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Issue 23 - June 2020
Welcome to our June newsletter. In the months since the last newsletter, the lives of all Australians have been affected, both personally and professionally. Government has put in place measures to protect the public in response to the challenges of COVID-19. It is pleasing that the recent data and modelling suggest these measures are working. As states and territories continue to reduce restrictions at a different pace, we encourage you to stay up to date with the latest information from the Commonwealth and your respective state and territory jurisdictional health directions and guidance about COVID-19. The Australian Government Department of Health provides information that is updated daily, including the current pandemic status, protection of yourself and others including appropriate infection control measures, and additional advice for the health sector. Please pay attention to your own health needs and those of your staff during this challenging period and take care during the weeks and months ahead.
Dr Wayne Minter AM Chiropractor Chair, Chiropractic Board of Australia
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The Board encourages all chiropractors to understand their obligations as a registered health practitioner. Under the National Law1, you have obligations that must be met in order to be registered and while practising. These include maintaining health records and advertising in compliance with the National Law.
Maintaining clear, appropriate, factual, objective and accurate health records is essential for continuing good care.
You can find detailed guidance in the Guidelines for clinical record keeping for chiropractors. These guidelines are supplementary to the information provided in section 9.4 of the Code of conduct for chiropractors and should be read in conjunction with the code.
You must create and maintain clinical records that serve the best interests of patients and contribute to the safety and continuity of their care. Keeping adequate clinical records is fundamental to the safe and effective care of a patient. Good clinical records may also be helpful in any investigation or dispute resolution.
It is your responsibility as a chiropractor to ensure that:
The Board is particularly concerned that during the ongoing COVID-19 pandemic there are claims in advertising that suggest spinal adjustments and/or manipulation can boost or improve general immunity or the immune system.
There is insufficient acceptable evidence to support such claims in advertising. Acceptable evidence mostly encompasses empirical data from formal research or systematic studies, in the form of peer-reviewed publications. Information about what constitutes acceptable evidence for advertising can be found in the Advertising resources section of the Ahpra website.
Advertising that there is a relationship between manual therapy (e.g. spinal adjustments and/or manipulation) and achieving general wellness or boosting or improving immunity contravenes the National Law and the Guidelines for advertising regulated health services.
Although many claims do not directly reference spinal adjustments and/or manipulation preventing or protecting from COVID-19, there is currently greater awareness of immunity issues and the public is seeking information on ways to prevent or protect themselves from the disease. Consequently, there is a greater risk that claims about spinal adjustments and/or manipulation boosting or improving general immunity may be interpreted to be claims about boosting or improving immunity to COVID-19.
Making claims in advertising that spinal adjustments and/or manipulation can boost or improve general immunity or the immune system is likely to result in regulatory action being taken by the Board.
1 The Health Practitioner Regulation National Law, as in force in each state and territory.
Ms Anne Burgess was first appointed to the Chiropractic Board of Australia in 2012. We asked Anne to tell us about her background, role as a community member and vision for the profession.
I trained as a social worker and spent the first half of my career working in mental health in hospitals, the community and with multidisciplinary teams. At the time there was fear and stigma surrounding mental illness and when I was appointed Director of Mental Health in my state that was the greatest challenge. I went on to have other statutory positions as Director of the Office for Women and Commissioner for Equal Opportunity. Since leaving full-time work … I’m on a mission to eradicate the word ‘retirement’ ... I’ve served on and chaired several boards and committees in the health, ageing and regulatory sectors. Looking back, there’s a theme of social justice that underpins my work.
I was approached to join the state-based Chiropractic Board before the start of the National Registration and Accreditation Scheme (National Scheme). I found the Board, like the boards of other health professions at the time, was struggling to put in place regulatory standards and practices that ensured the profession provided effective services to their patients. I found that work interesting and applied to join the National Scheme when a position became available.
All Board members have the same responsibilities for governance and regulation of the profession. The National Law recognises the importance of gaining a balance between the perspectives of a Board’s health practitioners and the views and expectations of the public, through the community members. As a community member I aim to bring an independent, unbiased eye to discussions and decisions, to listen, ask questions and play my part in protecting the public. I’ve always found my Board colleagues welcoming of that approach.
It’s really important to me that we work hard on our two main roles, to register only competent practitioners and to carefully assess any complaints. I’ve particularly valued the Board’s opportunities to meet practitioners at roadshows, presentations and workshops and the increased communication through e-newsletters and social media. It helps us to improve our regulatory tools and clarify our communication and, hopefully, helps practitioners understand the roles and responsibilities of the Board and comply with the codes and guidelines. I firmly believe, for example, that improvements in practitioners’ advertising will lead to better public understanding of chiropractic.
