused on our response to the COVID-19 pandemic. The current outbreaks in Victoria and New South Wales show how rapidly conditions can change.

The Board recognises the profession’s efforts to apply government-imposed public health restrictions and especially wishes to acknowledge the commitment of the Australian Dental Association’s Infection Control Committee. Its members continue to provide advice to the Australian Health Protection Principal Committee, the Australian Government’s key decision-making committee for public health emergencies.

We recognise the strain all dental practitioners have been under in recent months while continuing to provide high quality care to patients. For this reason, we brought forward the launch of Dental Practitioner Support, a confidential health and wellbeing support service which started on 6 July. More about the 24/7 service is in this newsletter.

Stay COVID safe and continue to take care of yourselves and staff, patients, family and friends.

Let the eye of vigilance never be closed. Thomas Jefferson.

Murray Thomas
Chair, Dental Board of Australia

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Board news

COVID-19 means dental practitioners must be vigilant

Dental practitioners have an important role in helping to contain the spread of COVID-19 and like everyone, must remain alert, as shown by recent outbreaks in Victoria and New South Wales.

The Board recognises the strain all dental practitioners have been under in recent months and which is ongoing for some practitioners in these unprecedented times. You are a critical part of the health workforce, looking after the oral health of your patients while remaining vigilant about containing any possible spread of COVID-19.

The current circumstances in Victoria and New South Wales show how rapidly conditions can change. While the emergency response to COVID-19 is a national issue, some practitioners may be subject to further restrictions, put in place by state or territory governments under public health Acts. These Acts allow for restrictions to control and prevent the spread of COVID-19.

Make sure you stay up to date with your respective state and territory jurisdictional health directions and the latest Australian Government guidance. Never has adhering to infection control measures been more important than it is now; and you must exercise your professional judgement when caring for your patients.

While healthcare settings are an essential service, you should consider the current risk environment and public safety when making decisions about whether to defer non-urgent or elective dental services.

An outbreak or hotspot of COVID-19 may increase the risk of transmission. In these circumstances, you may decide to go beyond government restrictions and apply greater risk control measures in your practice to minimise the risk of transmission.

Underpinning the Board’s Code of conduct is the assumption that you will exercise your professional judgement to assess and manage risk to deliver the best possible outcome for your patients.

Links to resources to help you manage COVID-19 are included in the Board’s 9 July news item.

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Health and wellbeing support just a phone call away

Need to talk to someone? Support for dental practitioners is just a quick phone call or click away.

Dental Practitioner Support is the first national 24/7 health and wellbeing support service for all dental practitioners. A telephone and online service, anyone using it does not have to give their name and can seek support anonymously.

Callers have access to an experienced team who can provide confidential advice and referral on a wide range of issues, including mental and physical health and general wellbeing.

Access Dental Practitioner Support:

The service offers support to all dental practitioners, which includes dentists, dental prosthetists, oral health therapists, dental hygienists and dental therapists. It is also available to dental students, educators, employers, Australian Council exam candidates and concerned family members and friends.

While funded by the Board, the service is run independently by Turning Point so you can have complete confidence in reaching out for confidential support. Turning Point is a leading addiction treatment, research and education organisation based in Victoria.

The Board warmly thanks dental practitioners who participated in workshops to help train the team of counsellors who will be taking calls. Because your health matters, we encourage you to add the service’s contact number to your phone and not to delay calling, if and when you need support.

Podcast interview

Hear from Dental Board of Australia Chair, Dr Murray Thomas, and Turning Point Program Director Anthony Denham in a recorded podcast interview by the New South Wales branch of the Australian Dental Association.

Dr Thomas outlines why the Board sought to establish a support service that is easily accessed by all dental practitioners. Mr Denham explains the importance of reaching out early and how all dental practitioners, no matter where they are based, can access the same support services.

Listen to the 13 minute podcast now.

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Revised scope of practice standard in effect

Scope of practiceOn 1 July 2020, the Board’s revised scope of practice standard and guidelines came into effect.

The revised Scope of practice registration standard no longer includes the regulatory requirement for a structured professional relationship between a dentist and other members of the dental team. If an employer wishes to have a formal arrangement, that is a workplace matter between the two parties.

