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The purpose of Competence Reviews

The Health Practitioners Competence Assurance Act (2003) requires the Board to oversee a system providing for Competence Reviews and Competence Programmes. These are not disciplinary in nature.

A Competence Review is for the purpose of assessing a psychologist’s current competence, and is therefore evaluative and educational.

Competence Programmes include the Board’s Continuing Competence Programme programmes that are specific to individuals or classes of psychologists.

Competence reviews can be triggered when a psychologist’s professional colleagues and/or employer, a Professional Conduct Committee or the the Health and Disability Commissioner raise a significant concern about their competence.

Reviews can be initiated in accordance with section 34 of the Act. The Board can initiate a review if it has not received a section 34 notice. If a section 34 Notice is received, the Board must promptly make inquiries into the matter and may review the competence of a psychologist who holds a current practising certificate.

The Competence Review Panel

Where applicable, a Competence Review Panel (CRP) will be appointed by the Board to carry out a Competence Review. The CRP will comprise two psychologists who are competent, have good interpersonal skills, and have some knowledge of performance and educational assessment relevant to the scope of practice of the psychologist being reviewed.

The psychologist being reviewed will be told about the substance of the Board’s concerns and the assessment process. This may include reviewing written work and files and interviews with the psychologist as well as other commonly accepted assessment tools. This may take from a half-day to a full day or more, depending on the breadth of the competence concerns.

The Board has developed guidelines to assist CRP members and guidelines for the psychologist being reviewed. The Board will meet the costs of a Competence Review. The psychologist must cover any personal costs, such as travel.

Competence Review Panel findings

Within a month of conducting the Competence Review, the CRP must report its findings to the Board’s CCF Committee. If the Committee subsequently determines that the psychologist does not meet the required standard of competence, then they must make one or more of the following orders:

• That the psychologist undertakes an individually prescribed Competence Programme. If this is ordered, the Board will develop a programme to address the concerns identified in the review. This will include specific educational activities and objectives, and periodic reporting (usually through a Board-approved supervisor) and, if required, reassessment at the end of the programme. The psychologist must meet the cost of completing the Competence Programme.
• That one or more conditions be included in the psychologist’s scope of practice.
• That the psychologist sits a specified examination or assessment.
• That the psychologist be counselled or assisted by one or more nominated persons.

Notifications prompting a Competence Review

If you are a health practitioner you may inform the Board if you believe that another psychologist may pose a risk of harm to the public by practising below the required standard of practice. You may wish to refer to the Board’s best practice guideline What To Do If You Have Concerns About Another Psychologist.

When a psychologist resigns or is dismissed from their employment for reasons relating to competence, their employer must give the Board’s Registrar prompt written notice of the reasons for that resignation or dismissal. This will not trigger civil or disciplinary proceedings against any person unless that person has acted in bad faith.

If the Board assesses a risk of serious harm to the public because the psychologist is practising below the required standard of competence, the Board can suspend the psychologist’s practising certificate or alter their scope of practice by changing the health services they are permitted to perform or by including any conditions that the Board considers appropriate.

Frequently Asked Questions

Why introduce Competence Reviews and Competence Programmes?

The Act requires the Board to oversee a system providing for Competence Reviews and Competence Programmes. These are not disciplinary in nature. A Competence Review is to assess the practitioner’s competence, and is therefore evaluative and educational. A Competence Programme is remedial. The Board believes both should be as consultative and supportive as possible. Above all, the Board strives for a system that promotes openness, transparency, and good faith.

Who can ask for a psychologist to be reviewed?

Notifications normally come from other health practitioners (including other psychologists); supervisors; employers (especially where the psychologist has resigned or was dismissed for reasons relating to competence); the Health and Disability Commissioner; or from a Professional Conduct Committee. The Board can also initiate a review without having received any notification.

How does someone request a Competence Review?

A referral must be made in writing to the Board, setting out the reasons why the psychologist may pose a risk of harm to the public by practising below a required standard of competence.

How are competence notifications screened?

Competence notifications are screened by the Board’s CCF Committee (under due delegation) with reference to the Board’s guidelines.

Who conducts the Competence Review?

A Competence Review Panel (CRP) will be appointed. The CRP will normally comprise two psychologists, one of whom is practising in the same area or specialty as the psychologist being reviewed. Where cultural issues are a source of concern the panel will normally include cultural expertise.

In special circumstances, the panel may co-opt others for specific expertise or advice.

Suitable reviewers will be competent, have good interpersonal skills, and have some knowledge of performance and educational assessment. The psychologist being reviewed is informed of the names and qualifications of the proposed panel members and may request a change in the proposed membership if he or she perceives a conflict of interest or has other sound reasons. Such requests will be carefully considered, but may not be granted.

How does the Competence Review proceed?

Notice will be given to the psychologist, including:

• the substance of the concerns, and the grounds on which the Board has decided to carry out a review,
• information relevant to their competence that is in the Board’s possession,
• the terms of reference for the Competence Review. This will give the detail of the review’s focus, and the activities to be undertaken in order to assess competence.

The psychologist is given a reasonable opportunity to make written submissions and be heard (i.e. to make oral submissions) on the matter, either personally or by their representative. If heard personally, the psychologist is entitled to have a support person present.

If any other competence issues are identified during the course of the Competence Review which would normally be serious enough to warrant concern, the CRP will notify the Board.

If other matters that pose a risk to safety are discovered during the course of the review (even if outside of the terms of reference) these must also be conveyed to the Board.

