November 2022

Issue 21 - November 2022

• Chair’s message
• Priority news
• Registration renewal is open – renew now to avoid late fees
• Board news
• Graduates – apply for registration now!
• Professional indemnity insurance alert
• Clinical decision-making in practice
• Meet your Board
• Benjamin Graham, community member from the Australian Capital Territory
• Registration news
• Practitioners opt in to extend their registration on the pandemic sub-register
• Latest workforce data released
• Extension of temporary acceptance of additional English language tests for registration applicants
• What’s new?
• Cosmetic surgery complaints line and online hub launched
• New Resources hub makes finding information easy
• Latest podcasts – listen up!
• National Scheme news
• Keep in touch with the Board

Chair’s message

We have had a busy program of work this year, with the publication of the Supervised practice framework and the shared Code of conduct along with resources for practitioners and consumers. See more below about the new code, and how the resources can aid you in practice.

Engaging with our stakeholders has been a strong theme. In September, I gave a webinar to this year’s final year optometry students called Ready to work: your obligations as an optometrist. The webinar focused on Board requirements such as recency of practice, criminal history declarations and other mandatory requirements. You can view the recording on our website.

In October we met face to face for the first time in two years with our Optometry Regulatory Reference Group, which includes stakeholders in the optometry profession.

Judith Hannan
Chair, Optometry Board of Australia

Priority news

Registration renewal is open – renew now now to avoid late fees

Optometrists have until 30 November 2022 to renew their general or non-practising registration on time.

We encourage you to renew now to avoid delays during the busy renewal period. Renewing on time also means you’ll avoid late fees which apply from 1 December 2022.

Look out for an email from Ahpra providing access to online renewal.

Read more in the news item.

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Board news

Graduates – apply for registration now!

Optometry graduates set to complete their course this year can take the first step in their new career by applying for registration now. Applying before you finish your studies means we can start assessing your application while we wait for your graduate results.

Registration with the Board is required before you can start work – and means you can work anywhere in Australia. Check out our webinar recording, Ready to work: your obligations as a registered optometrist.

You’ll find helpful advice, tips for avoiding common causes of delay and downloadable information flyers on the Graduate applications page of the Ahpra website. On that page, you can watch a video, Applying for graduate registration, and check out the accompanying flyer, Quick guide: how to apply.

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Professional indemnity insurance alert

A reminder to check your professional indemnity insurance (PII) cover!

The Board has seen a number of PII cases where there has been a period without cover. These cases have either been discovered at audit, or after declarations to Ahpra.

You must have appropriate PII to practise. Please check that your PII policy is current and paid because PII lapses can easily occur. In optometry, PII is usually provided as part of membership of a professional body, through your employer or directly from an insurer. Not all employers will cover your PII and it’s your responsibility to check.

Some recent cases where a practitioner’s PII has lapsed include the following scenarios:

• New graduate or locum optometrist assuming and not checking with an employer that they are covered by PII
• Reminders haven’t been received, have ended up in junk mail or been sent to an old email address
• Credit cards with a direct debit set up to pay PII have been cancelled, stolen, hacked or details have been changed, resulting in a cancelled policy
• A third party which is responsible for paying PII invoices has paid late, or not at all, resulting in a period without cover
• Change of providers has left a gap in cover
• Not enough money in a bank account to pay a PII direct debit, resulting in a cancelled policy.

Important points for optometrists about PII

It is a registration requirement that you are covered by PII – this can either be your own arrangement or via a third party, such as an employer.

See the Professional indemnity insurance arrangements registration standard.

• Practising without any or adequate indemnity insurance is taken seriously by the Board and will be investigated, because it is a statutory requirement to hold PII
• Failure to have insurance is never seen as an administrative oversight – it is a professional responsibility to ensure you have PII
• You must notify the Board within seven days if you no longer have appropriate PII
• Practising without indemnity insurance calls into question an optometrist’s commitment to patient safety
• It is important that patients can recover any compensation they might be entitled to in the event of a successful claim
• PII can potentially have consequences for the wider public interest, which include the reputation of the profession and upholding standards of conduct and behaviour
• Most optometrists are in private practice and are individually responsible for their own PII
• Do not base your annual declarations about PII on a guess – always check.

