Welcome to our summer newsletter. In this issue you’ll find important information about new registration standards that came into effect on 1 December 2019. Other matters are patient health record-keeping, importing herbal granules and an upcoming audit of English language-related conditions of registration.
We also provide the results of the recent survey about the acceptance among registered Chinese herbal medicine practitioners of the Guidelines for safe Chinese herbal medicine practice.
I would like to welcome our new community member, Ms Stephanie Campbell. Stephanie is a lawyer who has worked in both the public and private sectors. With many years of practical and academic experience of a legal, governance and policy nature, she is committed to developing and implementing best practice standards and procedures which promote transparency, accountability and good decision-making. Stephanie has previously held ministerial appointments as a member of the Central Australian Human Research and Ethics Committee and the Northern Territory Board of the Nursing and Midwifery Board of Australia.
The Chinese translation of the newsletter will be available to view on our website shortly, please check our Newsletters page from Monday 23 December.
Best wishes for the festive season from the Board.
Distinguished Professor Charlie C. Xue
Chair, Chinese Medicine Board of Australia
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The Chinese Medicine Board of Australia’s (the Board) revised registration standards1 came into effect on 1 December 2019. They are:
The revised registration standards were published on 31 July 2019 to give practitioners time to understand the revised requirements. Make sure you have read and understand the revised registration standards and know what you need to do to meet them. Some of the main changes are outlined below and you can read the registration standards in full on the Registration standards page of the Board's website.
Every time you renew your registration you must declare you meet recency of practice, professional indemnity insurance arrangements and continuing professional development registration standards.
The revised registration standard requires you to have practised 450 hours over the last three years, or 150 hours over the last year. If you are registered in more than one division of the register you must include some practice relevant to each of the divisions in which you are registered.
You will also need to submit a professional development plan to the Board for approval if you are making a substantial change to the scope of your practice, for example from an administrative role to providing clinical care.
The revised registration standard has been made easier to read and understand. To meet the registration standard, you need to have appropriate insurance. The Board is no longer specifying a minimum amount of cover. You must evaluate your own practice and ensure you have an appropriate amount of cover for all aspects of your practice. It needs to be appropriate to the nature, context and risks of your individual practice. The appropriate amount for you may depend on a combination of factors, including, for example:
The revised registration standard still requires you to do 20 hours of CPD each year and four of those hours must still relate to professional issues.
A new requirement is that five of these hours must be interactive. This means learning that involves a two-way flow of information with other practitioners, such as face-to-face or interactive online education.
You can find more information about the revised CPD registration standard in the CPD guidelines on the Codes and guidelines webpage.
The Board will be publishing more information about the other revised registration standards in the FAQ section on the Codes and guidelines webpage in coming weeks.
1 Registration standards define the requirements that applicants and registrants in the regulated professions need to meet to be registered.
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The Board has completed the annual revision of the Nomenclature compendium of commonly used Chinese herbal medicines (the compendium). The compendium provides standard terminology to support the Board's Guidelines for safe practice of Chinese herbal medicine.
The compendium is available on the Board's website on the Guidelines for safe practice of Chinese herbal medicine page.
The compendium cross-references commonly used Chinese herbs by:
The Board takes care to ensure that information in the compendium about herbs subject to the SUSMP or CITES classifications is correct at the time of annual update release. However, the SUSMP and CITES documents are updated periodically so you must ensure that the information is correct at the time of use.
The SUSMP information is available on the Therapeutic Goods Administration website and the CITES list relevant to Australia is available on the CITES website.
The compendium published on the Board's website is the authorised, current version. The new document date is 17 June 2019.
Your feedback on the compendium is welcome. Please email firstname.lastname@example.org.
The Board is very grateful to the 914 Chinese herbal medicine practitioners and dispensers who responded to the survey. This is an exceptional response rate of 29%, which is much higher than comparable benchmarks. The Board also thanks the associations for their support of the survey.
