Safeguarding confidentiality review

Learn more about the Ombudsman and Commissioner’s report and recommendations about the confidentiality of notifiers

Download the report

About the review

In late 2018 the Australian Health Practitioner Regulation Agency (Ahpra) requested that the Ombudsman and Commissioner conduct an independent review of the confidentiality safeguards for people making notifications about registered health practitioners.

The request was made after the conviction of South Australian general practitioner Dr Brian Holder for the attempted murder of pharmacist Kelly Akehurst. Ms Akehurst had made a notification to Ahpra about Dr Holder’s prescribing practices and it is thought that the notification was the motive for the crime.

While acts of violence against notifiers are rare, this experience threw a necessary spotlight on whether Ahpra’s handling of notifications adequately safeguards the confidentiality of notifiers.

The review's findings

The Ombudsman and Commissioner’s review found that Ahpra’s current approach offers reasonable safeguards for notifiers.

The Ombudsman and Commissioner concluded that it is preferable for Ahpra to share with the relevant practitioner all information it holds about a notification, including the identity of the notifier (if known). This means the practitioner is given the best opportunity to understand the notification and to respond, in detail, to the allegations that have been made. It also simplifies the way Ahpra manages notifications.

The Ombudsman and Commissioner also concluded that Ahpra’s current process of accepting confidential and anonymous notifications serves an important purpose. It is clearly in the public interest for Ahpra to be made aware of concerns about registered health practitioners, regardless of the source of those concerns or whether any additional steps need to be taken to keep the notifier’s identity confidential.

However, the Ombudsman and Commissioner identified that improvements could be made to the handling of notifications to better safeguard the confidentiality of notifiers.

Support services

Call Lifeline on 13 11 14

Call Beyond Blue on 1300 22 4636

Call Kids Helpline on 1800 55 1800

Health practitioners are also encouraged to contact support services available to their profession if needed.

Pharmacists’ Support Service

Call 1300 244 910

AMA Doctor Support Service

Call 03 9280 8722

Accessibility

To receive this report in an accessible format please email media@nhpopc.gov.au.

Downloads

Executive summary and recommendations

Safeguarding confidentiality review report

Media release: Ombudsman and Commissioner makes recommendations to safeguard confidentiality

Media release: Ombudsman and Commissioner welcomes progress on the implementation of all recommendations from her review

The Ombudsman and Commissioner’s recommendations

Consideration of confidentiality safeguards for notifiers

The Ombudsman and Commissioner recommended that Ahpra introduces a new step in the notifications process to proactively consider safeguarding the confidentiality of the notifier. Ahpra could mitigate risks of harm to notifiers by assessing on a case-by-case basis how the notifier’s personal information will be used and whether it is necessary to disclose the notifier’s identity to the practitioner in the first instance.

Improvements to the administrative management of confidential and anonymous notifications

The Ombudsman and Commissioner recommended that identified gaps in Ahpra’s policies, processes and staff training in relation to confidential and anonymous notifications be addressed, including by:

  • reviewing and updating Ahpra’s privacy policy and collection statement relevant to notifications
  • strengthening guidance for Ahpra staff regarding confidentiality safeguards for notifiers
  • improving how confidential and anonymous notifications are recorded in Ahpra’s electronic case management system (Pivotal) and, where possible, automating processes for managing confidential and anonymous notifications.

Improvements to communication about privacy and confidentiality for notifiers

The Ombudsman and Commissioner recommended that Ahpra reviews all communications about notifications and makes necessary amendments to ensure consistency in messaging about a notifier’s privacy. It was also recommended that Ahpra requires staff to have a verbal discussion with notifiers about how their personal information will be used and disclosed during the notifications process.

Consequences for practitioners who harm, threaten, intiminate, harass or coerce notifiers

The Ombudsman and Commissioner recommended that Ahpra develop guidance for staff about how to deal with information that suggests a practitioner has sought to harm, threaten, intimidate, harass or coerce a notifier.

Further, the Ombudsman and Commissioner recommended that Ahpra seeks an amendment to the Health Practitioner Regulation National Law to make it an offence for a registered health practitioner to harm, threaten, intimidate, harass or coerce a notifier.

Managing the risk of vexatious notifications

While the evidence suggests that vexatious notifications are rare, the Ombudsman and Commissioner recommended that Ahpra develops and publishes a framework for identifying and dealing with this type of notification.

Ahpra's response

The Ombudsman and Commissioner has welcomed Ahpra’s acceptance of all of her recommendations, which have been implemented or are in the process of being implemented.

View Ahpra’s response

View Ahpra's progress update

Progress update: one year on

The Ombudsman and Commissioner has welcomed progress on the implementation of all recommendations from her review into safeguarding the confidentiality of people making notifications about registered health practitioners.

On 27 May 2021 the Australian Health Practitioner Regulation Agency (Ahpra) and the National Health Practitioner Boards (the Boards) announced that all the Ombudsman’s recommendations have been implemented or are in the process of being implemented.

“I am pleased that Ahpra and the Boards have taken significant steps to strengthen and communicate the safeguards available to those who make a notification,” said Ombudsman and Commissioner Richelle McCausland.

“It’s essential that people feel safe to notify Ahpra and the Boards if they are concerned that a practitioner’s health, conduct or performance is putting the public at risk. Health practitioners also need to have confidence that they will be treated fairly if a notification is made about them.”

Several significant areas of progress include Ahpra and the Boards:

  • updating relevant policies to reflect that possible confidentiality safeguards for the notifier will be considered when assessing each new notification
  • publishing an updated privacy policy and collection statement to clarify how personal information will be used and disclosed (particularly in relation to confidential and anonymous notifications)
  • providing new guidance to staff about how to safeguard confidentiality, including in relation to redacting a notifier’s information and sharing a notifier’s information with the relevant practitioner.

The Ombudsman and Commissioner said that the publication of a new framework for handling vexatious notifications is a significant step forward for the National Scheme.

“Our complaints data suggests that it is rare that a notification is truly vexatious, meaning it is groundless and made with the intent to cause distress. However, we know that responding to notifications can be very stressful for health practitioners and this framework clarifies how Ahpra and the Boards will identify and handle vexatious notifications if they do occur,” said Ms McCausland.

Ahpra is awaiting further advice from Health Ministers regarding the recommended amendment to the Health Practitioner Regulation National Law to make it an offence for a registered health practitioner to harm, threaten, intimidate, harass, or coerce a notifier.

The Ombudsman and Commissioner said she is satisfied with Ahpra and the Boards’ progress and that her office has welcomed continued involvement and consultation following the review.

“I will continue to monitor issues related to confidentiality safeguards for notifiers. I encourage notifiers or practitioners to contact Ahpra to discuss any concerns and to reach out to my office about any unresolved issues,” said Ms McCausland.

Contact us

Read Ahpra's update

 

More information

Can’t find what you’re looking for? Give us a call on 1300 795 265