Healthcare Ethics Australia
Ahpra notifications · Australia · The process, explained
A letter has arrived
The Ahpra investigation process, explained
what happens between the letter and the decision: the stages, the timeframes, the outcomes, what a National Board is weighing — and where remediation courses fit
- A notification is not a finding
- Assessment: 60 days, Ahpra's aim
- Most closed within 90 days
- NSW and Queensland differ
In one line
Every regulatory statement on this page is sourced from Ahpra's own published guidance, linked at the foot of the page. This is general information about the process, not advice on your matter. For that, speak to your indemnity insurer, your professional association or a lawyer.
The short version
What happens after an Ahpra notification
A notification is a concern raised with Ahpra about a registered health practitioner. Anyone can make one, and making one is not a finding that anything went wrong.
Ahpra assesses the concern on behalf of your National Board, aiming to finish within 60 days, and says most notifications are closed within 90 days. The Board then decides: often, no further action. Where it goes further, the route runs through investigation, and in the most serious matters through a panel or a tribunal. Only a court or tribunal can cancel registration.
In New South Wales your profession's Council works with the Health Care Complaints Commission; in Queensland the Office of the Health Ombudsman receives every complaint. Between them those two states hold roughly half the registered practitioners in Australia.
Step by step
The stages, in order
Not every notification passes through every stage. Most stop at the third or fourth.
- A notification is made Anyone can raise a concern with Ahpra about a registered practitioner. Ahpra receives it on behalf of your National Board. In New South Wales and Queensland a different body receives it — see below.
- You are told, and asked for information Ahpra normally contacts the practitioner and may ask for a written response. This is usually the first and best opportunity to put your account, your reflection and any steps you have already taken in front of the people deciding.
- Assessment Ahpra gathers information and assesses risk, then reports to the National Board. Ahpra aims to finish assessment within 60 days, and says most notifications are closed within 90 days. The report goes to the Board, not to you or to the notifier.
- The Board decides The Board may take no further action, or refer the matter for investigation, or for a health or performance assessment. If it proposes to restrict your registration you are told in writing and given the chance to show cause first.
- Investigation, if it goes that far An investigator is appointed and gathers evidence. A Board can also start an investigation of its own motion, without any notification, if it has information suggesting a risk.
- Panel or tribunal, in the most serious matters A health panel, a performance and professional standards panel, or a tribunal. Only a court or tribunal can cancel registration. Many notifications never reach this stage.
Three different front doors
Who handles yours
This is the first thing worth establishing, because it changes who writes to you and under which process.
Most of Australia
Ahpra manages the notification on behalf of your National Board. The Board makes the decisions; Ahpra gathers the information and administers the process.
New South Wales
NSW did not adopt Part 8 of the National Law. Your profession's NSW Council works with the Health Care Complaints Commission. There are fifteen such Councils, sharing one administrative body.
Queensland
The Office of the Health Ombudsman receives every complaint, and decides what it keeps and what it refers on to Ahpra.
What is being weighed
What a National Board is actually weighing
Ahpra publishes the things it takes into account when it assesses practitioner risk. The list is worth reading closely, because most of it is fixed by the time the letter arrives — and one item is not.
- The events described What is said to have happened, and in what circumstances.
- Your practice setting Including whether you work in isolation, and whether you work with vulnerable patient groups.
- The nature of your practice Including which Board standards and guidelines cover that kind of practice.
- Your regulatory history What the regulator already holds about you.
- Your responses, reflections and actions Ahpra lists this among the things it weighs. It is the one item on this list you can still do something about after the letter arrives.
- Your workplace The support and risk mitigation offered or already put in place around you.
Where we come in
Where a course actually fits
Of the six things above, five are settled by the time the letter reaches you. The sixth — your responses, reflections and actions — is not, and it is the one Ahpra names in its own list.
That is the whole of the claim we make. No course from us or from anyone else determines or influences what a National Board decides, and we say so on every page. What a course can do is help you think an event through properly and put something on paper that shows it. Whether that helps is for your Board to judge.
