paramedic registration march_2017
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Paramedic registrationUpdate Status – 31 March 2017
@Arban70 @ParamedProfhttps://www.facebook.com/ParamedProf
An independent authority registers and controls:� Who enters the profession – i.e. who gets on the register; making
sure that those who are registered are fit and competent - entry
� Who stays on the register - ensure those on the register are able to practice safely and maintain their competence - monitoring
� Who is removed from the register - those shown to be lacking ability or fitness to practice – removal
� The outcomes are open to public scrutiny - transparency
How does registration work ?
Registration involves transparency, objectivity & due process
The National Registration & Accreditation Scheme (NRAS) was established under separate jurisdictional legislation to:
− protect the public by ensuring that only suitably trained and qualified practitioners are registered
− facilitate workforce mobility across Australia− enable the continuous development of a flexible, responsive and
sustainable health workforce
The NRAS is administered by AHPRA* and a number of professional regulatory Boards. It provides independent:
− protection of title− a register of practitioners− established registration standards− investigation of complaints− accreditation of courses
What is NRAS registration ?
*AHPRA - see https://www.ahpra.gov.au/
The NRAS commenced in 2010 with 10 health professions
Chiropractic OsteopathyDental PharmacyMedical PhysiotherapyNursing & Midwifery PodiatryOptometry Psychology
A further four professions entered the scheme in 2012
Aboriginal & Torres Strait Islander health practiceChinese medicineMedical radiation practiceOccupational therapy
Currently registered professions
As at June 2016 there were 652,958 registered health practitioners in Australia – see http://bit.ly/2dF51Me
The profession had advocated for registration of paramedics for many years – but with limited success, despite practise protocols for out of hospital care developing rapidly
New and significant advocacy was begun in 2007 including the preparation of submissions on healthcare policy issues
In February 2010, the Australian Health Workforce Ministerial Council requested advice to include paramedics in the NRAS (like the other health professions)
Health Ministers agreed to undertake a Regulatory Impact Study (RIS) and a project group was set up under WA Health
In July 2012 a consultation program sought feedback & conducted stakeholder meetings nationally
The paramedic journey 1
Gaining agreement across all jurisdictions has taken many iterations - with other regulatory developments including a review of the NRAS framework also part of the mix
Three states (SA, Tas & NSW) recognised the risks of practise and introduced interim legislation protecting the title of ‘paramedic’ but using different legislative frameworks:
SA – via amendment to NRAS National Law – October 2013Tas – via an amended Ambulance Service Act – November 2013NSW – via an amended Health Services Act - 1 February 2016
Health Ministers in 2015 also agreed to adopt a national Code of Conduct for unregistered health workers - http://bit.ly/1yS81vA That would apply to paramedics (and others) if not registered
The paramedic journey 2
Paramedic registration under the NRAS was supported by all states & territories except NSW at the COAG meeting on 7 August 2015 – but delayed - see http://bit.ly/1Nee6VE
Complicating matters, changes were also being proposed for the NRAS itself following a Review – see http://bit.ly/1PVs3vv
Health Ministers on 6 Nov 2015 agreed to support registration under NRAS with jurisdictions able to ‘opt-in’. NSW still reserved its decision but other jurisdictions declared their intention to participate – see http://on.fb.me/1NYNskM
Independently, the Senate Committee chaired by Senator Glenn Lazarus released its Final Report on 9 May 2016 fully supporting national registration http://bit.ly/1TOe7DL
The paramedic journey 3
The Australian Health Ministers Advisory Council (AHMAC) agreed that Victoria’s Department of Health & Human Services (DHHS) would provide the lead agency for implementation of the paramedic registration project
The DHHS project team was charged with developing the ‘roadmap’ for registration and the necessary legislative changes – with implementation planned for September 2018
The DHHS team appointed a project manager and set up an invited stakeholder Reference Group in March 2016
The first meeting of the Reference Group was on 4 April 2016 and a general information Bulletin was issued - see http://ow.ly/LqKG300avuW
The paramedic journey 4
Work continued during 2016 on exploring ways to resolve the NSW concerns regarding participation so as to achieve an inclusive national scheme – see http://bit.ly/2fq4Sel
