Participant procedure: CDT screening
Medical
Published on 11 Apr 2018
Procedures provide practical step by step guidance to describe processes and actions required to enable the implementation of a policy or guideline. They can also be developed to ensure compliance with legislative or policy requirements by members, staff or delegates of the Council.
| Document type | Procedure |
| TRIM reference number | DD17/63382 |
| Date of endorsement | 6 February 2018 (effective from 4 June 2018) |
| Endorsed by | Medical Council NSW |
| Publication date | 11 April 2018 |
| Review date | 6 February 2023 |
Summary
This procedure explains to medical practitioners and students who have CDT screening conditions imposed on their registration how to participate in screening. It also explains the process for sample collection for any other blood tests that may be required in the course of alcohol screening.
Applies to (scope)
• NSW medical practitioners and students required to undergo CDT screening
• Medical Council of NSW, its delegates and secretariat staff
| Document owner | Medical Director |
| Functional group/subgroup | Monitoring |
1. Purpose
If you have CDT screening conditions on your registration, this procedure explains how to:
• prepare for screening
• give samples at the required times
• get your results
• manage any absences you need to take
• apply to decrease your screening.
If you are required to have any other blood test in the course of alcohol screening, this procedure explains how to give that sample.
2. Compliance context
You must comply with this procedure and:
• our Alcohol screening policy
• any alcohol screening conditions on your registration
If a condition on your registration is inconsistent with this procedure or the Alcohol screening policy, the condition prevails.
If you must attend other types of alcohol screening you must also comply with the relevant alcohol screening procedure.
We will decide all aspects of screening, including how often you need to attend. Our monitoring team will monitor your compliance.
3. Key information
We use CDT screening to monitor medical practitioners and students where there is a history of or concerns about alcohol misuse or dependence and whose conditions require them to only consume alcohol in a controlled and safe manner, as per the national guidelines. We do this to protect the public.
We understand that providing samples can be inconvenient, intrusive and expensive. However, negative CDT results are an effective way for us to know you are not affected by alcohol and can continue safely in practice or training.
4. Responsibilities
| Parties responsible (Positions/Groups/Bodies) | Key responsibilities |
|---|---|
| NSW medical practitioners and students | comply with processes for CDT screening outlined in this procedure. |
| Monitoring team | monitor compliance with this procedure on behalf of the Council. |
| the Council | make decisions about a participant’s progress and compliance with the Alcohol screening policy and this procedure. |
5. Definitions and abbreviations
| Term | Explanation |
|---|---|
| CDT | Carbohydrate-Deficient Transferrin – a screening test designed to identify excess consumption or harmful use of alcohol |
| Council / we / our | Medical Council of NSW |
| the guidelines / the national guidelines | Australian Guidelines: To reduce health risks from drinking alcohol, as revised from time to time |
| participant / you / your | a medical practitioner or student participating in CDT screening because a condition on their registration requires it |
| substance | any:
|
6. Preparing for screening
6.1 Timing
| Topic | Requirements |
|---|---|
| Start date | We will tell you when you need to start CDT screening. |
| Frequency | You must attend for CDT screening on the first Monday of the month. |
| Public holidays | You do not need to attend for scheduled screening on public holidays (as defined in the Public Holidays Act 2010 (NSW)). But you must attend the next business day after the holiday. |
| Extra screening | We may require you to attend for extra screening if we: • are concerned you are not complying with this procedure, the related policy or any alcohol screening conditions on your registration • believe you may have consumed alcohol excessively. We will advise when you need to attend for extra screening. You may need to attend on a weekend. |
6.2 What to avoid
| Topic | Requirements |
|---|---|
| Alcohol | You may only consume alcohol in a safe and controlled manner as per the guidelines. |
| Prescribed substances and over-the-counter preparations | Some prescription medicines and over-the-counter preparations may cause abnormal screening results. It is your responsibility to avoid these while you are attending for screening. You must vigilantly check any prescribed medicines and over-the-counter preparations you take, including supplements and complementary medicines. You must: • review the ingredient list for alcohol • review the ingredient list for any substance that may cause abnormal results • avoid the preparation if the exact ingredients are not listed or you are unsure. |
| Some health and personal hygiene products, food and drink | Ingredients in health and personal hygiene products, foods and drinks can cause abnormal results. Before you use a health or personal hygiene product or eat or drink anything, carefully check that it does not include alcohol or any other ingredients that may cause abnormal results. If you cannot find out its exact ingredients, you must avoid it. |
7. Giving samples
7.1 Collection centres
| Topic | Requirements |
|---|---|
| Council-approved collection centres | You must attend a Council-approved collection centre for screening. Contact your nominated collection centre to confirm their opening hours and the time you need to attend. |
