1. Outcomes of notifications to health practitioner boards: a retrospective cohort study
Matthew J. Spittal, David M. Studdert, Ron Paterson and Marie M. Bismark
Funding
NHMRC and Australian Health Practitioner Agency (through an NHMRC Partnership Grant)

3. Background
Practitioner boards rely on patients, practitioners, employers and other agencies (such as police) to report notifications of concern regarding practitioner health, conduct and performance.
Health professions in Australia are regulated by a unified scheme, in operation since Data reliably captured on registered practitioners and notifications.
This allowed us to study the “epidemiology” of notifications to understand how the system is operating.

5. Methods
All notifications lodged between 2011 or 2012 were followed for between 3 and 4.5 years to identify the outcome of these notifications
Population: All practitioners registered in2011 and 2012
Doctors
Nurses and midwives
Dentists
Psychologists
Pharmacists
All other registered professions
NSW excluded (cannot be tracked in the same way as the other states)

6. 6,920 practitioners received 8,307 notifications
Open notifications (n=409)
Closed notifications (n=7,898)
No further action (n=5,363)
Referral to another official agency (n=867)
Caution, reprimand or fine (n=850)
Restrictive action (n=818)
Undertaking (n=308)
Imposition of condition (n=489)
Suspension or cancellation (n=21)

7. Improper use or management of health information (7.6%)
Other conduct (15.8%)
Disruptive behavior (8.1%)
Other health (1.8%)
Concerns about clinical care (30.7%)
Drug misuse (1.4%)
Mental Illness (2.4%)
Other performance (3.4%)
Poor communication (4.4%)

8. Number and rates of notification

9. Restrictive actions: source of notification

10. Restrictive actions: issue of notification

11. Restrictive actions: target of notification

12. Restrictive actions: age of practitioner

13. Conclusions
Doctors have high rates of notification but low rates of restrictive action.
Nurses are the opposite: low rates of notification but high rates of restrictive actions
Notification by peers and employers much more likely to result in restrictive action than notifications by patients.
Notifications about health issues more likely to result in restrictive action than notifications for other reasons (e.g. poor performance or poor conduct). Of concern because only 6% of notifications are about health issues.