Explanatory Notes Regarding Registration Renewal

NSW MEDICAL BOARD EXPLANATORY NOTES REGARDING REGISTRATION RENEWAL

NOTE: There are changes to the requirements for professional indemnity insurance in your Annual Return. With effect from 1 October 2008 under section 127A (1A) Medical Practice Act 1992, all medical practitioners are required to provide the Board with documentary evidence of their professional indemnity insurance. (See section 3 below.)

1. YOUR RENEWAL DOCUMENTS

Your renewal documents consist of:

  • Annual Renewal Form with Annual Return on reverse side. Both sides are to be completed after reading these explanatory notes. The renewal documents must be completed in entirety by the registrant or other person with Power of Attorney (evidence of Power of Attorney must be provided). Incomplete applications will be returned and the registration process delayed.
  • Workforce Questionnaire (collected on behalf of the AIHW). Participation is not compulsory, but the statistics drawn from this national survey are of considerable utility to the profession and government.

Please complete and return these documents in the envelope supplied together with payment of the annual registration fee. Your registration card and receipt will be sent to your registered address as soon as possible.
The Medical Practice Act 1992 requires the removal from the register of the name of any practitioner who fails to pay on time. It is illegal to practise in NSW if unregistered.

2. YOUR ANNUAL RETURN

  • If you believe that you may be required to make a positive declaration in relation to questions concerning your health, disciplinary decisions in other jurisdictions, or criminal convictions, it is recommended that you contact your medical defence organisation for assistance.
  • If you answer "Yes" to any of questions 1-7 you are required to provide further details, including details of any penalties imposed for offences.
  • Please note that the Board conducts random audits of practitioners to verify statements made in their Annual Return.
  • Your registered address is available for public inspection (see section 6, Privacy). A Post Office Box is ideal to ensure you receive your required mail as well as providing a secure contact address.

3. PROFESSIONAL INDEMNITY INSURANCE (PII)
3.1 General

  • The Health Care Liability Act 2001 requires you to be covered by approved Professional Indemnity Insurance (PII), or to fit within a specified exempt category within the meaning of the Act if you practise medicine in NSW. This includes writing scripts and referrals.
  • Section 127(1A) of the Medical Practice Act 1992 now requires a practitioner to provide documentary evidence to the Board to demonstrate the practitioner either holds approved professional indemnity insurance or is exempt from holding PII.
  • The Act requires evidence in respect of the 'return period', defined as the period of 12 months ending two months prior to your due date.
  • Details of the documentary evidence required to be submitted to the Board are provided below. Relevant documentation, including forms, is included with these renewal documents and also posted on the Board's website.
  • The Board's view is that a registered medical practitioner working in an area with no patient contact and no risk of personal injury claim against that practitioner is not practising medicine for the purposes of the Health Care Liability Act 2001.

3.2 PII documentary evidence required

Note: You may fit in more than one category. Where this is the case, you must provide the required documentation for all applicable categories.

3.2.1 Practitioners who hold PII with an approved insurer

Medical practitioners who are insured with approved professional indemnity insurers (Avant, Invivo, MDA National, MIPS, MIGA) must provide a Certificate of Insurance that relates to the PII cover held during their individual return period, (ie, showing PII cover held during the previous 12 months). These are obtained by contacting your insurer's member services. Although a copy of the policy is acceptable to comply with the regulation, the Board prefers you to provide a Certificate of Insurance. Please indicate on the Annual Return the name of your approved insurer and your member code.
The Board recognises that PII documentation will not necessarily cover the exact period referred to in the Annual Return and will accept the appropriate PII documentation related to the relevant 12-month return period (eg, a Certificate of Insurance demonstrating cover held for the substantial part of the return period, or multiple Certificates of Insurance where appropriate).
Document required: Certificate of Insurance OR policy of insurance

3.2.2 Practitioners exempt from holding PII with an approved insurer

Under the Health Care Liability Regulation 2007, specific provision is made for medical practitioners in different areas of practice, e.g. employees in the public health system, private practice, academics, researchers, and defence service personnel and others who may be exempt from holding PII with an approved insurer. You must provide documentary evidence to demonstrate that you fit within an exempt category. A summary of exempt categories appear below and the full definition of exempt categories is found in the Health Care Liability Regulation 2007, a copy of which is posted on the Board's website.

