If your employer, a colleague or a practitioner treating you has reported you to Ahpra, they have made a mandatory notification. The law requires one when they reasonably believe you have practised while intoxicated by alcohol or drugs, engaged in sexual misconduct connected with your practice, practised with an impairment that places the public at risk of substantial harm, or practised in a way that is a significant departure from accepted professional standards and places the public at risk of harm. A practitioner treating you has higher thresholds for three of these. A mandatory notification is a concern for Ahpra and your National Board to assess, not a finding against you. Before you do anything else, contact your indemnity insurer, keep every record exactly as it is, and do not approach the person you believe made the notification.
If a concern has been raised about your practice, Dealing with a Complaint or Investigation Professionally covers how to respond to a notification, what Ahpra and your Board look for in your response, and how to show insight and remediation. It is A$200 (A$140 with Bulk Buy 10) for 2 CPD hours, self-paced, with a dated certificate on completion.
For what happens to any notification, stage by stage, read the Ahpra investigation process explained. For your first steps in detail, read Got an Ahpra notification? What to do first.
Who must make a mandatory notification
Under the National Law, health practitioners, employers of health practitioners and education providers must make a mandatory notification when the threshold is met. Anyone else, including a patient, a family member or a colleague who is not sure the threshold is met, can make a voluntary notification.
- A colleague who is a health practitioner and forms the belief in the course of their work, without treating you.
- A treating practitioner, meaning a practitioner who becomes aware of the concern while providing you with a health service. Their thresholds are higher for three of the four kinds of conduct (see the table below).
- Your employer, meaning the organisation that employs or engages you. An employer's obligation covers its staff only where they are registered practitioners.
- An education provider, about a registered student, under a separate guideline.
The four kinds of notifiable conduct
Ahpra's guidelines set the threshold for each kind of conduct, and the threshold depends on who forms the belief.
| Notifiable conduct | Colleague or employer must notify when | Treating practitioner must notify when |
|---|---|---|
| Impairment | you practise with an impairment that places the public at risk of substantial harm | the impairment places the public at substantial risk of harm |
| Intoxication while practising | they reasonably believe you practised while intoxicated by alcohol or drugs | it places the public at substantial risk of harm |
| Significant departure from accepted professional standards | the departure places the public at risk of harm | it places the public at substantial risk of harm |
| Sexual misconduct in connection with your practice | they reasonably believe you have engaged in it | they reasonably believe you have engaged in it, are engaging in it, or might engage in it |
Ahpra describes "substantial risk of harm" as a very high threshold. An impairment on its own is not notifiable: Ahpra's guidelines say a notification is not needed where effective controls manage the impairment, such as a break from practice on sick leave, or treatment the practitioner is engaged in and complying with.
Reasonable belief, not rumour
A notifier must form a reasonable belief that the conduct happened and that it places the public at risk where the threshold requires one. Ahpra's guidelines say "speculation, rumours, gossip or innuendo are not enough". A report from a reliable person who saw or experienced the conduct directly can be enough.
Section 237 of the National Law protects anyone who makes a notification in good faith from civil, criminal and administrative liability, including defamation. If the notifier is a registered practitioner, a notification made in bad faith can lead to regulatory action against them. If you believe a notification about you was made for that reason, say so to your insurer, not to the notifier.
When your employer makes the notification
An employer that makes a mandatory notification remains responsible for managing your performance and protecting patients, so its own processes can run alongside Ahpra's: a workplace investigation, a review of your credentials or scope of practice, or changes to your duties. These are separate from the Board's process and have their own rules and timeframes.
If your right to practise at a hospital or health service is restricted or withdrawn, section 130 of the National Law requires you to tell Ahpra and your National Board within seven days. Failing to do so is not an offence, but Ahpra says it could lead to health, conduct or performance action. Your insurer can help you word the notice.
Resigning does not end the matter. Ahpra's guidelines give the example of an employer that must notify after a practitioner resigned and refused a health assessment, and they state that a clause in a resignation agreement does not remove the obligation to notify.
What happens after a mandatory notification about you
- Ahpra contacts you You are given a case officer, and Ahpra arranges a time to speak with you about what happens next. In some cases, such as where contact could put someone at risk, it cannot contact you straight away.
- Ahpra assesses the concern It gathers information, which can include your response, records and statements, and decides with the Board how the matter is managed: closed, referred to another body, or taken to investigation, a health assessment or a performance assessment.
- The Board decides The outcome can be no further action, a caution, conditions, an undertaking, or referral to a panel or a tribunal. Where the Board believes there is a serious risk, it can take immediate action while the matter continues. What each outcome means is explained in our outcomes guide.
Ahpra says most notifications close within nine months and about 40% within one month, and it will update you at least every three months on a longer matter.
What to do first
- Call your indemnity insurer, medical defence organisation or union before you speak to Ahpra or your employer about the detail of the concern.
- Keep every record exactly as it is. Never change or add to clinical notes after the event.
- Write your own account of the events in question while you remember them clearly, for your insurer, not for sending.
- Do not approach the person you believe made the notification about it, and do not discuss the detail with colleagues who may be asked for information.
- Use the support available. Ahpra lists support services for practitioners and says it is important to engage the supports you need early, including your indemnity insurer and professional association.
- Start remediation where the concern is about conduct or standards, so that your response can show what you have understood and changed, not only what you intend to do.
Where remediation fits
For a concern about a departure from professional standards or about sexual misconduct, the Board looks at whether you understand what went wrong and whether it could happen again. A response that shows insight, a written reflection and completed remediation answers that question with evidence. Our guide on what Ahpra means by insight and remediation explains what counts.
For a concern about impairment or intoxication, the Board looks first at your health and how it is managed: treatment, assessment and any limits on your practice. A course does not replace that, though a course on the subject of the concern can support your response once your health is being managed.
The courses that fit a mandatory notification are Dealing with a Complaint or Investigation Professionally, Professional Boundaries for a boundaries concern with a patient or a colleague, and Insight and Reflection for Fitness to Practise.
Sources and further reading
- Ahpra: Guidelines for mandatory notifications
- Ahpra: Self-reporting for notice of certain events
- Ahpra: What to expect if a concern is raised about you
- Ahpra: Practitioner support services
Frequently asked questions
Is a mandatory notification more serious than a voluntary one?
Not of itself. A mandatory notification means the notifier believed the threshold for notifiable conduct was met. Ahpra and the Board still assess the concern on the information they gather, and the outcome depends on what that information shows.
Does resigning stop my employer from reporting me?
No. Ahpra's guidelines give the example of an employer that must notify after a practitioner resigned and refused a health assessment, and they state that a clause in a resignation agreement does not remove the obligation to notify.
Will a practitioner treating me for a health condition have to report me?
Only in narrow circumstances. For impairment, intoxication and departures from standards, a treating practitioner must notify only where there is a substantial risk of harm to the public, which Ahpra describes as a very high threshold. The threshold for sexual misconduct is lower. Treating practitioners in Western Australia are exempt from the requirement.
Do I have to tell Ahpra if my hospital restricts my practice?
Yes. Under section 130 of the National Law you must tell Ahpra and your National Board within seven days if your right to practise at a hospital or health service is restricted or withdrawn. Failing to do so is not an offence, but Ahpra says it could lead to health, conduct or performance action.
Can I contact the person who reported me?
Do not contact them about the notification. Anyone who notifies in good faith is protected by section 237 of the National Law, and contacting them about it can harm your own response. If you believe the notification was made in bad faith, tell your insurer.
This article is published by Healthcare Ethics Australia for general information. It is not legal advice and does not replace advice from your indemnity insurer, professional association or a lawyer about your own matter.