Late last year, the Medical Board of Australia (MBA) announced a new Professional Performance Framework (PPF) for Australian doctors, which is the culmination of the MBA’s ‘discussion’ around revalidation of the professional competence of doctors.¹

The PPF aims to ensure that all doctors practice competently and ethically through their careers and provide safe care to patients.  It is intended to build on existing frameworks and systems.   It covers:

Strengthened continuing professional development (CPD) requirements

  • Doctors choose a CPD ‘home’ (college or other education provider) and develop a professional development plan with the support of their college / provider;
  • Minimum 50 hours CPD each year – 25% each for education, performance review and outcomes measurement, with the balance split across all three areas;
  • Colleges to have a stronger role in working with doctors to determine appropriate CPD for scope of practice, supporting remediation where it is needed and sharing information with employers and other bodies where there are risks to patients; and
  • Colleges will have a mandatory requirement to report to the MBA if a doctor has not completed CPD requirements.

Active assurance of safe practice

  • Responding to risk factors relating to age and professional isolation;
  • Formal peer review and health check for all doctors from age 70, and three yearly afterwards – outcomes of these processes are not reported to the MBA unless there is a serious risk to patients; and
  • MBA to provide guidance on what professional isolation is and how to manage it, and increase peer-based CPD for isolated doctors.

Strengthened assessment and management of doctors with multiple, substantiated complaints

  • Focusing on the 3% of doctors who account for nearly 50% of complaints; and
  • Requiring formal peer review in cases of multiple, substantiated complaints – there is no set threshold for this, and it will initially depend on the circumstances. The MBA considers results and determines any necessary action.

Guidance to support doctors

  • Stakeholder consultations to revise the Board’s Good Medical Practice Code of Conduct, and revise / develop a range of new standards, including for CPD and personal health; and
  • Colleges to increase support for career transitions, including changes in scope of practice and retirement.

Collaboration to foster a culture focused on patient safety and respect, encouraging doctors to take care of their own health and well-being

  • Looking at how to improve professionalism in students and younger doctors, including behaviour and personal health;
  • Addressing under-developed and fragmented systems for early identification and remediation of under-performance in doctors; and
  • Encourage ‘large data holders’ to make information available for the benefit of individual doctors, and explore scope for organisations to share data around poor performance and public risks.

The framework is subject to further consultation on how it will work in practice, and will be introduced in phases over the next couple of years.

MIGA has contributed to various consultations and discussions around PPF / revalidation over the last couple of years, including through stakeholder meetings, convening high level discussion forums, raising key issues through professional publications and at conferences,² and providing detailed submissions to the MBA.³

Given what we have now is only a broad framework, much work remains to be done on the specifics of PPF and its operation.  There are key issues around assessment processes, thresholds for reporting and further action, remediation, sharing information and professional expectations which are still to be worked through.  We are also conscious of the emotional and resourcing burdens that this new system may place on our members and the broader profession, and are looking to minimise this wherever practically possible.

We will continue to advocate in the interests of members, work with the MBA and other stakeholders, and keep you up to date as the framework develops and implementation approaches.

Details of the PPF are available
2 See MIGA session at Rural Medicine Australia 2017 – ‘Revalidation – revolution or incremental reform’ – available here to download
3 MIGA’s detailed submission to the Board’s consultation on initial proposals is available here to download.

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