Please tick the appropriate box(es) on your Annual Return and attach the relevant document(s). Relevant forms and guidelines listed below are attached to your renewal documents. Copies can also be downloaded from the Professional Indemnity Insurance pages of the Board's website (www.nswmb.org.au). If you are reading the online version of these Explanatory Notes, please select the links in the following text to access relevant documents.

Public Health Organisation employees/contractors
Guidelines have been developed for practitioners who work in a public health organisation as:
* Interns
* Resident Medical Officers
* Registrars
* Career Medical Officers
* Medical Superintendents
* Postgraduate Fellows
* Staff specialists
* Visiting medical officers
* Clinical academics.
Document required: Please read the Guidelines: PII documentation for employees/contractors of PHOs for advice on relevant documentation

Other indemnified employee or contractor
An exemption applies to a medical practitioner who practises medicine in the course of being:

(i) employed by another person, or
(ii) engaged by another person under some contractual arrangement.

This exemption applies only in relation to a medical practitioner:

(a) to the extent that the medical practitioner is practising medicine as an employee of, or contractor to, the other person, and
(b) to the extent that the medical practitioner is indemnified, under an insurance policy issued to the other person, for civil liability arising out of the provision of, or failure to provide, health care by the medical practitioner, and
(c) if the other person is not the medical practitioner's practice company.

For the purposes of subclause (b): an insurance policy issued to the other person includes arrangements established or entered into by the State to cover civil liability arising out of the provision of, or failure to provide, health care by a public health organisation or its employees, agents or contractors.
Document required: Form C

Practice outside NSW
An exemption applies to a medical practitioner who practises medicine primarily outside New South Wales and who is covered by professional indemnity insurance of any kind. This does not apply to practitioners working overseas - see section 3.3.2 below.
Document required: Certificate of Insurance or policy of any kind which need not be issued by an `approved insurer'

Not providing health care/opinions
An exemption applies to a medical practitioner whose medical practice does not include the provision of health care or medical opinion in respect of the physical or mental health of a person.
Health care is defined as `any care, treatment, advice, service or goods provided in respect of the physical or mental health of a person.'
Document required: Form D

Government indemnity
An exemption applies to a medical practitioner who, while practising medicine, is covered by an indemnity arrangement established or entered into by the State or the Commonwealth to cover civil liability.
Document required: Form D

Statutory exemption from liability
An exemption applies to a medical practitioner who, while practising medicine in accordance with a function conferred or imposed by or under any State or Commonwealth Act or regulation, does not, under that Act or regulation, incur any personal liability.
Document required: Form D

3.3 PII documentary evidence not required for the following categories

3.3.1 Registered but not practising

Tick this box on the Annual Return if you are registered but not practising medicine. The Board's view is that a registered medical practitioner working in an area with no patient contact and no risk of personal injury claim against that practitioner is not practising medicine for the purposes of the Health Care Liability Act 2001. Examples would include researchers and academics in non-clinical positions.

3.3.2 Practitioner working overseas
Tick this box on the Annual Return if you are a medical practitioner practising exclusively overseas.

3.3.3 Limited prescribing and referral (LPR)
Tick this box on the Annual Return if you are a medical practitioner and your practice is limited only to:
(a) Without fee or reward refer a person to another medical practitioner for the purpose of providing health care,
and/ or
(b) Without fee or reward write a repeat prescription, provided that:

  • the practitioner has undertaken professional education activities relating to the prescribing of therapeutic substances in the preceding 12 months
  • the prescription is a repeat of a prescription issued within the previous six months by another practitioner who is in active practice, and the prescription does not relate to a drug of addiction, or
  • the prescription is provided to a person who requires temporary relief or first aid, pending attendance by that person upon another practitioner who is in active practice.

