May 2019

Issue 17 - May 2019

Chair’s message
Board news
Registration
- Latest registrant data released
Regulation at work
- Dental assistant successfully prosecuted, convicted and fined
National Scheme news
Keep in touch with the Board

Chair’s message

Murray Thomas Welcome to our latest newsletter.

At the beginning of May, I attended the Australian Dental Association’s Congress 2019 in Adelaide. I congratulate the ADA, the organisers, presenters, support staff, dental trade and delegates attending from the complete dental team for making the event such a successful and valuable learning opportunity. It was encouraging to see participants from all divisions of the dental profession register.

Life-long adult learning is a rewarding gift that health professionals should embrace. It sends a strong signal to patients, consumers and regulators that practitioners are maintaining the expected high standard in their professional practice.

Continuing professional development (CPD) is how members of the profession maintain, improve and broaden their knowledge, expertise and competence, and develop the personal and professional qualities required throughout their professional lives. Make sure you are aware of the annual requirements by reading the CPD registration standard.

CPD programs alone cannot be used to increase scope of practice. You cannot become or practise as a dentist unless you have completed an approved program for registration as a dentist. For an update on the revised Scope of practice registration standard, read the story below.

Practitioners doing CPD often combine a variety of learning methods, including self-directed learning, goal-based learning and problem-based learning, adopting a hands-on approach. The effectiveness of CPD depends primarily on how carefully you conceive, plan and implement the skills/knowledge acquired through your learning experiences.

Tell me and I forget, teach me and I may remember, involve me and I learn. Benjamin Franklin

Murray Thomas
Chair, Dental Board of Australia

Board news

Update on scope of practice

Many of you will be keen to hear an update about the progress of the Board’s proposed revised Scope of practice registration standard.

The Board submitted the proposed revised standard to the government in late 2018, and on 8 March 2019, the Chair of the Board and the CEO of AHPRA briefed Health Ministers on the proposed changes at their meeting in Adelaide.

At that meeting Health Ministers agreed to refer the proposed revised standard to the Australian Commission on Safety and Quality in Health Care (the commission), and to report back to Health Ministers at their next meeting in July 2019.

We are sharing all relevant background materials with the commission to support the independent review of the standard.

We are continuing our engagement work to support the implementation of the proposed revised registration standard and will keep dental practitioners informed about progress, including on the work of the commission.

In our recent discussions with dental practitioners, professional associations, and state and territory dental directors, we have responded to several questions and misunderstandings about what the proposed changes will mean in practice. In response to the feedback, we are working to strengthen the revised guidelines to clarify what the changes mean for practitioners in each division of registration.

Results of discussions and feedback

Some key points the Board will reinforce in the revised guidelines include:

The proposed changes will not alter the scope of practice of any registered dental practitioner − dentists, dental hygienists, dental prosthetists, dental therapists and oral health therapists. The scope of practice of each division of dental registration is described in the revised guidelines and detailed in the professional competencies for each division developed by the Australian Dental Council.
The proposed changes will not allow dental practitioners from the other four divisions − dental hygienists, dental prosthetists, dental therapists and oral health therapists − to become or practice as a dentist, through continuing professional development (CPD) courses. CPD programs may improve or broaden a practitioner’s knowledge or provide experience in a technique or procedure within their scope of practice.
The current requirement for a structured professional relationship does not include supervision – but is a referral and management framework only. All dental practitioners are still required to work within their scope of practice and refer when necessary, which is made clear in the revised standard and the Board’s Code of conduct.
You are registered health professionals, and the proposed changes to the Board’s Scope of practice registration standard will strengthen your responsibility to ‘know your own scope of practice’.

Consumer input and reaction to the changes

We are also working with AHPRA’s Community Reference Group to develop consumer-focused messages about the changes, and they will advise on which consumer groups will be interested to know about the proposed changes.

We expect that consumers will continue to seek a primary relationship with their dentist because there remains a broad range of complex conditions that only a dentist can diagnose, plan for and manage. The proposed change will, however, empower consumers to exercise an increased choice of interaction within the dental team.

Caring for you – a practitioner support service for every dental practitioner

The Board is planning a dental practitioner support service for every registered dental practitioner and dental student in Australia. This is something we have been considering for some time and we made it a key initiative for FY 2019/20 at our November 2018 planning day.

The support service will be a confidential information and referral service, available nationally for those dental practitioners and students who may be experiencing health-related issues or life stresses.

The service is an opportunity for the Board to support the profession and protect the public by enabling timely, lifesaving information and referral to support services. It will help dental practitioners and students seek early, confidential assistance in the management of their health and wellbeing.

This work gives us an opportunity to work collaboratively with professional associations who can help inform the development of the service. It is also an opportunity for professional associations to work with each other to promote the importance of all dental practitioners looking after their health and wellbeing and seeking help when they need it.

