Participant procedure: CDT screening
HPCA
Aboriginal and Torres Strait Islander Health Practice
Published on 1 June 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.
| Date of Endorsement | 1 June 2018 |
| Endorsed By | Health Professional Councils of NSW |
| Publication Date | 1 June 2018 |
| Review Date | 1 June 2023 |
| Summary | This procedure explains to NSW health professionals and students¹ 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 health professionals and students¹ required to undergo CDT screening • Health Professional Councils of NSW, their delegates and HPCA staff. There are separate policy and procedure documents for the Medical Council and the Nursing and Midwifery Council. |
| Document Owner | Assistant Director – Council Services |
| Functional Group/Subgroup | Council Services, HPCA |
¹does not apply to Psychology
Table of Contents
- Purpose
- Compliance context
- Key information
- Responsibilities
- Definitions and abbreviations
- Preparing for screening
- Giving samples
- Getting your results
- Managing absences and operational issues
- Ending your screening
- Contacts and further information
- Legislation and references
- Related policies
- Revision history
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 NSW health professionals and students¹ 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 registered health professionals and students¹ | comply with processes for CDT screening outlined in this procedure. |
| HPCA monitoring team | monitors compliance with this procedure on behalf of the Council. |
| Councils | 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 | relevant Health Professional Council |
| the guidelines / the national guidelines | Australian Guidelines: To reduce health risks from drinking alcohol, as revised from time to time |
| HPCA | Health Professional Councils Authority |
| participant / you / your | a registered health professional or student¹ participating in CDT screening because a condition on their registration requires it |
| 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). |
¹does not apply to Psychology
6. Preparing for screening
6.1 Timing
Item | 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
| Item | 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 and any substance that may cause abnormal results. If the exact ingredients are not listed or you are unsure, you must avoid the preparation. |
| 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
| Item | 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
| Blood | |
|---|---|
All blood samples are collected and handled in line with the 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
| 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. professional 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
| Item | 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
| 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. professional indemnity insurer. |
8.2 Interpreting results or unsatisfactory results
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 below.
Result | Interpretation |
|---|---|
| < 1.7% | Low |
| 1.7 – 2.5% | Borderline |
| > 2.5% | Frankly elevated |
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
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.
Planned absences
If you intend to take a planned absence from practice, you must:
- complete our Leave from screening form
- ensure we receive this at least five (5) business days before your planned absence.
You must tell us if you plan to be absent on the date you must attend CDT. We will tell you when you need to attend for screening. We will use the date you attend to recalculate your next screening date.
You must also meet the following requirements:
| Reason | Requirements |
|---|---|
| Planned medical procedure | You must inform us of any planned medical procedure that may stop you from attending for screening. When you return from leave, you must: • attend for screening no later than the next business day • send us written confirmation of the procedure from the practitioner who performed it and any substance they advised, prescribed or administered, within five (5) business days. |
Unplanned absences
| Reason | Requirements |
|---|---|
| Missed screen | If you realise you have missed your screening, you must: • notify us immediately and explain why • provide us with evidence to support your absence within five (5) business days • attend for screening no later than the next business day. |
| Illness | If you are ill and cannot attend for screening, you must: • notify us within 24 hours of failing to attend • visit a medical practitioner who knows you are required to attend for screening and ask them to complete an Illness certificate form. When you return from leave, you must: • attend for screening no later than the next business day • ensure we receive your Illness certificate form within five (5) business days. The certifying medical practitioner can only certify that you are ill for a maximum of three (3) business days. If you are ill for more than three (3) days you need to notify us and send us another completed Illness certificate form. We prefer the same medical practitioner completes the form each time. If you remain ill after that and are unable to screen you must contact us and provide supporting information from your treating practitioner about your illness, whether any substance has been advised, prescribed or administered, and when you will be able to return to screening. You must not practise during this time. |
9.2 Operational issues
| Pathology provider issues | |
|---|---|
If the Council-approved collection centre cannot collect your sample, you must: • tell us immediately • attend for screening no later than the next business day • send us the pathology provider’s written explanation for why they could not collect the sample, within five (5) business days. |
10. Ending your screening
10.1 Decreases
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:
- your request and the evidence you provide
- your CDT screening results and other information from the pathology provider
- any other alcohol screening results
- reports from your Council-appointed practitioner, treating practitioner and any interview or hearing with us
- your compliance with the conditions on your registration
- your engagement with treatment
- your health
- any other information about your progress.
11. Contacts and further information
Drug screening contacts
Support services
| Service | Details |
|---|---|
| Queensland Medical Laboratory (QML) | Phone: 07 3121 4945 (Commercial services) Visit: www.qml.com.au |
| Councils | Phone: 1300 197 177 Visit: www.hpca.nsw.gov.au/councils-list Mail: mail@hpca.nsw.gov.au |
| 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 |
Council Email addresses
- mail@atsihealthpracticecouncil.nsw.gov.au
- mail@chinesemedicinecouncil.nsw.gov.au
- mail@chiropracticcouncil.nsw.gov.au
- mail@dentalcouncil.nsw.gov.au
- mail@medicalradiationpracticecouncil.nsw.gov.au
- mail@occupationaltherapycouncil.nsw.gov.au
- mail@optometrycouncil.nsw.gov.au
- mail@osteopathycouncil.nsw.gov.au
- mail@pharmacycouncil.nsw.gov.au
- mail@physiotherapycouncil.nsw.gov.au
- mail@podiatrycouncil.nsw.gov.au
- mail@psychologycouncil.nsw.gov.au
12. Legislation and references
Fact sheets
We have a range of fact sheets providing information about alcohol screening.
13. Related policies
14. Revision history
| Version | Approved by | Amendment notes |
|---|---|---|
| 1st Version | N/A | N/A |
Last updated on 1 June 2018
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