Atsumi's story

Atsumi, a practitioner, was required by a National Board to undergo a health assessment. This led to the Board imposing conditions on her registration that required her to undergo drug testing. She contacted our office because she was concerned about Ahpra’s initial phone call to her, the information Ahpra included in its brief to the health assessor and several aspects of Ahpra’s protocol for drug testing.

We decided to investigate Atsumi’s complaint. During our investigation, we obtained information related to Atsumi’s regulatory matter. We also obtained information and documents related to Ahpra and the Board’s health assessment process and Ahpra’s drug testing protocol more generally.

Our investigation found that Ahpra did not follow its internal guide on making initial phone calls to practitioners who are subject to an investigation when it first contacted Atsumi. This guide requires staff to advise practitioners that information they provide during a phone call with an Ahpra investigator may be used in relation to the investigation. Ahpra’s record of its initial phone call with Atsumi indicated that this did not occur. We provided feedback to Ahpra about this issue and Ahpra undertook to take steps to remind its staff to comply with the requirements of the guide.

Our investigation also found that Ahpra has an internal guide that provides information to its staff about how to prepare health assessment briefs. However, Ahpra’s brief regarding Atsumi’s health assessment was inconsistent with this guide. We considered that Ahpra’s brief included more information than was necessary for the health assessor to complete their assessment. We also found that the brief included information that could be seen to have biased the health assessor.

Ahpra informed our office that since the time Atsumi’s matter had been handled, it had introduced a specific team to prepare its health assessment briefs. We recognised that this would likely improve Ahpra staff’s adherence to its health assessment guide. Nevertheless, we provided feedback to Ahpra that it should ensure its staff are following the guide. We highlighted that this could be achieved by organising staff training on how to brief a health assessor. 

We also found that Ahpra’s protocol for drug testing was based on a 10-year-old report. Although the protocol had since been updated based on advice from an expert panel, we found that there had not been a comprehensive review of the protocol since it was first implemented. There was also a lack of transparency about changes to the protocol.

Following our investigation, we provided feedback to Ahpra about its drug testing protocol. We suggested Ahpra should consider:

• whether to commission an updated report

• adding a standing agenda item for the relevant expert panel’s annual meeting to review whether the protocol remains adequate and suitable, or advise on any changes required

• maintaining clear records of its decisions to change the protocol, including any supporting evidence

• whether the protocol could include more information to enhance its transparency.

Ahpra’s senior leadership and the relevant expert panel considered our investigation report. The expert panel decided to add a standing agenda item to review Ahpra’s protocol at each of its regular meetings. It also commenced a substance use disorder and professional regulation rapid response literature review. 

The review is considering the protocols and parameters used to identify and manage high risk professionals with a substance use disorder, including the regulatory approaches and substance detection limits used in professions such as aviation, mining and construction. This includes the regulatory approaches taken in Australian jurisdictions and in other countries.