Occupational Therapy Board of Australia - December 2021
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December 2021

Issue 19 - December 2021

    Chair's message

    Welcome to our final newsletter for 2021.

    This year we celebrated the fact that there are now more than 26,000 of us practising around the country. While the COVID-19 pandemic continues to create challenges in our work and personal lives, it is a great reflection on the passion, enthusiasm and dedication of you all that the profession continues to grow despite the challenges.

    If you’re a practitioner you will have received an email inviting you to renew your registration and graduates, if you’re set to complete your course in the next three months – apply now!

    Since our last newsletter we held our first combined stakeholder meeting of the Association (Occupational Therapy Australia), Council (Occupational Therapy Council of Australia Limited) and the Board. We discussed matters of mutual interest including how the pandemic has changed the ways in which we work and support the profession. We are looking forward to continuing these productive dialogues in 2022.

    This newsletter features articles highlighting some practical guidance on common issues that have arisen in our complaints data.

    As the year comes to an end, I wish you all the very best over the festive season and the Board and I look forward to a great year ahead for us and for you in 2022.

    Julie Brayshaw 

    Chair, Occupational Therapy Board of Australia

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    Board news

    Advance copy of supervised practice framework published

    Twelve National Boards and Ahpra have published an advance copy of the revised Supervised practice framework. The framework has been revised to reflect a responsive and risk-based approach to supervised practice across the National Registration and Accreditation Scheme (the National Scheme).

    The Occupational Therapy Board of Australia is among those implementing the framework in 2022.

    The framework comes into effect on 1 February 2022. An advance copy has been published to allow time for supervisees, supervisors, employers and others to familiarise themselves with the revised framework.

    Read more in the Board’s news item.

    Answering your questions about supervised practice

    The framework applies to supervised practice that is used for regulatory purposes across the National Scheme. Practitioners who are required by the Board to do a period of supervised practice, must do so in accordance with arrangements that have been approved by the Board.

    The purpose of supervised practice is to enable the practitioner to demonstrate that they meet the competencies as set out in the Australian occupational therapy competency standards 2018.

    The framework applies to supervised practitioners and their supervisors. If you are supervising a registered practitioner you must:

    • comply with requirements to provide supervision within the approved supervised practice arrangements
    • provide feedback to the supervisee on their professional responsibilities and the constraints within which they must operate, and expectations of ethical conduct
    • ensure that supervision is provided at the appropriate level
    • ensure that the supervisee is practising safely
    • work with the supervisee to address areas identified in the arrangements for development and/or identified problems.

    Since publication of the advance copy of the revised Supervised practice framework for regulatory purposes, the Board has received some enquiries about the requirements for supervision in everyday employment settings: what’s different, and what’s the same?

    Supervision may be provided in workplaces for a variety of reasons including for guidance, support and monitoring performance. These arrangements are managed by employers directly and are not subject to the requirements of the Supervised practice framework.

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    Communicating effectively

    One of the most common types of complaints that the Board receives is about communication between occupational therapists and their clients.

    Most often the complaints describe circumstances where the client was not explicitly aware of the purpose of an assessment or what to expect after an assessment had been completed. While in many cases there has been evidence that practitioners had attempted to provide relevant information, the information provided and what the client comprehended was not always the same.

    The Australian occupational therapy competency standards 2018 state that occupational therapists must practise with open, responsive and appropriate communication to maximise the occupational performance and engagement of clients and relevant others. Practitioners need to adapt written, verbal and non-verbal communication appropriate to the client and practice context.

    In providing good care it is important to be aware of how these factors can affect how you communicate with clients. Good communication is a critical part of the practitioner-client relationship.

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    Professional indemnity insurance arrangements – what you need to know

    The Health Practitioner Regulation National Law (the National Law) states that a registered health practitioner must not practise within the profession in which they are registered unless they have appropriate professional indemnity insurance arrangements (PII arrangements) in place for their practice.