- Insight for Fitness to Practise What insight means to a regulator, and how it is evidenced in writing.
- Reflection for Fitness to Practise Structured reflection on an event, rather than an assertion that you have reflected.
- Remediation for Fitness to Practise The steps that reduce the chance of a repeat, and how to record them.
- Ensuring No Repeat of Misconduct or Mistake in Future Practice Turning a single event into a change in practice.
- Fitness to Practise for Healthcare Professionals What the phrase means, and what a Board is deciding when it uses it.
- Dealing with a Complaint or Investigation Professionally Conduct during the process itself, which is also observed.
- Rebuilding Trust of Patients, Colleagues, Public and Healthcare Regulator Where the process ends, and what comes after it.
Those seven run alongside a pair written for your own profession — ethics and professionalism, set against your own Board’s code and guidelines rather than a general one. Together they are the Core Ahpra Remediation Set. Each course is self-paced, opens as soon as payment clears, and carries 2 CPD hours issued by Healthcare Ethics Courses. No Australian National Board accredits any provider’s courses, and we do not claim otherwise.
How it can end
The outcomes a Board can reach
Where a Board proposes to restrict registration, you are told in writing and given the opportunity to show cause before it does.
- No further action Either no ongoing risk was identified, or the steps you and your workplace have already taken are enough to manage it. This is a common outcome.
- A caution A written warning, intended as a deterrent. Ahpra says a caution is not usually recorded on the public register, though a Board may publish one if it considers that appropriate.
- An undertaking A promise you give the Board, usually limiting your practice in some way. Compliance is monitored.
- Conditions on registration Restrictions imposed by the Board rather than offered by you. Also monitored, and recorded on the register.
- Referral elsewhere To a health complaints entity, a coroner, police or Medicare, in whole or in part.
- A reprimand A formal rebuke, available after a panel or a tribunal. Reprimands are published on the national register.
- Suspension or cancellation The most serious outcomes. Only a court or tribunal can cancel registration.
Separate from the outcome
Immediate action, and why it is separate
A National Board can take immediate action at any point in a matter, before anything is decided, if it forms a reasonable belief that there is a serious risk to the public and that restricting practice is the proportionate way to manage it until the matter is resolved.
Two things follow from that. It is a risk decision rather than a finding against you, and it is not the outcome of your notification — the substantive matter continues underneath it. Immediate action carries its own show cause process, and Ahpra describes when it is used on its immediate action page.
Definitions
The words the letters use
Regulatory correspondence uses terms precisely. Reading them loosely is how practitioners frighten themselves unnecessarily, or miss something that mattered.
- Notification. The word the National Law uses for a complaint or concern raised with Ahpra about a registered practitioner. It is not itself a finding of anything.
- Notifiable conduct. The narrow set of concerns that trigger a mandatory notification: practising while intoxicated, sexual misconduct in connection with practice, placing the public at risk of substantial harm through an impairment, or a significant departure from accepted standards.
- Assessment. The stage at which Ahpra gathers information and assesses risk before the Board decides. Ahpra aims to complete it within 60 days.
- Show cause. Where a Board proposes to restrict your registration, it must tell you in writing and give you the opportunity to say why it should not.
- Immediate action. An interim step a Board can take at any time to restrict practice where it forms a reasonable belief of a serious risk. It is a risk decision, not a finding of guilt, and it is separate from the outcome of the notification.
- Own motion. An investigation a Board starts on its own information, without anyone having made a notification.
- Impairment. A physical or mental impairment, disability, condition or disorder, including substance abuse or dependence, that detrimentally affects or is likely to affect your capacity to practise. The National Law treats it as a health matter, usually through a health assessment, and a finding of impairment is not a finding of misconduct.
- Unsatisfactory professional performance. Knowledge, skill or judgement, or the care exercised, below the standard reasonably expected of a practitioner of equivalent training or experience. It is the performance ground, dealt with through a performance assessment rather than a conduct process, and education is the usual remedy.
