PSR Newsletter, October 2020
Welcome to the October 2020 edition of the quarterly PSR Panel Newsletter.
Agency activity summary for the quarter
In the period from 1 July 2020 to 30 September 2020 the Agency received 18 new requests. This included the referral of two practitioners with a previous effective determination or negotiated agreement. The Agency finalised 27 requests. This comprised:
- 22 effective section 92 agreements
- 3 effective final determinations
- 2 section 91 ‘no further action’ outcomes
A total of $4,117,627 in repayment directions were made from the finalised matters. Of the finalised matters, 19 involved some form of disqualification.
In this period one new peer review Committee was established and three practitioners were referred to AHPRA because of significant patient safety concerns.
New appointments to the PSR Panel
The following appointments were made to the PSR Panel in the last quarter:
- Professor Nadia Badawi, Neonatal and Perinatal Medicine
- Professor Peter Barlis, Cardiologist
- Professor Paul Colditz, Neonatal and Perinatal Medicine
- Dr John Cosson, Oral and Maxillofacial Surgeon
- Dr Matthew Hawthorne, Oral and Maxillofacial Surgeon
- Professor William Heddle, Cardiologist
- Associate Professor Solomon Menahem, Nephrologist
- Dr Cullen O’Gorman, Neurologist
- Associate Professor Susan Tomlinson, Neurologist
The process is currently underway to appoint six additional specialists.
PSR intends to hold training for Panel members on the following dates:
- Saturday 20 February 2021 in Sydney, for NSW members
- Saturday 27 February 2021 in Brisbane, for Queensland members
- Saturday 6 March 2021 in Canberra, for ACT, SA and Tasmania members
We will consider training for Victorian and Western Australian members as border restrictions evolve.
Contact Andrew Shelley if you have suggestions for the training program.
PSR Annual Report and Statements of Expectation and Intent
PSR received a Statement of Expectations from the Minister for Health, The Hon Greg Hunt, and is currently working to respond with a Statement of Intent, which is due on 14 November 2020. These documents, when finalised, will become publically available as part of the Australian Government’s commitment towards transparency and accountability in operational matters.
PSR reminds practitioners that if they handwrite their notes, there is an expectation that they are legible. If another practitioner cannot read your notes, then this may raise a concern over whether a note is adequate and contemporaneous. This is particularly true for writing prescription details, where illegible handwriting may risk an incorrect prescription being issued.
PSR has reviewed a number of cases this year where the legibility of handwriting was a concern.
Retrospectively amending medical records
PSR reminds practitioners that if they are requested to supply records for peer review, they should not alter the records. PSR has continued to see a number of reviewed practitioners alter their medical records after a request to provide them for peer review. In other cases, PSR has found practitioners entering a large number of entries several days to several months after the alleged date of the medical service. Computer data analysis has demonstrated that hundreds of entries were entered collectively well after the service was performed.
Whilst it is not always possible to enter a record of a consultation at the time of service, there is an expectation that it will be entered as soon as feasible after the service.
Pasting examination findings
PSR has seen a number of practitioners pasting identical examination findings across multiple consultations and across multiple patients. Sometimes the pasted examination findings make no sense. For example a patient may present with a sore knee, but the identical pasted examination for the heart, chest and abdomen are present, and there is no documentation of a knee examination recorded. This raises a concern that the pasted examination findings may not be accurate, or may not have been performed. This raises a concern about the accuracy of the medical record.
Practitioners are reminded that they should record all relevant examinations performed and the actual findings in relation to the patient.
Federal Court Outcomes
On 17 July 2020, the Federal Court delivered its judgment in National Home Doctor Service Pty Ltd v Director of Professional Services Review  FCA 1016. This case followed from the judgment in March 2020 (see the April Newsletter), in which the Court set aside the Director’s decision to refer NHDS to a Committee. Following that judgment, the Director advised NHDS that she was continuing her review.
NHDS then commenced a new action in the Federal Court challenging the Director’s power to continue the review. NHDS argued that as more than 12 months had elapsed since the Director originally commenced her review, the matter is taken to have been dismissed because there was no valid referral made to a Committee within that period.
The Court rejected that argument, and held that for the purposes of section 94, a referral had, in fact, occurred even though it was found subsequently to be invalid. Therefore, section 94 no longer applied to limit the Director’s review. The application for judicial review by NHDS was dismissed and the Director is able to continue her review. The judgment can be accessed here.
PSR publishes a monthly summary of case outcomes on its website. Each summary provides some idea of the person under review's practice profile (in comparison to their peers) and this helps understand why they were referred to PSR for review. In addition, the summaries detail the items investigated, the findings (in the case of a Committee) or the agreement reached between the person under review and the Director (PSR), and the penalties applied.
The PSR Case outcomes can be found here