The Board’s next steps will be to complete more detailed scoping of the options for the support service, and host and coordinate a roundtable with professional associations and the Australian Dental Council (ADC) in September 2019.

Alert – issues with hand-held nitrous oxide device

The Board was recently alerted to patient and community safety concerns about the availability of a hand-held nitrous oxide device. Earlier this year, the device was marketed to dentists. The concerns raised about the device were that it lacked some important safety features and posed an increased risk of leading to hypoxia of a patient during its use. Some people also thought that some of the guidance for patient selection may not be appropriate.

We had further discussions about the risk to the safety of the public with the Australian Dental Association (ADA) and also sought advice and guidance from the Therapeutic Goods Administration (TGA) about this device. We understand that the retailer has voluntarily suspended the sale of the device pending further advice from the relevant regulator.

The Board reminds dental practitioners to act professionally and exercise clinical judgement when you are introducing new devices and procedures into your practice.

Registration

Latest registrant data released

The Board has published its quarterly data report for 1 January-31 March 2019. There are 23,629 registered dental practitioners, a decrease of 85 on the figures from the 1 October-31 December 2018 report. Of the total, 17,675 are dentists.

There are 98 practitioners endorsed for conscious sedation.

The gender balance nationally for all dental practitioners is 51.8% female (12,243), 48.2% male (11,386). Of the female practitioners, 491 have specialist registration. Of the male practitioners the number of specialists is 1,270.

For further details on registration by division, gender, age, principal place of practice and specialty, visit our Statistics page.

Regulation at work

Dental assistant successfully prosecuted, convicted and fined

A Victorian woman was recently convicted over charges laid by the Australian Health Practitioner Regulation Agency (AHPRA).

A New South Wales Local Court convicted dental assistant Ms Sara Matthews of offences under the National Law¹ and fined her $4,000 after she pleaded guilty to three charges filed by AHPRA. She was also ordered to pay AHPRA’s costs of $3,025.

Ms Matthews pleaded guilty to one count of unlawfully claiming to be authorised or qualified to practise in a health profession; in this case, dentistry; and two counts of performing restricted dental acts.

Ms Matthews has never held registration as a registered health practitioner or student under the National Law with any National Board, including the Dental Board of Australia.

On 30 July 2018, AHPRA filed charges against Ms Matthews alleging that when employed as a dental assistant at the Good Teeth Dental Clinic in Kiama, NSW, she performed restricted dental acts, including fitting and/or adjusting artificial teeth and braces for two patients. Ms Matthews was also charged with knowingly or recklessly using the description ‘dental assistant’ to imply that she was authorised or qualified to practise the dental profession.

The conviction is another example of regulation working to protect the public. Someone who claims to be a registered practitioner when they are not represents a real risk as they are neither qualified to assess a patient’s suitability for the treatment, nor are they able to intervene should an emergency arise. AHPRA takes reports of this kind of offending very seriously and, where appropriate, will prosecute in the criminal courts.

Dental Board of Australia Chair Murray Thomas said, ‘Being a dental assistant does not mean you can perform procedures on patients that should be performed by a registered dental practitioner. Doing so is dangerous and reckless. When this does happen, it is patients who feel duped and betrayed.

‘My advice to the public is to check using online register of practitioners. There you will find the name of every registered dental practitioner in Australia. It is better to be safe and check that your practitioner is listed. A practitioner who is registered has met the Board’s requirements for registration and they have the experience and qualifications to provide patients with care.’

1 The Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).

National Scheme news

Legislative amendments on mandatory reporting and fake practitioners

The Health Practitioner Regulation National Law and Other Legislation Amendment Act 2019 (Qld) (the Act) was passed by the Queensland Parliament. The amendments include revisions to the mandatory reporting requirements for treating practitioners and an extension of sanctions for statutory offences.

The changes to the National Law intend to support registered practitioners to seek help for a health issue (including mental health issues). They will also increase the penalties (including the introduction of custodial sentences) for some offences under the National Law, including where a person holds themselves out to be a registered health practitioner when they are not.

AHPRA and National Boards will now work to implement these amendments. This will require working closely with professional bodies, employers and state and territory health departments to help spread the message that practitioners should be supported to seek help about their health issues.

The passing of the Act in Queensland marks the second set of legislative amendments to the National Law since the start of the National Scheme in 2010. When they take effect, the amendments will apply in all states and territories except Western Australia, where mandatory reporting requirements will not change.

Read a news item about the amendments on the AHPRA website or the Act on the Queensland Legislation website.

The Board wishes to remind all dental practitioners of their obligations about mandatory reporting. You can find Guidelines for mandatory notifications and further guidance on notifications on the Board’s and AHPRA websites.