- Unprofessional conduct. Professional conduct of a lesser standard than the public or your professional peers might reasonably expect. Under the National Law it includes breaching a condition or undertaking, over-servicing, and referring patients to a business you have an interest in without disclosing it. It is the lower of the two conduct thresholds.
- Professional misconduct. Unprofessional conduct substantially below the expected standard, repeated unprofessional conduct that together falls substantially below it, or conduct inconsistent with being a fit and proper person to hold registration. Only a tribunal can make this finding, and it is the ground on which registration is cancelled.
- Fitness to practise. The umbrella phrase practitioners, employers and the UK regulators use for whether someone should be practising at all. The National Law does not use it as a ground; it names four: impairment, unsatisfactory professional performance, unprofessional conduct and professional misconduct. Our Fitness to Practise courses are written to those four grounds.
- Insight. The regulator's shorthand for whether you understand what went wrong, why it mattered, and what you would do differently. It is assessed from what you write and do, not from what you say you feel.
- Remediation. The steps taken to reduce the chance of the same thing happening again — education, supervision, changes to systems or scope.
Before anything else
Where to get help
In roughly this order, and before you write anything.
- Your indemnity insurer or medical defence organisation This is what the cover exists for. Contact them before you draft a response.
- Your professional association Most run a member advice line and have seen the process many times.
- Independent practitioner support Ahpra publishes a list of support services for practitioners who are the subject of a notification.
- A lawyer, where the matter is serious Particularly if immediate action has been proposed, or the matter is heading for a panel or a tribunal.
Written and last reviewed by Dr Shehzad Iqbal, MBBS, MRCS, MRCGP, Postgraduate Certificate in Healthcare Law and Ethics, University of Dundee. Last reviewed . This page is general information about the notification process, not advice on any individual matter. How we handle anything you send us is set out in our privacy policy, and our terms and conditions apply to any course bought on this site.
Questions practitioners ask
Frequently asked questions
Short answers, with the regulator's own guidance linked where it applies.
Does a notification mean I have done something wrong?
No. A notification is a concern raised, not a finding. Anyone can make one. Ahpra assesses it, and in many matters the Board takes no further action.
It is reasonable to find it distressing all the same. Ahpra itself acknowledges the process is stressful and publishes a list of independent support services for practitioners.
How long does an Ahpra notification take?
Ahpra says it aims to finish the assessment stage within 60 days, and that most notifications are closed within 90 days. Those are published aims rather than guarantees, and a matter that goes to investigation, a panel or a tribunal takes considerably longer.
Ahpra sets out its own timeframes on how long the process takes.
What should I do in the first week?
Read the letter properly and note any date you are asked to respond by. Contact your indemnity insurer or medical defence organisation before you write anything — that is what the cover is for. Speak to your professional association.
We are not lawyers and this is not advice on your matter. What we can say is that the written response is usually the practitioner's main opportunity to be heard, and that it is worth taking seriously.
Do I have to respond?
You are usually invited to. Not responding does not stop the process; it means the Board decides without your account of what happened, your reflection on it, or any steps you have already taken.
I am in New South Wales or Queensland. Is my process different?
Yes. New South Wales did not adopt Part 8 of the National Law, so your profession's NSW Council works with the Health Care Complaints Commission. In Queensland the Office of the Health Ombudsman receives every complaint.
Between them, those two states account for roughly half the registered practitioners in Australia. Ahpra explains the separate NSW and Queensland arrangements.
Will completing courses resolve my notification?
No. No course from us or from anyone else determines or influences what a National Board decides. Anyone who tells you otherwise is selling you something.
What Ahpra does say it weighs, among other things, is the practitioner's responses, reflections and actions. Structured remediation is one way of evidencing those. It is not a shortcut, and it is not a defence.
Will my employer be told?
Ahpra may contact your workplace as part of gathering information, and the assessment expressly considers the support and risk mitigation your workplace offers. That is separate from anything we do — we never tell an employer, Ahpra or a National Board that you have taken a course.
Will it show on the public register?
