Mandatory notifications about health practitioners

• Health practitioners and employers of health practitioners are legally obliged to notify Ahpra of other practitioners (and sometimes students) whose conduct may place the public at serious risk of harm. 
• Impairment, intoxication when working, a significant departure from accepted professional standards and sexual misconduct must be reported.  
• Practitioners notifying Ahpra will be protected from liability so long as they act in good faith. 

Note: This information is for health practitioners who are not in a treating relationship with the health practitioner of concern.  

If you are treating a health practitioner and have a concern, refer to our factsheet: Mandatory notifications for treating practitioners.

To protect the public, all registered health practitioners and employers of registered health practitioners are required by law to notify Ahpra if they believe a health practitioner may be not practising safely by engaging in particular types of conduct in connection with their practice.  

The obligation to notify applies to all 16 regulated health professions, not only doctors. This means you may be required to make a notification about a health professional who is not a doctor. 

Before making a mandatory notification, you must form a ‘reasonable belief’ that another practitioner is engaging in ‘notifiable conduct’.

Have you formed a reasonable belief?

A reasonable belief should be based on actual, known events rather than anecdotal accounts. Speculation, gossip, rumours or innuendo do not form a reasonable belief.  

This can be difficult to assess objectively, so consider your personal knowledge of the facts and circumstances that led to your concern. Use your experience and expertise to determine if you have a ‘reasonable belief’. Sometimes it’s helpful to take a step back and ask whether another reasonable person would have formed the same belief.

Notifiable conduct is defined in legislation and includes the following:

• practising with an impairment
• practising while intoxicated
• significant departure from accepted professional standards
• sexual misconduct.

Health practitioners and education providers of registered students are also obliged to report students on the grounds of impairment.

Impairment

Ahpra must be notified if a health practitioner is placing the public at risk of substantial harm by practising with impairment. A risk of substantial harm is a high threshold to meet.  

An impairment is any physical or mental impairment, disability, condition or disorder including substance abuse or dependence. Notification is only required if the condition detrimentally affects or is likely to detrimentally affect the practitioner’s capacity to practise.  

The impairment does not need to be reported if effective controls are in place to manage it and reduce the risk and severity of harm to the public. Controls could include treatment, sick leave or a career break, supervision or a modified scope of practice.  

Health practitioners and education providers of registered students are also obliged to report students with an impairment who are undertaking clinical training, if they are placing the public at substantial risk of harm.  

Intoxication

Practising while intoxicated by drugs (including illicit substances, alcohol, and prescribed and other medicines) is notifiable. The relevant consideration is whether the practitioner’s ability to practise is impaired or adversely affected due to intoxication.  

Behaviours outside of work are only notifiable if you have a reasonable belief the practitioner went on to practise while still intoxicated.  

Significant departure from accepted professional standards

Conduct that is a serious deviation from accepted professional standards and places the public at risk of harm, must be reported. This does not include minor variations or professional differences of opinion over clinical or treatment decisions, if accepted professional standards are met. It must be a significant departure that would be obvious to a reasonable practitioner. Accepted professional standards include (but are not limited to) formal documents and guidelines such as the Medical Board of Australia’s Good medical practice: a code of conduct for doctors in Australia, clinical practice guidelines and hospital guidelines.  

Sexual misconduct

You must report a health practitioner if you have a reasonable belief they have been or are engaging in sexual misconduct in connection with their practice. This includes with a patient under the practitioner’s care or a person related to their patient, such as the parent of a paediatric patient. It applies irrespective of whether the patient consented to or initiated the sexual relationship.  

Sexual misconduct includes: 

• sexual activity with a current patient (and in some circumstances a former patient) 
• making sexual remarks 
• touching patients in a sexual way 
• touching a patient in an intimate area without clinical indication 
• engaging in sexual behaviour in front of a patient. 

When deciding whether to submit a mandatory notification, you need to decide if you have a reasonable belief about notifiable conduct. In the case of impairment or a significant departure from accepted professional standards, you also need to consider the level of potential harm to the public. Further information about your obligations and levels of risk are available in Ahpra’s guidelines for mandatory notifications. 

Exceptions to the mandatory notification obligations

There are limited circumstances in which a mandatory notification about a health practitioner is not required, including if you:

• know or reasonably believe the notifiable conduct has already been reported
• are providing legal advice, involved in legal proceedings or are a member of a quality assurance committee or other body, that is bound by legal confidentiality requirements
• work for a professional indemnity insurer and become aware of notifiable conduct because of legal proceedings or legal advice arising from the insurance policy.

Protection when making a mandatory notification

You are protected from legal liability if you make a notification in good faith – that means on reasonable grounds, with good intentions and without malice. Regardless of the outcome of your notification, you cannot be subject to claims such as defamation or breach of privacy. Making a notification is not considered a breach of professional standards.  

You may be subject to regulatory action if your notification is vexatious or not in good faith. A notification arising from a mere difference of opinion or motivated by a desire for commercial advantage may be in bad faith.  

What happens if I do not make a mandatory notification?  

If you do not report notifiable conduct to Ahpra and it is later determined you should have, you may be subject to disciplinary action.  

Making a notification to Ahpra 

Before making a mandatory notification, read Ahpra’s guidelines and other resources to help you make your decision.  

If you are unsure, consider talking to a senior colleague about the circumstances, being mindful about privacy obligations you may have to the practitioner.  

You can also call Avant’s Medico-legal Advisory Service to discuss the circumstances and your obligations.  

• Ahpra - Guidelines: Mandatory notifications about registered health practitioners
• Ahpra - Resources: helping you understand mandatory notifications
• Avant factsheet - Mandatory notifications for treating practitioners
• Medical Board of Australia - Guidelines: Sexual boundaries in the doctor-patient relationship

For medico-legal advice, please contact us on nca@avant.org.au or call 1800 128 268, 24/7 in emergencies.