    Requiring registered health practitioners to hold appropriate PII arrangements is an important part of how the National Scheme protects the public by addressing the risk posed by uninsured practitioners.

    As a registered occupational therapist it is your responsibility to ensure that you have PII arrangements in place that provide cover appropriate to the nature, context and risks of your professional practice.

    The amount of cover depends on the range of factors, for example:

    • the practice setting and type of service being provided
    • the client group
    • the experience of the occupational therapist
    • the number of clients to whom treatment, advice, guidance or care is provided
    • history of insurance claims and the type of claim made against the occupational therapists in the past
    • advice from PII insurers, professional associations or industrial organisations, including advice regarding the history and volume of professional liability claims experienced by other members of the profession, and
    • current employment status.

    What might be appropriate cover for one registered health practitioner may not be appropriate for another. You need to make sure that you consider the risks which may arise from your practice. If you are in doubt about what is the appropriate level of cover you might find it helpful to consult with an insurance professional, who will help you assess the potential risk of harm to the public and the appropriate level of cover given that risk. The Board does not specify the amount of cover that practitioners must obtain.

    As a registered occupational therapist, it is your responsibility to ensure that you meet the requirements of the Board’s Professional indemnity insurance arrangements registration standard.

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    Good practice in maintaining health records for your clients

    Following the article in the last newsletter about the Board’s expectation that practitioners create and maintain clear, accurate and up-to-date health records for every patient, we put together the following examples to highlight the importance of accurate health records.

    Case study 1

    Facts: Peta, a registered occupational therapist, gave her client some forms to complete before their first appointment. The forms were intended to collect vital information about the client such as their address, a contact person in case of emergency and the presenting condition. The client did not complete the information.

    Issue: Peta did not review the documentation to check that it was complete and proceeded with the therapy program.

    Implications: The client’s health record was inadequate to instigate proper management in an emergency and would not have allowed another practitioner to effectively take over or continue the care of the client if necessary.

    Case study 2

    Facts: Simone, a registered occupational therapist, did not adequately record in the client’s health record, the assessment/s and treatment plan that she had developed with the client.

    Issue: The client’s record did not comply with the requirement of the Australian occupational therapy competency standards or the Code of conduct.

    Implications: The incomplete client health record creates an inability to assess treatment outcome/s; insufficient information to allow another practitioner to continue care; proper management in an emergency setting may be adversely affected and evidence of care in the context of a notification would be difficult to establish.

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    Renew online by 31 December to avoid lapsed registration

    Occupational therapists had until 30 November 2021 to renew their general, specialist or non-practising registration. If you did not renew on time and apply to renew your registration in December, you will have to pay a late payment fee as well as the registration fee.

    If you don’t apply to renew your registration by 31 December 2021 your registration will lapse. Your name will be removed from the Register of practitioners and you will not be able to practise as an occupational therapist in Australia until a new application for registration has been processed and the register is updated.

    Further information about changes to renewal this year can be found in the Board's news item

    Latest workforce data released

    The Board’s latest quarterly registration data has been released. The report covers 1 July to 30 September 2021. At this date, there were 26,021 registered practitioners (which includes 363 on the pandemic response sub-register).

    For more data, including registrant numbers by age, gender and principal place of practice, visit our Statistics page.

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    Students and graduates

    Graduating soon? Apply now and be ready to work

    Once you are registered, you can work as an occupational therapist anywhere in Australia. Before you can start practising and using the protected title, ‘occupational therapist’, you must be registered with the Occupational Therapy Board of Australia (the Board).

    If you're set to complete your course within the next three months – apply for registration now. We'll start assessing your application while we wait for your graduate results.

    How do I apply?

    Create your account using the online services portal and complete your application

    Upload your documents and pay the required fees. Check that you have provided all required documentation to prove you’ve met the registration standards, including certified copies of your photo ID.

    Once we’ve received your graduate results from your education provider and we are satisfied that you have met all the requirements for registration, we will finalise your application.

