Review of confidentiality safeguards for people making notifications about health practitioners

About the confidentiality safeguards review

In late 2018 the Australian Health Practitioner Regulation Agency (Ahpra) requested that the Ombudsman and Commissioner conduct an independent review of the confidentiality safeguards for people making notifications about registered health practitioners.

The request was made after the conviction of South Australian general practitioner Dr Brian Holder for the attempted murder of pharmacist Kelly Akehurst. Ms Akehurst had made a notification to Ahpra about Dr Holder’s prescribing practices and it is thought that the notification was the motive for the crime.

While acts of violence against notifiers are rare, this experience threw a necessary spotlight on whether Ahpra’s handling of notifications adequately safeguards the confidentiality of notifiers.

The review’s findings

The Ombudsman and Commissioner’s review found that Ahpra’s current approach offers reasonable safeguards for notifiers.

The Ombudsman and Commissioner concluded that it is preferable for Ahpra to share with the relevant practitioner all information it holds about a notification, including the identity of the notifier (if known). This means the practitioner is given the best opportunity to understand the notification and to respond, in detail, to the allegations that have ben made. It also simplifies the way Ahpra manages notifications.

The Ombudsman and Commissioner also concluded that Ahpra’s current process of accepting confidential and anonymous notifications serves an important purpose. It is clearly in the public interest for Ahpra to be made aware of concerns about registered health practitioners, regardless of the source of those concerns or whether any additional steps need to be taken to keep the notifier’s identity confidential.

However, the Ombudsman and Commissioner identified that improvements could be made to the handling of notifications to better safeguard the confidentiality of notifiers.

The Ombudsman and Commissioner’s recommendations

Consideration of confidentiality safeguards for notifiers

The Ombudsman and Commissioner recommended that Ahpra introduce a new step in the notifications process to proactively consider safeguarding the confidentiality of the notifier. Ahpra could mitigate risks of harm to notifiers by assessing on a case-by-case basis how the notifier’s personal information will be used and whether it is necessary to disclose the notifier’s identity to the practitioner in the first instance.

Improvements to the administrative management of confidential and anonymous notifications

The Ombudsman and Commissioner recommended that identified gaps in Ahpra’s policies, processes and staff training in relation to confidential and anonymous notifications be addressed, including by:

  • reviewing and updating Ahpra’s privacy policy and collection statement relevant to notifications
  • strengthening guidance for Ahpra staff regarding confidentiality safeguards for notifiers
  • improving how confidential and anonymous notifications are recorded in Ahpra’s electronic case management system (Pivotal), and where possible, automating processes for managing confidential and anonymous notifications.

Improvements to communication about privacy and confidentiality for notifiers

The Ombudsman and Commissioner recommended that Ahpra review all communications about notifications and makes necessary amendments to ensure consistency in messaging about a notifier’s privacy. It was also recommended that Ahpra requires staff to have a verbal discussion with notifiers about how their personal information will be used and disclosed during the notifications process.

Consequences for practitioners who harm, threaten, intimidate, harass or coerce notifiers

The Ombudsman and Commissioner recommended that Ahpra develop guidance for staff regarding how to deal with information that suggests a practitioner has sought to harm, threaten, intimidate, harass or coerce a notifier.

Further, the Ombudsman and Commissioner recommended that Ahpra seek an amendment to the Health Practitioner Regulation National Law to make it an offence for a registered health practitioner to harm, threaten, intimidate, harass or coerce a notifier.

Managing the risk of vexatious notifications

While the evidence suggests that vexatious notifications are rare, the Ombudsman and Commissioner recommended that Ahpra develops and publishes a framework for identifying and dealing with this type of notification.

Read or download the report

Ahpra’s response

The Ombudsman and Commissioner has welcomed Ahpra’s acceptance of all of her recommendations.

View Ahpra’s response here.

More information

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