This survey was to test the usefulness of the guidelines and compendium to the profession, not to review the content. The review of the content of the guidelines commenced in late 2019 and any proposed changes will involve the normal consultation processes used for updating regulatory documents. There is an annual update of the compendium.
The 914 practitioners are generally representative of the demographics (in terms of gender, age and work location) of all Chinese herbal medicine practitioners and dispensers on the Chinese medicine register.
Some of the key results are:
Some initial findings drawn from the survey results which relate to the work of the Board and the profession are:
Under the National Law 2, a Chinese medicine practitioner must hold registration granted by the Chinese Medicine Board of Australia in order to practise and treat patients.
In the rare event that a registered Chinese medicine practitioner’s registration is suspended for a serious matter affecting public safety, the practitioner must immediately stop practising and not treat patients during the period of suspension.
It is illegal for a suspended practitioner to continue to practise, and practice while suspended would not be covered under professional indemnity insurance.
Membership of a professional association is not relevant to registration to practise and does not in any way entitle a suspended practitioner to practise.
Many associations require their members to inform them of any adverse regulatory findings such as suspension.
2 The Health Practitioner Regulation National Law, as in force in each state and territory.
The Board is developing a new regulatory examination which will replace the interim examination arrangement that has been in place since 2015.
The regulatory examination is for any person who is qualified from a non-Board approved program of study; this applies to programs both in Australia or overseas.
The revised examination will involve written and clinical assessments. Ensuring the validity and reliability of assessment results has been a focus of the examination design. Over the coming months, the Board and Ahpra will partner with appropriate experts to finalise the examinations for registration as an acupuncturist and/or Chinese herbal medicine practitioner in preparation for implementation in April 2020. Finalising the examination for registration as a Chinese herbal dispenser will follow later in 2020.
The Board is grateful to its interim arrangement partners, Sydney Institute of Traditional Chinese Medicine and the University of Technology Sydney.
The Board is concerned that poor quality record-keeping frequently arises as a secondary issue during notifications.
The Patient health records guidelines are important to your practice and can be used as evidence of what constitutes appropriate professional practice during a hearing.
It is important that you are familiar with these guidelines which are available on our Codes and guidelines page. Make sure you understand the key aspects of the guidelines.
Registered Chinese medicine practitioners need to keep and maintain confidential, accurate, up-to-date, factual health records for each patient. The record must contain enough detail to allow another practitioner to take over the care of the patient if necessary.
Your patient records need to be clear, legible and report relevant details of:
You must ensure your patient records include:
Patients have a right to access their health information. The retention and destruction of records must be in accord with your state or territory laws. If you work in multi-practitioner clinic you should know your contractual arrangements with management regarding patient records.
All practitioners must record patient identity and up-to-date emergency contact details in English.
You must also record a comprehensive patient record as defined in the guidelines in English, unless you were registered with English language conditions during the grandparenting period.
There may be a situation where records kept in a language other than English need to be translated and supplied to a third party. While translation options are available, it is your responsibility to be confident that the option you select provides an accurate translation of the content of the original patient record.
If you import herbal granule products for supply to patients, then under the Therapeutic Goods Act 1989 you could be regarded as the sponsor of that product on the Australian market.
As the sponsor of that product you may need to enter the product onto the Australian Register of Therapeutic Goods before supply. You are also responsible for the quality, safety and efficacy of the product including reporting any adverse events to the TGA and if needed, the recall of the product from the market.
Similar considerations apply if you import other types of medicines for supply to patients, or medical devices such as acupuncture needles or heat lamps for use with patients.
There are specific criteria that must be met in order for products like herbal granules to be imported without needing to be on the Register beforehand (for example, for personal use, or medical professional importing on behalf of a specific patient).
Also, if you make herbal formulations for supply other than when these are prepared for a specific patient, you may also come under the requirements of the Therapeutic Goods Act.
If in doubt, check with the TGA.
