Welcome to the Spring 2018 issue of the Podiatry Board of Australia’s newsletter. 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.
You will have all received an email in early August informing you that our new endorsement for scheduled medicines registration standard and guidelines are in effect. If you are planning to extend your knowledge and skills and work towards gaining an endorsement for scheduled medicines, it is very important that you familiarise yourself with the information on the Board’s website about the requirements for endorsement before you start. September is also a time to reflect on your progress in meeting the Board’s requirements for continuing professional development (CPD) and make sure you are on track to meet your CPD obligations by the time you renew your registration in November.
Chair, Podiatry Board of Australia
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The Board’s revised registration standard for endorsement for scheduled medicines and associated guidelines came into effect on 1 August 2018. The news item about the revised registration standard and guidelines can be found on our website.
The revised registration standard replaces the previous registration standard that was in effect until 31 July 2018. It applies to podiatrists and podiatric surgeons applying to have their registration endorsed for scheduled medicines, as well as those whose registration is already endorsed for scheduled medicines.
Recognising that there were practitioners working towards an endorsement under Pathway 2 of the previous registration standard when the new registration standard took effect, the Board developed transitional arrangements which allow these practitioners to continue under Pathway 2 or switch to Pathway B of the new registration standard. Practitioners who wanted to use the transitional arrangements had until 1 September 2018 to let the Board know and submit relevant documents.
The registration standard and guidelines as well as other supporting information, including templates, FAQ and a Prescribing self-assessment tool, are available on the Endorsement for scheduled medicines page.
Registered podiatrists and podiatric surgeons are required to comply with the Board’s registration standards.
When renewing their registration each year, practitioners declare whether they have been compliant with registration standards, including continuing professional development, recency of practice, and professional indemnity insurance arrangements registration standards. Practitioners also declare whether there was any change in their criminal history since their previous declaration.
Each year, AHPRA randomly selects and audits registered podiatrists and podiatric surgeons to check compliance with the registration standards and declarations made at renewal. The 2018 audit is underway. You can read more about the audit process on the Board’s audit page.
For all audits initiated and completed in 2017, approximately 95% of podiatrists and podiatric surgeons were found to be compliant with the registration standards.
Of these, 73% were fully compliant and 22% were subsequently able to meet the standard – nearly all of these related to non-compliance with cardiopulmonary resuscitation (CPR) requirements. Of the remainder:
While the 2017 audits have found that there was a relatively high level of compliance by podiatrists and podiatric surgeons with the Board’s registration standards, the audit has shown that the percentage of practitioners who were fully compliant with the standards has decreased since the 2016 audit. In 2016, approximately 86% were fully compliant compared to 73% fully compliant in 2017.
The 2016 and 2017 audits have shown a substantial portion of practitioners audited failed to complete CPR requirements in accordance with the Board’s CPD registration standard and guidelines.
As required by the CPD registration standard, podiatrists must complete training that includes CPR, management of anaphylaxis and use of an Automated External Defibrillator (AED). Training in management of anaphylaxis and the use of an AED must be renewed at least every three years and the CPR component must be renewed annually. This is based on the Australian Resuscitation Council recommendation that CPR skills should be refreshed at least annually.
We remind you of your obligation to meet the requirements of the Board’s mandatory registration standards and your obligation to ensure the declarations you make when you renew your registration each year are accurate.
We encourage you to review the Board registration standards and guidelines to make sure you understand their requirements and expectations. Information about the registration standards is available on the registration standards page.
As a registered health professional you will understand the importance of continuing professional development in providing safe and effective podiatry services, regardless of whether you have been practising for many years or are a relatively new graduate. CPD enables us to maintain, improve and broaden our knowledge, expertise and competence, as well as developing the personal and professional qualities required throughout our professional lives.
When you renew your registration you must declare declare whether, during the preceding period of registration, you met the Board’s CPD requirements as outlined in the CPD registration standard.
The Board has published guidelines for CPD as well as FAQ and templates to help you plan and record your CPD activities. These can be found on the policies, codes and guidelines section of the Board’s website.
Effective infection prevention and control is central to providing quality healthcare for patients and a safe working environment for those who work in healthcare settings.
The Board expects you to continue to maintain and update your knowledge throughout your career across all areas of your practice, and recommends that you regularly include a course in infection prevention and control as part of your CPD. This will help you attain and maintain contemporary knowledge of the required standards, policies and procedures in infection prevention and control.
The Board’s Guidelines for infection prevention and control are published on the policies, codes and guidelines section of our website, together with a self-audit tool that you can use to see how well you comply with the Board’s guidelines.
We encourage you to use the self-audit tool as a checklist to ensure your workplace is clean and hygienic and you are taking the necessary feasible steps to prevent or minimise the spread of infection.
The Board’s Code of conduct for registered health practitioners can be found on our website.
The Code of conduct seeks to assist and support you to deliver effective podiatric care within an ethical framework. You have a duty to make the care of patients your first concern and to practise safely and effectively. Maintaining a high level of professional competence and conduct is essential for good care.
You have a professional responsibility to be familiar with the Board’s Code of conduct and to apply the guidance it contains about important standards for practitioner behaviour.
One of the areas in the code that the Board would like to highlight is the section on providing good care. This includes working within the limits of your competence and scope of practice; ensuring you maintain adequate knowledge and skills to provide safe and effective care; communicating effectively with your patients; practising in accordance with the current and accepted evidence base of the profession, including clinical outcomes; and maintaining adequate health records.
The Board acknowledges that podiatrists and podiatric surgeons practise in a range of clinical settings and in some of these there may be time pressures placed on you. However, it is important that you allow sufficient time during all consultations to ensure that you meet your professional obligations to provide safe and effective podiatric care to your patients.
