July 2021 Newsletter

Message from the President

As I write, the Greater Sydney Region has had it's lockdown extended as a result of the current COVID-19 situation, whilst parts of the Central West of NSW have had their stay-at-home orders lifted. Registered paramedics are on the frontline of health care delivery under difficult circumstances with demand for services high. They are also working in various incident management activities ensuring services can continue to be delivered. The Council extends its appreciation for your continued dedication to serving the community of NSW during this difficult time.

Given the current situation it is worth drawing attention to our responsibilities as registered health practitioners as they relate to public health. Earlier this year the National Boards and Ahpra issued a joint statement concerning COVID-19 vaccination. This contains important information on our responsibilities as registered health practitioners in protecting the health and safety of the public including the responsibility to participate in efforts to promote the health of communities and meet obligations with respect to disease prevention including vaccination, health screening and the reporting of notifiable diseases (Code of Conduct Section 5.4 (e)). Paramedics occupy a significant position of community trust and as a consequence can influence the understanding, behaviour and decisions of community members concerning public health issues. From a regulatory perspective the Joint Statement has emphasised this responsibility:

 “Any promotion of anti-vaccination statements or health advice which contradicts the best available scientific evidence or seeks to actively undermine the national immunisation campaign (including via social media) is not supported by National Boards and may be in breach of the codes of conduct and subject to investigation and possible regulatory action”

The Council recommends all paramedics review the Joint Statement and Code of Conduct to ensure you are aware of the expectations of registered health practitioners in relation to public health matters.

It is now nearly three years since Paramedicine entered the National Registration and Accreditation Scheme. The Council has also completed its first three year term. Details concerning the appointments for the next Council period can be found in this Newsletter. I would particularly like to recognise the service of Mr Brian Parsell over the last three years. Brian has played a pivotal role in the establishment of the Council and we thank him for his commitment to serving the public during his time on Council. I would also like to welcome our new members Dr Ruth Townsend and
Mr Phillip Ebbs.

The 7 August 2021 will see the Inaugural National Day of Recognition for Aboriginal and Torres Strait Islander Health Workers and Practitioners. The Aboriginal and Torres Strait Islander Health Worker and Practitioner Workforce is the only culturally based health workforce with national training and registration in the world. This day celebrates the achievements of our Aboriginal and Torres Strait Islander Health Worker colleagues, highlighting their professional profile and status in the health care system. I encourage you to join with us in celebrating the Inaugural National Day of Recognition for Aboriginal and Torres Strait Islander Health Workers and Practitioners. For more information please visit the National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners website.

The Paramedicine Council has recently endorsed the Ahpra and National Boards joint statement on No place for sexism, sexual harassment or violence in healthcare. The Council strongly holds the view that respect is a cornerstone of good, professional practice and it is fundamental to the Australian community’s trust in registered health practitioners. As a consequence, to maintain this community trust there can be no place for sexism, sexual harassment or gendered violence in healthcare. As registered health professionals it is essential we always treat patients, consumers, students, employees and colleagues with respect.

Finally this newsletter focuses on continuing professional development (CPD). CPD is foundational to good practice and figures prominently in the paramedicine regulatory standards. Ultimately CPD, and registration, is about ensuring the safety of the public to whom we provide health care. We hope you find the article on CPD useful in supporting your professional practice.

Mr Alan Morrison ASM

President, Paramedicine Council of NSW

Council changes

The inaugural Council was established at the inception of paramedics joining the National Registration and Accreditation Scheme on 1 December 2018. The inaugural Council members appointed were:

• Mr Alan Morrison ASM – President and Practitioner member
• Mr Peter Lang – Deputy President and Practitioner member
• Ms Cassandra McKenzie – Practitioner member
• Mr Brian Parsell – Practitioner member
• Ms Margo Gill – Community member
• Mr Greg McAllan – Australian Lawyer (up to 2020)
• Dr Ruth Townsend – Australian Lawyer (from 2020 to 30 June 2024)

In our December newsletter, we advised of the expressions of interest process for paramedics and the community to apply for appointment to Council for three years commencing July 2021. The assessment of applications, managed by the Health Professional Councils Authority, concluded with the following appointments by the NSW Governor.

• Mr Alan Morrison ASM – Reappointed President and Practitioner member
• Mr Peter Lang – Reappointed Deputy President and Practitioner member
• Ms Cassandra McKenzie – Reappointed Practitioner member
• Ms Margo Gill – Reappointed Community member
• Mr Phillip Ebbs – New Practitioner member

All members will be joining Ruth Townsend on a three-year term of appointment until 30 June 2024.

Meet our Legal Member

Dr Ruth Townsend

Dr Ruth Townsend was appointed as the Legal Member of Council in November 2020 due to the resignation of its inaugural legal member Mr Greg McAllan. Ruth once worked as a paramedic with NSW Ambulance but has been a lawyer for around twenty years. Ruth is currently a senior lecturer in law, ethics and professionalism at Charles Sturt University and has specialist knowledge in paramedic law and ethics. Ruth is the co-editor and author of the text, ‘Applied Paramedic Law, Ethics and Professionalism’ as well as numerous other book chapters and published articles on areas of paramedicine and the law. Ruth has a PhD in law from the Australian National University. Her thesis is titled, ‘The role of the law in the professionalization of paramedics in Australia’. Ruth is a familiar face to the profession having served for a number of years in associated bodies.