Tips to prevent PII shock

• Don’t assume without checking that an employer has your PII covered, if you don’t have your own
• Check annually if your employer holds insurance for you
• Set reminders in your calendar about renewing PII
• Check your junk mail around PII renewal time
• Actively and manually look up your PII records to check currency when declaring at registration renewal
• Don’t delegate paying PII or renewing/declaring at registration to an administrative assistant, accountant, receptionist or colleague
• Check your bank account regularly for direct debit PII payments
• Get retroactive cover for previous events if you change providers, and leave no gap in cover
• Store your PII policy in a folder with other records such as CPD, as you should visit and update this folder regularly.

What to do immediately if you find that you do not hold PII

• Do not practise until you have PII cover
• You must notify Ahpra within seven days using the Notice of certain events form: Form - NOCE-00 - Notice of Certain Events.

If you fail to notify the Board of a gap in PII at the time, but instead declare this several months later, you have failed to comply with your obligations under the National Law. This is a serious matter that can become a ground for a notification about a practitioner, as it is considered professional misconduct.

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Clinical decision-making in practice

The Board stresses the importance of ensuring that optometrists can make clinical decisions in the interest of patient care freely, and without pressure from employers to meet business targets.

This is addressed in the new shared Code of conduct (the code), which came into effect in June this year. The code sets out National Boards’ expectations of ethical and professional conduct for the health practitioners they regulate. Underpinning the code is the expectation that practitioners will use their professional judgement to achieve the best possible outcomes for their patients.

Ahpra and the National Boards have published case studies highlighting how the code can be applied in practice. The case studies below show how an optometrist could respond to pressure to meet a business performance target that is not in the best interests of the patient.

Case studies: Business practice

Example 1

Darcy is an employee in a busy optometrist practice. The practice has recently purchased an expensive visual field analyser. The practitioner owner who employs him sets a performance target that requires Darcy to provide a certain number of visual field tests each month. These tests attract a Medicare benefit. Darcy reviews his patient numbers and informs the practice owner that to achieve the target he would need to recommend a visual field test to some patients who do not have any signs or symptoms that indicate clinical need for analysis.

Applying the code

Darcy and the practice owner read the code and in particular section 8.10 Conflicts of interest, which states:

Good practice includes that you:

i. do not set performance targets, quotas or engage in business practices that are inconsistent with this code, and/or may negatively impact patient safety, if you employ other registered health practitioners.

Darcy and the business owner agree that good care includes the quality use of the tests based on the best available evidence and the patient’s needs.

Example 2

Chris is an employed optometrist in a busy city practice. Bernard, the practice owner and employer, sets a performance target that Chris must prescribe and sell more optical appliances which, if achieved, will result in a significant financial bonus. Chris reviews their patient numbers, ages and prescriptions and informs Bernard that to achieve the target it is likely they would need to sell products to patients where there was no indication or clinical need.

Chris and Bernard read the code and in particular section 1.2 Good care, which states:

Maintaining a high level of professional competence and conduct is essential for good care.

Good practice includes that you:

f) provide treatment options that are based on the best available information and are not influenced by financial gain or incentives.

Chris and Bernard agree that good care includes only recommending products based on the patient’s needs and that offering a financial incentive is inconsistent with the requirements of the code.

The Code of conduct is available on the Board’s website, and the case studies are available on Ahpra’s website.

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Meet your Board

Benjamin Graham, community member from the Australian Capital Territory

What attracted you to the role?

Initially, I was actually quite sceptical about the role and wasn’t sure I should apply. I didn’t want to go onto a board where a community member position was viewed as a tokenistic ‘tick and flick’ exercise by practitioner members and largely ignored. After speaking to a few people I know in the consumer health movement who were familiar with the positive impact community members have had historically on Ahpra boards, I decided to throw my hat in the ring.

My real motivator for applying was to have a seat at the table where health and practice decisions are made, and to use that seat to really champion the needs of the community and to be their voice.

It has been great to see how all my Optometry Board colleagues have been receptive to hearing that voice and being able to influence change for the betterment of the community.

Tell us a little about your previous work

My work history is a mixture of communication and marketing roles (I’m a journalist by training), and senior management roles within peak bodies and membership associations, predominantly in the health and social services sectors.

I have previously served as the Executive Officer of Chronic Pain Australia, the local grass-roots voice of people living with chronic pain; Interim CEO of the Australian Diabetes Educators Association; and I also worked at the Australian General Practice Network when they were lobbying to become Medicare Locals (today’s Primary Health Networks). I have also served on numerous community and health related boards, including as Chair of Community Options Australia, which managed a collective of NSW and Commonwealth government community care contracts.

What are you hoping to achieve in this position?

