The regulator is in a unique position to build coalitions across professions and organisations, according to the man who led it for 15 years.
In a case study published in the Australian Health Review this week, former AHPRA CEO Martin Fletcher pointed to the potential for more effective use of data at the national health practitioner regulator.
Mr Fletcher announced that he would be standing down as CEO of the regulator in August 2024, having been in the job since AHPRA’s inception in mid-2010.
Over his tenure, AHPRA was subject to 25 reviews and inquiries, both internal and external.
Some of these – including independent reviews into complexity and immediate action – are ongoing at time of writing.
Mr Fletcher was largely positive about AHPRA’s achievements, noting that it has led globally recognised work on responding more humanely to practitioner distress arising from regulatory processes and is a WHO collaborating centre on health regulation.
“In exploring these experiences and improving its regulatory processes, [AHPRA] has contributed to wider discussion about regulating for both patient safety and kindness,” Mr Fletcher wrote in AHR.
“However, the proportionality of regulation and where the public interest lies is debated, particularly for practitioners with a health impairment.”
Another key challenge facing the scheme, he wrote, is working with other regulators.
The independent review of medical practitioners who perform cosmetic surgery, for instance, highlighted the multi-jurisdictional nature of the health system.
Earlier this year, the government moved to amend national laws to allow AHPRA investigators to use information obtained by the PSR under certain circumstances.
“Collective action that is aligned can produce meaningful improvements, and the Scheme is in a unique position to build coalitions across professions and organisations, drawing on its public interest mandate,” Mr Fletcher wrote.
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In the coming years, he said, the rise and rise of online-only telehealth operators, augmented intelligence and social media would pose challenges to AHPRA’s efforts to ensure accountability, transparency, equity and patient safety.
Because notifications and complaints only arise after an adverse event has already happened, it also means that AHPRA is necessarily on the back foot when it comes to understanding emerging risks.
The answer to those problems, the former CEO argued, may well be staring the regulator in its proverbial face.
“Few agencies hold the breadth of data on health practitioners maintained by [AHPRA],” he wrote.
“There is an opportunity to use the data it holds, and that of others, to better anticipate health care disruptors and changing patterns of risk.
“There is also a need to continue to build research capability to strengthen the evidence base of regulation.
“Evolving artificial intelligence technologies and their application in regulatory practice may accelerate and deepen the use of regulatory data for learning and risk identification.”
There are some signs that AHPRA has already begun to adopt a more proactive footing in terms of regulation.
A recent statement relating to medicinal cannabis prescribing contained a “word of caution” noting that AHPRA would be working with other regulators to understand prescribing patterns and may investigate practitioners with high rates of prescribing even in the absence of a complaint.
