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An overview on Accrediation of Australia Health System

06/11/2018 | 08:52 AM

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The accreditation function provides a framework for assuring that individuals seeking registration are suitably trained, qualified and competent to practise as health practitioners in Australia. This is a crucial quality assurance and risk management mechanism for the National Scheme.


Performance snapshot

·        161,114 students studying to be health practitioners through an approved program of study or clinical training program

·        Over 740 accredited approved programs of study delivered by over 330 education providers

·        Over $10 million of National Board funding contributions to accreditation authorities

Accreditation and the National Scheme

Effective delivery of the accreditation function ensures that:

·        graduates of approved programs of study have the knowledge, skills and professional attributes necessary to practise their profession, and

·        overseas-trained practitioners are subject to rigorous assessment to determine whether they have the knowledge, skills and professional attributes necessary to practise their profession in Australia.

Accreditation authorities develop, review and submit accreditation standards to National Boards for approval, which are published on the relevant Board's website. Accreditation authorities also assess and accredit education providers and programs of study against those approved standards, and they are often responsible for assessing overseas-trained practitioners.

Accreditation authorities may be external entities, or they may be committees established by the relevant National Board. They must provide six-monthly reports to their relevant National Board. In 2017/18, AHPRA continued to work with the National Boards to implement an integrated approach to monitoring these reports.

Each year, the National Boards contribute funding to accreditation authorities (refer to Table 1).

For more information, visit the Accreditation authorities page on the AHPRA website.

Table 1: National Board funding contributions to accreditation

National Board

2017/18 ($ '000)1

2016/17 ($ '000)1

Aboriginal and Torres Strait Islander Health Practice Board of Australia

1882

173

Chinese Medicine Board of Australia

1322

133

Chiropractic Board of Australia

176

176

Dental Board of Australia

438

430

Medical Board of Australia

3,695

3,600

Medical Radiation Practice Board of Australia

3922

202

Nursing and Midwifery Board of Australia

2,685

2,659

Occupational Therapy Board of Australia3

15

0

Optometry Board of Australia

306

297

Osteopathy Board of Australia

182

190

Pharmacy Board of Australia

567

550

Physiotherapy Board of Australia

345

260

Podiatry Board of Australia

146

164

Psychology Board of Australia

938

853

Total

10,205

9,687

Note:

1.     These are actual amounts. Requirements of the accounting standards may result in differences between these and the amounts stated in our financial statements.

2.     These amounts include funding for the joint accreditation standards review.

3.     The accreditation authority for occupational therapy did not request any funding from the Board in 2016/17 and requested funding only for the accreditation standards review in 2017/18.

Developing accreditation standards

AHPRA's procedures for developing accreditation standards are an important governance mechanism. They set out issues that:

·        an accreditation authority should consider in developing or changing accreditation standards

·        an accreditation authority should explicitly address when submitting accreditation standards to a National Board for approval

·        a National Board should consider when deciding whether to approve accreditation standards developed by the accreditation authority, and

·        a National Board should raise with the Ministerial Council – and when they should be raised – as they may trigger a Ministerial Council policy direction.

The procedures are published on the Procedures page on the AHPRA website.

Accreditation committees

Three of the National Boards exercise accreditation functions through a committee established by the Board:

·        the Aboriginal and Torres Strait Islander Health Practice Accreditation Committee (ATSIHPAC)

·        the Chinese Medicine Accreditation Committee (CMAC), and

·        the Medical Radiation Practice Accreditation Committee (MRPAC).

AHPRA's role in supporting the accreditation committees provides an opportunity for multi-profession approaches to the accreditation function. This year, AHPRA continued to support the accreditation committees to assess and accredit programs of study and to monitor approved programs.

As at 30 June 2018, the accreditation committees accredit 49 programs of study across the three professions as per Table 2.

Table 2: Accreditation programs in 2017/18

Accreditation committee

Programs currently accredited 
as at 30/06/2018

New accreditation applications 
received in 2017/18

New programs accredited 
in 2017/18

Programs monitored 
in 2017/18

ATSIHPAC

15

0

3

12

CMAC

9

0

3

7

MRPAC

25

2

9

19

Total

49

2

15

38

A risk-based approach to monitoring approved programs

During 2017/18, AHPRA continued to support the three committees to implement and refine a risk-based approach to their monitoring activities. The National Law supports a flexible, risk-based model and AHPRA works with the committees to tailor the methods and frequency of activities to monitor education providers' compliance with the accreditation standards based on specific issues and risk profiles.

This year, AHPRA supported the committees to join the accreditation councils for optometry and chiropractic as partners in a project to develop common risk-based accreditation procedures. Committee members and AHPRA representatives participated in a joint workshop in mid-March 2018 and work is progressing on draft common procedures. Consultation on draft procedures will start in the second half of 2018.

Health Professions Accreditation Collaborative Forum

The three accreditation committees, accompanied by AHPRA, continued to participate in the Health Professions Accreditation Collaborative Forum (HPACF). This participation reflects the HPACF's multi-profession and multi-entity nature and its consideration of issues affecting all accreditation entities.