| Alternative arrangements | We must approve any alternative arrangements, and will only do so in exceptional circumstances. If you cannot attend a Council-approved collection centre, you must: • write to us explaining why • propose an alternative collection arrangement. These arrangements must meet all our collection and screening requirements, and can include collection by a local registered medical practitioner, nurse or pathology provider. You are responsible for any additional costs that may be incurred. |
7.2 Sample collection and handling
| Topic | Requirements |
|---|---|
| Blood | All blood samples are collected and handled in line with all relevant standards of the Council’s approved pathology provider and this procedure. You must not handle your specimen at any time during the collection. |
7.3 Forms
| Topic | Requirements |
|---|---|
| CDT screening request form | We will provide you with CDT screening request forms. You must complete the participant section of this form at every collection. You must complete this form correctly or the pathology provider may not screen your sample. On the form, you must write down: • any substances (prescribed or otherwise) you consumed since your last sample collection • which parties need your results, including us, your treating practitioner and your Council-appointed practitioner • whether you want your results sent to you and any relevant group e.g. medical indemnity insurer. |
| Chain of custody | Every sample must have an accompanying chain of custody form. You must ensure the collector completes this form, and you must sign it when the sample is collected. We recommend you also keep your own sample collection records and ask the collector to sign them each time. |
7.4 Costs, identification and privacy
| Topic | Requirements |
|---|---|
| Payment | You are responsible for all collection and screening costs. You must pay the collection centre when you attend for screening. If you cannot pay when you attend, the centre cannot collect a sample. We will consider this a missed screen. Screening is not eligible for a Medicare rebate. |
| Proof of identity | You must show government-issued photo identification, such as a valid driver licence, identity card or passport, to the collector each time you give a sample. |
| Pseudonyms | If we approve, you can use a pseudonym for screening. You must write to us and provide your: • proposed pseudonym • real name and photo identification • consent to provide the pseudonym to all treating practitioners and Council-appointed practitioners who may receive your screening results. The collector must verify your real identity each time you give a sample. |
8. Getting your results
8.1 Recipients
| Topic | Requirements |
|---|---|
| Nominated parties | The pathology provider will send your results to the parties nominated on your CDT screening request form. You can also request a copy for: • yourself • any relevant group e.g. medical indemnity insurer. |
8.2 Interpreting results
| Result | Interpretation |
|---|---|
| < 1.7% | Low |
| 1.7 – 2.5% | Borderline |
| > 2.5% | Frankly elevated |
| Topic | Requirements |
|---|---|
| Interpreting CDT results | All CDT results will be considered by the Council. We may ask the pathology provider for more information to interpret the result. A guide to result interpretation is included above. |
| Unsatisfactory results | Your CDT result is unsatisfactory if your blood sample is: • adulterated or substituted • otherwise inadequate or unsuitable. If you receive an unsatisfactory result, we will: • ask you for a written explanation • use your explanation and information from the pathology provider to decide whether to take further action. |
9. Managing absences and operational issues
9.1 Absences from screening
| Topic | Requirements |
|---|---|
| All absences | You must follow these procedures when taking leave from practice. If you take leave, we may also: • require your employer or accreditor to confirm your leave period • verify your absence from practice with Medicare. If you are absent and do not follow these procedures we may take further action, particularly if your absences follow a pattern. |
10. Ending your screening
10.1 Decreases
| Topic | Requirements |
|---|---|
| Decreasing your screening | We will decide when you can end your CDT screening. |
| Reviews | You can request a review of your screening requirements by writing to us and providing evidence to support this request. |
| Considerations | We will decide whether to end your screening based on factors such as:
|
11. Contacts and further information
| Drug screening contacts | Support services |
|---|---|
| Queensland Medical Laboratory (QML) Phone: 07 3121 4945 (Commercial services) Visit: www.qml.com.au | Doctors Health Advisory Service Phone: (02) 9437 6552 Visit: www.dhas.org.au |
| Council details | Medical Benevolent Association of NSW Phone: (02) 9987 0504 Visit: www.mbansw.org.au |
Phone: 02 9879 2200 Mail: PO Box 104, Gladesville, NSW 1675 DX: 22808 Gladesville | Beyond Blue Phone: 1300 22 4636 Visit: www.beyondblue.org.au |
| Lifeline Phone: 13 11 14 Visit: www.lifeline.org.au | |
| Alcoholics Anonymous Australia Phone: 1300 222 222 Visit: www.aa.org.au | |
| Australian Doctors in Recovery Visit: https://www.idaa.org/sites/adr/ |
12. Legislation and references
| Category | Reference |
|---|---|
| Handbooks | Our Health Program Handbook provides you with more information about the Health program |
| Fact sheets | We have a range of fact sheets providing information about alcohol screening. |
13. Related policies
Medical Council of NSW Alcohol screening policy
14. Revision history
| Version | Approved by | Amendment notes |
|---|---|---|
| N/A | N/A | N/A |
Related resources
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