Under the revised standard, dental practitioners across all divisions of dentistry are responsible for the decisions, treatment and advice they provide and must only perform dental treatment:

  • for which they have been educated and trained, and
  • in which they are competent.

Why was the standard changed?

The revised standard continues the Board’s incremental approach to moving away from prescriptive requirements for scope. The revised standard and guidelines, together with the Code of conduct, are part of the Board’s regulatory framework. Because these documents apply to all dental practitioners across a range of clinical settings to meet the needs of patients, they don’t refer to clinical areas of practice.

All members of the dental team have a responsibility to provide the best possible care and outcomes for their patients. This may mean needing to refer a patient when the care is outside a practitioner’s scope of practice. The Board’s Code of conduct talks about working with other practitioners and all dental practitioners should maintain strong professional relationships with other practitioners and divisions so they can work as a cohesive dental team.

Scope of practice resources

A know your scope hub launched in May has information and resources to support your understanding of your obligations under the revised standard, including:

Resources on the hub were developed with input from practitioners and professional associations, including the reflective practice tool. You can use the tool when planning your continuing professional development as it will help you to reflect on your individual scope of practice and identity areas where you might broaden your scope within the division of your registration.

We also encourage you to use the resources available in the ‘know your scope’ hub and read the revised Guidelines for scope of practice which include a definition of dentistry.

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Management of tongue ties by dental practitioners

The Board notes a recent statement from the Australian Dental Association (ADA) regarding the treatment of tongue ties1 and we advise you that the Board’s position on this practice remains the same.

A dentist treating tongue-ties must be able to demonstrate they have the necessary training, qualifications and competence to be able to do so safely.

The Board applauds the ADA’s leadership in developing the Ankyloglossia and oral frena consensus statement by a multi-disciplinary working group. It is an essential foundational step in supporting dental practitioners in providing safe and quality care.

We would like to remind you of your obligations as registered practitioners under the National Law.2

The Board describes its requirements of dental practitioners in its registration standards, codes and guidelines published on the Board’s website. These documents do not refer to specific clinical areas of practice as they need to apply to all dental practitioners across a range of clinical settings, to meet the needs of patients.

We expect you to practise within this regulatory framework at all times, including when treating tongue ties, which may involve the use of surgical procedures, such as frenotomies, on infants to treat these conditions.

Of particular importance if you are managing tongue ties

  • The Scope of practice registration standard describes the Board’s requirements of all dental practitioners to practise within the scope of their education, training and competence.
  • The associated Guidelines for scope of practice include a broad definition of dentistry. You need to practise within this definition.
  • If you are treating tongue ties you must be able to demonstrate that you have the necessary training, qualifications and competence to be able to do so safely.
  • The Code of conduct describes the Board’s expectations of what constitutes good practice. You have a duty to make the care of patients your first concern, and to practise safely and effectively at all times.
  • Treatment for tongue ties should only be used if it can be justified. You must obtain informed consent, including financial consent, and explain the risks associated with the treatment to the patient, and document this.
  • You need to be particularly aware of the patient’s expectations about treatment for tongue ties. You must communicate effectively with the patient to ensure that you are meeting this standard and that the patient’s expectations are reasonable.
  • Any person, including businesses, advertising the treatment of tongue ties must comply with the requirements of the National Law when advertising a regulated health service.
  • The Board and Ahpra have published information to help dentists better understand their advertising obligations, including further information on advertising therapeutic claims.
  • This information does not replace the Board’s Guidelines for advertising regulated health services, which should be your first point of reference to understanding your obligations. The burden is on you to substantiate any claim you make that your treatments benefit patients.
  • If you do not understand whether the claims you have made can be substantiated based on acceptable evidence, then you need to remove them from your advertising.

If your practice was brought into question through a complaint or concern raised with the Board, you would be expected to demonstrate how you had complied with these obligations.

1 Anklyglossia or tongue tie can be described as a congenital birth defect whereby there is partial or complete fusion of the tongue to the floor of the mouth or the lingual frenulum may be short, tight and thick.
2 The Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).

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New guidelines for practitioners and students on blood-borne viruses

New Guidelines for registered health practitioners and students in relation to blood-borne viruses came into effect on 6 July 2020.