In early 2020 a random sample of Chinese medicine practitioners with English language conditions will be chosen for audit.
If you are chosen for audit you must respond. You will be notified in writing, given instructions and a timeframe to respond. You will be asked to provide information which shows how you comply with the English language conditions on your registration.
The Board will provide guidance to help you prepare if you are chosen for audit.
Every year when you renew your registration you are asked to declare that you are complying with your English language conditions.
The National Law requires you to comply with conditions placed on your registration and for the National Board to monitor this. The Board must meet its obligations to monitor practitioners with conditions and has decided to carry out a compliance audit of a sample of practitioners with English language conditions.
Remember, you only have to declare that you are complying with your conditions if you do have conditions on your registration.
At renewal if you have not complied with your conditions you must honestly say so.
If as a result of the audit we identify that you made a misleading or false declaration at renewal, the Board may consider whether you have engaged in conduct for which action may be taken. Misleading or false declarations at renewal are a very serious matter and may result in disciplinary action and/or affect your registration.
If you are chosen and do not respond to the audit, the Board may consider whether you have engaged in conduct for which action may be taken. This could have serious consequences for your registration and ability to practise.
Over 800 Chinese medicine practitioners have English language conditions. During the grandparenting period, when Chinese medicine entered the National Registration and Accreditation Scheme (the National Scheme), practitioners who did not meet the Board’s English language registration standard were granted registration with conditions related to English language proficiency. These conditions balanced the need to protect the public with facilitating access to health services provided by Chinese medicine practitioners.
English language conditions will remain until you provide evidence to the Board of your English language competence by successfully completing one of the Board-approved English language assessments: see Registration standard: English language skills.
If you would like further information about English language conditions or the upcoming audit you can email the National Compliance team at email@example.com or call the customer service line Monday to Friday, 9am to 5pm AEST on 1300 419 495.
About 4,900 Chinese medicine practitioners hold general or non-practising registration with the Chinese Medicine Board of Australia. The late period for registration renewal is in effect until 31 December. If you have not yet renewed the quickest and easiest way to do so is online.
Renewal applications received in December will incur a late payment fee in addition to the annual renewal fee. A fees schedule is published on the Board’s website.
If your application for renewal is received during the one-month late period, you can continue practising while your application is processed.
If you do not apply to renew your registration by 31 December 2019 your registration will lapse. You will be removed from the Register of Chinese medicine practitioners and will not be able to practise your profession in Australia.
For more information, see:
A page dedicated to advertising resources for registered health practitioners is now available on the Board’s website.
Since the launch of the Advertising compliance and enforcement strategy for the National Scheme in April 2017, several helpful tools and examples of non-compliant advertising have been published in the Advertising resources section of the Ahpra website.
To help visitors to the Chinese Medicine Board of Australia website quickly locate information for practitioners about advertising, including the Guidelines for advertising regulated health services, we have published a new page – Advertising a regulated health service – that links directly to all advertising resources relevant to Chinese medicine practitioners.
This information is easily reached via the homepage of the Board’s website by clicking on the promo tile, ‘Advertising your health service: How to comply with the National Law’.
Website analysis shows that advertising resources developed by the National Boards and Ahpra are accessed regularly. Resources being downloaded as PDFs include the tool on using titles in health advertising and the tool explaining why testimonials are prohibited. A good resource to use when you check and correct your advertising to ensure it complies with National Law requirements is the self-assessment tool.
The National Law includes provisions about advertising regulated health services to protect consumers. If you are advertising a regulated health service3, your advertising must not:
We encourage you to read the advertising resources to ensure you are meeting your legal and professional obligations when advertising a regulated health service.
Our primary role is public protection and we aim to do this through a risk-based approach to regulation, taking action proportionate to the risks to public health and safety we have identified. Our goal is to ensure advertising about regulated health services is done responsibly to keep the public safe from false or misleading claims and to help them make informed decisions about their healthcare. If you are unsure about your advertising obligations, you should refer to our published information and/or seek independent advice from your legal adviser.
