AHPRA strengthens national drug screening

AHPRA to introduce hair testing for all practitioners with substance related impairment. Mandatory hair testing will be routine for all registered health practitioners with substance-related impairment, under a screening protocol to be introduced by the Australian Health Practitioner Regulation Agency (AHPRA) and the National Boards.

Under the protocol, all health practitioners who have restrictions on their registration linked to past substance abuse will have routine hair testing in addition to urine testing.

Routine hair testing helps provide comprehensive information about the use – over time - of a wide range of drugs (not just based on the practitioner's drug taking history).

AHPRA CEO, Martin Fletcher, said the protocol provided a clear framework across professions for AHPRA's advice to National Boards about the management of registered practitioners with drug related impairment.

"It will make sure drug screening in the National Scheme is evidence-based, effective and up to date," Mr Fletcher said.

National Boards will continue to make decisions about individual practitioners with impairment case by case, based on testing standards set out in the protocol. This includes:

• nationally consistent threshold limits, so all pathology providers conducting the tests use consistent testing baselines (e.g. will report all positive alcohol readings over 30pg/mg in hair)
• agreed 'critical events' – in addition to positive test results - requiring action and follow up (e.g. unexplained delayed screening tests or results, failure to attend screening, diluted or unsuitable samples etc)
• agreed triggers for National Boards to consider disciplinary action (e.g. positive test results, non-compliance with screening requirements etc)

AHPRA has established an expert panel to provide ongoing advice on the biological assessment, testing and monitoring of applicants and registrants with drug and/or alcohol misuse, including impairment. The panel includes Professor Olaf Drummer, Professor Jenny Martin and Dr Robert Ali. Terms of Reference for the panel are published on our Expert Panel on Drug and Alcohol Screening page.

AHPRA is now seeking expressions of interest from pathology providers to provide drug-screening services to AHPRA to support ongoing monitoring of practitioners known to have drug related impairment.

The drug screening protocol is part of a wider, national strategy to effectively manage compliance and monitoring across the National Scheme. The strategy, progressively implemented from July 2014:

• applies to AHPRA's management, on behalf of National Boards, of all registered health practitioners with limitations on their registration related to health, conduct, performance or registration
• includes structural change, with the appointment of a national director, compliance and monitoring and
• ensures coordination across all states and territories of AHPRA's compliance and monitoring program.

Background

AHPRA introduced an interim drug screening protocol nationally in July 2014 to guide the monitoring of practitioners with drug-related impairment.

The interim protocol was reviewed by independent expert Professor Olaf Drummer from Victorian Institute of Forensic Medicine, to ensure the approach to biological testing in the National Scheme was evidence based and up-to-date. His report is published on the Monitoring and compliance page on the AHPRA website.

AHPRA has updated the interim protocol in response to Professor Drummer's findings, including making it more specific about the drugs to be tested, the cut off levels for testing and introducing the use of hair testing. It will be further refined, fully implemented and published when AHPRA has selected an ongoing provider of pathology testing services. The proposed new protocol is published on our Monitoring and compliance page.

The role of the National Boards and AHPRA in the National Registration and Accreditation Scheme is to protect the public and manage risk to patients, including by managing the registration of practitioners with a health impairment (including substance abuse).

More about the assessment and management of practitioners whose health impairment may pose a risk to the health and safety of the public is published online:

• information about the notifications process
• fact sheet about monitoring and compliance
• fact sheet about health assessments.

Another important feature of the National Scheme is the online national register of practitioners, which provides accurate, up to date information about the current registration status of every registered health practitioner in Australia. The National Law¹ determines what information about each practitioner is published on the register.

The online register is an invaluable source of information to consumers and health professionals. It is used by consumers to help them make informed decisions about health practitioners, and by employers to check the registration status of employee health practitioners.

For more information

• Lodge an online enquiry form
• For registration enquiries: 1300-419-495 (within Australia) +61-3-9275-9009 (overseas callers)
• For media inquiries: contact Nicole Newton, (03) 8708-9200 or 0407-998-611

Reference

1. Health Practitioner Regulation National Law (National Law), as in force in each state and territory.