3.3.4 Non-practising registration
Tick this box on the Annual Return if you are a person whose registration as a medical practitioner is, in accordance with section 9 of the Medical Practice Act 1992, subject to the condition that the person does not practise medicine. (You must hold non-practising registration - see explanation below).

3.3.5 Other
Please provide details if you consider that you do not fit any of the PII categories described. You may not practise medicine in NSW if you do not hold approved PII, or fit within an exempt category.

Please note:
Emergencies:A practitioner who renders assistance on a voluntary or Good Samaritan basis in an emergency is exempt from PII.
Cessation of insurer's business: If a medical practitioner ceases to be covered by approved professional indemnity insurance as a consequence of the cessation of business of the insurer who provided the insurance, the medical practitioner is, in accordance with section 19 (4) (b) of the Act, exempt from the approved insurance requirement but only for a period of no more than 3 months (or such longer period as may be prescribed) immediately following the date on which the medical practitioner ceased to be so covered.

4. NON-PRACTISING REGISTRATION

If you do not intend to practise medicine in NSW during the entire 12 months from your renewal date but wish to remain on the register, you may apply for Non-Practising Registration.

Non-practising registrants are required to complete all the registration renewal documentation, but are exempt from continuing professional education and professional indemnity insurance requirements. No medical practice of any kind may be undertaken by registrants in this category, including writing scripts or referrals. The Provider Number section of Medicare Australia is advised of your change of status.

Please note: To return to active registration, non-practising registrants will have to re-apply for registration. You will have to satisfy the Board as to your fitness to resume practice and may be required to provide evidence of CPD undertaken to maintain knowledge and skills and of your physical and mental health.

Non-practising registrants receive Board correspondence such as newsletters and annual renewal papers. A $50 annual administration fee is payable for Non-Practising registration.

If you wish to move to Non-Practising Registration, please indicate on the first page of the renewal notice and your registration status will be altered from your due date for renewal.

5. REGISTRATION FOR LIMITED PRESCRIBING AND REFERRAL (LPR)

Practitioners who have retired or who have left clinical practice, but wish to remain registered in order to undertake strictly limited prescribing and referral may select this category of registration. If you wish to transfer to active practice at a later date you will have to demonstrate suitability for reregistration.

An annual registration fee of $50 is payable for Limited Prescribing and Referral (LPR) registration.
LPR Registration is subject to conditions as set out above in these explanatory notes under the Professional Indemnity Insurance section for Limited Prescribing and Referral and in the Board's LPR policy (see www.nswmb.org.au under `Policies').

The following summarises the conditions of LPR registration:

  • registration is limited to providing, without fee or reward, renewal of a prescription provided by another medical practitioner (who is in active practice) and referrals.
  • the registrant cannot initiate treatment (including prescribing) or serve as the primary care provider for self or others except in emergency situations.
  • details of professional development activities relating to the prescribing of therapeutic substances must be included with annual returns to the Medical Board.
  • the registrant cannot undertake any medical practice, including part-time practice, locum work, signing medical certificates etc.
  • as per the Board's policy regarding medical practitioners treating relatives and self, all medical practitioners should have their own, independent General Practitioner (see www.nswmb.org.au under `Policies').

If you wish to move to Limited Prescribing and Referral registration, please indicate on your annual renewal and your registration status will be amended to LPR from the due date for your renewal.

6. PRIVACY

The Board is required by law to keep a Register of Medical Practitioners in New South Wales. The Register must be made publicly available. The purpose of a Register is to ensure that administrators, health consumers and other medical practitioners can be assured that a practitioner is a registered medical practitioner.

The Register consists of the practitioner's name, qualifications, registered address and registration status. Your name and registered address is part of the public register and is made available to the public on the Board's website www.nswmb.org.au.

You may provide an address of your choosing, but we can maintain only one address. You should ensure that it is an address through which the Board can communicate with you for such purposes as annual renewals and newsletters. If you believe your safety or well being could be affected by publication of this information, you should advise the Board in writing of your reasons, requesting that your details be suppressed.


