October 2018


Issue 15 - October 2018 special edition


Improving scope of practice regulation to reflect contemporary dental practice

Since the start of the National Registration and Accreditation Scheme (the National Scheme), the Dental Board of Australia (the Board) has moved incrementally from the prescriptive requirements for scope of practice to implement changes that encourage a responsive, risk-based approach that aligns with the Regulatory principles of the National Scheme.

These include to:

  • Provide for the protection of the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered.
  • Facilitate access to health services in the public interest by encouraging a team approach between dental practitioners so that patients are assured of receiving the most appropriate treatment from the dental practitioner who is most appropriate to provide it.
  • Enable a flexible, responsive and sustainable workforce by enabling dental practitioners to practise to the full scope of their education, training and competence.

Over the past year the Board has carried out a review of the current Scope of practice registration standard and associated regulatory documents. The Board has heard from the profession and community about the proposed changes, and this feedback has informed the Board’s final version of the proposed revised registration standard, which it will submit to COAG Health Council for approval. 

We have listened to your feedback and acknowledge that this transition can present challenges to some in the dental profession. However, the Board’s regulatory framework must reflect contemporary dental practice. The changes outlined strengthen healthcare teams, recognise the roles and responsibilities of all dental practitioners, and support dental practitioners to understand their own scope of practice.

We have submitted the proposed registration standard (which is consistent with the consultation draft) for approval and now await the final decision, which is a matter for Ministers.

back to top

Board news

Refresh what you know about the scope of practice review

In mid-2017, the Board began a scheduled review of the Scope of practice registration standard and Guidelines for scope of practice, which establish the requirements for the scope of practice for all registered dental practitioners.

Section 38 of the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law) gives the Board the discretion to develop registration standards about the scope of practice of health practitioners registered in the profession. Under this section, the Board developed a revised standard which was approved by the Ministerial Council on 11 April 2014, with this standard and its associated guidelines effective from 30 June 2014. 

As part of this review and in line with its obligations, the Board consulted widely with stakeholders.  Consultation is an important part of the Board’s engagement with dental practitioners, members of the public and other stakeholders. The feedback provided is greatly valued and informs the Board’s development of its regulatory documents.

On 22 March 2018, the Board’s public consultation paper on a proposed revised Scope of practice registration standard, a proposed revised Guidelines for scope of practice, and a new Reflective practice tool for scope of practice was released. 

Public consultation concluded on 14 May 2018 with an overwhelming response. More than 1,100 submissions were received and a variety of views expressed. The key themes of the submissions have centred on the:  

  • proposed removal of the requirement for a structured professional relationship between a dentist and dental therapists, dental hygienists or a oral health therapists
  • proposed removal of the bar on independent practice for dental therapists, dental hygienists and oral health therapists, and
  • reduction in unnecessary regulation in light of well-established accreditation functions which have shaped practitioner training and competencies.

Want to take a look at what people said?

Submissions can be viewed on the Board’s website under Past consultations.

back to top

What does this mean for you? About the key changes

Strengthening healthcare teams

  • The requirement for a structured professional relationship between a dentist and dental therapists, dental hygienists or oral health therapists will not be regulated by the Board.
  • Dental practitioners should be mindful of other regulatory requirements and workplace agreements which will continue to cover credentialing and scope of clinical practice.
  • The Board’s expectations of professional relationships are set out in the Board’s Code of conduct (the Code).
  • The Code sets out the standards of professional conduct the Board expects and is used to evaluate dental practitioners’ conduct.
  • By defining the Board’s expectations of professional conduct, including professional relationships, the Code supports patients’ interests, good patient care and the delivery of appropriate, effective services within an ethical framework.
  • Practitioners have a professional responsibility to be familiar with and to apply the Code.

Recognising the professional roles and responsibilities of all dental practitioners

  • The regulatory bar on independent practice for dental therapists, dental hygienists and oral health therapists will be removed. 
  • The Board has seen important changes to the education programs for dental therapists, dental hygienists and oral health therapists and current training is sufficient to support these practitioners in working in team-based settings without supervision.
  • This change has no influence on the ability for dental therapists, dental hygienists and oral health therapists to own and run a dental business – as that right already exists.
  • The ability of dental therapists, dental hygienists and oral health therapists to access a provider number or other funding sources is not the responsibility of the Board.

Understanding your own scope of practice

  • The Board has designed a reflective tool to support practitioners in reflecting on their knowledge, skills and abilities, and consider how their competence relates to their areas of practice.
  • You should review your individual scope of practice regularly.
  • This is especially important when updating or refreshing your knowledge and skills in response to changes in your workplace setting or before the introduction of new technologies, equipment and/or treatments into your practice.
  • As a registered dental practitioner it is your responsibility to know your own scope of practice and ensure that you comply with the requirements of the Board’s registration standard and guidelines.