National Boards and AHPRA host research summit

The National Registration and Accreditation Scheme 2019 Research Summit took place on 27 February 2019 at the Melbourne Convention and Exhibition Centre.

The summit asked how research can be harnessed to strengthen regulation and improve patient safety to contribute to improved health outcomes.

Led by AHPRA and the National Boards, the all-day Research Summit hosted 17 speakers and drew more than 300 participants from national, state and territory board and committee members, AHPRA staff, co-regulatory bodies, representatives from accreditation authorities and key partners.

With the theme ‘Optimising research for regulatory effectiveness’, the Research Summit explored the National Scheme’s evolving approaches to risk assessment, lessons from research into notifications, and future opportunities to use smart data. At the heart of discussions was asking how we can use data and research to improve regulatory processes and, ultimately, contribute to safer care for patients.

Professor Zubin Austin from the University of Toronto, Canada, was a keynote speaker. His stirring address highlighted that competency assessment has emerged as a dominant issue for regulators, educators and employers worldwide. Professor Austin called for more attention to be focused on notions of teamwork, emotional intelligence, and genuine practitioner engagement as important concepts in defining and evaluating competency.

Read more in the media release about the summit.

‘Let’s talk about it’ videos launched

AHPRA has launched a series of new videos to support the public and registered health practitioners as they go through the notification process.

The video series, called ‘Let’s talk about it’, explains what happens when concerns are raised with the regulator, gives easy-to-follow information about the notifications process and addresses common questions, so consumers and health practitioners know what to expect when they interact with AHPRA and National Boards.

There are three videos:

A notification has been made about me features five health practitioners who work within the National Scheme and is directed at health practitioners who have had a notification made about them.
I have a concern, am I in the right place? is targeted at members of the public who have a concern but aren’t yet sure whether AHPRA is the right place in which to raise it.
I have raised a concern with AHPRA provides information for individuals who have just raised a concern with AHPRA.

The videos sit alongside other written resources available on our website, see: www.ahpra.gov.au/Notifications.

You can view the videos on the AHPRA and National Board websites or from our YouTube and Vimeo channel, and join the conversation by following AHPRA on Facebook, Twitter or LinkedIn: use the hashtag #letstalkaboutit and tag @AHPRA.

Titles in health advertising – how to get it right

A new resource to help practitioners understand their legal obligations when using titles in health advertising addresses the uncertainty some dentists might have around this issue.

Misuse of a protected title, specialist title or endorsements is an offence under sections 113-119 of the National Law or may constitute behaviour for which health, conduct or performance action may be taken against a registered health practitioner under Part 8 of the National Law.

However, advertisers should also be aware that while the use of some titles may not necessarily breach title protections under sections 113-119, they may be considered false, misleading or deceptive under the advertising provisions in the National Law (section 133).

The titles tool will help practitioners understand how titles can be used in advertising. It also outlines some of the common pitfalls that can result in titles being considered misleading under the National Law.

The titles tool is the latest in a series of resources and support materials developed by AHPRA and National Boards to help health practitioners, healthcare providers and other advertisers of regulated health services check and correct their advertising so it complies with the National Law.

The titles tool is available in the Advertising resources section of the AHPRA website.

Health Ministers announce a review of the practice of spinal manipulation

Health Ministers announced an independent expert review on the practice of spinal manipulation for infants and young children following the COAG Health Council’s March meeting.

The review will be carried out by Safer Care Victoria. It will focus on the risk of harm and adverse events, and the current best evidence for the efficacy of spinal manipulation to treat childhood illnesses or health concerns in infants and young children.
National Boards do not define the types of treatments in which a registered health practitioner may choose to be qualified and competent to carry out in their chosen scope of practice.

Under the National Law, only registered chiropractors, medical practitioners, osteopaths and physiotherapists are permitted to manipulate the cervical spine when treating patients.

The National Law says that manipulation of the cervical spine means ‘moving the joints of the cervical spine beyond a person’s usual physiological range of motion using a high velocity, low amplitude thrust’.

AHPRA and the National Boards regulating the professions able to carry out cervical spinal manipulation support the independent review and await its outcome and recommendations with keen interest.

Read more in the COAG Health Council’s March communiqué.

Keep in touch with the Board

As always, we encourage you to regularly check the Dental Board website for information and updates relating to the dental profession.

Visit our website for information on the National Scheme and the mandatory registration standards, codes, guidelines, policies and fact sheets. Board communiqués and consultation papers are published on the site under News.
Lodge an online enquiry form.
For registration enquiries call 1300 419 495 (from within Australia) or +61 3 9275 9009 (for overseas callers).
Address mail correspondence to: Executive Officer, Dental Board of Australia, GPO Box 9958, Melbourne VIC 3001.