Approaches to management of complaints and notifications about health practitioners in Australia

Satchell, Claudette; Walton, Merrilyn; Kelly, Patrick J.; Chiarella, E. Mary; Pierce, Suzanne M.; Nagy, Marie; Bennett, Belinda; Carney, Terry

doi:10.1071/ah15050

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…The most serious matters, those that are characterised as prima facie so significant a risk or breach as to be likely to lead to deregistration (and those involving repeated breach of conditions or failure in the above pathways) are referred to a legally headed disciplinary tribunal, the only body with the power to deregister a practitioner altogether. 3,5 As Elkin et al 6 note, the number of matters that appear before tribunals are therefore the product of three interrelated elements: the rate of underlying misconduct in each profession, the rate at which it is reported and the rate at which it is referred on to tribunals. Therefore, the present study of tribunal cases is not on the prevalence of misconduct per se, but rather addresses regulatory responses and, in particular, the issue of consistency in outcomes of the most serious disciplinary matters determined since the advent of the National Law.…”

Section: Introductionmentioning

confidence: 99%

Serious misconduct of health professionals in disciplinary tribunals under the National Law 2010–17

Millbank¹

2020

Aust. Health Review

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Objective There is a gap in knowledge regarding serious disciplinary matters concerning health professionals under the Health Practitioner Regulation National Law Act 2009 (hereafter ‘National Law’). The present study applies a typology of misconduct to the first 7 years of available tribunal cases under the National Law brought against the five most populous regulated health professions with the overarching goal of mapping the relationship between type of misconduct and outcome. As subquestions, the study examined whether the ostensibly uniform law is producing consistency of outcomes, both between the professions and between jurisdictions. Methods All publicly available Australian tribunal-level decisions concerning complaints of serious misconduct and/or impairment brought against the five most populous regulated health professions (nurses and midwives, doctors, psychologists, pharmacists, and dentists) were gathered from 1 July 2010 to 30 June 2017. Decisions were coded for case and respondent attributes, the type/s of misconduct alleged, whether proved, and the relevant disciplinary outcome. Respondent attributes were: profession, sex, legal representation, and certain identified ‘risk’ factors from previous studies. The type of allegation was coded based on five main categories or heads of misconduct, with subtypes within each. Outcomes for proved conduct were coded and categorised for severity. Analyses of cases was conducted using SPSS, version 21 (IBM, New York, NY, USA). Data was subject to statistical analysis using Pearson’s Chi-squared test with an α value of 0.05. Results Major variations were identified in outcomes across the professions, with doctors being subject to less severe outcomes than other professions, in particular compared with nurses, even when the same main head of misconduct was in issue. Differences in legal representation did not completely account for such variation. Marked disparities were also identified between outcomes in different states and territories, suggesting that the National Law is not being applied in a uniform manner. Conclusion Tribunal cases reflected complaint data in that: (1) male practitioners were greatly over-represented as respondents; (2) outcomes were most severe for sexual misconduct and least severe for clinical care; and (3) doctors faced less severe outcomes than other professions. There were also significant variations in severity of outcome by jurisdiction. Variations were more pronounced when deregistration was the focus of analysis. What is known about this topic? Existing research on complaints data under the National Law in place since 2010 has suggested that doctors may be receiving less severe outcomes than other professions at board level. There is a gap in knowledge concerning serious disciplinary matters heard by tribunals. Unlike data on complaints against regulated health professionals collated by AHPRA, legal tribunals, which hear only the most serious matters, do not record data on cases in a consistent or centralised form. What does this paper add? This study is the first to compare tribunal outcomes for the five most populous professions by reference to the type of misconduct proved. The finding that different professions are receiving different outcomes for the same malfeasance is novel. Other novel findings include significant variations in severity of outcome by jurisdiction, more pronounced variations in outcomes by both profession and jurisdiction when deregistration was the focus of analysis and variations in outcome according to legal representation. What are the implications for practitioners? There are major implications for policy makers and decision makers in terms of whether the National Law is operating consistently, with important outcomes for practitioners in terms of equitable and fair treatment when facing disciplinary charges.

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Section: Introductionmentioning

confidence: 99%

Serious misconduct of health professionals in disciplinary tribunals under the National Law 2010–17

Millbank¹

2020

Aust. Health Review

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“…If the complaint/notification is thought to have substance, one of three statutory pathways (health, performance, or conduct) is selected for investigation or management; each with a range of available outcomes for decision makers to pursue (Satchell et al. ).…”

Section: Assessment Of Complaints/notificationsmentioning

confidence: 99%

“…Actions Available to NSW Council or National Board at the Assessment Stage of a Complaint/Notification (Adapted From Satchell et al. )…”

Section: Assessment Of Complaints/notificationsmentioning

confidence: 99%

National Registration of Health Practitioners: A Comparative Study of the Complaints and Notification System Under the National System and in New South Wales – Decision Makers who Handle Complaints/Notifications About Regulated Health Practitioners in Australia

et al. 2017

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When the National Registration and Accreditation Scheme (NRAS) for health practitioners commenced in Australia in 2010, all jurisdictions joined the scheme for the registration and accreditation of health practitioners, but NSW retained its existing co-regulatory complainthandling system. We sought to compare the new National notifications and the NSW complaints handling processes, as NSW has an independent investigative and prosecutory body to manage serious complaints. Decision makers from both the National and NSW schemes, who handled notifications/complaints at assessment, were invited to participate in a survey consisting of case studies. A qualitative thematic approach was used to determine and compare

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How are complementary health professions regulated in Australia? An examination of complementary health professions in the national registration and accreditation scheme

Sibbritt

Kaye

Millbank

et al. 2018

Complementary Therapies in Medicine

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Approaches to management of complaints and notifications about health practitioners in Australia

Cited by 6 publications

References 9 publications

Serious misconduct of health professionals in disciplinary tribunals under the National Law 2010–17

Serious misconduct of health professionals in disciplinary tribunals under the National Law 2010–17

National Registration of Health Practitioners: A Comparative Study of the Complaints and Notification System Under the National System and in New South Wales – Decision Makers who Handle Complaints/Notifications About Regulated Health Practitioners in Australia

How are complementary health professions regulated in Australia? An examination of complementary health professions in the national registration and accreditation scheme

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