    When you are registered, we will publish your name to the Register of practitioners, and you can start working as an occupational therapist!

    Get your application right

    Check out Ahpra’s graduate video to help you get your application right. You’ll find helpful advice, tips for avoiding common causes of delay and downloadable information flyers on the Graduate applications page of the Ahpra website.

    Photo ID

    It's important that you provide correctly certified photo ID documents with your application – the wording is very specific.

    ‘I certify that this is a true copy of the original and the photograph is a true likeness of the person presenting the document as sighted by me.’

    To get it right first time, download the guide Certifying documents and take it with you to the authorised officer.

    Who can certify documents?

    In addition to JPs, registered health practitioners, public servants, teachers, lecturers and members of the legal profession can certify photographic ID documents. For the full list of authorised officers see the guide.

    Meeting the Board’s registration requirements

    When you apply for registration, your application is carefully assessed against the Board’s requirements for registration, which includes meeting the following registration standards:

    You also need to tell us about any criminal history and declare any health impairments that may affect your ability to practise.

    We cannot register you until we are satisfied that you meet the requirements for registration and are suitably trained and qualified. If you’ve submitted everything you need to prove you’ve met the requirements, we aim to finalise your application within two weeks of receiving your graduate results.

    Financial hardship

    If you are experiencing financial hardship and are unable to pay the required fees you should contact Ahpra’s Customer Service team via web enquiry or on 1300 419 495 to discuss your individual situation before completing your online application.

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    Services Australia notification: Upgrade to digital health and aged care channels

    Services Australia is pleased to be working with Ahpra to prepare you for the upgrades the agency is making to its digital health and aged care channels.

    Services Australia is upgrading its digital health and aged care channels. These upgrades will ensure that patient and provider information is secure, now and into the future.

    To continue accessing the channels below, you’ll need to be using web service-compatible software by 13 March 2022:

    • Medicare Online
    • Australian Immunisation Register
    • Department of Veterans’ Affairs
    • PBS Online
    • Aged Care Online

    Services Australia is also strengthening its authentication process by replacing Public Key Infrastructure (PKI) site certificates with Provider Digital Access (PRODA) for organisations. PRODA will help you do your electronic business with Services Australia securely.

    If you use an alternative channel for your claims and don’t use software, you don’t need to do anything. These upgrades won’t affect you.

    For more information about PRODA, visit www.servicesaustralia.gov.au/proda

    What you need to do

    Your software developer will have information on their transition and upgrade plans for your site. If you haven’t heard from them, contact them now and ask:

    • when will your web services-compatible software be available, and
    • if you will need to register your organisation in PRODA to authenticate to Medicare Online/ECLIPSE web services.*

    *Users of PBS Online and Aged Care must register their organisation in PRODA to authenticate to their web services-enabled software.

    If you use PBS Online, your software developer will contact you when more information is available.

    It is important that you understand these changes, as they will affect your business if you use software to submit claims and data to Services Australia.

    For more information, visit www.servicesaustralia.gov.au/hpwebservices

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    National Scheme news

    Annual report: Registered health practitioner numbers grow with paramedics leading the charge

    A continued growth in the registered health workforce is highlighted in Ahpra’s 2020/21 Annual report.

    While it was another year dominated by the challenges of the COVID-19 pandemic, the work of regulation continued and adapted to the impacts of the pandemic. A particular aim was to ensure that students were able to graduate with sufficient clinical experience despite placement delays. National Boards also looked to greater flexibility in some regulatory requirements, while maintaining their focus on patient safety.

    Growth across the professions

    As at 30 June 2021, there were 825,720 registered health practitioners across 16 regulated professions, 24,061 more than last year. This includes 26,595 health practitioners on the 2020 pandemic sub-register which offers a surge workforce for the health system response to COVID-19. Overall, 75% of registered practitioners are women.

    The largest growth in registrants was paramedics (up 8.3% on 2020).