The Board’s guidelines are for practitioners and students who perform exposure-prone procedures3 and registered health practitioners who are treating registered health practitioners or students living with a blood-borne virus who perform exposure-prone procedures. It is likely that dental practitioners will be performing exposure-prone procedures in their clinical practice.

The guidelines support those practitioners and students to comply with the Communicable Diseases Network Australia (CDNA) guidelines Australian national guidelines for the management of healthcare workers living with blood borne viruses and healthcare workers who perform prone procedures at risk of exposure to blood borne viruses.

The CDNA guidelines set out safe practice in relation to exposure-prone procedures and the hepatitis B virus, hepatitis C virus and/or human immunodeficiency virus.

The Board’s guidelines also explain when a practitioner treating a registered health practitioner or student who performs exposure-prone procedures may have a responsibility to notify Ahpra if their patient is not complying with the CDNA guidelines and potentially poses a risk to the public.

What this means for dental practitioners

At registration and renewal of registration, dental practitioners who perform exposure-prone procedures will have to declare that they comply with the CDNA guidelines.

Among other things, the CDNA guidelines recommend that practitioners who perform exposure-prone procedures take reasonable steps to know their blood-borne virus status and should be tested for blood-borne viruses at least once every three years.

The Board will not ask for test results for the purpose of registration or renewal of registration but can take action if a dental practitioner makes a false declaration about complying with the CDNA guidelines.

Dental practitioners living with a blood-borne virus who perform exposure-prone procedures can practise their profession if they comply with CDNA guidelines. The CDNA guidelines provide details about the circumstances under which practitioners can resume exposure-prone procedures.

Links to helpful CDNA resources are included in the Board’s 23 June news item.

3 Exposure-prone procedures are procedures where there is a risk of injury to the healthcare worker resulting in exposure of the patient’s open tissues to the blood of the healthcare worker. These procedures include those where the healthcare worker’s hands (whether gloved or not) may be in contact with sharp instruments, needle tips or sharp tissues (spicules of bone or teeth) inside a patient’s open body cavity, wound or confined anatomical space where the hands or fingertips may not be completely visible at all times.

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Guidelines for dental records to be retired

Following a review in 2019, the Board is planning to retire its Guidelines for dental records on 1 October 2020. The Board carries out regular reviews of all its registration standards, codes, guidelines and policies to ensure continued relevance in a dynamic regulatory environment.

Our public consultation on the proposed retirement of the guidelines concluded in January. Four submissions were received and are published on the Board’s website together with an overview of the public consultation process.

We are going to retire the guidelines as the Code of conduct contains adequate guidance about health record management. The code is seen as the seminal document for setting standards and regulatory requirements for dental practitioners. As one of the Board’s regulatory tools, the code will therefore be positioned as the main point of guidance for dental practitioners.

A fact sheet and self-reflective tool are being developed to help you understand your obligations under the code. Both documents will be published on the Board’s website before the guidelines are retired.

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Practitioner profile

Patricia Elder is ‘stoked’ to be an Indigenous dentist

DBA Patricia Elder

Proud Yindjibarndi woman Patricia Elder is excited about starting her professional life as a dental practitioner in government-run outreach programs.

Patricia was one of three Indigenous women who last year graduated with a Doctor of Dental Medicine from the University of Western Australia. This boosted the number of Australia’s Indigenous dentists by more than six per cent. Indigenous Allied Health Australia data shows that as at December 2019, there are 48 Indigenous dentists practising around Australia.

Earlier this year, Patricia started working for the Western Australia Government Dental Health Services in Kununurra. Her role incorporates the community outreach programs to Balgo, Kalumburu, Yuri Yungi and the Aboriginal Medical Services at the Ord Valley Aboriginal Health Service.

Due to her remote location, Patricia’s work supporting a population of about 5,300 people has continued relatively as normal despite the COVID-19 pandemic. However, reduced deliveries to rural areas have required conservative use of the limited supply of daily consumables.

Communities being in lockdown and travel restrictions have forced patients to travel long distances for dental appointments. Most patients attending Patricia’s practice do so for emergency treatment and care; and the dental team has been busy.

Patricia is relishing the opportunity to educate and teach her patients how to manage their dental health.

