Participant procedure: EtG screening

• NSW health professionals and students¹ required to undergo EtG 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.

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).

You must call 1800 654 068 each weekday between midnight and 5 pm to find out whether you must attend for screening that day.

You will be screened at least 15 times every six (6) months on randomly selected dates.

If you must attend two (2) times a week EtG screening you do not need to attend for screening on public holidays (as defined in the Public Holidays Act 2010 (NSW)). But you must attend the next business day after the holiday.

If you must attend random EtG screening you do not need to call the Council random screening phone number on a public holiday.

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.

We will advise when you need to attend for extra screening. You may need to attend on a weekend.

Some prescription medicines and over-the-counter preparations may cause positive screening results. It is your responsibility to avoid these while you are attending for screening.

You must vigilantly check any prescription 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 a positive result. If the exact ingredients are not listed or you are unsure, you must avoid the preparation.

Ingredients in health and personal hygiene products, foods and drinks can cause positive 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 a positive result. If you cannot find out its exact ingredients, you must avoid it.

Do not drink too much water before you attend for EtG screening, as this can dilute your sample and cause an unsatisfactory result.

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.

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

• ensure that we receive this proposal as soon as possible, noting that for urine drug screening you must start screening within 7 days of the condition being placed on your registration.

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.

If you are giving a urine sample it must be collected under direct supervision. The collector will stand in front of you and directly observe the urine passing from the urethra into the container.

Samples are otherwise collected and handled in line with the Standard.

You must not handle your specimen at any time during the collection.

We will provide you with EtG 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.

Every sample must have an accompanying chain of custody form, completed in line with the Standard.

For a urine sample, this must state:

• how the sample collection was supervised

• the sample temperature, recorded within 4 minutes of collection

• the urine creatinine result.

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.

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.

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.

The pathology provider will send your results to the parties nominated on your EtG screening request form.

You can also request a copy for:

• yourself

• any relevant group e.g. professional indemnity insurer.

A dilute urine sample has a creatinine level below 1.76 mmol/L.

If your EtG result shows you provided a dilute sample, we will notify you and ask you to take the necessary steps to avoid further dilute samples.

Your EtG result is unsatisfactory if:

• you provide more than one dilute urine sample

• your urine sample was adulterated or substitute

• your sample was 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.

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.

You must continue to screen during absences from practice, except in the circumstances specified below.

If you are absent and do not follow these procedures we may take further action, particularly if your absences follow a pattern.

You must continue to attend for screening while you travel and attend the Council-approved collection centre you nominated on your Leave from screening form.

If you are travelling to a remote location with no available approved centre, we may approve leave from screening.

When you return, you must:

• attend for screening no later than the next business day

• send us evidence of your travel, such as boarding passes and receipts, within five (5) business days.

You do not need to attend for screening while you are outside Australia.

When you return from leave, you must:

• attend for screening no later than the next business day

• send us evidence of your travel, such as boarding passes and receipts, within five (5) business days.

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.

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.

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.

If the random screening phone number is not working when you call, you must:

• note the time you called

• tell us immediately.

We will tell you whether you need to attend for screening that day.

The next day, call the random screening phone number as usual. If we don’t expect the issue to be fixed by the next day, we will tell you what to do.

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.

You may be eligible to decrease to random EtG if you:

• can show you have fully complied with your conditions, this procedure and the related policy

• received negative results for 18 months.

You may be eligible to stop your screening if you:

• can show you have fully complied with your conditions, this procedure and the related policy

• received negative results for a further 12 months.

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