PARAMEDIC REGISTRATION

After decades, paramedic registration is almost upon us...

Latest News

Regulation of the NZ paramedic workforce under the HPCA Act 2003

In May 2017 the NZ Ministry of Health sought input into the regulation of paramedics under the Health Practitioners Competence…
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Earlier Updates

Paramedic Registration Update – May 2017

A significant milestone has occurred in paramedic registration! This month the Australian Health Practitioner Regulatory Authority updated its ...
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Paramedic Registration Update – March 2017

Over the next 18 months, we will see the draft Health Practitioner Regulation National Law Amendment Law 2017 ...
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Paramedic Registered Health Profession

The journey towards the registration of paramedics under the National Registration and Accreditation Scheme (NRAS) for health professionals ...
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Paramedic Registration Update – October 2016

Paramedics set to become the 15th Registered Health Profession The journey towards the registration of paramedics under the ...
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Update May 2016

The Senate Legal and Constitutional Affairs Committee report into the “Establishment of a national registration system for Australian ...
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Update April 2016

The Paramedic Registration Project has moved into full swing with the appointment of a Principal Policy Advisor at ...
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Update March 2016

Back on November 6 last year the COAG Health Council / Health Ministers discussed options for the registration ...
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Update November 2015

National Registration of Paramedics to be included in the NRAS The Federal and State and Territory Health Ministers ...
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Update October 2015

The College has had a busy couple of months communicating with all state and territory Ministers in regards ...
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Update August 2015

At a COAG meeting in Darwin on the 7th of August the issue of paramedic registration was once ...
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Update 22 October 2014

The Australian Health Workforce Ministerial Council (the Council) met and considered the establishment of paramedics as a profession ...
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Update October 2014

The matter of national registration has remained at the front and centre of the Australian and New Zealand ...
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Update October 2013

The past financial year has been one of steady progress on the topic of National Registration for Paramedics. ...
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UNDERSTANDING REGISTRATION

COAG Decisions

COAG Decision - October 2016

Paramedics set to become the 15th Registered Health Profession

The journey towards the registration of paramedics under the National Registration and Accreditation Scheme (NRAS) for health professionals has been a long one. Another big step was taken towards this goal when the Council of Australian Governments (COAG) Health Council met in Canberra last week.

At the COAG Health Council meeting the State and Territory Health Ministers agreed to proceed with the legislative amendments that are required to bring paramedics into the NRAS alongside the 14 other registered health professions. The Ministers were finally all happy that the issues that had previously required further attention, such as the scope of the paramedic workforce and recognition of vocational and tertiary pathways, had been satisfactorily addressed to their collective requirements.

As far as the College is concerned, the best news in the COAG communique was that since all Ministers agreed that paramedics will be registered in all jurisdictions, that an ‘opt-in’ mechanism would not be required. This is a significant development making the NRAS truly national, and not just covering States that opted in to the scheme. As the College and COAG have previously reported, NSW had previously reserved its right to participate which had the potential to undermine the strength of the scheme. The College and others have worked very hard to convince the NSW Government to participate fully and thankfully this has resulted in this development. We await the drafting of the legislation to learn the details of the final result.

What does this mean: The legislative amendments will be introduced across Australian jurisdictions in 2017. The working groups report that they are on track for the register of paramedics to be in place for a commencement in late 2018.

The whole COAG communique can be viewed here (Paramedics page 4 of PDF):

http://www.health.gov.au/internet/main/publishing.nsf/Content/mr-yr16-dept-dept006.htm

COAG Decision - November 2015

National Registration of Paramedics to be included in the NRAS
The Federal and State and Territory Health Ministers met in Adelaide today (6th November) at the COAG Health Council to discuss a range of national health issues, including National Registration of Paramedics.ANZCP welcomes the decision made to move towards National Registration of Paramedics under the National Registration Accreditation Scheme (NRAS). It is positive that we are officially moving forward but the communique wording below details that further work is needed and it does appear that not all states will necessarily be onboard.

After many year's of advocacy, ANZCP communicated with all State and Territory Health Ministers again in the past 6 months, including a meeting with NSW Health staff, to ensure the Ministers were aware of the ongoing support of the profession for national registration.

Today has been the culmination of a huge amount of work by many people - starting in the days of ACAP, involving all state branches - and the ongoing advocacy of Paramedics Australasia and ANZCP.

ANZCP will continue to advocate on behalf of the profession for the benefit and safety of patients.

COAG Health Council
Communique
November 6 2015

Options for national registration of the paramedic profession
Health Ministers discussed options for the registration of paramedics and, on a majority vote, the meeting agreed to move towards a national registration of paramedics to be included in the National Registration Accreditation Scheme with only those jurisdictions that wish to register paramedics adopting the necessary amendments. Ministers agreed that work would need to come back to AHMAC for consideration. This would include the consideration of implementation of the recommendations of the NRAS Review, resolution of the scope of the paramedic workforce and the development of vocational as well as tertiary pathways. It was noted that NSW will reserve its right to participate. The Commonwealth dissented from the decisions as it is not consistent with the principles of the NRAS as a national regulatory reform.

