1. What rules apply to unregistered health practitioners? Kieran Pehm Commissioner Health Care Complaints Commission

2. Inquiries and complaints

3. Complaints received about unregistered practitioners 2007-082008-092009-102010-112011-122012-13 Complaints about unregistered health practitioners 3241719976 114 % of all complaints about individual health practitioners 1.8%2.0%3.2%3.9%2.9% 3.9% % of all complaints1.0%1.2%2.0%2.4%1.8% 2.5%

4. What people complain about - unregistered providers (2012-13) Counted by issue

5. The role of the Health Care Complaints Commission

6. How are unregistered health practitioners regulated? As employees of health organisations –Accreditation procedures –Ministry of Health directives and policies for public facilities –Internal reviews (RCA, sentinel events etc.) –Health Care Complaints Commission Self-employed –Code of Conduct for Unregistered Health Practitioners –Health Care Complaints Commission –Public opinion, professional reputation

7.  August 2008: Code of Conduct for unregistered health practitioners came into force  October 2008: Commission issued first public statement in relation to the conduct of a radiographer  August 2013: Health Ministers agree to strengthen regulation of non-registered professions and develop a national Code of Conduct modelled on current NSW and SA codes, including provisions for mutual recognition of any orders. Background

8. Code of Conduct The intention of the code is to:  set out minimum practice and ethical standards  inform consumers of the standards they can expect  inform consumers how they can complain.

10. Code of Conduct 1.Health practitioners are to provide services in a safe and ethical manner 2.Health practitioners diagnosed with an infectious medical condition must take precautions to avoid transmitting it to clients 3.Claims to cure certain serious illnesses must not be made 4.Standard precautions for infection control to be in place 5.Appropriate conduct in relation to treatment advice (not dissuading clients from consulting registered practitioners; informed consent, cooperation with other providers, reporting of other providers)

11. Health Practitioners must: 6.Not practise under the influence of alcohol or drugs 7.Not practise with certain physical or mental conditions 8.Not financially exploit clients 9.Have a clinical basis for treatments 10.Not misinform their clients Code of Conduct - continued

12. Health Practitioners must also: 11.Not engage in a sexual or improper personal relationship with a client 12.Comply with relevant privacy laws 13.Keep appropriate records 14.Keep appropriate insurance 15.Display the Code of Conduct and information on how to make a complaint to the Commission. Code of Conduct - continued

13. Assessment decision notified to parties s28 Written complaint received Notification to provider s16(1) Assessment Referral to other body s26(1)b Referral to Resolution Service Discontinuation s27 Investigation s23 Complaints process - Assessment

14. Complaints process - Investigation Notify employer of investigation s28(2) Investigation s23 Refer to Director of Public Prosecutions Submission from practitioner s40 Public warning Place conditions Commission provides statement of decision s41B Appeal of decision allowable to the NCAT (within 28 days) Blanket prohibition order No further action Comments

15. Investigating complaints During an investigation evidence is gathered that may prove or disprove the issues raised in a complaint  The Commission considers advice from experts  The Commission has the power to obtain documents and information from health service providers and any other relevant persons  May interview the practitioner at a hearing.

16. Commission Powers During the investigation, the Commission has the power to issue a temporary prohibition order where it believes that the practitioner or service they provide pose a serious risk to public health and safety.

17. Commission Powers At the conclusion of its investigation, the Commission can make orders when it finds that the provider:  breached the code of conduct, or  has been convicted of an offence under Part 7 of the Public Health Act 2010, or  has been convicted of an offence under the Fair Trading Act 1987 (NSW) or the Competition and Consumer Act 2010 (Cth) & poses a risk to the health or safety of the public.

18. Commission Powers At the conclusion of an investigation, the Commission can:  issue a prohibition order  place conditions on the provision of health services  issues a public statement or warning about the practitioner and his or her services.

19. Outcomes of Investigations

22. Thank you! www.hccc.nsw.gov.au