Chiropractic is governed in the same way as the other 15 health professions in the National Scheme. I hope that members of the public will feel confident that they can include a chiropractor among the suite of their health providers, knowing when that is appropriate for the treatment they require. I don’t think we’re there yet! In my view, to make these improvements it will take leadership by the profession, education of the public and other professions and willingness to continue to confront the issues. I am optimistic that this can be done!
The Board published its latest quarterly report in April covering workforce data from 1 January to 31 March 2020.
As at that date, there are 5,753 registered chiropractors, of whom 5,383 have general registration. There are 370 who have non-practising registration.
The workforce consists of 2,335 (40.6%) female and 3,416 (59.4%) male practitioners.
For further information, including data breakdowns by principal place of practice and age, visit the Statistics page on our website.
Ahpra has released a number of podcasts on areas of interest to all health professionals in the Taking care podcast series. The topics covered in the podcasts include pandemic and non-pandemic-related issues.
In a recent episode on Health practitioner wellbeing in the pandemic era and beyond, psychiatrist Dr Kym Jenkins, clinical psychologist Margie Stuchbery and Dr Jane Munro, a rheumatologist, share personal and professional insights on practitioner wellbeing. They discuss practical and evidence-based strategies to safeguard and support practitioners and teams through the COVID-19 pandemic and beyond.
Ahpra releases a new episode every fortnight. You can download on the Ahpra website or listen and subscribe on Spotify, Apple Podcasts and by searching ‘Taking care’ in your podcast player. Podcasts include:
National Boards, accreditation authorities and Ahpra, with the Australian Government through the Health and Education portfolios, have issued national principles for clinical education during the COVID-19 pandemic.
This unique multi-sector collaboration to protect Australia’s future health workforce is helping students learning to become health practitioners during the COVID-19 pandemic continue their studies and graduate.
Some student placements have been paused, cancelled or otherwise modified as health services respond to the pandemic. This has led to uncertainty and change for students and educators as education providers, accreditation authorities, clinical supervisors and others explore alternative options for students to progress towards graduation.
The principles aim to provide helpful guidance about how placements can occur safely, taking into account the significant changes across the health and education sectors due to COVID-19. Visit the National principles for clinical education during COVID-19 to find out more.
In April, the Australian Indigenous Doctors’ Association (AIDA) issued a media release detailing instances of medical practitioners denying Aboriginal and Torres Strait Islander people access to culturally safe healthcare. They were seeking testing for COVID-19. These cases in rural New South Wales and Western Australia involved refusal of care on the grounds of patient identity and racist stereotypes of Aboriginal and Torres Strait Islanders not practising self-hygiene.
Racism from registered healthcare professionals will not be tolerated, particularly given the vulnerability of Australia’s Aboriginal and Torres Strait Islander Peoples to the virus. They continue to experience prejudice and bias when seeking necessary healthcare. Discrimination in healthcare contributes to health inequity.
We encourage Aboriginal and Torres Strait Islander people who have experienced culturally unsafe incidents of care or refusal of care by a registered health practitioner to submit a notification or complaint to Ahpra.
In February 2020, the National Scheme’s Aboriginal and Torres Strait Islander health and cultural safety strategy 2020-2025 was released, proving our commitment to achieving patient safety for Aboriginal and Torres Strait Islander Peoples as the norm and the inextricably linked elements of clinical and cultural safety. The strategy strives to achieve the national priority of a health system free of racism.
We remind all registered health practitioners that they are required to comply with their profession’s Code of conduct, which condemns discrimination and racism in health practice.
Following a request from Australia’s Health Ministers, Ahpra and National Boards established a short-term pandemic response sub-register to help fast-track the return to the workforce of experienced and qualified health practitioners. The pandemic response sub-register came into effect on 6 April 2020 with over 40,000 doctors, nurses, midwives and pharmacists added in the first phase and an additional 5,000 diagnostic radiographers, physiotherapists and psychologists in the second phase later that month.
The register operates on an opt-out basis and anyone with a health issue that prevents them from practising safely or who will not have professional indemnity insurance arrangements in place was encouraged to opt out. So far over 35,000 practitioners remain on the sub-register.
There is no obligation for anyone added to the sub-register to practise or remain on it. They can opt out at any time for any reason.
Practitioners who choose to stay on the pandemic sub-register and go back to work, must comply with their profession’s Code of conduct, professional indemnity insurance requirements and work within their scope of practice. After 12 months, they will be removed from the sub-register. If they would like to continue practising after that time, they will need to apply for registration through the standard process.
Being added to the sub-register is the first step in returning to practice. We encourage practitioners to go to their state and territory health department website where they can express interest in joining their COVID-19 workforce. Employers, including health departments, will also play an important role by carrying out employment and probity checks and providing any induction and training that may be needed.
More information, including FAQs, for practitioners and employers is available on the COVID-19 information page.