    Registered health practitioners have done exceptional work in very challenging times. It is very encouraging to see the continued growth in the number of health practitioners over the past year.

    Aboriginal and Torres Strait Islander representation

    Only 8,311 (1.1%) of all health practitioners identify as Aboriginal and/or Torres Strait Islander. Since 2015 the number of occupational therapists who identify as Aboriginal and/or Torres Strait Islander has grown from 76 (0.4% of all registered occupational therapists) to 137 (0.6% of all registered occupational therapists).

    This is well short of the 3.3% Aboriginal and Torres Strait Islander representation in the general population.

    Ahpra and the National Boards are working closely with Aboriginal and Torres Strait Islander leaders and organisations to increase the participation of Aboriginal and Torres Strait Islander Peoples across all registered health professions and to promote cultural safety and the elimination of racism in healthcare.

    To view and download the 2021/21 annual report, visit the Annual report page.

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    Consent matters in healthcare: International Day for the Elimination of Violence against Women

    To mark International Day for the Elimination of Violence against Women (25 November), online news site Women’s Agenda published an editorial called Consent matters in healthcare. What to do if something feels wrong, co-authored by Gill Callister PSM, Chair of Ahpra’s governing board, Dr Anne Tonkin, Chair of the Medical Board of Australia, Rachel Phillips, Chair of the Psychology Board of Australia and Annette Symes, Presiding Member of the Nursing and Midwifery Board of Australia.

    When seeing a health practitioner, many people, especially women and girls, may feel at their most vulnerable. It’s important to discuss the safety of women, and what to do if something doesn’t feel right.

    Many of the complaints made to Ahpra about inappropriate behaviour involve practitioners breaching the normal boundaries of the patient-practitioner interaction. Some involve touching patients inappropriately and without adequate informed consent from the patient. Sexual misconduct is an abuse of the treating relationship and can cause significant and lasting harm.

    In the past three years, Ahpra and National Boards referred 150 health practitioners to a tribunal, and outcomes included cancellation of registration for up to five years. You can read the published summaries of these cases and others on Ahpra’s website, and visit the Register of cancelled, disqualified and/or prohibited practitioners.

    We know the majority of practitioners are doing the right thing, but we will continue to respond strongly to cases of sexual misconduct. Part of our role is ensuring that the public can have trust in registered health practitioners. We all have a role to play in preventing sexism, sexual harassment and violence in our communities, including in healthcare.

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    Changes to notification management in Queensland

    Queensland has introduced joint consideration of all notifications about health practitioners between Ahpra, the National Boards and the Office of the Health Ombudsman (OHO) as of 6 December 2021. The changes aim to speed up the initial assessment of notifications, which will benefit registered health practitioners and notifiers.

    All notifications about occupational therapy in Queensland will continue to be received by the OHO. Currently, the OHO deals with the most serious matters it receives and refers most of the remaining notifications to Ahpra and the Occupational Therapy Board of Australia.

    From December, all notifications received by the OHO about occupational therapist will be shared with Ahpra and the Board when they are received. Ahpra and the OHO will review each notification at the same time and agree on which agency should manage the matter. All notifications that raise a concern about a practitioner’s performance will be reviewed by an occupational therapy clinical advisor.

    The changes provide greater opportunity for earlier closure of concerns that do not need a regulatory response.

    For more information on how notifications are managed, see Ahpra's website.

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    Updated regulatory principles – supporting trust and confidence in regulated health professions

    We’ve updated our regulatory principles to foster a culturally safe, responsive and risk-based approach to regulation. The regulatory principles guide the National Boards and Ahpra when making regulatory decisions.

