Alcohol screening policy - Medical Council
Medical
Published on 11 Apr 2018
Medical Council policies outline legislative principles and can also reflect the values/philosophies of the Medical Council. They direct conduct and decision making and must be complied with and implemented by members and staff or delegates of the Council and/or medical practitioners and students practising and training in NSW.
| Document type | Policy |
| TRIM reference number | DD17/63379 |
| Date of endorsement | 6 February 2018 (effective from 4 June 2018) |
| Endorsed by | Medical Council of NSW |
| Publication date | 11 April 2018 |
| Review date | 6 February 2018 |
Summary
This policy and its related procedures outline how to comply with conditions requiring a medical practitioner or student to undergo alcohol screening and the consequences of any non-compliance.
Applies to (scope)
• NSW medical practitioners and students required to undergo alcohol screening
• Medical Council of NSW, its delegates and secretariat staff
| Field | Value |
|---|---|
| Document owner | Medical Director |
| Functional group/subgroup | Monitoring |
1. Purpose
To ensure that medical practitioners and students who are required to undergo alcohol screening comply with conditions imposed on their registration, and explain the consequences of non-compliance.
2. Introduction
The Council uses alcohol screening to monitor medical practitioners and students where there is a history of or concerns about alcohol misuse or dependence.
The Council uses the following screening tests either on their own or in combination to monitor participants:
• Breath-testing for alcohol
• EtG screening
• CDT screening
The Council understands that alcohol screening can be inconvenient, intrusive, and expensive. However, negative alcohol screening results are an effective way for the Council to protect the public, by knowing that a participant is not affected by alcohol and can continue safely in practice or training.
3. Definitions and abbreviations
| Term | Explanation |
|---|---|
| breath-testing for alcohol | a screening test to ensure a participant is not under the influence of alcohol |
| CDT | Carbohydrate-Deficient Transferrin – a screening test designed to identify excess consumption or harmful use of alcohol |
| Council | Medical Council of NSW |
| EtG | Ethyl-glucuronide – a screening test to monitor compliance for abstinence from alcohol, by detecting the presence of EtG (an alcohol breakdown product) in urine |
| the guidelines / the national guidelines | Australian Guidelines: To reduce health risks from drinking alcohol, as revised from time to time |
| HCCC | Health Care Complaints Commission |
| participant | a medical practitioner or student participating in alcohol screening because a condition on their registration requires it |
| the Standard | the AS/NZS 4308:2008, Procedures for specimen collection and the detection and quantitation of drugs of abuse in urine |
| substance | any: • substance listed in Schedule 1 of the Drug Misuse and Trafficking Act 1985 • pharmacist only, prescription only or controlled drug medication as contained in Schedule 3, 4 or 8 of the Poisons Standard (SUSMP) |
| the Tribunal | NSW Civil and Administrative Tribunal |
4. Mandatory requirements for alcohol screening
4.1 Compliance with this policy
Participants must comply with all aspects of this policy, the Council’s related alcohol screening procedures and all alcohol screening conditions on their registration.
If a condition is inconsistent with this policy or the procedures, the condition prevails.
All aspects of screening, including the type of screening and how often participants must attend, will be overseen by the Council. Compliance will be monitored by the monitoring team.
4.2 Non-compliance with alcohol screening
Non-compliance with alcohol screening is any failure to follow the requirements of this policy, the Council’s alcohol screening procedures, and any alcohol screening conditions on a participant’s registration.
If a participant does not comply, the Council will ask them for a written explanation, and may also ask the breath-testing supervisor and breath-testing device manufacturer, or pathology provider for more information. The Council will then consider whether further action is required. In some cases the Council may take action without asking the participant for an explanation.
Non-compliance with alcohol screening includes, but is not limited to, the circumstances listed in the following table.
| Screening type | Circumstance |
|---|---|
| All | • a positive alcohol screening result • the participant fails to commence screening within the required timeframe • the participant fails to attend for screening when required • the participant provides samples for screening outside of the approved collection and testing regimen • the participant fails to complete request forms as required (not for breath-testing) • the participant provides samples that do not meet the chain of custody (not for breath-testing) • the participant uses, makes, alters or possesses an object or product to defraud an alcohol screening test • the provided sample is inadequate or unsuitable for testing • the participant fails to provide supporting information about any absences from screening within the required timeframe • a pattern of participant behaviour raises concerns about their compliance with this policy, the related procedures or related conditions on their registration. |
| Breath-testing for alcohol | • the participant fails to provide the Starting breath-testing for alcohol form within the required timeframe or the information submitted is inadequate or insufficient for approval • the participant fails to maintain their breath-testing log as required • the participant fails to provide their breath-testing log to the Council • the participant fails to service their breath-testing device as required • the participant fails to make alternative arrangements for breath-testing while their device is being serviced. |
If a participant does not comply the Council may:
• give the participant a warning and explain any other action the Council may take if they do not comply in the future
• increase the frequency or length, or change the type of alcohol screening
• require that the participant attend an interview or hearing to consider the matter further
• take immediate action, such as imposing more restrictive conditions (including a critical impairment condition) on or suspending the participant’s registration and refer a complaint to the HCCC
• refer a complaint to the HCCC.
4.3 Compliance with critical impairment and critical compliance conditions
4.3.1 Critical impairment and critical compliance conditions
There are two types of critical conditions that can be imposed on a participant’s registration that have specific consequences for non-compliance. The following table shows which bodies can order these conditions and which participant group is affected.
| Condition type | Ordered by | For |
|---|---|---|
| Critical impairment condition | Medical Council of NSW | Medical practitioners |
| Critical compliance condition | the Tribunal | Medical practitioners and students |
| Professional Standards Committee | Medical practitioners |
4.3.2 Non-compliance with critical impairment and critical compliance conditions
If a participant does not comply with a critical impairment or critical compliance condition, the Council must take action. The following table shows what action is taken if the Council considers that a participant has breached one of these conditions.
| Condition type | Action taken |
|---|---|
| Critical impairment condition | The Council must refer the matter to the HCCC |
| Critical compliance condition | The Council will immediately suspend the participant’s registration and refer the matter to the Tribunal, which must cancel the participant’s registration if it is satisfied that the condition has been breached |
5. Implementation
| Implementing party (Position/Groups/Bodies) | Key actions required by identified party to implement the policy |
|---|---|
| NSW medical practitioners and students | comply with this policy, its related procedures and related conditions imposed on their registration. |
| Monitoring team | monitor compliance with this policy, its related procedures and related conditions imposed on a participant’s registration, on behalf of the Council. |
| the Council | make decisions about a participant’s progress with screening and compliance with this policy, the related procedures and any related conditions imposed on their registration. |
6. Legislation and references
| Category | Reference |
|---|---|
| Laws and standards | AS/NZS 4308:2008, Procedures for specimen collection and the detection and quantitation of drugs of abuse in urine |
| Handbooks | The Council’s Health Program Handbook provides participants with more information about the Health program. |
| Fact sheets | The Council has a range of fact sheets providing information about alcohol screening. |
7. Related policies
8. Revision history
Version | Approved by | Amendment notes |
|---|---|---|
| N/A | N/A |
Last updated on 11 Apr 2018
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