The Board has frozen the registration fee at $378 for the third consecutive year. It will cover the registration period for most practitioners of 1 December 2018 to 30 November 2019.
The fee for practitioners whose principal place of practice is New South Wales is $4041.
A full fee schedule, including the fee arrangements for practitioners whose principal place of practice is NSW, has been published on the Board’s website.
The National Registration and Accreditation Scheme (the National Scheme) is funded by practitioners’ registration fees. Although the Board has frozen the fee, it will still provide sufficient funds to allow the Board to carry out its duties and protect the public.
1 NSW is a co-regulatory jurisdiction.
Podiatrists and podiatric surgeons may be required to work under supervision for a range of regulatory purposes, including when the practitioner:
Appropriate supervised practice arrangements provide assurance to the Board and the community that a registered podiatrist or podiatric surgeon whose practice is being supervised is safe to practise and not putting the public at risk. Supervision requirements will be different for each practitioner, depending on their particular circumstances.
The Guidelines for supervision of podiatrists, which are published on our website, set out the principles the Board considers central to safe and effective supervision in a range of clinical contexts. We have published templates to support the supervision guidelines, including a template supervised practice plan and template supervision report.
A supervised practice plan is a plan that is agreed between the Board, the supervisor and supervisee that sets out the objectives for, levels, type and amount of supervision required and how the supervision is to occur. The plan will include the supervision requirements, including the expected progression through the levels of supervision and reporting to the Board.
We have developed an example of a supervised practice plan to provide guidance to practitioners about our expectations. You can find this on our website. We have also updated the template supervised practice plan and template supervision report. The changes are minor and relate mainly to the style and flow of the templates.
The Board publishes quarterly data profiling Australia’s podiatry workforce. The data report for the April to June 2018 quarter was recently published on our website. The report includes a number of statistical breakdowns.
As at 30 June 2018, there were 5,155 registered podiatrists and podiatric surgeons in total. Of these, 5,016 held general registration as a podiatrist; 35 held both general registration and specialist registration as a podiatric surgeon; and 104 held non-practising registration. Ninety-five practitioners had their registration endorsed for scheduled medicines.
AHPRA has published further guidance for advertisers of regulated health services to emphasise that selectively editing reviews or testimonials has the potential to break the law.
The recent example of an organisation only publishing positive reviews and removing all negative information from consumer reviews shows the importance of advertisers understanding their advertising obligations under all relevant legislation.
Selectively editing reviews or testimonials has the potential to be false, misleading or deceptive and, therefore, be unlawful. For example it is inherently misleading to:
Reviews influence consumer choice about their healthcare so advertisers must make sure reviews are genuine and not misleading. Advertisers’ moderation guidelines about publishing reviews must comply with the National Law and the Australian Consumer Law.
AHPRA and the National Boards recently published a testimonial tool to help advertisers understand what reviews can and can’t be published, and have updated the tool to help advertisers get it right when they are moderating reviews or testimonials against the National Law’s advertising requirements.
The updated testimonial tool is available in the Advertising resources section on the AHPRA website.
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.
AHPRA and the National Boards have welcomed the 700,000th health practitioner to be registered in Australia since the start of national regulation in 2010, Victoria-based enrolled nurse Alison Tregeagle.
Reaching the 700,000th 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.
At 31 March 2018, there were over 5,100 registered podiatrists and podiatric surgeons.
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 information sharing site. Queries about AHPRA’s work as a Collaboration Centre can be directed to WHO_CC_HWR@ahpra.gov.au.
The National Scheme has made a landmark commitment to help achieve equity in health outcomes between Aboriginal and Torres Strait Islander Peoples and other Australians to close the gap by 2031.
Launched at Melbourne Museum on Thursday 5 July 2018, the National Registration and Accreditation Scheme Statement of Intent is a joint commitment between 37 health organisations, including leading Aboriginal and Torres Strait Islander health organisations and entities, AHPRA, all National Boards and all accreditation authorities.
AHPRA’s Aboriginal and Torres Strait Islander Health Strategy Group is leading this work, 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:
AHPRA’s first Reconciliation Action Plan (RAP) was also launched with support from Reconciliation Australia. The RAP is an important document outlining what AHPRA will do to start addressing the imbalance in health outcomes between Aboriginal and Torres Strait Islander Peoples and other Australians.
More information is available in the news item, the Statement of Intent and AHPRA’s Reconciliation Action Plan.
AHPRA and Victoria Police have announced a Memorandum of Understanding (MOU) to enable greater cooperation which will see the public better protected.
The MOU is the first of its kind between AHPRA and a police force. It recognises the cooperation already in place between the two agencies. It establishes procedures for timely and appropriate information sharing, within the law, where AHPRA or Victoria Police discover certain information in the course of their investigations.
The MOU provides a mechanism for the release of information by AHPRA when it identifies information relating to criminal offences, including physical harm, sexual offending, production of exploitative material and/or drug offences.
Victoria Police will also be better placed to share information with AHPRA about practitioners who they suspect may pose a risk of substantial harm to the public or individuals posing as registered health practitioners when they are not.
The agreement lays out detailed security protocols around the transmission, storage, use and disclosure of information that is shared between Victoria Police and AHPRA.
The MOU recognises the learning that came from the Chaperone Review, a report into the use of chaperones to protect patients. The report stated that where there are allegations of indecent or sexual assault there needed to be greater clarity around whether AHPRA contacts the police or relies on the notifier (the person who makes the complaint) to do so.
The report also considered it was important that AHPRA was kept aware of developments in police investigations, which may trigger the need to review risk and take immediate action on a registered health practitioner’s ability to practise their profession.
For more information, see the media release on the AHPRA website.