‘I want them to know that they are in control of their oral health and if they don’t take care of it, then it will cost more to repair the damage and get back to optimal oral health.’

Treating children has been the biggest highlight for Patricia but it’s also been challenging.

‘I usually see children aged up to four years old and they haven’t seen anyone about their oral health before me. So, trying to build a rapport with the children and their parents is hard.

‘I love seeing the children’s big, beautiful smiles, and it’s empowering when people who were previously petrified of dentists come back each week because they now have an appreciation for their own oral health.’

Despite graduating as a registered nurse in 2012, becoming a dentist was always Patricia’s dream.

‘As a young child I was a frequent patient of the remote dental school service and had no understanding of my dental treatment or its importance.’

It was not uncommon for children in Patricia’s community to have poor teeth due to a lack of knowledge about dentists, treatment and the importance of oral hygiene.

‘I realised later that I wanted to make dental care a positive experience for young children, particularly for those in rural areas.’

Reaching a senior position in nursing gave Patricia the confidence to pursue her dream and she continued to practise as a nurse while studying dentistry.

Patricia had previously worked in the Plastics, Ear, Nose and Throat (ENT) and Ophthalmology Ward of Perth’s Sir Charles Gairdner Hospital and in the Intensive Care and High Dependency Unit at Joondalup Health Campus.

‘I enjoyed my time working as a nurse and so it was good to keep practising to support myself through university.

‘While this was not without its challenges, I’m glad I kept working as I wouldn’t be where I am today or be as passionate as I am about what I do now.’

Patricia was surprised to note the attitudes and opinions of other allied health professionals during her transition from nursing to dentistry.

‘Nursing is more patient-centred care, and I think dentists risk falling into the trap of seeing teeth, and not people. This can be detrimental to the long-term health outcomes of patients.’

Patricia is proud of her achievement, particularly because of the challenges she faced growing up and the four years of combined work and study.

‘At first it felt a bit surreal and slightly bittersweet, but now I feel like I am slowly having a positive impact on the community by providing services to people who wouldn’t necessarily have the option to access dental care.

‘Honestly, I am stoked to be an Indigenous dentist and I hope to be a mentor to other Aboriginal women and men seeking a similar path.’

Patricia’s family is from Roebourne, Western Australia, where they have strong family connections to Millstream. She grew up with her extended family from Northampton (Mooniemia) on Yamatji country.

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Regulation at work

Fake dentists convicted after Ahpra prosecution

Two people who carried out invasive dental treatment on a person and falsely claimed to be dentists have been convicted in a Sydney court. Mr Majid Rahebi and Ms Shirin Ramezani Kharavani were prosecuted by Australian Health Practitioner Regulation Agency (Ahpra) for offences against the National Law. Neither has ever held registration as a dentist.

The charges related to events in October 2018 when Ms Kharavani represented that she and Mr Rahebi were dentists to a patient who attended a dental clinic in Sydney for treatment. Mr Rahebi and Ms Kharavani then drilled out the patient’s tooth and applied a temporary filling. An anaesthetic was also administered. The treatment left the patient with severe damage to her tooth. Mr Rahebi also presented himself as a dentist to the same patient on a later date. For further details, see the media release.

Man convicted of illegal dental treatments at his home

In the Local Court of NSW, Brazilian national Mr Eduardo Soares Penques was convicted in his absence of holding himself out as a dentist and carrying out restricted dental acts following charges laid by Ahpra. He was fined $16,500 and ordered to pay $3,173 in costs.

Mr Soares Penques has never held registration as a dentist in Australia. He is a resident of Brazil and was temporarily residing in Australia at the time of the offending. For further details, see the media release.

Anyone claiming to be a dentist must be registered with the Dental Board of Australia. We encourage the public to ask questions about the person and check the register of practitioners to see if the person giving the care is listed. Anyone with concerns about whether an individual is registered can check the register of practitioners or contact Ahpra on 1300 419 495.

Dentist suspended for not obtaining ‘vulnerable’ patients’ informed consent

A tribunal in Victoria has suspended a dentist’s registration after finding she engaged in professional misconduct regarding her examination and treatment of five patients with intellectual disabilities. All five patients were unable to effectively communicate and did not have capacity to provide consent or make decisions about their dental treatment.