Meet our new Practitioner Member

Mr Phillip Ebbs

Mr Phillip Ebbs was appointed as a Practitioner Member of Council in July 2021. Phillip is a paramedic, university lecturer and researcher. He commenced his paramedicine career in 2001 and has since been involved in clinical, educational, managerial, research and advisory roles across NSW and internationally within the profession. He was a paramedic advisor to the NSW Clinical Excellence Commission, and served as Deputy Chair of the CEC Clinical Council from 2012-2015. A key area of his research explores the complex factors that can contribute to mistakes, misunderstandings and ‘blind-spots’ in clinical practice settings, and the types of strategies needed to help address these complexities. Phillip is a familiar face, having served for many years in NSW Ambulance and associated NSW bodies.

Council hearing and panel members

The Council retains a list of suitably qualified paramedics to support the Council as hearing and panel members. Hearing and panel members are not members of the Council and are not employees of the Health Professional Councils Authority (HPCA). A hearing and panel member will work in collaboration with other members appointed to various hearing panels and assessments. Other categories of hearing and panel members include legal, medical and community members.

If you are interested in becoming a hearing and panel member, and/or have any questions, contact the Council via email at mail@paramedicinecouncil.nsw.gov.au

Continuing Professional Development

In this article we outline the importance of CPD and give some practical examples of how we might go about maintaining and enhancing this part of our professional practice.

The Paramedicine Board of Australia (Board) has established mandatory registration standards and other standards relevant to the eligibility of individuals for registration in the profession. As registered health practitioners, we are required to comply with the CPD registration standard to ensure that we are suitably qualified, and practise in a safe and effective manner. The standards aim to set the benchmark, so as to protect the public from potentially unsafe practice.

What does the CPD registration standard say?

The Board’s CPD registration standard requires us to:

1. Complete at least 30 hours of CPD each year that:

• seek to improve patient outcomes and experiences
• draw on the best available evidence, including well-established and accepted knowledge that is supported by research where possible, to inform good practice and decision-making
• contribute directly to improving your competence (performance and behaviour) and keeping you up to date in your chosen scope and setting of practice
• build on your existing knowledge, and
• include a minimum of eight hours CPD in an interactive setting with other practitioners.

2. Maintain a portfolio that documents your learning goals, records all your planned CPD activities, your reflection on how these CPD activities have or are expected to improve your practice and evidence of having completed these activities.

How can you ensure you meet the CPD registration standard?

The Board’s Guidelines for CPD provide information about how to meet the CPD registration standard. As registered practitioners, you are expected to understand and apply these guidelines together with the CPD standard.

Learning and development occurs throughout a paramedic’s career. CPD is an important foundation of lifelong learning and helps paramedics to maintain and enhance their competence to practise.

Here are some key areas you need to know about meeting the CPD registration standard in a meaningful way:

- Plan your CPD activities so that you are more likely to achieve your learning goals. It is important to reflect on and identify your strengths and any gaps in your practice at the beginning of each CPD cycle (when you renew your registration) as well as throughout the year.

- Choose CPD activities that draw on the best available evidence, that is supported by research where possible, and is aimed at improving patient outcomes. When you are looking for activities you should consider a range of options to help you find CPD that best meets your learning goals.

- Record your learning goals and the CPD activities that you plan to do to meet those goals in your portfolio.

- Reflect on what you have learned and how your CPD has impacted on your practice.

- Record the reflections in your portfolio along with the records and evidence of your completed CPD activities.

There are a range of tools and resources that can support you in developing and maintaining your CPD portfolio. Some of this information is available on the Board’s website.

An example of how one practitioner recorded CPD

This is an example of how CPD might work following receipt of complaint by the Council. It is entirely fictional and bears no relationship to any practitioner.

After coming to the attention of the Council, Rodney was required to provide his CPD portfolio. The following is an excerpt of his reflection on attending an online event:

This online learning provided me with new knowledge and reinforced existing knowledge. It was directly relevant to my scope as a paramedic in the areas of paramedicine. I undertook this activity because I wanted to increase my confidence and knowledge in these areas. I am likely to make changes to my practice. What I learnt provided me with valuable knowledge.

The example above lacks any real details about what was learnt, how it may impact on future practice or what the practitioner might do differently as a result of this new knowledge. It is also not linked to any real learning goal. It does not provide a good example of reflective practice.

A better example?

CPD is yours to manage and undertake, and whilst there are guidelines on how it should be done, the detail of how it is documented or written out is entirely up to you. There is an example template on the Board’s website, however you may choose a format suitable to you for recording your CPD. There are also a number of other options that can be found on the internet or from your professional organisation. You may also use a simple paper template if preferred.

