It would be fair to say that most health professionals choose to work in healthcare because they want to help others and contribute positively to their community and that the journey to qualification and beyond requires dedication and commitment. 

So as a health professional, it can come as quite a shock to be on the receiving end of a complaint or an Ahpra ‘notification’.

What do you know about Ahpra notifications?

Since 2009, physiotherapy and 15 other registered health professions in Australia have been regulated by Ahpra and the National Boards, who jointly administer the National Registration and Accreditation Scheme guided by the Health Practitioner Regulation National Law. 

As part of this role, Ahpra manages complaints (notifications) about practitioners on matters related to their performance, conduct or health.

A robust complaints management system in healthcare is a significant component of health regulation’s paramount aim: to
protect the public. 

It also helps to maintain public trust that health professionals are appropriately qualified, monitored and law-abiding.

Notifications can cause anguish

Research in recent years has exposed the experiences of practitioners subject to notifications or complaints. 

Findings include high levels of distress, anxiety and shame; impacts on personal lives; and diminished professional identity and practice (Maben et al 2021, Horsfall 2014). 

Tragically, many practitioners have also died by suicide while awaiting the outcome of an investigation (Bourne et al 2015, Biggar et al 2023).

However, the vast majority of notifications do not result in loss of registration.

What is Ahpra doing to help?

In 2021, Ahpra commissioned an external advisory group to explore practitioner distress while involved with the regulator. 

The findings and recommendations were made public in February 2023.

A total of 15 recommendations and 33 proposed actions were presented. All have been accepted.

Some actions had early implementation, such as the establishment of a health management team to specifically manage complaints related to a health impairment. 

This has resulted in a 51 per cent decrease in ‘immediate action’ in 2022–23 compared to the previous year, through more collaborative engagement with practitioners, their employers and their treating teams.

Some of the other recommendations require partnership with external agencies.

How is the APA’s National Professional Standards Panel involved?

In February 2024, Ahpra held a series of three symposia to consult with representatives from the registered health professions, professional associations, defence firms, indemnity and education providers and co-regulators to develop implementation strategies.

The APA was represented at the symposia by the APA’s National Professional Standards Panel (NPSP). 

Cases involving physiotherapists were presented, experiences shared, expert advisory group findings discussed and ideas and collaborative strategies developed.

The key opportunities for external agencies to help mitigate distress from notifications fall into two broad but interrelated categories:
•    providing accurate information— dispelling myths and misconceptions, clarifying processes, setting expectations and explaining possible outcomes
•    wellbeing and support—increasing uptake of formal and informal supports such as psychological services; talking with colleagues, managers, family and others who have been through the process before.

The NPSP has commenced work in these areas and is a participant in a dedicated multi-professional workgroup developing accurate and consistent content to form part of a suite of support resources.

The NPSP will continue regulating conduct of APA members that departs from what is expected by our colleagues and clients and is described in the APA Code of Conduct. 

We do this to the extent of what is not within scope for Ahpra or other regulatory bodies such as the Office of the Health Ombudsman.

NPSP-led regulation could include discipline and remediation actions determined independently by the NPSP and the APA Board or following the outcome of an Ahpra notification and/or tribunal finding.

Yes, we want to uphold our profession’s reputation and will investigate and discipline aberrant behaviour as appropriate but we also want physiotherapists to stay safe and well throughout a complaints process and emerge on the other side as a stronger
and better professional. 

We believe we can achieve both aims.

Did you know? In 2022–23:
•    1.5 per cent of all registered health practitioners nationally had a notification made about them
•    0.5 per cent of physiotherapists had a notification (224 notifications about 191 physiotherapists). 

Of these:
-    almost 60 per cent were closed with no regulatory action
-    approximately 25 per cent resulted in a caution, reprimand or conditions
-    only 2.2 per cent resulted in registration disqualification (Physiotherapy Board of Australia 2024).

For more information or support 

Detailed information about Ahpra’s notifications process and how they are working to improve practitioner experience is available on the Ahpra website here and here.

If you have had a notification and would like to speak with someone from the APA, contact the APA and direct your enquiry to the NPSP.

We also welcome contact from physiotherapists who have been through an Ahpra notification and would be willing to share their experience as peer support.

The Essential Network for Health Professionals is a service dedicated to maintaining health professionals’ mental wellbeing. It offers access to free individual psychological services here.

As an APA member, you also have access to the APA’s Employee Assistance Program here, which you can contact for support if required.

>> Alison Smith MACP is an APA Musculoskeletal Physiotherapist in practice at Canberra Health Services. Alison is the chair of the NPSP.
>> Tom Hindhaugh APAM is the practice director of Back In Motion Bayswater in Wantirna, Melbourne. Tom is a member of the NPSP panel.
>>Khanh Tran APAM is a physiotherapist at Lakeside Sports Medicine Centre in Albert Park, Melbourne. Khanh is a member of the NPSP panel.

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