December 2020

Issue 22

Chair’s message
Board news
Practice tips
- Safe needling on the thorax
- Change to TGA’s Permissible Ingredients Determination
Registration
Students and graduates
- Graduating soon? Here’s what you need to know about registration
- Recent graduates – call for volunteers!
National Scheme news
Keep in touch with the Board

Chair’s message

Distinguished Professor Charlie Xue

Welcome to the summer edition of our newsletter. Since the winter edition, our lives have continued to be disrupted and reshaped by the COVID-19 pandemic. Our planned 2020 roadshows were replaced by a highly successful webinar attended by over 550 registered Chinese medicine practitioners from across Australia: read more below.

We have a new section in our newsletter dedicated to students and graduates, and I would like to welcome all Chinese medicine students! You are an important part of the profession and we will include articles relevant to you as you progress through your studies. Congratulations to all graduating students, you can find helpful information on applying for first time registration below.

My third and final term as inaugural Chair of the Chinese Medicine Board comes to an end this year. I have been pleased to lead the Board in establishing Chinese medicine as an Australia-wide regulated health profession within the National Registration and Accreditation Scheme (the National Scheme). Read more below about other Board farewells and the retirement of our Executive Officer.

Best wishes for the Festive Season from the Board.

Distinguished Professor Charlie C. Xue

Chair, Chinese Medicine Board of Australia

Board news

Board farewells long-term members and Executive Officer

Our thanks to Di Wen Lai and David Graham

Ms Di Wen Lai, our practitioner member from Western Australia, will complete her third and final term in December. All of us on the Board thank Di Wen for her significant contributions to the Board’s work since its inception in 2011.

We also thank Dr David Graham, our community member from the ACT, Deputy Chair of the Board and Chair of the Board’s Policy, Planning and Communication Committee, who will also complete his term in December after six years of service.

Australia’s Health Ministers will announce the new make-up of the Board in the coming weeks, completing their scheduled end-of-term renewal and refresh process across several of the professions in the National Scheme.

Our thanks to Debra Gillick, Executive Officer

Our tireless Executive Officer, Debra Gillick, is retiring after almost 20 years of service to the profession, including as Registrar to the Chinese Medicine Registration Board of Victoria before the Chinese medicine profession joined the National Scheme in 2011.

Deb has been a dedicated and diligent health regulator – her expertise, quick wit and extensive knowledge will be missed not only by the Board and Ahpra but by many members of the broader Chinese medicine diaspora. We wish Deb all the very best as she moves on to the next chapter of her life, which she tells us will include spending much more time in her garden.

A farewell conversation with Distinguished Professor Charlie Xue

How is it you came to be interested in the regulation of Chinese medicine in Australia, and in the role of National Board Chair?

I became involved in regulation as early as 1995. At that time the Victorian government was reviewing the practice of Chinese medicine in Australia, which led to its regulation in Victoria. During that time, I learned a lot about the healthcare system and the requirements for a healthcare practice to be regulated. I am a big believer in public safety and protection.

I was a member of the Victorian board and eventually became the Deputy President. I was the first practitioner member to be given a leadership role of the Board − before that all presidents and deputy presidents were community members. I think that was a very good strategy and I learned much from the community members who led the Victorian board, to prepare myself for future leadership role.

My interest in becoming Chair of the Chinese Medicine Board of Australia (CMBA) was largely to see, through its regulation, Chinese medicine practice become more standardised, safer and more effective, and to ensure it meets the same public expectations as all other healthcare professions.

Which achievements are you most proud of in your time as Chair of the CMBA?

Introducing and implementing registration for Chinese medicine nationally within a very tight timeframe, while recognising the unique challenges in Chinese medicine including language issues, a lack of a culture of regulation and misunderstanding about the role of the regulator.

Always being mindful to be a responsible finance manager, making sure we do not introduce additional financial burden to a newly regulated healthcare profession. Initially we struggled with finances, but I think very quickly I simplified the committee structure, combined meetings and reduced travel and operational costs, so we were able to freeze fees from the 2014/2015 renewal process till now and we have just reduced the fees by 15 per cent. This was a real benefit for Chinese medicine practitioners over the last 5-6 years.