Among the Victorian Civil and Administrative Tribunal’s findings was that the dentist, who did not hold specialist registration in special needs dentistry, failed to obtain informed consent from the guardians or responsible persons for the patients. For further details, see the news item.

Since 1 July 2019 things have changed

In February 2019, the Health Practitioner Regulation National Law and Other Legislation Amendment Act 2019 (Qld) was passed by the Queensland Parliament. The amendments included increased penalties and introduced an imprisonment term of up to three years for offences against the National Law. The penalties will apply to offences committed after 1 July 2019. The introduction of an imprisonment term means that some offences will automatically become indictable offences in all states and territories (except Western Australia).

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National Scheme news

Podcasts on the pandemic and beyond

Ahpra has released many 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, discussing current topics and the latest issues affecting safe healthcare in Australia. Podcasts include:

  • How is COVID-19 changing the experience of healthcare from both sides of the bed?
  • Let’s meet the decision-makers
  • A glimpse of healthcare in our rural and remote communities
  • Balancing purpose and progress in regulation: Professor Kieran Walshe
  • 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.

Download and listen to the latest Ahpra Taking care podcast episode today. You can also listen and subscribe on SpotifyApple Podcasts and by searching ‘Taking care’ in your podcast player.

 

If you have questions or feedback about the podcast, email communications@ahpra.gov.au.

 

Taking care podcast image July 2020

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Protecting our health practitioners of the future: clinical education principles

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.

The Australian Dental Council (ADC), in collaboration with all Australian dental practitioner program providers, has also released the COVID-19 dental practitioner program accreditation principles (the principles). Endorsed by the Board, the principles help guide how both groups will work together during the COVID-19 pandemic. Agreed to by the ADC and the providers of Australian dental education programs, the principles are designed with mutual respect of the other’s role within the National Registration and Accreditation Scheme (the National Scheme) and the education sector.

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No place for racism in healthcare

In April, the Australian Indigenous Doctors’ Association (AIDA) issued a media release detailing instances 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.

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False and misleading advertising on COVID-19

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. Members of the public 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 currently 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. For a registered health practitioner, 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.

For more information, see Ahpra’s Advertising resources web page.

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National Boards and Ahpra welcome policy directions

National Boards and Ahpra have welcomed two new policy directions from the COAG Health Council which reinforce that National Boards and Ahpra 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, National Boards and Ahpra will continue to ensure fairness for health practitioners in regulatory processes. The policy directions can be viewed on the Ahpra website.

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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 by a treating practitioner 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.

The guidelines aim to explain the mandatory notifications requirements in the National Law clearly so that practitioners, employers and education providers understand who must make a mandatory notification about a practitioner or student and when they must be made. They also aim to make it clearer when a notification does not need to be made.

Changes to the guidelines include the following:

  • 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.
  • There are now two separate guidelines 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. 
  • Introduction of risk charts that highlight risk and mitigating factors that may be relevant to deciding if a mandatory notification is required.

To help explain the requirements and raise awareness, Ahpra and National Boards have released a range of information materials to both ensure patient safety and support practitioner wellbeing. Read the revised guidelines for practitioners and students and the additional resources developed to help explain mandatory notifications.

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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 has been released 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 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, and
  • 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.

NRAS combined meeting

L to R: Karl Briscoe, Co-Chair, Aboriginal and Torres Strait Islander Health Strategy Group; Julie Brayshaw, Chair of the Occupational Therapy Board of Australia and Co-Chair, Health Strategy Group; Prof. Greg Phillips, immediate past chair, Health Strategy Group; Gill Callister, Chair, Agency Management Committee (Ahpra); Martin Fletcher, CEO, Ahpra.

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Statement by National Boards and Ahpra on the misuse of protected titles

Protected titles are an important public safety measure and we take their misuse seriously.

While we are unable to talk about individuals, we would like to thank everyone who has helped to promote a greater community understanding of the importance of protected titles and their appropriate use.

We have recently been working with media organisations to ensure they understand their legal obligations when using titles such as ‘nurse’, ‘medical practitioner’ or ‘psychologist’.

In Australia, titles that relate to a registered health profession are protected by law. You must be registered with a national health practitioner board (National Board) to use a protected title. To be registered, you must be suitably trained, qualified and satisfy the National Board’s requirements for continuing professional education, professional indemnity insurance and recency of practice.