It depends on the outcome. Conditions and reprimands are recorded on the national register. Ahpra says a caution is not usually recorded, though a Board may publish one where it considers that appropriate. A notification that ends in no further action is not published.
My registration is suspended or has conditions. Can I still do a course?
Yes. Nothing about taking an online course depends on your registration status, and nothing you do with us is reported to anyone.
What is immediate action?
An interim restriction a Board can impose at any point where it believes there is a serious risk to the public. It is a risk decision taken before the matter is resolved, not a finding against you, and it carries its own show cause process.
Ahpra describes immediate action and when it is used.
Written for your Board
Find the page written for your Board
Each profession has its own page: the concerns that Board often raises, the Core Set with the ethics and professionalism pair written for that profession, and the topic courses that match the kind of concern. Start with yours rather than a general page — the vocabulary, the code and the guidelines differ.
- Doctors Medical Board of Australia · Ethics and Ethical Standards for Doctors and Professionalism and Professional Standards for Doctors, with the rest of the Core Set and the topic courses for the concerns that Board sees
- Nurses and midwives Nursing and Midwifery Board of Australia · Ethics and Ethical Standards for Nurses and Midwives and Professionalism and Professional Standards for Nurses and Midwives, with the rest of the Core Set and the topic courses for the concerns that Board sees
- Dentists and dental practitioners Dental Board of Australia · Ethics and Ethical Standards for Dentists and Dental Practitioners and Professionalism and Professional Standards for Dentists and Dental Practitioners, with the rest of the Core Set and the topic courses for the concerns that Board sees
- Pharmacists Pharmacy Board of Australia · Ethics and Ethical Standards for Pharmacists and Professionalism and Professional Standards for Pharmacists, with the rest of the Core Set and the topic courses for the concerns that Board sees
- Psychologists Psychology Board of Australia · Ethics and Ethical Standards for Psychologists and Professionalism and Professional Standards for Psychologists, with the rest of the Core Set and the topic courses for the concerns that Board sees
- Physiotherapists Physiotherapy Board of Australia · Ethics and Ethical Standards for Physiotherapists and Professionalism and Professional Standards for Physiotherapists, with the rest of the Core Set and the topic courses for the concerns that Board sees
- Chiropractors Chiropractic Board of Australia · Ethics and Ethical Standards for Chiropractors and Professionalism and Professional Standards for Chiropractors, with the rest of the Core Set and the topic courses for the concerns that Board sees
- Osteopaths Osteopathy Board of Australia · Ethics and Ethical Standards for Osteopaths and Professionalism and Professional Standards for Osteopaths, with the rest of the Core Set and the topic courses for the concerns that Board sees
- Optometrists Optometry Board of Australia · Ethics and Ethical Standards for Optometrists and Professionalism and Professional Standards for Optometrists, with the rest of the Core Set and the topic courses for the concerns that Board sees
- Every other registered practitioner All fifteen National Boards · Ethics for Healthcare Professionals and Professionalism for Healthcare Professionals, with the rest of the Core Set and the topic courses for the concerns that Board sees
Primary sources
Read the regulator's own words
Everything above is drawn from these. Where this page and Ahpra differ, Ahpra is right — guidance changes, and conduct is assessed against the guidance in force when it occurred.
Has a concern been raised about you?
Ahpra's own landing page for practitioners who are the subject of a notification.
What to expect
Ahpra's account of the process from the practitioner's side.
Assessing notifications
How Ahpra assesses risk, including the list of things it weighs.
Investigating practitioners
What happens if a matter is referred for investigation, including own motion investigations.
Possible outcomes
The full range, from no further action through to cancellation.
How long the process takes
Ahpra's published timeframes for assessment and closure.
Guidelines for mandatory notifications
What counts as notifiable conduct, and who must report it.
Practitioner support services
Independent support Ahpra points practitioners towards.
When you are ready
When you are ready to respond
Insight and remediation are not things you can assert. They are things you evidence. If a course would help you do that, the courses are written to Ahpra and each National Board's standards — and none of them changes what your Board decides.
Certificates are issued by Healthcare Ethics Courses.