New resources are available to help Chinese medicine practitioners and other advertisers understand if claims made in advertising are supported by accepted evidence.
You can access the new information via a link on the Advertising a regulated health service page on the Board’s website.
The approach taken to assessing evidence to support claims is consistent with the wider scientific and academic community. However, there is an important difference between acceptable evidence for claims made in advertising and the evidence used for clinical decisions about patient care.
When treating patients, practitioners must obtain informed consent for the care they provide and are expected to discuss the evidence for different treatment options. In advertising, the claims are generic, and practitioners are not available to clarify whether a treatment is appropriate for an individual patient.
There are many aspects to take into consideration when reviewing whether there is acceptable evidence to support a claim made in advertising a regulated health service. Factors to consider include:
Study design is also an important aspect to consider when assessing if claims are supported by acceptable evidence. The following types of studies will generally not be considered acceptable evidence for advertising claims:
The evidence base for clinical practice is constantly developing so it is important to make sure that the evidence you rely on is current.
The new information on acceptable evidence in health advertising, which includes issues to consider about study design, is available in the Advertising resources section of the Ahpra website.
The latest report on the National Scheme is packed full of data and descriptions of what National Boards and Ahpra do and how we work in partnership. While its most attentive readership is Health Ministers and their staff, the report is also a useful source of information for a wide audience: board members, other regulators, registrants, students, overseas-trained health professionals, employers, education providers, consumer groups, patients and the broader community.
It’s quite startling to realise that one in every 17 working Australians is a registrant in one of the regulated health professions in the scheme. At over 744,000 registrants, this is a huge and growing workforce.
When paramedics joined the scheme last year, becoming nationally regulated and registered for the first time, the number of professions regulated increased to 16, and the number of National Boards to 16 (the professions of nursing and midwifery are both regulated by one board).
To ensure this large workforce is trained, qualified and competent, there are now over 1,000 approved programs of study.
The report also shows Ahpra directly received 9,338 concerns (notifications) about registered health practitioners and closed 8,979 during 2018/19. More notifications were received and more closed than ever before. We are committed to improving the notification experience for both notifiers and practitioners and this report indicates we are making progress. The number of notifications received by Ahpra also suggests the public are becoming more aware of their option to report their healthcare concerns.
Other insights from the year include:
To view and download the 2018/19 annual report, visit the Ahpra website.
Individual National Board summaries are also published online: you can view the Chinese Medicine Board summary on our new Annual report webpage.
From 1 July this year, the law got tougher on people who pretend to be a registered health practitioner.
The penalties for anyone prosecuted by Ahpra under the National Law for these offences now include bigger fines and the prospect of prison time.
Australia’s Health Ministers wanted to address the serious risk to the public posed by anyone who pretends to be a registered health practitioner, so they increased the sanctions offenders face.
Ahpra has a strong track record of taking action on individuals pretending to be a registered health practitioner when they are not. Since 2014, Ahpra has successfully prosecuted more than 50 cases where people were falsely claiming to be registered practitioners.
These included people pretending to be medical practitioners, pharmacists, nurses, psychologists, physiotherapists and dentists.
Fake practitioners betray the trust that patients place in them. Under the changes to the law, offenders face the possibility of a maximum term of three years’ imprisonment per offence. They also face an increase in the maximum fines from $30,000 to $60,000 per offence for an individual and from $60,000 to $120,000 per offence for a corporate entity.
Everyone can check the online register of practitioners to make sure they are seeing a registered practitioner who is qualified and meets national standards.
Read more in the media release.
Earlier this year, Ahpra launched a series of videos to support the public and registered health practitioners as they go through the notification process.
The video series, called ‘Let’s talk about it’, explains what happens when concerns are raised with the regulator, gives easy-to-follow information about the notifications process and addresses common questions, so consumers and health practitioners know what to expect when they interact with Ahpra and National Boards.
