Earlier this year I had the privilege of representing the ANMF at a symposium hosted by the Australian Health Practitioner Regulation Authority (Ahpra) exploring the distress and stress experienced by practitioners involved in a regulatory process.

The symposium was part of a project undertaken by an Expert Advisory Group (EAG) commissioned by Ahpra and the National Boards in 2021 to explore practitioner distress while involved with the regulator.

In 2023, the EAG made 15 recommendations and proposed 33 actions to Ahpra to minimise the emotional impact on health practitioners of receiving a notification. These were based on qualitative research into the distress of health practitioners involved in a regulatory complaints process and can be viewed on the Ahpra website.

At the symposium, Ahpra discussed actions already taken in response to the EAG recommendations including mental health education and training for Ahpra employees involved in notification processes, improved case management, decreasing time to an outcome, and offering additional support to health practitioners identified at significant risk of mental ill health relating to regulatory processes. Despite support services being provided to health practitioners involved in a regulatory complaints process there is poor uptake. Research has demonstrated this is largely due to the stigma, shame, guilt and fear health practitioners experience when they receive a complaint. Often when practitioners think about being notified to Ahpra about their practice they assume worst case scenario – this is the end of my career, a poor perception of how the complaint will be managed by the regulator and concern that accessing support services for ensuing mental ill health will add to their regulatory woes through mandatory notification processes.

Take a moment to consider what receiving a notification would mean to you, how you feel about interactions with Ahpra, what you know about the notification process, who you would look to for support if you received a notification, and how you would respond to a colleague who has had a notification made about them. I think many can relate to the findings of the research when they contemplate these questions.

In 2022/23, 0.4% of all midwives and 0.5% of all registered nurses received one or more notifications. Of the notifications closed, 82% of those relating to midwives, and 70% of those relating to registered nurses resulted in no further action.¹ These are very small numbers and perhaps surprisingly, many of the complaints were closed with no further action rather than career ending sentences. This is one example of how a misperception may add to the stress and distress of being involved in a regulatory complaint.

Ahpra emphasised they are working to humanise the way they perform their role and how they exercise their responsibilities. They are looking to health practitioner representative groups and mental health organisations to collaboratively develop strategies designed to support health practitioners navigate the regulatory system and overcome barriers such as misinformation to support services being accessed.

Some of the strategies explored included: regulation-specific education included in undergraduate preparation and transition to practice programs to improve perception of the regulator; dispelling myths regarding typical outcomes of notifications and increased understanding of mandatory notification processes; utilising health practitioner specific mental health supports such as the Nurse Midwife Support Service or navigator service; and, allocating support workers alongside regulatory processes such as social workers or those with lived experience.

A common thread throughout the day was that everyone – the regulator, stakeholder representatives and health practitioners – have a role to play in minimising the stress and distress experienced by health practitioners involved in a complaints process.

What can you do?

• Have a look at the ‘About Notifications’ page on the Ahpra website paying particular attention to the supports available (see below);
• Familiarise yourself with the stats on notifications and potential outcomes;
• Seek support for mental ill health as a priority over regulatory concerns; and,
• Advocate for positive practice environments.
  
  

For further information go to
https://www.ahpra.gov.au/Notifications.aspx
https://www.nmsupport.org.au/

Reference
Australian Health Practitioners Regulation Authority (2023) Annual report 2022/23 retrieved 8 February 2024 from https://www.ahpra.gov.au/Publications/Annual-reports/Annual-report-2023.aspx#