The review has now been completed and the Board has submitted a proposed revised registration standard (consistent with the consultation draft) to COAG Health Council for approval. 

The Board will inform registered dental practitioners and stakeholders of the outcome once a decision has been made by Ministers.

back to top

Phasing out the approval of Programs to extend scope

Before the National Scheme, dental hygienists, dental therapists and dental prosthetists could extend their scope of practice in some jurisdictions by completing an ‘add-on’ program. The add-on programs, now known as Programs to extend scope, transitioned to the National Scheme as programs reviewed and approved by the Board.

Last year, the Board announced that it had agreed to phase out approval of Programs to extend scope – this means these programs will no longer be accredited by the Australian Dental Council (ADC) or approved by the Board. The approval of the current programs will expire on 31 December 2018 and the list will be removed from the Board’s website.

These types of programs can continued to be delivered as continuing professional development (CPD). CPD is how all dental practitioners continue to learn and develop their professional practice. If you decide to complete CPD that broadens your knowledge, expertise and competence (e.g. a CPD course to learn a new technique), you need to:

  • self-assess whether you have been provided with sufficient clinical experience
  • assess the quality of training to incorporate this new technique into your clinical practice, and
  • make sure you are practising within your division of registration and definition of dentistry.

The Board has published updated frequently asked questions (FAQ) to answer common queries that you might have about this transition phase.

back to top

Dental practitioners to be asked about advertising compliance as part of 2018 renewal

Dental practitioners renewing their registration in 2018 will be asked to declare that, if they advertise, their advertising meets the National Law’s advertising requirements.

This additional step at renewal follows the National Board’s agreement to take part in a pilot audit for advertising compliance. The Chiropractic Board of Australia is also taking part.

Random audits of advertising compliance will advance a risk-based approach to enforcing the National Law’s advertising requirements and facilitate compliance by all registered health practitioners who advertise their services.

Regulatory Operations Executive Director Kym Ayscough said the audit for advertising compliance would provide opportunities to extend the current action under the Advertising compliance and enforcement strategy launched in April 2017.

'The audit will provide opportunites for AHPRA and the National Boards to become more proactive in helping to prevent non-compliant advertising by registered health practitioners,’ she said.

This pilot audit has been modelled on the well established approach to auditing compliance with core registration standards so involves adding an extra declaration about advertising compliance when dental practitioners apply for renewal of registration in 2018. (The National Law1 enables a National Board to require any other reasonable information2 to be included with a renewal application.)

'The audit will potentially improve compliance with advertising obligations across the entire registrant population, not just those who have had an advertising complaint,’ Ms Ayscough said.

When applying to renew their registration, dental practitioners will be required to complete a declaration in response to the following statement:

I confirm that if I advertise my services or my business as a dental practitioner that advertising complies with section 133 of the National Law and the Board’s advertising guidelines as it:

  • is not false, misleading or deceptive or likely to be misleading or deceptive
  • does not offer a gift, discount or other inducement without stating the terms and conditions of the offer
  • does not use testimonials or purported testimonials about the service or business
  • does not create an unreasonable expectation of beneficial treatment, and
  • does not directly or indirectly encourage the indiscriminate or unnecessary use of my services.

Practitioners who are renewing non-practising registration and those who have contacted AHPRA in response to a complaint about their advertising in the past 12 months will not be included in the audit sample.

Ms Ayscough said the audit would not delay a decision on the application for renewal.

The audit will be carried out by AHPRA’s Advertising Compliance Team from January 2019 and will involve a random sample of dental practitioners who renewed their registration in 2018.

'One of the audit’s main objectives is to analyse the rate of advertising compliance for those health practitioners who advertise and who have not been the subject of an advertising complaint in the past 12 months,’ Ms Ayscough said.

Other objectives of the audit are:

  • to inform the evaluation of the compliance and enforcement strategy
  • establish the rate of advertising compliance within the profession, and
  • address any non-compliance with advertising obligations identified in the audit.

A pilot audit report addressing the above objectives and including data analysis and recommendations will be prepared for National Boards to consider the pilot outcomes and implications for future compliance work.

For information about your advertising obligations see the advertising resources page at www.ahpra.gov.au/Publications/Advertising-resources.aspx.


1 The Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).
2 Section 107(4)(e) of the National Law

back to top 

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 for 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 8708 9001 (for overseas callers).
 
 
Page reviewed 3/10/2018