The series is part of work to minimise the adverse impact of the notifications process on practitioners and notifiers. Over the last few months two new videos were added. These provide a first-hand account of the notification process from a practitioner’s perspective:
The other videos in the series are:
A notification has been made about me features five health practitioners who work within the National Scheme and is directed at health practitioners who have had a notification made about them.
I have a concern, am I in the right place? is targeted at members of the public who have a concern but aren’t yet sure whether Ahpra is the right place in which to raise it.
I have raised a concern with Ahpra provides information for individuals who have just raised a concern with Ahpra.
The videos sit alongside other written resources available on the website, including information about understanding the notifications experience. See: www.ahpra.gov.au/Notifications.
You can view the videos on the Ahpra and National Board websites or on our YouTube and Vimeo channel, and join the conversation by following Ahpra on Facebook, Twitter or LinkedIn, use the hashtag #letstalkaboutit and tag @AHPRA.
Ahpra and National Boards have published a new guide to help registered health practitioners understand and meet their obligations when using social media.
The guide reminds practitioners that when interacting online, they should maintain professional standards and be aware of the implications of their actions, just as when they interact in person.
The guide does not stop practitioners from engaging online or via social media; instead, it encourages practitioners to act ethically and professionally in any setting.
To help practitioners meet their obligations, the guide also outlines some common pitfalls practitioners may encounter when using social media.
Community trust in registered health practitioners is essential. Whether an online activity can be viewed by the public or is limited to a specific group of people, health practitioners have a responsibility to behave ethically and to maintain professional standards, as in all professional circumstances.
In using social media, health practitioners should be aware of their obligations under the National Law, their Board’s Code of conduct, the Advertising guidelines and other relevant legislation, such as privacy legislation.
This guide replaces the Social media policy on Boards’ codes, guidelines and policies pages and is available in the the Advertising resources section of Ahpra’s website. The guide will be updated as needed.
Older Australians will be better protected as the result of a memorandum of understanding (MOU) signed recently by Ahpra and the Aged Care Quality and Safety Commission (the commission).
The MOU underpins the positive and collaborative working relationship that already exists between Ahpra and the commission. It will ensure that information can be appropriately shared between the two agencies where there may be concerns in aged care.
It will support the commission raising concerns about the health, performance or conduct of registered health practitioners working in aged care. In a reciprocal arrangement, Ahpra will disclose information to the commission if it has concerns about the care and safety of someone receiving Commonwealth-funded aged care services.
Aged Care Quality and Safety Commissioner Janet Anderson PSM said the commission was pleased to work with Ahpra to support the timely sharing of information and two-way communication to help both parties better fulfil their statutory mandates.
Ahpra will also work with the commission to ensure that all aged care employers use our our online national register to check that health practitioners working in aged care are appropriately registered and meet required registration standards and codes of conduct.
Ahpra and National Boards have released results from a social research project aimed at helping us understand perceptions about us and our work.
The aim of the social research project was for Ahpra and National Boards to better understand what the community, regulated health professions and our stakeholders think and feel about us, particularly in areas of understanding, confidence and trust. We are using insights gained from the project to better understand how registered health practitioners view what we do and to inform how we can improve our engagement with both the professions and the community.
Ahpra has released a report of results from the project which included a short, anonymous survey of a random sample of registered practitioners from across 15 of the 16 regulated health professions. (Because the practitioner survey was conducted before paramedics joined the National Scheme the report does not include survey results for this profession.)
The anonymous survey of practitioners was done simultaneously with an anonymous survey sent to a random sample of members of the public across communities in Australia. Both surveys were managed by an independent consultant. We invite you to take a look at the results.
The National Boards have also published profession-specific reports based on the results of the online survey of registered health practitioners.
To help inform our future work to ensure the public has access to a safe registered health workforce, we are surveying practitioners and the community again in 2019.
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