I’ve Received a Letter From AHPRA

What is a notification?

A notification is a complaint or concern about a medical practitioner that is lodged with AHPRA or the Medical Board.

Note: NSW and Queensland manage notifications differently. In NSW, the Health Care Complaints Commission receives complaints about medical practitioners. In Queensland, such complaints are received by the Office of the Health Ombudsman.

Who can make a notification?

Anyone can make a notification about a medical practitioner to AHPRA, which receives it on behalf of the Medical Board. The majority of notifications are made by patients or their families. While health practitioners, employers and education providers have mandatory reporting obligations imposed by the National Law,¹ the majority of notifications are voluntary.

The notifications process²

After AHPRA receives a notification, a preliminary assessment is conducted. Grounds for a notification include:

• the practitioner’s professional conduct is, or may be, of a lesser standard than that expected by the public or the practitioner’s peers
• the knowledge, skill or judgement possessed, or care exercised by the practitioner is, or may be, below the standard reasonably expected
• the practitioner is not, or may not be, a suitable person to hold registration
• the practitioner has, or may have, an impairment
• the practitioner has, or may have, contravened the National Law
• the practitioner has, or may have, contravened a condition of his or her registration or an undertaking given to the Board
• the practitioner’s registration was, or may have been, obtained improperly.

If the preliminary assessment suggests there may be grounds for notification, the medical practitioner is usually sent a copy of the notification and invited to provide a written response. The notification and the practitioner’s response are then sent to the Medical Board for assessment.

The Medical Board’s decisions are focused on keeping the public safe. In the majority of cases, the Medical Board makes a decision to take no further action and the matter is closed. However, if the notification raises concerns that the practitioner’s conduct or the way in which they practise is unsatisfactory, or they are impaired, the Board may decide to investigate the matter or require the medical practitioner to undergo a performance or health assessment.

The Medical Board has the power to take a range of actions at any time after an assessment or investigation, including:

• take no further action
• refer the practitioner for a health assessment
• refer the practitioner for a performance assessment
• refer the matter to a health panel
• refer the matter to a performance and professional standards panel
• impose conditions on, or accept an undertaking from, the practitioner
• caution the practitioner
• take immediate action
• refer the matter to a tribunal
• refer the matter to another entity, e.g. a health complaints authority.

AHPRA and the Medical Board: Facts and Figures

• There was a 19% increase in notifications about medical practitioners in 2013/14 – compared with a 16% increase across all registered health professions.
• 4.9% of medical practitioners were the subject of a notification in 2013/14.
• 85% of notifications closed in 2013/14 resulted in no further action.
• There was a slight decrease in the number of medical practitioners subject to mandatory notifications, from 28.9/10,000 in 2012/13 to 27.2/10,000 medical practitioners in 2013/14.
• There was wide variation in mandatory reporting across states and territories, with a 79% increase in Queensland, a 13% decrease in NSW and a 5% decrease in Victoria.
• The Medical Boards took “immediate action” 246 times – up 67% from 2012/13. The biggest increase was in WA, where the WA Medical Board took immediate action 38 times, up from 11 in 2012/13.
• 69% of “immediate actions” led to regulatory action – such as conditions, undertakings or suspension of registration.

Dr Sara Bird
Manager, Medico-legal and Advisory Services
MDA National

References

1.  National Board Guidelines for Registered Health Practitioners: Guidelines for Mandatory Notifications. March 2014.
2.  Australian Health Practitioner Regulation Agency. A Guide for Practitioners: Notifications in the National Scheme. 18 June 2013.
3. Australian Health Practitioner Regulation Agency. Annual Report 2013/14.