Paramedic Registration Project

The Paramedics Registration Project is the implementation project for national registration of paramedics. The College has been a key stakeholder representing the needs of College members and the profession on the Reference Group supporting the work of the Project team.

Bulletin 4
April 2017

Bulletin 3
November 2016

Bulletin 2
April 2016

Bulletin 1
March 2016

FAQ

Paramedic Registration Q & A

Number 1 – January 2016
You can view this Q&A in a PDF document (for easy downloading and printing) by clicking here

Number 2 – February 2016
You can view this Q&A in a PDF document (for easy downloading and printing) by clicking here

Number 3 - October 2016
You can view this Q&A in a PDF document (for easy downloading and printing) by clicking here

Number 4 - February 2017
You can view this Q&A in a PDF document (for easy downloading and printing) by clicking here

National Law Amendment

The draft National Law Amendment should make its way through the Queensland Parliament and then the other jurisdictions to become National during the second half of 2017.

Summary of the draft Health Practitioner Regulation National Law Amendment Law 2017 - click here

Health Practitioner Regulation National Law Amendment Law 2017 - Frequently asked questions - click here

What is Option 4?

In 2012 the Australian Health Ministers’ Advisory Council Health Workforce Principal Committee released the Consultation paper, Options for regulation of paramedics, July 2012. Click here to see the full Consultation Paper

NOTE: The below information is a direct excerpt from the Consultation Paper - some aspects of how National Registration will or could work are likely to be different

Options for Registration of Paramedics
This consultation paper listed a number of options for regulatory reform. The four options identified were:

  • Option 1: No change – rely on existing regulatory and non-regulatory mechanisms, and a voluntary code of practice
  • Option 2: Strengthen statutory health complaint mechanisms - statutory code of conduct and powers to prohibit those who breach the code from continuing to provide health services
  • Option 3: Strengthen State and Territory regulation of paramedics
  • Option 4: Registration of paramedics through the National Scheme

Option 4: Registration of paramedics through the National Scheme

Under this option, the Health Practitioner Regulation National Law Act 2009 (the National Law) would be amended to include the profession of paramedics as a regulated profession under the National Law. A National Board would be appointed by the Australian Health Workforce Ministerial Council, and a Register of Paramedics would be established, administered by the Australian Health Practitioner Regulation Agency. The National Board would have powers to set standards for registration as a paramedic which would include qualifications requirements and probity checking. The National Board would also have powers to receive and investigate complaints against registered paramedics, and to prosecute serious disciplinary matters before the relevant state or territory tribunal (or through the HCCC in NSW). If a paramedic was found to have engaged in professional misconduct as defined under the National Law, the tribunal would have the power to suspend or cancel their registration. The National Board would have a range of other powers to protect the public, including criminal history checking, monitoring of impaired registrants or those whose performance or conduct was unsatisfactory.

Discussion of Options
Option 4: Registration of paramedics through the National Scheme

The Health Practitioner National Law Act 2009 (the National Law), includes objectives and guiding principles (Appendix 9). In addition, the National Law, Part 8, Health Performance and Conduct describes notifiable conduct and provides mechanisms by which matters of incident or complaint (known as notifications) may be reported to the National Board of the relevant health profession.

If the location of the incident was in NSW, the matter is referred to the HCCC. In adopting the national scheme, NSW elected not to adopt the national arrangements for managing complaints about practitioners, and notifications about poor performance and impairment issues. Accordingly NSW has retained the previous co-regulatory system which includes the HCCC as the independent investigator and prosecutor of serious complaints. The co-regulatory system requires that there be a professional regulation body, known as a Council akin to the former state boards, to receive and manage complaints in conjunction with the HCCC. Therefore the Health Practitioner Regulation National Law (NSW) establishes a regulatory council for each profession to undertake these functions. In all other jurisdictions, notification matters are reported to Australia Health Practitioner Regulation Agency (AHPRA), the organisation responsible for the implementation of the National Scheme.

Section 141 of the National Law requires all registered health practitioners who, in the course of practising their profession, form a reasonable belief that another practitioner has behaved in a way which constitutes notifiable conduct to report that conduct to AHPRA.

In Division 2, Mandatory Notification, (s.140) of the National Law provides the following definition of notifiable conduct:
In this Division — 
notifiable conduct, in relation to a registered health practitioner, means the practitioner has —

  • (a) practised the practitioner’s profession while intoxicated by alcohol or drugs; or
  • (b) engaged in sexual misconduct in connection with the practice of the practitioner’s profession; or
  • (c) placed the public at risk of substantial harm in the practitioner’s practice of the profession because the practitioner has an impairment; or
  • (d) placed the public at risk of harm because the practitioner has practised the profession in a way that constitutes a significant departure from accepted professional standards.