To use a protected title when you’re not registered, or to hold someone else out as registered when they’re not, breaches the trust the public has in their registered health practitioners. That’s because when the public sees a protected title, they trust that they’ll be receiving safe and professional healthcare and advice.

Ahpra wrote to media organisations to remind them of their obligations under the National Law, and to advise that the easiest way to check if someone is registered to practise and entitled to use a protected title in Australia, is by checking our online register of practitioners. The register, which contains the most up-to-date information about a practitioner’s registration status, is available to members of the public, employers and third-parties. It’s free, available 24/7, with updates made daily.

If you are concerned that someone might be holding themselves out to be a registered practitioner when they’re not, call 1300 419 495 or notify us via the Ahpra website.

Tougher penalties for offences committed after 1 July 2019

In February 2019, the Health Practitioner Regulation National Law and Other Legislation Amendment Act 2019 (Qld) was passed by the Queensland Parliament. The amendments included increased penalties and introduced an imprisonment term of up to three years for offences against the National Law. The penalties apply to offences committed after 1 July 2019.

The introduction of an imprisonment term means that some offences will automatically become indictable offences in all states and territories (except Western Australia).

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Social media guide for health practitioners

National Boards and Ahpra have published a new guide to help registered health practitioners understand and meet their obligations when using social media. The guide reminds practitioners that when interacting online, they should maintain professional standards and be aware of the implications of their actions, just as when they interact in person.

The guide does not stop practitioners from engaging online or via social media; instead, it encourages practitioners to act ethically and professionally in any setting.

To help practitioners meet their obligations, the guide also outlines some common pitfalls practitioners may encounter when using social media.

Community trust in registered health practitioners is essential. Whether an online activity can be viewed by the public or is limited to a specific group of people, health practitioners have a responsibility to behave ethically and to maintain professional standards, as in all professional circumstances.

In using social media, health practitioners should be aware of their obligations under the National Law, the Board’s Code of conduct, the Advertising guidelines and other relevant legislation, such as privacy legislation.

This guide replaces the Social media policy on Boards’ codes, guidelines and policies pages and is available in the Advertising resources section of Ahpra’s website. The guide will be updated as needed.

Consumer safety and cosmetic procedures: ‘be safe first’

Ahpra has launched a new education campaign called ‘be safe first’ to advise consumers of the risks associated with cosmetic procedures, particularly those offered by unregistered practitioners. The ‘be safe first’ campaign includes resources to help consumers know what kinds of questions to ask before going ahead with a cosmetic procedure.

Many concerns are raised with Ahpra after someone has had a bad outcome from a cosmetic procedure. Over the past three and a half years, Ahpra has helped to protect consumers by working with other agencies to respond to such concerns. This has included prosecuting eight individuals and companies for offences under the National Law which related to cosmetic procedures.

Penalties for such offences have doubled since 1 July 2019, including a potential jail time of up to three years for some offences.

In the ‘be safe first’ campaign, Ahpra is advising consumers to check first if the person carrying out the procedure is registered and appropriately qualified on the online register of practitioners.

The campaign resources and supporting materials include a new ‘cosmetic surgery and procedures’ section on the Ahpra website, with dedicated pages for specific audiences including:

  • information to help consumers know what questions to ask and what to look out for
  • information about who to contact with a concern and the roles and responsibilities of organisations involved in regulating cosmetic procedures and surgery
  • a new fact sheet on cosmetic injectables
  • information resources for practitioners about cosmetic procedures, including links to guidance developed earlier by the Dental, Medical and Nursing and Midwifery Boards of Australia.

Consumers can ‘be safe first’ by checking out information on Ahpra’s website: www.ahpra.gov.au/besafefirst.

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Keep in touch with the Board

As always, we encourage you to regularly check the Dental Board website for information and updates relating to the dental profession.

  • Visit our website for information on the National Scheme and the mandatory registration standards, codes, guidelines, policies and fact sheets. Board communiqués and consultation papers are published on the site under News.
  • 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: Executive Officer, Dental Board of Australia, GPO Box 9958, Melbourne VIC 3001.

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Page reviewed 31/07/2020