I want to ensure that the voice of the community is heard and viewed as an equal voice in all discussions and decisions involving the way that optometry is practised in Australia. I want to ensure that the person-centred model of care is being fully utilised in all communities and not just viewed as an optional extra to the clinical model of care. I want to make sure that optometry in Australia continues to be practised safely, and patients and practitioners have healthy and equitable working relationships.

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Registration news

Practitioners opt in to extend their registration on the pandemic sub-register

A total of 1,792 practitioners opted in to remain registered on the pandemic sub-register for another year, continuing to support the health system. These include Aboriginal and Torres Strait Islander Health Practitioners, dental practitioners, diagnostic radiographers, medical practitioners, midwives, nurses, occupational therapists, optometrists, pharmacists, physiotherapists, podiatrists and psychologists who have opted to extend their registration on the sub-register to 21 September 2023 or apply to transition to the main register for ongoing registration.

Practitioners who were on the sub-register and did not contact Ahpra are no longer registered as of midnight on 21 September 2022. The names of these practitioners were removed from the sub-register; if they wish to continue to be registered, they will need to apply for registration through the standard process.

For more information go to:

• Pandemic response sub-register
• FAQs for practitioners and employers.

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Latest workforce data released

The Board’s quarterly registration data to 30 September 2022 has been released. At this date, there were 6,575 registered optometrists (which includes three practitioners on the pandemic sub-register).

For more details, including registration data by principal place of practice, age and gender, visit our Statistics page.

Extension of temporary acceptance of additional English language tests for registration applicants

National Boards are accepting the TOEFL iBT® Home Edition test for applications received until 21 February 2023.

COVID-19 pandemic lockdowns have disrupted many English language tests and made it difficult for some applicants to use the English language test pathway to meet National Boards’ English language skills registration standards.

In response, earlier this year the National Boards established a temporary policy accepting the following additional language tests for a limited time:

• The OET computer-based test and the OET@home test for applications received until 21 February 2023, and
• The TOEFL iBT® Home Edition for applications received until 1 June 2022.

National Boards have now updated this temporary policy which means that, along with the OET computer based and OET@home tests, the TOEFL iBT® Home Edition will also be accepted, for applications received until 21 February 2023.

All other requirements set out in the National Boards’ English language skills registration standards still apply. There are no changes to any other requirements in the standards, including minimum test scores.

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What’s new?

Cosmetic surgery complaints line and online hub launched

Ahpra and the National Boards are committed to making cosmetic surgery safer. Patients who have been harmed by cosmetic surgery can now report their concerns to a hotline. Practitioners who are aware of unsafe cosmetic surgery practices are also encouraged to call.

Key points

Our Cosmetic Surgery Hotline – 1300 361 041 is a new service for cosmetic surgery patients and concerned practitioners to tell us about their bad experiences. If we know about it, we can investigate it. The specialised notifications team is here to listen Monday to Friday 9am – 5pm AEDT. Concerns can also be lodged confidentially.

We have also set up an online Cosmetic surgery hub that gathers helpful resources for practitioners and the public in one place.

The hotline and hub are part of the response by Ahpra and the Medical Board of Australia to the Independent review into the regulation of medical practitioners who perform cosmetic surgery.

Read more in the news item.

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New Resources hub makes finding information easy

A new hub on the Ahpra website makes it easier to find helpful resources.

The Resources hub aims to support professional practice and help patients make safer health choices.

The hub includes information on requirements for advertising, social media, cosmetics, supervised practice and more. Information for practitioners and the public is clustered according to useful topics, to make it easier to find.

Latest podcasts – listen up!

Our Taking care podcast series covers a wide range of current issues in patient safety and healthcare in conversation with health experts and other people in our community. We also publish transcripts of our podcasts. Recent episodes include:

• The inextricable link between climate change and healthcare
• The unique world of rural and remote healthcare
• Accessing safe healthcare when cost is an issue
• Two conversations about caring for the LGBTIQA+ community, from the perspectives of patients and of practitioners
• Safe healthcare for people experiencing homelessness
• Safe healthcare for refugee and asylum seeker communities
• Openness and candour – a road to greater patient safety.

Listen and subscribe by searching for 'Taking care' in your podcast player (for example Apple Podcasts or Spotify), or listen on our website.

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National Scheme news

Click on the image below to read the National Scheme newsletter. Our next issue will be published in December, and you can subscribe on the newsletter page.

Keep in touch with the Board

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