UPDATE ON RECENT PROGRESS OF PARAMEDIC REGISTRATION

1. Countdown to
paramedic registration
Status – 1 May 2017
@Arban70 @ParamedProf
https://www.facebook.com/ParamedProf

2. Overarching criteria – public safety / public trust
̶ does paramedic practice pose potential risk of harm?
̶ do patients take expertise on trust?
Paramedics:
̶ make clinical assessments
̶ perform invasive procedures
̶ administer powerful drugs
̶ make critical judgements and decisions
̶ patients accept practitioner competence on trust
̶ paramedic practitioners operate autonomously within SOP
The why of paramedic regulation

3. An independent authority registers and controls:
̶ Who enters the profession – i.e. who gets on the register; making
sure that those who are registered are fit and competent - entry
̶ Who stays on the register - ensure those on the register are able
to practice safely and maintain their competence - monitoring
̶ Who is removed from the register - those shown to be lacking
ability or fitness to practice – removal
̶ The outcomes are open to public scrutiny - transparency
How does registration work ?
Registration involves transparency, objectivity & due process

4. The National Registration & Accreditation Scheme (NRAS)
was established under separate jurisdictional legislation to:
− protect the public by ensuring that only suitably trained and qualified
practitioners are registered
− facilitate workforce mobility across Australia
− enable the continuous development of a flexible, responsive and
sustainable health workforce
The NRAS is administered by AHPRA* and a number of
professional regulatory Boards. It provides independent:
− protection of title
− a register of practitioners
− established registration standards
− investigation of complaints
− accreditation of courses
What is NRAS registration ?
*AHPRA - see https://www.ahpra.gov.au/

5. What is AHPRA ?
AHPRA is the:
̶ Australian Health Practitioner Regulation Agency
̶ AHPRA administers the National Registration and
Accreditation Scheme (NRAS) for the health professions
̶ provides administrative support to the National Boards
̶ provides legal support & interpretation
̶ makes recommendations to Boards
̶ first point of contact for registration matters

6. The NRAS commenced in 2010 with 10 health professions
Chiropractic Osteopathy
Dental Pharmacy
Medical Physiotherapy
Nursing & Midwifery Podiatry
Optometry Psychology
A further four professions entered the scheme in 2012
Aboriginal & Torres Strait Islander health practice
Chinese medicine
Medical radiation practice
Occupational therapy
Currently registered professions

7. As at June 2016 there were 652,958 registered health
practitioners in Australia – see http://bit.ly/2dF51Me

8. Who does what ?

9. Gaining agreement for registration across all jurisdictions has
taken many years - with other regulatory developments
including a review of the NRAS framework also part of the mix
Three states (SA, Tas & NSW) recognised the risks of
practice and introduced interim legislation protecting the title
of ‘paramedic’ but using different legislative frameworks:
SA – via amendment to NRAS National Law – October 2013
Tas – via an amended Ambulance Service Act – November 2013
NSW – via an amended Health Services Act - 1 February 2016
Health Ministers in 2015 also agreed to adopt a national Code of
Conduct for unregistered health workers - http://bit.ly/1yS81vA
Note: The provisions of the National Code apply to paramedics
(and others) if not registered – see http://bit.ly/2qoTi9i
The paramedic journey

10. 6 Nov 2015 - Health Ministers agree to support registration with
jurisdictions able to ‘opt-in’. NSW remained the sole stand-out
but other states & territories continued to work towards
registration – see http://on.fb.me/1NYNskM
2016 - Victoria’s DHHS appoints a Project team
9 May 2016 - Senate Committee chaired by Senator Glenn
Lazarus releases its Final Report fully supporting national
registration of paramedics – see http://bit.ly/1TOe7DL
7 October 2016 - Ministers agree to proceed with registration
giving green light to development - see http://bit.ly/2dDF0wJ
February 2017 - Consultation with stakeholders to review the
legislative amendments for implementing paramedic registration
(as well as other changes arising from review of the NRAS)
The pace quickens

11. 24 March 2017 – Ministers agree to the draft legislative
amendments to the National Law - see http://bit.ly/2ndgm9R
The next formal step sees the legislation go to the Queensland
Parliament and adoption by other states / territories (SA / WA)
The implementation process now transitions largely to AHPRA
including appointment of the inaugural Paramedicine Board
April - AHPRA advertises for Paramedicine Project Manager
April - AHPRA establishes dedicated webpage to keep people
informed of registration developments - see http://bit.ly/2qdQtL5
29 April 2017 – AHPRA advertises for Board positions with target
for appointment September 2017 - see http://bit.ly/2pOhp4a
The current status (1 May 2017)

12. What are some key reforms?
Paramedicine added to the definition of ‘health profession’
under the National Law
‘Paramedic’ becomes a protected title
New s307 and s308 establish the Paramedicine Board of
Australia. The Board has:
- limited functions until the participation day s308(1)&(3) but can start work
- same powers and functions as existing 14 Boards from participation day
New s.308 (2) allows Ministerial Council to appoint
practitioner members to the Board prior to participation day
New s.310 allows “Grand-parenting” recognition of existing
practitioners during the first three years of the scheme

13. The Paramedicine Board will comprise 6 practitioner and 3
community members. It will consult & progressively develop:
- Registration standards: eg continuing professional development, criminal
history, English language skills, recency of practice and professional
indemnity insurance, for recommendation to Ministers; and
- Codes and guidelines under s39 (see http://bit.ly/2ePHJWy )
Recommend course accreditation arrangements and approve
accreditation standards
Make administrative arrangements for processing early
applications and other procedural matters for registration
Perform all the functions of a professional regulatory Board
(except initially for some specific roles e.g. complaints)
See information guide: http://online.fliphtml5.com/eeyoy/fcyl/
The Paramedicine Board

14. Legislation in place June/July 2017
Recruit and appoint a national Board (Ministers)
Board consults regarding standards, codes,
guidelines & AHPRA systems/process design
Recommend/ Approve standards & accreditation
arrangements (Ministers to approve)
List of approved pathways/programs (Board)
Publicise requirements / open applications
Assess applications and go ‘live’ - Sept 2018
Future implementation steps
2017
2018
2017-2018

15. The Victorian DHHS paramedic registration project team:
Meredith Carter
Manager Legislative Reform Projects, Workforce Regulation
Victorian Department of Health and Human Services
Phone: 03 9096 1852
Email: Meredith.Carter@dhhs.vic.gov.au
Current AHPRA personnel in paramedic registration group:
Andrea Oliver
Manager, Intergovernmental Relations, Strategy and Policy
Australian Health Practitioner Regulation Agency
Phone: AHPRA ext. 4736 (internal use)
Email: Andrea.Oliver@ahpra.gov.au
Further details (Australia)

16. For additional information on regulatory and general matters
affecting paramedicine - follow these social media channels:
Twitter on @Arban70 and @ParamedProf
Paramedic Observer http://bit.ly/1EUgjUu
Australian Emergency Law http://bit.ly/2nW38Ac
Information on paramedic practice is available on the websites
and social media channels of (in alpha order):
─ Australian and New Zealand College of Paramedicine (ANZCP)
─ Australian Paramedics Association (various jurisdictions)
─ Council of Ambulance Authorities (CAA)
─ National Council of Ambulance Unions (NCAU)
─ Paramedics Australasia (PA) - also see their dedicated ‘registration’
channels Twitter @ParaRegAU and Facebook http://bit.ly/1FMQVwm
─ Private Paramedicine Australia (PPA) http://on.fb.me/1OSq0Uq
Other information sources