    The changes reflect community expectations and new policy directions from the Health Council, as well as feedback from public consultation. They recognise that community confidence in the regulation of health practitioners is key to a safe and effective health system. Overall, the changes:

    • reinforce that public protection is the paramount objective of the National Scheme
    • recognise the role of the National Boards and Ahpra in developing a culturally safe and respectful health workforce
    • consider the risks to the public including Aboriginal and Torres Strait Islander Peoples and members of the community who are vulnerable to harm
    • embed fairness and transparency, and
    • highlight the importance of maintaining community confidence in regulated health professions and working with consumer bodies to achieve this.

    More information about the review of the regulatory principles is available on Ahpra’s website.

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    Thousands more health practitioners able to join the pandemic response

    From 22 September, thousands of extra health practitioners can join the COVID-19 response through a new temporary sub-register established by Ahpra and the National Boards.

    • Nearly 29,000 practitioners who recently stopped practising are now eligible to practise for up to 12 months.
    • This surge workforce will make more practitioners available to help with the pandemic response if they choose to do so.
    • Practitioners can opt out of the 2021 sub-register at any time and don't need to explain why.

    The 2021 pandemic response sub-register was established in response to the changing needs of Australia’s health system due to the COVID-19 pandemic. It includes 12 regulated health professions whose members can work to the full scope of their registration.

    On the 2021 sub-register are key professions identified by governments in their pandemic response planning. These include medical practitioners, nurses, midwives and pharmacists along with dental practitioners, diagnostic radiographers, occupational therapists, optometrists, physiotherapists, podiatrists and psychologists. Eligible Aboriginal and Torres Strait Islander Health

    Practitioners are being added to the 2021 sub-register if they choose to opt in.

    Read more on Ahpra’s website.

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    New independent accreditation committee established

    A new independent accreditation committee has been established by Ahpra in line with Health Ministers’ policy direction issued earlier this year and as a key element of Health Ministers’ response to the Independent review of accreditation systems final report. Accreditation provides a framework for assuring that individuals seeking registration are suitably trained, qualified and competent to practise as health practitioners in Australia.

    The broad stakeholder membership of the committee will bring a wide range of perspectives to the new committee’s work, recognising the importance of professional and accreditation expertise as well as community, employer and education provider involvement. Members have been appointed for a three-year term and committee’s terms of reference have been published on the Ahpra website.

    Read more in the news item.

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    You may notice that the public register looks a little different

    Ahpra has launched a new-look public register (the national online Register of practitioners) with enhanced search capabilities. The aim of the enhancements is to make the register easier to use, especially for those in our communities who may have barriers to access. Some of the changes you’ll see include:

    • increased prominence of the register on the Ahpra homepage so it’s easier to find
    • simplified language with pop-up information boxes, and
    • improved search functionality, including:
      • predictive text
      • phonetic searching capability
      • search by location, and
      • refined search filters (including being able to search by the 15 most common community languages).

    To help users navigate the new-look register, we’ve developed a ‘how to search’ video which is available on our Help and tips page.

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    Joint statement on COVID-19 vaccines to help patients sort fact from fiction

    A joint statement has been released by Ahpra and the National Boards, the Health Care Complaints Commission, the Office of the Health Ombudsman and the Therapeutic Goods Administration. We published the statement for patients and health consumers, to support informed decision-making.

    Its message is: You need reliable, evidence-based information to make good choices about your healthcare. In a climate thick with commentary about COVID-19 and vaccines, how do you sort fact from fiction?

    The statement covers four main points:

    • Get advice from the experts (with a link to the national online Register of practitioners).
    • Be safe in the knowledge that registered health practitioners must meet national standards (with links to the National Boards’ websites).
    • Don’t get swayed by opinions.
    • Reach out to a trusted person, like your GP.

    It also lists and links to reliable sources of information on COVID-19 and vaccinations in Australia to help people make sure they have the best, most accurate and evidence-based information for their specific needs when making decisions about their own or their loved ones’ health.

    The statement has been translated into Arabic, Farsi, Greek, Simplified Chinese and Vietnamese. These versions are available on Ahpra’s Translations page.

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    Keep in touch with the Board

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    Page reviewed 17/12/2021