COMPLETION OF YOUR ANNUAL RENEWAL FORM

IMPAIRMENT, OFFENCES, ETC (Questions 1 to 7)

If you believe that you may be required to make a positive declaration in relation to questions concerning your health, disciplinary decisions in other jurisdictions, or criminal convictions, it is recommended that you contact your medical defence organisation for assistance.

Criminal convictions, findings and sex/violence offences

  • Parking tickets and minor traffic offences are excluded offences, and are not required to be disclosed.
  • The following more serious traffic offences must be disclosed:
a) furious or reckless driving, or driving in a manner dangerous to the public
b) negligent driving, with a fine of greater than $200, or imprisonment
c) refusing to produce licence, to state name and address, or stating a false name or address
d) driving under the influence of alcohol or any other drug
e) driving whilst unlicensed
f) failing to stop after an accident
g) presence of prescribed concentration of alcohol
h) menacing driving
i) any offence leading to disqualification from driving
  • All criminal convictions and criminal findings, in NSW or elsewhere, with the exception of parking offences and minor traffic offences, must be notified as outlined below. (Note: A practitioner who is charged or found guilty / the subject of criminal finding with respect to a sex or violence offence alleged to have occurred in the course of the practice or purported practice of medicine in NSW or elsewhere must notify the Board within 7 days.)
  • A 'criminal finding' is defined as:
j) a finding that an offence has been proved without proceeding to a conviction.
k) a finding that an offence has been proved and the discharging of, or the making of an order releasing, the offender conditionally on entering into a good behaviour bond for a specified period or on other conditions determined by the court.
  • A 'sex or violence offence' is defined as an offence involving sexual activity, acts of indecency, child pornography, physical violence or the threat of physical violence.
  • A 'sex/violence criminal finding' is defined as a criminal finding for a sex or violence offence.
Significant Illness

The Board does not consider that practitioners with self limiting or well managed illness need to self notify unless the illness could be considered to detrimentally affect their capacity to practise safely.

The Board's Blood Borne Virus Policy states: `A registrant who is aware that he or she is infected with a blood borne virus must not undertake exposure-prone procedures.' The likelihood of positive BBV status detrimentally affecting capacity to practise will substantially depend upon whether such procedures are a foreseeable part of the doctor's practice.

If you have concerns about answering this question, it is recommended that you contact your medical defence organisation.
If the Board is already aware of your health status, there is no need to make a further declaration.

CONTINUING PROFESSIONAL DEVELOPMENT, ETC (Questions 8 to 10)

It is the Board's view that all medical practitioners should participate in Continuing Professional Development, relevant to their area of practice and at a level at least equivalent to that of the relevant College program.

You are required to advise the Board of details of any participation in CPD. The Board accepts as satisfactory evidence of CPD either a copy of your College documentation or a one page summary of your CPD activities for the return period. The Board recognises that College documentation will not necessarily cover the exact period referred to in the annual return and will accept a copy of your most recent College CPD/MOPS documentation.

The Board does not require evidence of CPD from practitioners who do not intend to undertake any form of medical practice. However, CPD is considered to be important and relevant to practitioners in non-clinical, part-time or occasional practice.

Junior Medical Officers and College trainees must complete the annual return, noting their level of training and, where appropriate, the relevant College. No CPD documentation is required.

If you have not done any CPD, you should say so in your annual return. Failure to participate in CPD will not impede your registration, but the question must be answered.

"Retired" practitioners who are exempt from holding Professional Indemnity Insurance in the category of limited prescribing and referrals are required to undertake professional education activities relating to the prescribing of therapeutic substances. Please see the exempt category for PII.

ANNUAL WORKFORCE QUESTIONNAIRE
You are encouraged to complete and return the Questionnaire, using the specialty and sub-specialty codes. This information is collected by all Australian Boards for the Australian Institute of Health and Welfare, and is used for data projection and workforce planning purposes.