Applications for accreditation

AHPRA received two new applications for accreditation and monitoring submissions from education providers addressing conditions and specific monitoring requirements for 38 programs.

AHPRA continued to use secure, cloud-based technology for education providers to electronically submit accreditation applications and responses to monitoring. This also allows secure access to assessors, who use the technology to review education provider documents and to submit reports. As education providers and accreditation assessors are located all around Australia, this technology has delivered efficiencies by reducing handling and postage costs.

In 2017/18, the focus of AHPRA's work with accreditation committees moved away from initial accreditation assessments that evaluate all accreditation standards, towards monitoring approved programs of study against higher-risk standards.

Policy, standards and process

AHPRA continued to support enhanced collaboration between the three accreditation committees to refine their approaches to routine monitoring of approved programs of study through annual data collection. This work included the use of a consistent cross-profession process and tools to collect information from more than 30 education providers.

This year, AHPRA continued to support a streamlined approach to accreditation assessment by the ATSIHPAC. This committee replaced the site visit as part of the accreditation assessment with a half-day teleconference. This expedites the timeframe for assessment and approval of programs of study and, because the duration of the programs is 12–18 months, it facilitates completion of these processes in a timeframe that enables students to register on graduation. A representative of the committee visits the education provider within 12 months of the accreditation decision as part of monitoring. In 2017/18, the committee completed monitoring visits to seven registered training organisations. Stakeholders have commented positively on this innovative approach.

Joint review of accreditation standards

In 2017/18, AHPRA started a project to review and revise the accreditation standards and processes for Aboriginal and Torres Strait Islander Health Practice, Chinese medicine and medical radiation practice. The project team is working in collaboration with the three accreditation committees to develop revised accreditation standards that are consistent across the three professions, reflect current and emerging trends in education and practice and address the relevant objectives and requirements of the National Law. The project is also reviewing the accreditation processes and the professional capabilities for the three professions. Wide-ranging multi-profession consultation on the draft revised standards started in June 2018, and the project is due to be completed in late 2018.

Approved programs of study

Accreditation authorities and the National Boards have separate and complementary roles. An accreditation authority's role is to decide whether to accredit a program of study based on the findings of its accreditation assessment. It reports its decision to the relevant National Board.

A National Board decides whether to approve an accredited program of study as providing a qualification suitable for registration in their profession.

AHPRA publishes a list of approved programs of study that provide qualifications for general registration, specialist registration or endorsement of registration. Visitthe Approved programs of Study page on the AHPRA website.

Accreditation systems review

Acting on recommendations from the Independent review of the National Registration and Accreditation Scheme for health professionals, the Ministerial Council asked the Australian Health Ministers' Advisory Council (AHMAC) to commission an independent review of accreditation systems (Accreditation systems review). Visit the Accreditation Systems Review page on the COAG Health Council website. AHMAC appointed Professor Michael Woods as the independent reviewer in late 2016.

During 2017/18, AHPRA continued to work with the National Boards to support their participation in the Accreditation systems review, including developing submissions to the draft report in October 2017. The Accreditation systems review reported to the Ministerial Council in late 2017 and the Health Ministers' response is forthcoming. The final report and Ministers' response will set the future direction for accreditation in the National Scheme.

Accreditation Advisory Committee

In 2017/18, the Agency Management Committee established an Accreditation Advisory Committee (AAC) as a standing committee. The committee will provide oversight and leadership on accreditation governance, accountability and transparency issues and a Scheme-wide perspective on AHPRA's management of contracts for the performance of the accreditation functions, including financial and reporting matters, such as the 2018/19 work-plan and funding updates and the 2018 review of accreditation arrangements.

Establishing the AAC responds to issues and themes identified by the Accreditation systems review draft report and is consistent with the Agency Management Committee's current functions and powers.

Visit the Accreditation Advisory Committee page on the AHPRA website.

Review of existing arrangements

The existing assignments of functions and contracts between the external accreditation authorities and AHPRA (the accreditation arrangements) end on 30 June 2019. In 2017/18, AHPRA worked in collaboration with the National Boards to undertake a scheduled review of the current arrangements for accreditation functions for all professions except paramedicine. The review was deferred from 2017 due to the Accreditation systems review. Following a period of public consultation on a multi-profession analysis of accreditation performance over the last five years, National Boards will decide on the assignment of accreditation functions beyond 30 June 2019. These decisions are subject to any relevant decisions by Ministers about the outcomes of the Accreditation systems review.

Future accreditation activities

A focus for 2018/19 will be finalising new agreements and terms of reference for the next assignment periods. The new agreements/terms of reference will address continued progress on key issues for the exercise of accreditation functions such as:

·        transparency and accountability

·        potential for multi-year agreements

·        embedding inter-professional education and practice

·        addressing workforce priorities

·        cultural safety

·        safety and quality

·        collaboration and sharing good practice

·        multi-profession approaches that avoid duplication and minimise regulatory burden

·        principles for funding and fees, and

·        reporting parameters and qualitative and quantitative key performance indicators.

A further focus will be work arising from any relevant decisions by Ministers about the outcomes of the Accreditation systems review.​