All registered health professionals are required by law to notify Ahpra about the conduct of another health professional that puts the public at risk of harm. 

This is referred to as a mandatory notification. 

The thresholds and requirements for making a mandatory notification vary depending on whether your relationship with the individual is as a treating practitioner, a non-treating practitioner or an employer. 

Notifiable conduct 

There are four types of conduct about which you must make a notification: 

• practising with an impairment
• practising while intoxicated
• a significant departure from accepted professional standards
• sexual misconduct. 

Defining impairment 

Impairment is a physical or mental impairment, disability, condition or disorder (including substance abuse or dependence) that may affect or is likely to affect the capacity to practise safely and effectively. 

It is important to note that a health condition is not the same thing as an impairment. 

You do not need to report a health condition or an impairment if adequate strategies or controls are in place to manage it, such as modified scope of practice, supervision arrangements, sick leave, roster adjustments and/or treatment. 

Intoxication while practising 

This type of conduct means practising under the influence of alcohol or drugs (including illicit, prescribed or over-the-counter medicines) to the extent that reasonable care and skill in the practice of the profession is impaired or adversely affected. 

What is a significant departure from accepted professional standards? 

A significant departure from accepted standards includes clinical practice and professional conduct that places the public at substantial risk of harm. 

Your judgement about this may depend on your level of knowledge and experience and consideration of the shared Code of conduct and/or clinical practice guidelines. 

You do not need to report variations in clinical treatment decisions, differences of opinion or innovative clinical practice if the practice meets accepted professional standards and does not present a risk of harm to the public. 

A ‘significant departure’ would be obvious to a reasonable practitioner. 

Understanding sexual misconduct 

For mandatory notifications, sexual misconduct is connected to the health professional’s practice and involves people under or linked to the health professional’s care, including relatives or carers of the patient or client. 

Any sexual activity with a patient or client is defined as sexual misconduct. 

It includes: 

• sexual activity with a current patient or client, whether or not they give consent
• making sexual remarks
• touching patients or clients in a sexual way
• touching a patient in an intimate area without a clinical indication whether or not they give consent
• engaging in sexual behaviour in front of a patient or client. 

Sexual activity with a person formerly under a health professional’s care after the therapeutic relationship has ended can also fall under sexual misconduct. 

When to report? 

Before making a mandatory notification, you need to have formed a ‘reasonable belief’ about the conduct. 

Reasonable belief means having direct knowledge, such as observing the behaviour yourself or a report from a reliable source. 

Wherever possible, encourage the person with the most direct knowledge of the behaviour to make the notification. 

In addition to considering the type of concern and risk of harm, your relationship to the health professional as a treating practitioner, non-treating practitioner or employer will determine whether or not you make a mandatory notification. 

A treating practitioner is defined as someone providing clinical care to a health professional who becomes aware of notifiable conduct in the context of that clinical care. 

The threshold for reporting by a treating practitioner is different from that of non-treating practitioners. 

This is to give health professionals confidence to seek treatment for an impairment or health issue (including substance abuse) without fear of having a mandatory notification made about them. 

A non-treating practitioner is someone who becomes aware of notifiable conduct outside of a therapeutic relationship. 

The concern cannot have come from within the provision of clinical care to the health professional in question. 

An employer is a person or organisation that employs the health professional under an employment or service contract or as a volunteer. 

Assessing the risk of harm to the public 

Factors to consider when assessing the risk of harm to the public (ie, patients, clients and the wider community) include circumstance, practice context, frequency of the conduct, level of insight and controls such as oversight or supervision, scope of practice modification, relevant education and training, and engagement with treatment. The list of factors is not exhaustive and some factors will be weighted more heavily than others depending on the circumstance. Ahpra’s Guidelines: mandatory notifications about registered health practitioners provides tools and examples to help you determine the level of risk and your obligation to report. 

What about students? 

Impairment is the only notifiable conduct that applies to students. 

You would only make a notification about a student with an impairment if the public is at substantial risk of harm during their training. 

Protections for notifiers 

The Health Practitioner Regulation National Law provides protection for notifiers from civil, criminal and administrative liability when a notification is made in good faith. 

Notifications that are vexatious or not in good faith may be subject to regulatory action. 

Exemptions 

Treating practitioners in Western Australia are exempted from making mandatory notifications. 

However, they still have a professional and ethical obligation to protect the public and may therefore consider making a voluntary notification. 

Other exemptions from making mandatory notifications include holding a reasonable belief that someone else has already made a notification about the same concern or that safeguards have been put in place to reduce the risk of harm to the public. 

It is important to be aware that if you do not make a mandatory notification when it is indicated, you could be subject to regulatory action. 

How to make a mandatory notification 

The simplest way to make a mandatory notification is to use the online portal ahpra.gov.au/notifications. 

You can also call 1300 419 495. 

You must make the notification as soon as practicable. 

Unlike voluntary notifications, mandatory notifications cannot be anonymous but if you would like to have your identity kept confidential, Ahpra will endeavour to fulfil that wish. 

Seeking guidance 

If you are unsure about making a mandatory notification, Ahpra has information on its website including a link to the mandatory notification guidelines. 

You may also contact Ahpra to discuss your concerns or speak with a trusted colleague, your professional indemnity insurer or a legal adviser. 

The notification process 

The notification process can be stressful for the practitioner in question and employers. 

The Ahpra website features a collection of resources to assist practitioners who have had a notification made about them, including a list of support services and a page dedicated to understanding the practitioner notification experience. 

Visit ahpra.gov.au/notifications/mandatorynotifications for more information.