What is one thing you will remember about the people you engaged with while working in regulation for the benefit of the National Scheme?

Developing constructive and positive relationships with all the other Board Chairs and Ahpra. The support of the leadership group within the National Scheme has been fantastic, particularly the other Board Chairs, and I thank them for that.

What do you suggest are future challenges for the Chinese medicine workforce in Australia?

The workforce needs to continue to develop a better understanding of and capability to apply evidence-based practice. This is probably the single biggest challenge the Chinese medicine profession faces.

The profession must also continue improving clinical practice standards and working towards more workforce integration with other forms of healthcare in Australia. This is a challenge for all healthcare professions as we move increasingly to a patient-centred care approach.

Will you still watch with interest developments in Chinese medicine regulation and how might you play an active role in this work?

I will definitely still watch with interest the developments in Chinese medicine regulation and how things evolve. I always believe in quality leadership and after almost 10 years in this role, it’s time for others to come in and have a fresh look and lead Chinese medicine regulation to the next level.

Chinese Medicine Reference Group update

At a recent meeting of the Board’s Chinese Medicine Reference Group (Reference Group) members noted the likely increased interest in, and use of, Chinese medicine by consumers for general wellbeing as a long-term outcome of the COVID-19 pandemic, and the need for early preparedness across all sectors of the healthcare network.

Among other presentations, there was an industry update about the development of a voluntary wholesalers’ code of practice for herbal product supply to Chinese medicine practitioners. The code aims to encourage standard practice among suppliers. You can read more in the Reference Group’s communiqué.

Virtual roadshow 2020: recording now available online

On 13 October, Board Chair Dist. Professor Charlie Xue led a webinar on Chinese medicine regulation in Australia. The webinar replaced the Board’s usual annual stakeholder engagement roadshow, which couldn’t happen this year due to COVID-19 restrictions.

The Board thanks the more than 550 registered practitioners who attended. We were happy to receive and respond to some very interesting questions.

If you missed the webinar or would like to view it again, you can find a recording, the presentation and FAQs on the Board’s website.

Have your say – upcoming consultations on guidelines

Draft revised Guidelines for infection protection and control for acupuncture practice and Guidelines for the safe use of herbal medicines are expected to be released for public consultation by the Board in early 2021 for at least eight weeks.

There is no change to the rules but rather, the documents have been updated with the latest information and made clearer and easier to understand. In the meantime, the existing guidelines remain in force.

Guidelines published by National Boards are widely consulted on during their development and provide clarity around the requirements of the National Law. We would be very pleased to receive your feedback on the guidelines.

Telehealth guidance for practitioners

Registered health practitioners are playing a vital role in treating and containing the novel coronavirus that causes COVID-19. This is an unprecedented situation and we know you are working hard to keep people safe in a demanding and fast-changing environment.

Ahpra and the Board have developed information which outlines our expectations of how Chinese medicine practitioners will use telehealth in the context of the COVID-19 pandemic. This guidance is for all registered health practitioners.

Annual report summary of Chinese medicine for 2019/20: regulating during a pandemic

Each year the Australian Health Practitioner Regulation Agency (Ahpra) and the National Boards publish an annual report and the Board publishes a separate snapshot of the Chinese medicine profession. Please take a look at our summary of statistics and regulation activities for 2019/20 in our news item.

Practice tips

Safe needling on the thorax

An educational resource on safe needling on the thorax, preventing pneumothorax, can be accessed on the Presentations page of the Board website.

The Chinese Medicine Council of NSW produced the video with assistance from the Board. It was developed in response to several notifications (complaints) received that related to pneumothorax incidents in recent years. The video is accompanied by two research papers on pneumothorax.

Change to TGA’s Permissible Ingredients Determination

The Board recently received correspondence from Adverse Event and Medicine Defect Section at the Therapeutic Goods Administration (the TGA) informing us of the TGA’s recent regulatory decision to cancel listed medicines that contain the herbal ingredient Fallopia multiflora.

