Australia’s new national health practitioner registration and accreditation scheme begins on 1 July, 2010. The new National Law (the Health Practitioner Regulation National Law Act 2009) covers the regulation of 10 health professions, including optometry.
Optometrists will now have to meet uniform requirements to be registered and their registration will be recognised in all States and Territories. The Optometry Board of Australia (OBA), set up last year to arrange registration standards, will ultimately determine how the new system will work for optometrists.
The object of this new legislation is to establish a national registration and accreditation scheme for the regulation of health practitioners. It also covers the registration of students undertaking qualification for registration in a health profession or clinical training in a health profession.
We encourage people to try to keep a hand in if they are going on leave, but of course sometimes this can be too difficult
While many of the changes are for the better, not all will be viewed in such a positive light. Optometrists face five new registration standards, a therapeutics endorsement and a number of guidelines that will be registration requirements and will affect all registered optometrists in Australia.
1. Criminal history
- All applicants for initial registration will have a Criminal History screening and must also declare any criminal history.
2. English language requirements
- For initial registration all applicants must satisfy the English language requirements unless an exemption in granted.
3. Professional indemnity insurance
- All registered optometrists (except those who hold non-practising or student registration) must be insured or indemnified.
- Annual renewal forms will require a declaration that the registrant has professional indemnity insurance that complies with the Board’s guidelines.
4. Continuing professional development
- All registered optometrists (with exception of non-practising registrants) must undertake continuing professional development as set out in the standard and guidelines. Briefly, 40 points must be completed annually of which 20 points must be face-to-face clinical learning.
- Therapeutically endorsed optometrists must complete 20 of the 40 points in related education.
- All registered and practising optometrists must have completed training in cardiopulmonary resuscitation within the previous three years on re-registration (Optometrists have until November 2011 to meet this requirement).
All registered optometrists must make a declaration on annual renewal (in November 2011) that they have met this standard during the previous period of registration.
5. Recency of practice
- All applicants, for initial registration as an optometrist and all registrants who are applying for renewal of registration must have sufficient practice experience in the three year period prior to their application in order to ensure their continuing competence to practice and will be required to make a declaration to that effect.
The Board will produce guidelines as to the level of practice required to meet this standard, including an exemption for new graduates.
Scheduled Medicines Endorsement
Those optometrists whose registration is therapeutically endorsed by their State or Territory government will automatically have their registration endorsed under the national scheme.
The conditions of therapeutic practice will, for the time being, remain under State or Territory legislation; however the Board has adopted a recommended common therapeutic standard.
As Optometrists Association Australia (OAA) President Andrew Harris explains: “National Registration is a catalyst for harmonising consistent therapeutics. Of course, there will be a bit of a lag for some states and there may be timing issues but, eventually everyone will be in line.”
Mr. Harris believes that “fundamentally, National Registration makes sense.”
“For example, for optometrists working in different states, or practicing on the cusp of two states, such as the NSW/Vic border, or NSW/QLD border, they will not have to register in two different states. It is really just a mutual recognition.”
Andrew McKinnon agrees that one of the most positive changes with National Registration is that now locums won’t have to move between multiple jurisdictions, “which will make life much easier for those concerned”.
The main concerns raised seem to be about the move to mandatory CPD and recency of optometry practice.
The new requirement states that optometrists seeking re-registration will have to show that they have undertaken sufficient continuing professional development face-to-face to earn 20 of the 40 points they are required to earn over a two year period.
The OAA has criticised the proposed CDP requirements, saying the specification of the number of hours of CPD in the requirements is unnecessarily restrictive and that it would be preferable to include it in guidelines that the board is to issue later.
According to a statement from the OAA: “National registration is continuing to advance. When the new National CPD system starts, all your previous CPD points with the OAA will vanish. Why? Because this new system has nothing to do with the OAA – it is run by the Optometrists Board of Australia under laws connected to National registration. So…you will revert to having zero (CPD) points. You’ll then have 12 months from the commencement date to accumulate 40 CPD points.”
Ms. Terri Smith, CEO of OAA Victoria Division explains that at a practical level the biggest change that will affect every optometrist is the move to mandatory CPD. “It is a real head shift.”
“There will now be an annual provision to complete CPD points rather than a two year provision,” she explains.
“So what used to happen was that if an optometrist did a lot of training in one year, they wouldn’t need to do as much the following year.”
The CEO of the OAA NSW Division, Andrew McKinnon, agrees with Ms. Smith, saying: “In terms of the issues that will be hard to grapple with, the main one is the move to mandatory CPD. I can only comment on ACT and NSW, but this will be a huge change. It is an indisputable fact that our compliance with the current CPD is not as good as in other states. This is probably due to the fact that the Sydney market is so competitive and it is therefore hard for people to get out of their practices… so from 1 December this will be a huge stir up.”
Recency of practice
Explaining why some optometrists may be concerned about recency of practice, Ms. Smith says: “What has happened over the years is that the gender balance in optometry is changing. Back in the 70’s there was barely one female in a group of optometry graduates, but now graduates are around 80 per cent young women.
“The impact of this is that we now have a group of optometrists who at one stage will be thinking of having babies. So recency of practice is an issue for them. Recency of practice applies to anyone who has had leave in a period of seven years. Lots of people have been calling the OAA to find out if they need to do anything to maintain their recency of practice.
“The really important thing to know for anyone who hasn’t practiced for five years is that they need to talk to the new Optometry board. They can make an arrangement for them so that they can renew their skills and can practice. It may be a requirement for an optometrist to be supervised while they work for a few months, or they may require some re-training.
“In short, this basically just means that an optometrist can’t automatically practice if they don’t meet the required guidelines, so they will need to negotiate this with the board. We encourage people to try to keep a hand in if they are going on leave, but of course sometimes this can be too difficult. While recency of practice is worrying for some optometrists, I do think this change is a good thing as it is in place to protect patients.”
Mr. Harris reaffirms this by explaining that “the reality is not as scary as everyone thinks.”
“One of the biggest changes for optometrists is that CPD will become compulsory to maintain registration… But the ‘new’ requirements are really in line with the existing requirements to be an OAA member,” he says.
“I understand that people are worried about the recency of practice issues, but these are really just maintained by common sense. If someone is unsure about whether they are registrable/compliant, the best advice is to contact the registrar and be upfront about where you are at. The registrar board is not trying to be draconian, it is just trying to protect the public and make things even across the board.”
Another change now is the date range. As Ms. Smith points out, optometrists were used to a two year CPD registration period stretching from 1 January to 31 December, but now the year will run from 1 December to 30 November.
“It’s just another little change for people to get their heads around,” says Ms. Smith.
There will also be new renewal dates for optometrists around the country, changing to 30 November instead of 30 December.
A common complaint across the board is that optometrists will now be required to do a CPR qualification every three years.
As Ms. Smith explains: “Quite understandably, a lot of optometrists are not happy about this as they don’t see it as particularly relevant to them. However, we must comply as this regulation was introduced as a means by which to maintain health standards across the board – across all 10 health professions – and optometry must also comply.”
Mr. Harris is keen to allay fears saying: “Really, I think it is going to be business as usual. People are always concerned about the unknown, but really nothing much will change on July 1, except, rather than having seven registration boards, we will only have the one. This is essentially removing a layer of bureaucracy, which from a practical point of view, makes perfect sense.
Ms. Smith agrees, saying: “Overall, we think the changes are really good. There are some small obstacles, but generally speaking the capacity to practice is great. It is wonderful to finally have consistent standards.”