The COAG Health Council on 7 October 2016 decided to proceed with amendments to the Health Practitioner Regulation National Law to bring paramedics into the NRAS - see http://bit.ly/2dDF0wJ
That Ministerial Council decision cleared the way for further development of legislative amendments that would enable both vocational (NSW) and tertiary educational pathways
Registration thus will be national in scope with paramedics registered in all Australian jurisdictions including NSW
The paramedic journey 5
Health Ministers agreed draft legislative amendments at the COAG meeting held 24 March – see http://bit.ly/2ndgm9R
The final legislation will go to the Queensland Parliament (say) mid 2017, and then other states / territories (SA / WA)
The latest COAG Communique is here: http://bit.ly/2n0bFyZ
Further steps include appointment of a Paramedicine Board, development of accreditation arrangements, registration standards & applicable fees – see http://bit.ly/2ePHJWy
The involvement of AHPRA* will increase over time with implementation drawing on the experience & lessons from the four professions that entered the scheme in 2012
The current status (31 March 2017)
*AHPRA - see https://www.ahpra.gov.au
Legislation in place June/July 2017
Recruit and appoint a national Board (Ministers)
Board consults regarding standards, codes, guidelines & AHPRA systems/process design
Recommend/ Approve standards & accreditation arrangements (Ministers to approve)
List of approved pathways/programs (Board)
Publicise requirements / open applications
Assess applications and go ‘live’ - Sept 2018
Final implementation steps2017
2018
2017
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201
8
Paramedicine added to the definition of ‘health profession’ in the National Law
‘Paramedic’ becomes a protected title nationally
New s307 and s308 establish the Paramedicine Board of Australia. The Board has:
- limited functions until the participation day s308(1)&(3) but can start work- same powers and functions as existing 14 Boards from participation day
New s.308 (2) allows Ministerial Council to appoint practitioner members to the Board prior to participation day
New s.310 allows ‘Grand-parenting’ during the first three years
What are some key reforms?
Some practitioner implicationsPractitioner mobility may be enhanced (local / offshore)Professional indemnity insurance (or other arrangements) will apply (see vicarious liability)Mandatory CPD & other ‘practise’ Standards will applyCriminal history, identity checks & ad hoc audits will applyMandatory requirement to report a registrant who is placing the public at risk of harm Independent complaint & ‘fitness to practice’ proceduresThere will be a cost (unknown - to be determined)
- Registration fee- Annual practicing certificate fee
The Trans-Tasman Mutual Recognition arrangement provides for close relationships between Australia and New Zealand in matters relating to the supply of goods and services. Regulatory matters come within the ambit of this arrangement
Meetings in New Zealand have reached agreement that paramedics as a professional group satisfy the criteria to be recognised under NZ law as registered health professionals
Health Workforce NZ (HWNZ) is expected to release a targeted stakeholder consultation document in the near future following which a final decision on regulation and registration of paramedics may be in place within a few months
And in related news from NZ …
The Victorian DHHS paramedic registration project team can be contacted as follows:Meredith CarterManager Legislative Reform Projects, Workforce RegulationVictorian Department of Health and Human ServicesPhone: 03 9096 1852Email: [email protected]
Anne-Louise CarltonManager, Workforce RegulationVictorian Department of Health and Human ServicesPhone: 03 9096 7610Email: [email protected]
Further details (Australia)
For additional information on regulatory and general matters affecting paramedicine - follow these social media channels:Twitter on @Arban70 and @ParamedProf Paramedic Observer https://www.facebook.com/ParamedProf Australian Emergency Law http://bit.ly/2nW38Ac
Information on paramedic practice is available on the websites and social media channels of (in alpha order):
─ Australian and New Zealand College of Paramedicine (ANZCP)─ Australian Paramedics Association (various jurisdictions)─ Council of Ambulance Authorities (CAA)─ National Council of Ambulance Unions (NCAU)─ Paramedics Australasia (PA) - also see their dedicated ‘registration’
channels Twitter @ParaRegAU and Facebook http://bit.ly/1FMQVwm─ Private Paramedicine Australia (PPA) http://on.fb.me/1OSq0Uq
Other information sources
Access the Final RIS report on Options for regulation of paramedics (amended
version) here: http://bit.ly/2djLnWm