The TGA further intends to remove Fallopia multiflora from the Permissible Ingredients Determination, meaning that it will no longer be permitted as an ingredient in listed medicines.

The TGA has taken these actions following an investigation into the potential for Fallopia multiflora to cause herb-induced liver injury. The TGA concluded that the risk of liver injury cannot be adequately mitigated, and as such the safety of Fallopia multiflora was not consistent with the listed medicines framework. Practitioners must be aware of the risk associated with Fallopia multiflora and consider alternatives to this herb.

Registration

Have you renewed your registration? Renew online now

The late period for registration renewal is in effect until 31 December. If you have not yet renewed the quickest and easiest way to do is online.

If you apply to renew your registration in December, you will have to pay a late payment fee as well as the registration fee. The Board has decreased the registration fee to $492, a 15 per cent decrease from last year’s fee. The fee for practitioners whose principal place of practice is New South Wales (a co-regulatory jurisdiction) is $403. A full fee schedule is published on the Board’s website.

If you do not apply to renew your registration by 31 December 2020, your registration will lapse. Your name will be removed from the national register of practitioners and you will not be able to practise as a Chinese medicine practitioner in Australia until a new application for registration has been processed and the national register is updated.

COVID-19 updates for registration renewal

Ahpra and National Boards are working with government, health services and others to support health practitioners during the COVID-19 pandemic. We have adapted our regulatory approach to support you in these exceptional circumstances. Your registration fees go directly to funding this work and regulating for safety in your profession. We sincerely thank you for your continuing commitment and professionalism.

What if I can’t meet the CPD requirements for this registration period because of COVID-19?

We encourage you to continue to do continuing professional development (CPD) that is relevant to your scope of practice and your current work environment. However, we understand that some health practitioners may have trouble meeting the CPD requirements during this challenging time.

If you can't meet the CPD standard because of the COVID-19 emergency, then we won't take any action for the registration period during which the COVID-19 emergency is in force.

What about recency of practice?

You are also strongly encouraged to meet the recency of practice requirements. If you are unable to meet the recency of practice standard due to COVID-19, we will not take action. Recency of practice requirements will need to be met when practitioners apply for renewal in 2021. More information is published on the COVID-19 updates All profession information page.

We also expect practitioners to comply with their professional obligations, including to recognise and work within the limits of their competence and scope of practice and to maintain adequate knowledge and skills to provide safe and effective care.

You should answer all renewal questions honestly and accurately and tell us whether you did or didn't meet the CPD and recency registration standards' requirements. Ahpra and the Board will not take action if you could not meet the requirements of either of these two standards in 2020 because of COVID-19.

What’s different about registration this year?

Advertising declaration and audit

You are required to complete a new declaration that your advertising complies with Health Practitioner Regulation National Law (National Law) advertising requirements.

This is part of a risk-based approach to enforcing the National Law’s advertising requirements and compliance by registered health practitioners who advertise their services and will include auditing of health practitioners to check advertising compliance.

Download your registration certificate and tax invoice

Another change this year is that paper certificates are no longer issued, but you can print a registration certificate from your online services account any time after you’ve renewed. You can also download your tax receipt.

Latest workforce data released

The Board has released its latest quarterly workforce data report, covering the period 1 July to 30 September 2020. At that date, there were 4,933 registered Chinese medicine practitioners in Australia.

Registration type by principal place of practice

Registration types	ACT	NSW	NT	QLD	SA	TAS	VIC	WA	No PPP	Total
General	71	1,911	11	851	183	43	1,250	247	50	4,617
General and Non-practising		2		1	1		1	1		6
Limited		1								1
Non-practising	3	84	2	47	12	1	72	11	77	309
Total	74	1,998	13	899	196	44	1,323	259	127	4,933

For more information, including registration data by age and gender, visit our Statistics page.

Students and graduates

Graduating soon? Here’s what you need to know about registration

This year’s graduate registration campaign is underway. If you're set to complete your course within the next three months, apply now! See the Board’s news item for everything you need to know, including helpful tips, links to guidance documents and our video for graduating students.

The COVID-19 pandemic has affected many aspects of our lives including clinical placements for students. Ahpra is taking COVID-19 into account in this year’s campaign.