The following is an example of someone’s CPD activity and reflection, but is not a template that must be followed. Don’t focus too much on the structure, focus on the outcome of the learning.

Learning objective:

Develop a greater understanding of CPD documentation requirements

Activities undertaken:

1. Read the CPD standard, guidelines and supporting documents found on the Paramedicine Board of Australia’s website (45 minutes)
2. Watched some recent online material (including videos) of examples of reflective practice from professional sources (i.e. professional college, international regulators, other health professions) (30 minutes)
3. Undertook a peer discussion on types of reflective practice using examples (30 minutes – interactive)
4. Looked for and read recent journal articles on CPD and reflective practice (15 minutes)

Recording the evidence:

Bibliographic details of articles read, websites accessed, and dates and times of peer discussion recorded.

Reflection:

CPD is an annual standard requirement of being a registered health professional, and for paramedicine that includes 30 hours of CPD activity per year, 8 of which must be interactive. The purpose of CPD is for the practitioner to develop their knowledge and skills in the areas they practise to ensure that the public are always provided with the best possible care that is up to date, well informed and practised, and suitable to their needs. Importantly, whilst I have been undertaking CPD and meeting the requirements of the standard, my documentation and planning has not been adequate. As a result of undertaking this learning activity I am now aware that I need to evaluate my practice for areas I need to improve, and plan my future CPD by setting learning goals so that they meet my needs. I also discovered that my reflective practice was not actually reflecting on my existing practice and what I needed to do differently, it was really just a description of what I did. I now understand that to truly reflect, I need to think about what I was doing, what I learnt, how that compares to my previous practice and what I need to do going forward. I need to document this more effectively so that I can demonstrate this process to others. As a consequence of this learning activity, I have started to set learning goals as I discover new things I need to learn. After undertaking learning activities to address these goals, I have undertaken a reflective exercise and documented what I have learnt and what I intend changing or doing differently in the future. As a result of this activity, I have a much better understanding of the CPD requirements. I am confident that my reflections will help improve my knowledge, skills and practice and help me commit the learnings to long term memory, therefore making me a more up-to-date and safe practitioner.

A word of warning about CPD records

If a complaint is made against you, or you are required to submit evidence of your CPD to the regulator, for any reason, you must do so. You are required to retain five years of evidence (or from when first registered if less than 5 years). If you do not, you are in breach of the registration standard, and potentially may be found to have been untruthful on your annual registration declaration.

Various applications and websites are available to help you collate and record your data in a central location. These are popular and helpful if you are not so good at keeping records. These can also assist you by posing questions to help you reflect. However, we are very familiar with the auto text reflections that are populated in some examples of these programs and do not consider those alone to be adequate demonstrations of your reflections. Reflections are specific to what YOU have learnt and what YOU are going to do differently, having completed the learning. Ensure you use your own words to demonstrate what you have learnt and what you are going to do differently as a result.

How does the Council manage complaints?

The Council works in partnership with the Health Care Complaints Commission (HCCC) to manage complaints about registered practitioners and students. A complaint can be made about the health, performance or conduct of a registered health practitioner or student.

The Council deals with complaints about registered practitioners and students where the safety of the public may be at risk, and intervention may be required to assure public safety. The HCCC conducts all investigations in NSW and prosecutes the most serious complaints.

Co-regulation occurs through consultation and clear regulatory functions as outlined in the Health Practitioner Regulation National Law (NSW) for the Council and the Health Care Complaints Act for the HCCC.

Any conditions placed on a registered health practitioner by the Council is notified to Ahpra and practice related conditions are made publicly available on the Register of practitioners. Conditions placed on registration apply nationally.

When a complaint is referred to the Council for management, we have different pathways available for managing these different types of complaints. The practitioner will be provided the details of the complaint and asked to respond to it. When managing complaints, we ensure that our assessment and decision-making processes are fair, and the outcomes result in public protection and safety.

Further information is available on our website:

• How we manage complaints
• A complaint has been made about you
• What do you need to know about our processes ​

Self-notifying about health

The Council has an established pathway to manage complaints about health which is constructive and non-disciplinary. We encourage you to read more about how we manage health complaints on our website, there is also some information about self-notifying if you have a health problem.

Mandatory reporting

In a past newsletter we explored the mandatory notification requirements on education providers, health practitioners and their employers if they have formed a reasonable belief that a practitioner has behaved in a way that constitutes notifiable conduct. Section 140 of the Health Practitioner Regulation National Law (NSW) defines notifiable conduct. The Paramedicine Board of Australia has published guidelines for mandatory notifications to provide direction to health practitioners, employers and education providers about the requirements for mandatory reporting. If you are ever in doubt about your or another health practitioner's performance, and if it requires mandatory reporting, refer to the Paramedicine Board of Australia’s guidelines for mandatory notifications.

Further information

If there are any topics you would like covered in forthcoming newsletters please email us at mail@paramedicinecouncil.nsw.gov.au.