The National Scheme provides a publicly available list of registered health professionals, a database where members of the public, employers or other health practitioners can access current information concerning an individual’s registration status and any conditions on his or her practice.
Registration aims to reduce the risk of unethical or fraudulent behaviour by applying fit and proper person requirements (to screen applicants for registration) and enforcing sanctions, for example, through deregistration. The purpose of regulatory oversight is to reduce health and safety risks and costs for consumers.

Consumers are likely to be more at risk when health practitioners use invasive techniques and equipment and carry out other types of high risk procedures (see Tables 7 and 8). If the incidence of harm associated with paramedics is small, the benefits of across-the-board registration will also be small. Therefore, the benefits to the community of extending the statutory registration regime to cover paramedics must outweigh the costs.

The National Scheme is self funded through the collection of practitioner registration fees. The National Law provides National Boards with extensive powers to regulate registered practitioners. National Boards undertake probity checking of all applicants before deciding whether to grant registration, with all applicants being required to demonstrate that they are appropriately qualified and competent to practice.

The National Law, part 8, provides the full definitions of ‘unprofessional conduct’, ‘professional misconduct’, ‘unsatisfactory professional performance’ and ‘impairment’ (see Appendix 10).

The National Scheme provides consistent and effective ways of dealing with practitioners who have professional conduct, practice or impairment issues. All professional misconduct matters are dealt with under the National Law by a tribunal, as constituted in each jurisdiction.

This option provides legislated protection for use of the title ‘paramedic’, with only those persons registered being able to use that title. Proof of registration, qualifications and any conditions or endorsements concerning areas of practice would be publically available on the AHPRA public website register. Any health, conduct or performance issues of a registered practitioner would continue to be managed irrespective of the jurisdiction in which they are working.

Depending upon the minimum educational standard required for registration, ‘Grandfathering’ will likely be required with regards to the existing workforce who may need to transition into any national registration scheme on the basis of ‘equivalent’ qualifications.

Should a decision be made to include paramedics in the National Scheme, amendments would be required to the National Law to incorporate paramedics. The National Law would then require the establishment of a national board for the profession of paramedicine. This could be achieved by the establishment of the Paramedic Board of Australia.

For paramedics to be included in the National Scheme:

  • amendments will need to be made to State and Territory legislation. Amendments to the QLD Act flow on to State and Territory legislation, except in WA which will also need to amend its legislation
  • additional infrastructure will be required within AHPRA to support the registration functions, and
  • a national course accreditation process will need to be endorsed.

Implementation could follow the process undertaken for that is currently underway for the 2012 inclusion into AHPRA of Aboriginal and Torres Strait Islander health practitioners, Chinese Medicine practitioners, Medical Radiation practitioners and Occupational Therapists. 
Under the National Scheme, ongoing administration costs for the National Board and AHPRA are required to be met by registration fees. However, the costs associated with the inclusion of paramedics in the National Scheme will need to be met by the State, Territory and Commonwealth Governments. Some of the costs to government will include:

  • parliamentary sitting time, and
  • establishment of a national board for paramedicine.

Benefits

The benefits associated with registration through the National Scheme may include:

  • the public being assured that paramedics are appropriately educated and suitable to practice
  • reduced risks to the public associated with the actions of a practitioner who may have health, conduct or performance issues that make them unsafe to practice
  • establishment of a national board with the powers to deal with any registered practitioner who may have health, conduct or performance issues that make them unsafe to practice
  • establishment of professional standards
  • establishment of national minimal education standard for paramedics
  • establishment of a national accreditation body for the assessment of educational qualifications leading to registration as a paramedic, and
  • legislated protection for use of the title ‘paramedic’, with only those person registered being able to use that title.

Costs

The costs to paramedics associated with registration through the National Scheme may include:

  • establishment costs that are generally met by governments, such as the cost of legislative drafting and parliamentary sitting time, the cost of establishing the infrastructure to support additional registration functions, the costs associated with establishing a registration board in advance of an available funding stream from registration fees
  • 
ongoing costs of administering the regulatory regime, to be recovered from the registration fees paid by paramedics, and
  • other compliance costs for individual paramedics, for example, the costs associated with achieving the qualifications necessary for initial registration, and the costs associated with meeting other regulatory requirements, such as maintaining professional competence, undertaking continuing professional development, and maintaining professional indemnity insurance.

T
he costs for registration under a National Scheme are determined by National Boards on an individual profession. The annual registration fees for the professions currently regulated under the National Scheme range from $115 for nurses and midwives, through to $650 for medical practitioners, with the unweighted average being around $385 a year.

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