Avoid delays with your application

Check out the resources on the Graduate applications page of the Ahpra website before you submit your application. This will help ensure your application is complete, so we don’t have to come back to you seeking clarification or more information. We can then get you registered as soon as we receive your graduate results.

Contact us if you are experiencing financial hardship

Some recent graduates may be experiencing financial hardship because of loss of casual or part-time employment in industries disproportionately affected by the pandemic. There may also be changes in financial circumstances in the graduate’s immediate household.

If you are experiencing financial hardship and are unable to pay the required fees, please contact the Ahpra Customer Service team via web enquiry or on 1300 419 495 to discuss your individual situation before you complete your online graduate application. You can start your application online and pause it if you need to contact us about financial hardship.

Graduate experience survey and service improvements

Last year Aphra conducted the first ever survey of new graduates to hear about their experience registering for the first time. We contacted just over 24,000 graduates and had a great response rate of over 15 per cent to the voluntary survey.

We’re very grateful to those graduates who participated, their feedback will help us improve the experience for this year’s graduates. Some of the improvements we’re making include:

emailing graduates with updates to complement the online application tracker and give more detail about where your application is at in the assessment process, and
providing more guidance on how to correctly certify photo identity documents.

We hope this will make first-time registration a smoother, less stressful experience.

Recent graduates – call for volunteers!

The Board and Ahpra are looking for recent graduates from approved Chinese medicine programs of study to test newly developed multiple-choice questions (MCQs). The MCQs form part of the Board’s regulatory examination and by helping us test questions you’ll be helping us keep the public safe.

The pilot examination will run at the end of January 2021 and all volunteers will receive a gift card in acknowledgement of your time and effort. If you’re a recent graduate and interested in helping, you can read more and sign up to help in the Board’s recent news item.

National Scheme news

Lend us your ears

Have you tuned into Ahpra’s podcast, Taking care? Listen to conversations with practitioners, patients, advocates and thought leaders discussing current issues, innovations and how the healthcare system works to keep the public safe.

Tune in to episodes about topics such as telehealth, practitioner wellbeing, the impact of the pandemic, and rural and remote practice. A recent episode,Collaboration across professions: Aboriginal and Torres Strait Islander Health Practitioners, hears from the Chair and practitioner member of the Aboriginal and Torres Strait Islander Health Practice Board; a dual registered Aboriginal health practitioner and nurse; and a GP and a midwife, about the importance of Aboriginal and Torres Strait Islander Health Practitioners in our healthcare system.

Now is a great time to download and listen to the latest Ahpra Taking care podcast, or pick any episode from our catalogue! You can also listen and subscribe on Spotify, Apple Podcasts and by searching ‘Taking care’ in your podcast player.

Taking care podcast image July 2020

Revised advertising guidelines are now available

Do you advertise your services? Health practitioners are encouraged to check and correct their advertising to make sure it complies with revised guidelines before they take effect on 14 December 2020.

The National Boards and Ahpra have jointly revised the Guidelines for advertising a regulated health service (the guidelines) as part of a scheduled review in line with good regulatory practice.

The guidelines aim to help registered health practitioners, and other advertisers, advertise responsibly so that the public receives accurate and clear information about regulated health services.

Changes to the guidelines include:

more content about testimonials, protected titles and claims about registration, competence and qualifications
new content about the evidence required for claims about the effectiveness of a regulated health service and what is acceptable evidence
restructuring of content so that information is easier to find, and
new flowcharts to help assess when advertising needs to be supported by acceptable evidence and whether a review is considered a testimonial.

The National Boards and Ahpra have also updated the Advertising compliance and enforcement strategy for the National Scheme following an evaluation in 2019. The strategy was launched in 2017 to improve voluntary compliance with the advertising requirements and to introduce a new enforcement approach to non-compliance.

Appropriate use of social media during the pandemic

Ahpra and the National Boards appreciate the importance of a vigorous national debate on public policy during the COVID-19 pandemic. However, we remind all registered health practitioners that their obligation to comply with their profession’s Code of conduct applies in all settings – including online.

