The Psychology Council of NSW (Council) is one of 15 Health Professional Councils (Councils) that are registered under the Health Practitioner Regulation National Law (NSW) (National Law) which came into place in 2010 when registration and regulation of health practitioners changed from state based to nationally based. The Council is located at Level 6, 477 Pitt Street, Sydney NSW 2000.
Registration and accreditation of health practitioners are managed nationally by the Australian Health Practitioner Agency (AHPRA).
Complaints. The Psychology Council of NSW’s primary responsibility is to ensure that registered psychologists in NSW practice in a way that ensures the health and safety of the public. This is achieved through regulation of NSW based health practitioners, including managing complaints (or notifications) about health practitioners.
In NSW all Councils including the Psychology Council, operate:
- in partnership with the Health Professional Councils Authority (HPCA)
- in collaboration with the NSW Health Care Complaints Commission (HCCC)
- as part of the National Registration and Accreditation Scheme (NRAS)
Under the NRAS, National Health Professional Boards and the Australian Health Practitioner Regulation Agency (AHPRA) handle registration of health practitioners Australia wide and also notifications about health practitioners in most states and territories of Australia except NSW and Queensland (that also has a co-regulatory model). The Councils are co-regulators under the NRAS. Information about registration and health practitioner numbers provides context for the Councils’ regulatory work. AHPRA maintains the National public register of health practitioners which is available on the website http://www.ahpra.gov.au/.
Students
The Psychology Board of Australia (a national Board within AHPRA) does not register students but instead has provisional registration for new graduates.
Regulatory committees and panels
Each of the 15 Councils is an independent statutory body constituted under the Health Practitioner Regulation National Law (NSW) (National Law) exercising the powers, authorities, duties and functions set out in the National Law.
Psychology Council of NSW Council responsibilities
The Psychology Council of NSW has a responsibility to protect public safety and wellbeing. This includes managing complaints that relate to the conduct, performance and health of registered health practitioners in NSW.
The Council and the HCCC jointly assess complaints to decide how each complaint should be managed. The HCCC is a separate statutory authority established under the Health Care Complaints Act 1993.
The Council acts in the interests of the public by ensuring that registered practitioners are fit to practise. The Council manages a range of programs, services and processes that support their objectives. These also provide the public with assurance that registered practitioners are maintaining proper and appropriate standards of conduct and professional performance.
Council membership
The National Law and the Health Practitioner Regulation (New South Wales) Regulation 2010 sets out the composition of individual Councils. The Psychology Council of NSW has 8 members. Council members (members) are appointed by the Governor. The term of appointment is three years and a member may serve up to a maximum of nine years. The Council membership comprises 5 psychology members, 1 legal member and 2 community representatives.
Funding
The NSW Councils are funded through a portion of registration fees paid to AHPRA by health practitioners who identify NSW as their principal place of practice. Councils also receive a portion of fees collected from practitioners who do not identify a principal place of practice. Under the Law Councils are not able to employ staff so HPCA staff provide administrative support.8.2%
The HPCA is an executive agency of the NSW Ministry of Health (MoH) and works in partnership with the Councils. The HPCA provides shared executive and corporate services to support the Councils’ regulatory purpose.
The HPCA also liaises with:
- The Ministry of Health to provide advice and responses to the Minister for Health and the Secretary on regulatory matters, member appointments and other operational functions
- The HCCC on complaints management issues
- The Australian Health Practitioner Regulation Agency (AHPRA) regarding finances, research, registration and reporting matters.
The HPCA’s shared services assist Councils to achieve efficiencies that would not be possible if each Council had to establish its own service support structure. Three year Service Level Agreements (SLAs) to 2019 are in place with all Councils. The SLAs define the scope and quality of services that Councils can expect, within the constraints of available resources.
Managing complaints
Regulation of health practitioners aims to minimise harm with the least possible restriction through remediation and supportive action. It is not intended to be punitive or an opportunity for complainants to seek compensation. However, on occasion disciplinary action may be needed to ensure public safety.
The National Law gives Councils powers to deal with complaints that relate to a practitioner’s performance, conduct and health, commonly referred to as ‘streams’ or ‘programs’. More than one stream may be applicable in some cases, but a primary stream is usually identified based on which issue is the most serious.
1. Performance
Performance issues are generally about the standard of a practitioner’s clinical performance and whether the practitioner’s knowledge, skill, judgement or care is significantly below the standard reasonably expected of a practitioner with equivalent training or experience.
2. Conduct
Conduct issues relate to a practitioner’s behaviours and may call into question the character or suitability of a practitioner. Conduct issues may constitute unsatisfactory professional conduct or professional misconduct, as defined in the National Law.
