June 2016

Issue 11


Chair’s message

Welcome to the 10th edition of the Chinese Medicine Board of Australia's (the National Board) newsletter. Previous issues can be found on the Newsletters page.

The Board continues to hold a forum adjacent to its monthly meeting in different states. The most recent one was in Brisbane and the next one is in Sydney, this will also be the last forum for now. After that the presentation will be available on the website for those of you who were unable to attend a forum.

These meetings give us the opportunity to discuss a wide range of issues with the profession, although currently the Board’s main emphasis has been on the recently published Guidelines for safe practice of Chinese herbal medicine. These guidelines are not only relevant to Chinese herbal medicine practitioners and dispensers but also to acupuncturists who prescribe herbs. For example, there is a section specifically addressing manufactured herbal medicines. The two-year transition to achieve full compliance is now well underway as the guidelines were published in November 2015. Please take the time to carefully familiarise yourself with these important practice guidelines for Chinese medicine.

In this newsletter we cover a number of important topics.

The Board has completed its consultation on a revision of the previous Patient records guidelines. A revised version of the guidelines, now called Guidelines: patient health records, will be published shortly.

I am very pleased to advise that the Board now has two new members. We welcome Mr Ian Dummett, practitioner member from Tasmania, and Dr David Graham, community member from the ACT. Read more about our new Board members on the Chinese Medicine board members page.

Finally, in this newsletter we announce new approved education programs as recommended by the Chinese Medicine Accreditation Committee.

Professor Charlie Xue
Chair, Chinese Medicine Board of Australia

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Sydney forum ‒ invitation for practitioners, students and stakeholders

Over the past few months the Board has held forums in Perth, Adelaide, Melbourne and Brisbane. 

Attendees at the recent forum in Brisbane (May 2016)

Photo: Attendees at the recent forum in Brisbane (May 2016).

The last forum currently scheduled will be in Sydney; Chinese medicine practitioners, students and stakeholders are invited to attend this free event to discuss regulation and encourage the integration of registration standards, codes and guidelines into Chinese medicine practice. It will also cover information on the role of the Board and the Australian Health Practitioner Regulation Agency (AHPRA), and policy and notification trends updates. 

Date  Monday 20 June 2016 
Time  5.30pm to 7.00pm
There will be a Board presentation, time for questions and a networking session with Board members. 
Venue  SMC Conference and Function Centre
66 Goulburn Street, Sydney 
RSVP  No later than 5.00pm Thursday 16 June 2016
Email cmbaupdate@ahpra.gov.au with your full name (surname in capitals) and confirmation that you would like to attend the forum. 
Please register your attendance as places are limited.

Topics include:

  • Role of AHPRA and the Chinese Medicine Board of Australia
  • Update: Policy ‒ guidelines for safe practice of Chinese herbal medicine
  • Update: notifications trends
  • Questions and discussion

For more information and registration details, please see the news item.

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Professional boundaries

The Chinese medicine Code of conduct (the code) is based on a common code developed collaboratively by most National Boards under section 39 of the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).

The code seeks to assist and support registered health practitioners to deliver effective regulated health services within an ethical framework. Practitioners have a duty to make the care of patients or clients their first concern and to practise safely and effectively. Maintaining a high level of professional competence and conduct is essential for good care.

The code contains important standards for practitioner behaviour in relation to:

  • providing good care, including shared decision-making
  • working with patients or clients
  • working with other practitioners
  • working within the healthcare system
  • minimising risk
  • maintaining professional performance
  • professional behaviour and ethical conduct
  • ensuring practitioner health
  • teaching, supervising and assessing, and
  • research.

The Chinese medicine Registration and Notifications Committee has advised the Board of its concerns about practitioners’ understanding of professional boundaries.

Section 3.14 of the code is titled ‘Understanding boundaries’. It sets out the following.

Good practice includes recognising the potential conflicts, risks and complexities of providing care
to those in a close relationship, for example close friends, work colleagues and family members and
that this can be inappropriate because of the lack of objectivity, possible discontinuity of care and risks to the practitioner or patient. When a practitioner chooses to provide care to those in a close relationship, good practice requires that:

  • adequate records are kept
  • confidentiality is maintained
  • adequate assessment occurs
  • appropriate consent is obtained to the circumstances which is acknowledged by both the practitioner and patient or client
  • the personal relationship does not in any way impair clinical judgement, and
  • at all times an option to discontinue care is maintained. (Also see Section 8.2 Professional boundaries.)

Section 8.2 of the code titled ‘Professional boundaries’ sets out the following.

Professional boundaries allow a practitioner and a patient/client to engage safely and effectively in a
therapeutic relationship. Professional boundaries refers to the clear separation that should exist between professional conduct aimed at meeting the health needs of patients or clients and a practitioner’s own personal views, feelings and relationships which are not relevant to the therapeutic relationship.

Professional boundaries are integral to a good practitioner–patient/client relationship. They promote
good care for patients or clients and protect both parties. Good practice involves:

  1. maintaining professional boundaries
  2. never using a professional position to establish or pursue a sexual, exploitative or otherwise inappropriate relationship with anybody under a practitioner’s care; this includes those close to the patient or client, such as their carer, guardian, spouse or the parent of a child patient or client
  3. recognising that sexual and other personal relationships with people who have previously been a practitioner’s patients or clients are usually inappropriate, depending on the extent of the professional relationship and the vulnerability of a previous patient or client, and
  4. avoiding the expression of personal beliefs to patients or clients in ways that exploit their vulnerability or that are likely to cause them distress.

