SIRA is seeking feedback on draft Guidelines for the Provision of Relevant Services (Health and Related Services).

Draft Guidelines for the Provision of Relevant Services (Health and Related Services)

SIRA is seeking feedback on draft Guidelines for the Provision of Relevant Services (Health and Related Services).

  • The Issue

    Consultation period: 06/02/2023 5:00 pm to 02/03/2023 5:00 pm

    What is this about?

    SIRA is seeking feedback on draft Guidelines for the Provision of Relevant Services (Health and Related Services) about services provided in the workers compensation (WC) and compulsory third party (CTP) schemes.

    The draft guidelines specify SIRA’s service and billing expectations for the relevant services delivered by health and health-related service providers in the WC and CTP schemes.

    The draft guidelines are part of the regulatory framework established by amendments to the State Insurance and Care Governance Act 2015 and the State Insurance and Care Governance Regulation 2021 (which SIRA consulted on last year) that empower SIRA to issue directions to health and related service providers.

    Relevant service providers (who are health and related service providers - see the list of services covered in the guidelines) will be required to comply with the guidelines. Currently, the majority of health and related services are provided to injured people with expert care and in compliance with the workers compensation and CTP legislation. SIRA is empowered to issue a direction to providers of relevant services who fail to comply with the Guidelines.

    When the final guidelines are published, SIRA will also publish a policy and procedures document for the regulatory framework, for the information of stakeholders.

    Submissions

    • Feedback and submissions on the draft guidelines should be submitted using the online form below, or via email.
      • Note: The online form can accept submissions up to 10,000 characters (approximately 1500-2500 words). It is suggested you draft your text in a word processing program and then cut and paste it into the form, the online form does not save your work.
    • If your submission is over 10,000 characters, please submit it via email or upload a PDF file using the online form.
    • The closing date for submissions is 5pm, 2 March 2023.
    • SIRA may publish submissions on its website unless accompanied by a request for confidentiality.

  • Milestones

    This consultation opens on Friday 3 February 2023 and closes Thursday 2 March 2023.

  • Outcomes

    The Guidelines are part of the regulatory framework which empower SIRA to manage outlier providers with a pattern of poor practices who have not responded to opportunities provided by SIRA to correct those practices.

    Under the regulation, SIRA has the option to issue a direction if a health-related service provider does not comply with these Guidelines.

    Consultation and response

    Thirty-eight submissions to the public consultation on the draft guidelines were received. SIRA also met with peak groups.

    The main issues raised by stakeholdersSIRA responses
    SIRA will be making decisions about clinical matters without clinical expertise

    In general, SIRA will not investigate concerns about a RSP’s clinical or professional conduct or intervene in individual clinical decision-making.

    If SIRA considers there is a potential risk to an injured person’s health or welfare, SIRA may refer the matter to an appropriate body for investigation, such as the Health Care Complaints Commission, the Health Professional Councils Authority, or other relevant body.

    SIRA is duplicating role of health practitioner boards and associations

    See above.

    Also, SIRA’s aim is to regulate compliance with the workers compensation and motor accident legislation and guidelines, and the Guidelines for the Provision of Relevant Services (Health and Related Services).

    Enforcing compliance with the above is outside the jurisdiction of health practitioner boards and associations.

    SIRA’s powers to issue directions are too broad for just a few outliersThe final guidelines are more focussed in content and have less detail than the consultation draft
    Publication of provider names on a public register is damaging for providers.

    Publication will help injured people and other scheme participants make informed decisions about an RSP.

    Except where there is risk of harm, issuing of a direction and publication on the register will usually occur at the end of a process where the provider has had opportunity to come into compliance.

    SIRA has the power to not publish information on the register and will consider relevant issues - for example the safety and health privacy of the provider. Providers will also be able to request non-publication.

    View the summary of key changes made to the draft Guidelines for the Provision of Relevant Services (Health and Related Services here.

    More information

    This page has more information on the Guidelines, legislation and Regulation, and the associated processes.

    Now the Guidelines have been published, RSPs will be required to comply and SIRA will use them to manage outlier RSPs in the workers compensation and CTP schemes.

    Submissions

    View the submissions here

Documents

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