The codes of conduct emphasise that practitioners must always communicate professionally and respectfully with or about other health care professionals.

We have received concerns about the conduct of some health practitioners engaged in online discussion, including in semi-private forums.

Community trust in registered health practitioners is essential. Whether an online activity can be viewed by the public or is limited to a specific group of people, health practitioners have a responsibility to maintain professional and ethical standards, as in all professional circumstances.

In using social media, you should be aware of your obligations under the National Law* and your Board’s Code of conduct. For more information see: Social media: How to meet your obligations under the National Law. Anyone with concerns about the online conduct of a health practitioner can contact 1300 419 495 or make a notification

*Health Practitioner Regulation National Law, as in force in each state and territory.

New guide to increase transparency in regulatory decision-making

We have published a new guide explaining how National Boards and Ahpra apply the National Law in the management of notifications about a practitioner’s performance, conduct or health. The guide aims to make it easier to understand how and why decisions are made.

The Regulatory guide and an executive summary are available on the Corporate publications page on the Ahpra website.

Resetting our approach to investigations

National Boards and Ahpra stand for safe, professional healthcare practice.

All health practitioners and the workplaces at which they practise have roles to play in ensuring public safety. We are improving the way we manage our regulatory investigations about practitioners to better account for our collective responsibilities.

We know that the public are best protected when we support practitioners and their employers to improve safety and professionalism in the delivery of health services. Our efforts and resources should better focus on matters where there are gaps in safe practice that create ongoing risk to the public.

Our revised approach, in place now, aims to improve the experience of notifiers and practitioners by completing most investigations faster. There is a stronger focus on speaking directly to the practitioner. This is so we can gather early information about the practitioner’s inpidual practice, reflection and their actions in response to notified events. This is key to:

closing concerns about low risk practitioners faster, and
concentrating our investigations on practitioners that represent higher risk.

Practitioners can help with this by:

engaging the supports they need through the process, including indemnifiers and/or professional associations and colleges
providing Ahpra with the information it needs as early as possible, and
giving their employer permission to share information about them with Ahpra to help validate what the practitioner has told us.

We also want to understand what a practitioner’s workplace has done in response to the events.The level of information we need to gather is more wide ranging when the concerns raised could constitute professional misconduct. This includes boundary violations, criminal and unethical behaviour, and significant departure from acceptable standards.

The National Board will take action in response to a concern, when the actions of an individual practitioner and/or their workplaces are not sufficient, to ensure we can prevent the same thing happening again.

More information is available on Ahpra’s Concerns about practitioners page.

Social research results: perceptions of Ahpra and National Boards, including CMBA survey

Ahpra and National Boards have released results from the second annual survey of stakeholder understanding and perceptions of our role and work. The results help us to better understand what the community, regulated health professions, and our stakeholders think and feel about us, particularly in areas of understanding, confidence and trust. The insights gained will inform how we can improve our engagement with both the professions and the community.

The report provides the results from anonymous surveys conducted in late 2019 of a random sample of registered practitioners and a random sample of members of the public across communities in Australia. There were nearly 6,000 responses from practitioners and 2,000 from the broader community. Both surveys were managed by an independent consultant.

Overall, the results show positive perceptions of Ahpra and National Boards. The surveys were, in the main, the same as ones carried out in 2018 and enable comparison of changes in awareness and sentiment over the period. The Chinese Medicine Board also published a report on the results of the online survey of registered Chinese medicine practitioners.The reports in PDF format are available in the news item.

Keep in touch with the Board

Visit the Chinese Medicine Board website for news about the profession, information on the National Scheme and for registration standards, codes, guidelines, policies and fact sheets.
Read the National Board communiqué each month on the website: these publications inform everyone of the decisions made at the Board’s monthly meeting.
Lodge an online enquiry form.
For registration enquiries call 1300 419 495 (from within Australia) or +61 3 9285 3010 (for overseas callers).
Address mail correspondence to: >Sylvia Sanders, Acting Executive Officer, Chinese Medicine Board of Australia, GPO Box 9958, Melbourne VIC 3001.