3. Health
Physical and psychological impairments can affect the health of a practitioner. This includes the abuse of alcohol and other drugs. Impaired practitioner assessments help Councils to decide whether or not a practitioner can continue to practise and appropriate safeguards, such as certain restrictions on practice, supervision or monitoring arrangements.
How complaints are managed
On receipt of a complaint the Psychology Council and HCCC jointly decide which agency will manage the complaint and what action is appropriate.
Councils may refer a practitioner for a health or performance assessment, for interview or counselling or to a panel, or conduct a Council Inquiry.
Complaints referred to the HCCC for investigation may be prosecuted before NSW Civil and Administrative Tribunal (NCAT).
The pathway for management depends on the nature and seriousness of the matter. A complaint may be discontinued at any point during the process if it is appropriate to do so.
Immediate action under s150 of the National Law
The National Law requires Councils to use their powers to either suspend or impose conditions on a practitioner’s registration if satisfied that such action is appropriate for the protection of the health or safety of the public, or is otherwise in the public interest. If a Council decides against immediate action at the outset of a complaint, it does not preclude immediate action by Council at a later stage or stop the Council or HCCC from continuing to deal with the complaint through other available measures.
Regulatory panels and committees assist Councils with their regulatory responsibilities. These include:
- Performance Review Panel
- Impaired Registrants Panel
Performance Review Panel
A Performance Review Panel (PRP) may review matters where unsatisfactory professional practice is indicated. The PRP examines evidence to establish whether a practitioner is performing to a standard reasonably expected of a practitioner with an equivalent level of training and experience.
A PRP consists of three people who may or may not be Council members. At least two panel members must be registered in the same profession as the practitioner who is subject of the complaint and one member must not be a health practitioner.
Impaired Registrants Panel
An Impaired Registrants Panel (IRP) deals with matters where a registered health practitioner has a physical or mental impairment that affects, or is likely to affect, their capacity to practise safely.
An IRP consists of two or three people who may or may not be Council members. At least one member must be registered in the same profession as the practitioner who is subject of the complaint and at least one panel member must be a medical practitioner. Each panel draws on a pool of members who are experienced in working with practitioners who have health problems. .
Assessments and hearings
Councils use regulatory committees or panels as appropriate to assist in assessing complaints, making further inquiries and managing complaints. In addition, Councils may require a practitioner to attend counselling or an interview.
NSW Civil and Administrative Tribunal
Serious matters may be referred to the NSW Civil and Administrative Tribunal (NCAT) following investigation by the HCCC, particularly where substantiated complaints could result in cancelled or suspended registration. The HCCC prosecutes these matters before NCAT. Disciplinary hearings may involve more than one complaint about the same practitioner.
Other relevant decision making functions carried out by NCAT include:
- Adjudicating appeals by a practitioner against certain decisions by a Council, a PRP or the National Boards
- Undertaking reviews of previous orders cancelling a practitioner’s registration and in some cases orders imposing conditions on registration.
NCAT decisions are publically available on the NSW CaseLaw website.
Outcomes for closed complaints
Complaints are carefully considered to determine the appropriate course of action. Inquiries into a complaint may lead to a decision to take no action. For instance a practitioner may have satisfactorily acknowledged the reason for a complaint and taken steps to ensure an improvement in practice so that further action by a Council is not needed.
Also a final outcome of ‘no further action’ may be recorded where Councils have already provided advice or comments in correspondence to the practitioner or required the practitioner to take some action, such as updating a patient consent form.
Where outcomes involved regulatory action, the most common action was counselling or interview. Outcomes for more serious matters involved conditions on practice or suspension or cancellation of registration.
Monitoring and compliance with orders and conditions
Councils are responsible for monitoring practitioner compliance with orders made and conditions imposed on practice by an adjudication body. Conditions fall into two categories:
- Public conditions that are published on the National register on the AHPRA website http://www.ahpra.gov.au/
- Private conditions that relate to impairment and are recorded by AHPRA but not published on the National Register due to privacy and confidentiality considerations.
Ensuring compliance with orders and conditions allows practitioners to continue to practise in a way that is safe for consumers. The conduct stream has the largest number of practitioners being actively monitored.
I hope this helps to explain the role and function of the Psychology Council of NSW and the part it plays in the co-regulatory national model. As a final note, I should mention that there are about 12,000 registered psychologists in NSW, which is 33 per cent of all registered psychologist in Australia. In NSW the number of complaints in the past year was about 300 and the number is increasing by about 5 per cent each year.
The Council is always looking for ways to provide education about the regulatory process to increase practitioner’s awareness of their professional responsibilities with the aim to reduce the number of complaints. Further information can be found on the Psychology Council of NSW website www.psychologycouncil.nsw.gov.au