About the Responsible Authority

How are members of the Responsible Authority appointed?

The members of the Responsible Authority are appointed by the Minister of Health and would include a majority of health practitioners (that the RA covers) and some lay people.

The Ministry of Health advertise for nominations (for people from the profession and for others – lay people outside of the profession who represent the public) and go through a selection and appointment process.

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What does a Responsible Authority do?

The principal purpose of the HPCA Act is to protect the health and safety of members of the public by providing for mechanisms to ensure that health practitioners are competent and fit to practise their professions.

In brief the functions of an RA include:

  • Prescribe the qualifications required for scopes of practice.
  • Accredit and monitor educational institutions, training courses, or programmes.
  • Authorise registration and consider applications for Annual Practising Certificates.
  • Review the competence of practitioners and recognise programmes to ensure the ongoing competence.
  • Receive and act on information about the competence of practitioners.
  • Consider the cases of practitioners who may be unable to practise due to ill health.
  • Set standards of clinical competence, cultural competence, and ethical conduct.
  • Liaise with other Responsible Authorities about matters of common interest.
  • Promote education and training in the profession and public awareness of the responsibilities of the Responsible Authorities.

Each year a practitioner has to apply for an Annual Practising Certificate (APC), the Responsible Authorities monitors the practitioner’s fitness and competence to practice and recertifies the practitioner for another year by issuing the APC.

One of the first tasks of a Responsible Authorities is to define the scope of practice of the health practitioners it regulates, which sets out the health services or tasks commonly performed by them.

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What are the options for Responsible Authority secretariat under the HPCA Act and the benefits and costs of the main options?

The way a Responsible Authority is set up partly depends on the way the RA board is formed and on the number of practitioners to be registered.

If only some ambulance officers and medics (for example ALS and ILS) covering about 1000 people were registered, it would not be cost effective to set up an independent paramedic secretariat.

All the current smaller Responsible Authorities (those with less than 1000 practitioners) are part of a secretariat or share services with another RA and share costs and expertise.

If all ambulance staff and medics were covered by registration, this would result in about 3000-4000 practitioners to be registered, which equates to a medium size Responsible Authority and it would be feasible for a Responsible Authority of this size to set up its own office. This would give the Responsible Authority more profile and allow it to set up its own systems.

Regardless of the number of practitioners to be covered, the Responsible Authority would need to review its options on the best way of organising itself. One of the outcomes of a recent review of the HPCA Act is that the Responsible Authorities and their umbrella group, the Health Regulatory Authorities of New Zealand (HRANZ), will be required to find more efficient ways of operating together.

Currently the Ministry of Health is also seeking changes to the HPCA Act to allow the Minister to join and restructure two or more existing authorities in situations where, after consultation, the Minister is satisfied that it is in the public interest to do and that the current Responsible Authorities and the professions they regulate are generally agreed about the change.

It would be advisable for any new Responsible Authority, no matter what size, to take this into consideration.

The decision on how it operates will depend on the Responsible Authority though it would need the support of the sector before joining a blended board.

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What are the possibilities for cooperation or combining with another Responsible Authority?

A Responsible Authority can work with other registered health practitioner groups at two levels.

The Responsible Authority could have a board which represents several professions to be regulated by that board - which is knownas a blended board. Or the Responsible Authority could have board which only has one group of practitioners and then it could combine with another RA or join a secretariat so there are some common staff and systems.

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What structures are possible for a Responsible Authority?

For ambulance personnel and medics the secretariat could be organised by having:

  • a blended board with one of the existing Responsible Authorities or with one of the new professions seeking coverage under the HPCA Act
  • by joining one of the existing secretariats or sharing a secretariat with other new Responsible Authorities currently seeking coverage under the HPCA Act
  • sharing with another Responsible Authority secretariat
  • organising a serviced office outside the sector or even using the facilities of Ambulance New Zealand
  • collaborating with others to purchase administrative services from another Responsible Authority.

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What are the advantages of being part of a blended board?

At present there are two blended Responsible Authorities.

The Dental Council which covers four groupings from the wider profession, dentists, dental hygienists, clinical dental technologists, dental technologists and dental therapists. The Optometrists and Dispensing Opticians Board covers optometrists and dispensing opticians. In this arrangement all groups to be regulated have some members of their profession on the board of the RA. Staff work across all the professions being registered.

The advantage of this arrangement is that the costs of the Responsible Authority are spread over a wider group of practitioners. Also the Responsible Authority could benefit from the expertise of others at the governance and staff level.

To have a blended board, with practitioners from two or more professions on the board, it is likely that any Responsible Authority would look for a group that had some similarity in ‘scope of practice’. In terms of the ambulance sector, the most compatible alignment would be with nursing and medicine.

A disadvantage would be that there may be concern that ambulance officers and medics would not want to be dominated by a larger profession such as nursing or medicine.

In reviewing the new professions to be regulated, the sector may consider it has matters in common with other new groups currently seeking regulation, for example anaesthetic technicians.

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The advantages of joining an Responsible Authority secretariat

Alternatively a paramedic Responsible Authority could join one of the existing secretariats. Currently there are two secretariats, the Medical Science Secretariat (MSS) and the Health Regulatory Authorities secretariat (HRAS).

In terms of joining a secretariat, the need to align scope is not as important as if there was a blended board.

The two secretariats do operate differently. As the MSS has one registrar and all its staff working across two boards, it would prefer to align itself with Responsible Authorities that can operate similarly to its two existing Responsible Authorities (both of whom have few complaints and disciplinary issues).

HRAS has a wider variety of Responsible Authorities in its secretariat and has a Registrar for each Responsible Authority who share an office and have some common staff to assist with reception, accounting duties and some policy development.

The advantage of being in a secretariat is that a new Responsible Authority could gain from the previous work of the other Responsible Authority in the secretariat. There would also be some savings to be made by sharing office costs and staff.

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Advantages of sharing with another Responsible Authority secretariat

This has been done once in the sector to date. The Psychotherapists Board of Aotearoa New Zealand has a desk within the office of the Occupational Therapy Board of New Zealand.

One of the biggest advantages of this arrangement for a small RA is that it enables it to be able to gain office space and equipment at lower costs and use systems and learn from the work of the other Responsible Authority.

To operate like this another Responsible Authority would need to be found which had spare office space and was willing to share with a new Responsible Authority.

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Benefits from working with other Responsible Authorities

Regardless of size of the group of practitioners to be registered, the Responsible Authority would organise its own systems and way of working but considerable information could be gained from existing Responsible Authorities, such as adapting other Authorities:

  • policies and processes
  • guidelines for dealing with complaints, competence and conduct issues
  • training programmes for members of Competence Reviews and Professional Conduct Committee. recertification systems.

This would allow a new Responsible Authority to build on what has been achieved to date in the sector.

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