Bullying, backlogs and overwork at AHPRA

Leaked documents cast light on why the regulator takes so long to deal with notifications against doctors.

---

Harassment, inappropriate behaviour and a rigid top-down management style could be crippling AHPRA from the inside, according to leaked documents and mainstream press.

Internal documents leaked to Nine newspapers paint an unpleasant picture of life working at the regulator.

Bullying and harassment were first raised as a key issue in a 2017 staff survey, and external consultants were first engaged in early 2019, with the report delivered in 2020.

According to current and former staff who spoke to the newspapers, unmanageable workloads and bullying behaviours continue to create a negative workplace at AHPRA.

Unattainable KPIs are mentioned several times in both the reporting and the leaked document, an internal presentation outlining the findings of the 2020 review.

While problems with notification backlogs were pre-existing, the situation reportedly got out of hand in late 2020 and early 2021, at which point AHPRA came down hard on employees who were not meeting KPIs.

Under threat of performance review, AHPRA investigators were pressured to work more efficiently, to the point where important tasks were rushed.

Since the 2018-19 financial year, the number of incoming notifications has increased significantly; there was an initial bump in 2019-20 of around 8%, it held steady through 2020-21 and increased by a further 6% in the year to June 2022.

One staff member calculated that, to meet KPI, staff were spending less than one hour working on any given case in a regular week.

“This appears to be enough for low-risk matters, however appears insufficient for high-risk and cluster matters [multiple complaints about one practitioner],” they said.

AHPRA told the newspapers that it took reports of bullying seriously, and that KPIs were regularly reviewed for suitability.

The leaked presentation was completed by third-party consultants on behalf of the regulator.

Methodology-wise, the consultants spoke with 317 members of staff in focus group settings, received 302 online survey responses and conducted 61 one-on-one interviews.

There were four main findings:

• Inappropriate and uncivil exchanges between staff, boards and management go unchecked, leading to a perceived culture of bullying and harassment.
• High turnover, poor induction, poor processes and inadequate resources are creating strain and tension among staff, exacerbating the uncivil behaviours.
• Hierarchy issues and emphasis on status through positional power are affecting the relationship between AHPRA and the boards.
• Siloed working styles are creating us-versus-them inter-team rivalries, sowing distrust, disconnection and disengagement.

The report prompted a formal investigation into at least one employee, according to the presentation.

Three main recommendations came out of the report.

The first was to improve leadership and manager capability, followed by fixing management systems and workload, and the third was to alter the workplace structure to increase staff voice.

At the centre of the first recommendation is overhauling the way managers and leaders communicate and changing the style from managing tasks to managing people.

In what could be an insight into the state of AHPRA’s culture, the granular recommendations in the “workplace systems” section include goals like making sure “mistakes are not openly criticised” and that people making mistakes are not given less desirable tasks as punishment.

The final recommendation, to change the balance of power, entails de-siloing the organisation and working to standardise procedures and behaviour standards.