Practitioners need to be aware of and comply with any guidelines of their National Board in relation to
professional boundaries.

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Chinese medicine programs approved

The Board received three reports from the Chinese Medicine Accreditation Committee (CMAC) on its accreditation decisions following a detailed assessment process against the Chinese medicine accreditation standards.

The CMAC is the accreditation authority for Chinese medicine education in Australia and is required under the National Law to provide a report to the National Board about the authority’s accreditation of a program of study. The Board is required by the National Law to make a decision on approval of an accredited program.

The Board considered the reports and approved the following programs for the purpose of registration.

  1. Master of Applied Science (Acupuncture) program offered by RMIT University
  2. Master of Applied Science (Chinese herbal medicine) program offered by RMIT University
  3. Bachelor of Health Science (Acupuncture) program offered by Endeavour College of Natural Health, for delivery at the Adelaide, Brisbane, Gold Coast, Melbourne, Perth and Sydney campuses.

For more information, please go to the Approved programs of study section of the Board’s website.

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Chinese medicine regulation at work in Australia, 2014/15

The Board has released its profession report for 2014/15.

The Board conducted a public consultation in 2014 on the Guidelines for safe practice of Chinese herbal medicine. The Board also held a number of meetings with the profession on its work to balance its obligations to implement the National Law, while also supporting practitioners meet their regulatory responsibilities.

A significant milestone for Chinese medicine in Australia was also reached: grandparenting arrangements – special transitional provisions that provide a possible pathway to registration for existing practitioners who do not have contemporary, approved qualifications – came to an end on 30 June 2015.

Highlights

  • Grandparenting arrangements came to an end on 30 June 2015.
  • Supervisions guidelines for Chinese medicine practitioners published.
  • 4,494 registered Chinese medicine practitioners on 30 June 2015.
  • 5.22% increase in number of registered Chinese medicine practitioners compared to 2013/14.
  • 40% of Chinese medicine practitioners based in New South Wales, 28% in Victoria.
  • 46% of registered Chinese practitioners are registered as acupuncturists and Chinese herbal medicine practitioners.
  • 15% decrease in number of notifications received about registered Chinese medicine practitioners compared to 2013/14.
  • 22 notifications received about registered Chinese medicine practitioners – 0.5% of the registrant base.
  • Two immediate action cases, the same as last year.
  • 883 Chinese medicine registrants under active monitoring on 30 June 2015, 98.5% due to suitability/eligibility.

Read more about the Chinese medicine profession profile.

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Consolidation of the nine National Boards with low regulatory workloads

In August 2015 the report of the independent three-year review of the National Registration and Accreditation Scheme (the National Scheme) was released.

There were 33 recommendations, and these were grouped around five major areas; one of which related to the consolidation of the nine low-regulatory-workload National Boards in the National Scheme. Our Board is one of these nine Boards.

Health ministers met in April 2016 and decided not to consolidate these nine National Boards at this stage.

Further details on the ministers’ decision can be found on the COAG Health Council website.

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National Scheme news

National drug screening protocol now in place

There are health practitioners with a history of substance misuse who have restrictions placed on their registration. These restrictions are generally designed to keep the public safe while the practitioner remains in practice.

When restrictions are placed on a health practitioner’s registration, AHPRA monitors the practitioner to make sure they are complying with the restrictions. This process is referred to as ‘monitoring and compliance’.

From November 2015, all health practitioners who have restrictions placed on their registration by their National Board as a result of past substance misuse will have routine quarterly hair testing, in addition to random urine testing. Routine hair testing provides additional information about the use of a wide range of drugs, over a longer time period. It therefore provides greater assurance to the Board that the practitioner is not impaired as a result of ongoing substance misuse.

The introduction of routine hair testing is based on expert advice about modern drug screening methods. Using contemporary scientific evidence and the advice of an expert panel, National Boards and AHPRA will manage the risk associated with practitioners with a history of substance misuse.

For more information, see the news item on AHPRA’s website.

Dangers of button battery ingestion

From time to time the National Boards are asked to publicise important public health messages for health practitioners.

The Queensland Coroner’s recent report into the death of a four-year-old girl, who died after swallowing a two-centimetre button battery, has highlighted the need for health practitioners to be aware of the dangers these products present to patients if ingested, and to be better equipped to handle suspected cases.

When swallowed, lithium button batteries (also known as ‘disc batteries’) can become lodged in the oesophagus and the residual charge can cause electrolysis. This burns through tissue causing severe, irreversible damage.

Recognising battery ingestion can be difficult if the ingestion is not witnessed, as the child may present with non-specific symptoms such as poor feeding, irritability, fever, vomiting, drooling or cough. The ingestion of disc batteries requires urgent intervention.

Further information is available from the ACCC or advice can be obtained by ringing the Poisons Information Centre in Australia on 13 11 26.

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Are your contact details up to date?

Throughout the year we need to send you important information related to your registration. So that you receive this information you need to check that we have your correct contact details.

You can check your details via the login icon at the top right of the AHPRA website.

Email accounts need to be set to receive communications from AHPRA and the Board to avoid misdirection to an account junk box.

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Keep in touch with the Board

  • Visit the Chinese Medicine Board website for news about the profession, information on the National Scheme and for registration standards, codes, guidelines, policies and fact sheets.
  • Read the National Board Communiqué each month on the website: these publications inform everyone of the decisions made at the Board’s monthly meeting.
  • 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: Prof. Charlie Xue, Chair, Chinese Medicine Board of Australia, GPO Box 9958, Melbourne VIC 3001.

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Page reviewed 15/08/2016