Once the CRP has been given the terms of reference, it will meet to discuss how the review will be carried out and which assessment tools will be applied to the specific situation. The CRP will decide the precise assessments and activities needed after considering any submissions by the psychologist.

It is anticipated that examples may include file reviews, direct observation, case scenarios, interviews, and other discussions with the psychologist. The Act specifies that the review (and any Competence Programme) may also inspect the psychologist’s clinical records.

The psychologist is notified of the planned activities, and a suitable time and place is arranged with the psychologist and any other necessary parties. This practical component of the review may take from a half-day to a full day or more, depending on the breadth of the problem. The psychologist will have an opportunity to be heard on the matter, either personally or by their representative. The psychologist is entitled to have a support person present.

What can a Competence Review decide, and what happens next?

Within a month of conducting the review, the CRP will submit a written report to the Board with a recommendation that the psychologist either meets or does not meet the required standard of competence.

The Board’s CCF Committee then considers the CRP’s report. If it determines that the psychologist does not meet the required standard of competence, the Committee must make one or more of the following orders:

• That the psychologist undertakes a Competence Programme;
• that one or more conditions be included in the psychologist’s scope of practice;
• that the psychologist sit a specified examination or assessment;
• that the psychologist be counselled or assisted by one or more nominated persons.

What are the confidentiality requirements of reviewers?

Reviewers sign a confidentiality agreement in which they undertake not to disclose any personal or health information obtained about the psychologist or their clients except as legally required during the course of the review. In addition, where specific cases are included in the report or discussed with the CCF Committee, no client identifying information is included. If client consultations are observed, the client must sign a consent before the consultation.

Who is informed that a Competence Review is taking place?

Where the psychologist being reviewed is employed in a hospital or health institution it may be required the relevant clinical director and the psychologist’s supervisor be informed. Aspects of the review such as reviewing client records and interviewing colleagues often require others in the workplace to be aware of the review. However, privacy concerns mean that, excepting those who must be notified of a review in accordance with section 35 of the Act, the Board does not normally release information about a psychologist being reviewed without the permission of the psychologist. Circumstances of risk or harm may override these constraints.

Who is informed about the outcome of the Competence Review?

If the review determines that the psychologist does not meet required standards of competence, and the CCF Committee issues orders concerning competence, within five working days the following must be given a copy of these orders:

• the psychologist,
• any employer of the psychologist,
• any person who works in partnership or association with the psychologist.

If the review determines that the psychologist never posed, or no longer poses, a risk of harm to the public, the Board will promptly inform anyone previously informed of the review.

What if the psychologist fails to take part in a Comptence Review?

If the Board is unable to conduct or complete a Competence Review because the psychologist fails to respond adequately to the Notice, then the Act states that the Board “has reason to believe that the psychologist fails to meet the required standard of competence”.

What information is given to the person who made the original notification?

When referrals are made for a Competence Review, the person making the referral is given information about the review process and advised that this is not a disciplinary process, and that the psychologist’s competence may be reviewed. The person is informed that if problems are found, the psychologist will be required to complete a Competence Programme. The original notifier may also be informed of the outcome of the review.

What conditions can be placed on a psychologist pending a Competence Review?

Section 39 of the Act gives the Board the authority to order the interim suspension of a psychologist’s practising certificate, or inclusion of conditions on the psychologist’s scope of practice before or after a review or assessment. This may be ordered where there are reasonable grounds to believe that the psychologist poses a risk of serious harm to the public by practising below the required standard of competence.

Who pays for the Competence Review?

The Board meets the costs of a Competence Review. However, the psychologist is responsible for any personal costs such as travel.

How is a Competence Programme developed?

A Competence Programme should be:

• designed to fill the gaps in the psychologist skills as described in the CRP’s report,
• developed to include specific objectives and educational activities and a process of reporting or reassessment at the end of the process,
• developed to ensure that the programme is feasible.

When necessary, this may include the appointment of a supervisor to guide the psychologist through the programme.

The Board’s CCF Committee drafts the requirements for the programme based on the CRP’s report, input from Chair of the CRP, and discussions with any other appropriate educational providers and any programme supervisor.

What will be included in a Competence Programme?

A programme may include the following:

• specific measurable objectives for the programme,
• details of educational activities the psychologist should participate in to meet these objectives (e.g. specified courses, audits, individual study, practice enhancement activities),
• the specific skills required of and tasks to be performed by any programme supervisor when it is considered that the programme is sufficiently extensive or complex to warrant such an appointment,
• the method for assessing whether the programme’s objectives have been met. Depending on the magnitude of the original problems, assessment might vary from simple reporting to monthly supervisor’s reports followed by a repeat review,
• an intended completion date.

The CCF Committee approves the programme, and an order containing the details of the programme will be sent to the psychologist concerned (and to the supervisor where one is appointed) within twenty working days of approval.

If a further review is required at the completion of the programme, whenever possible one or more of the original reviewers carries out the review. The supervisor is not normally part of the review team.

Who can become a Competence Programme supervisor?

A Competence Programme supervisor should:

• be a peer working in the same broad scope as the psychologist concerned,
• possess good facilitation and interpersonal skills,
• have significant previous experience as a psychology educator or supervisor,
• be competent and have recognised experience in the area of concern,
• be acceptable to the psychologist concerned.

The Board will select the supervisor after discussions with the psychologist, other relevant education providers or professional organisations, and cultural advisors, where necessary. The frequency and method of meetings (face-to-face or online meetings) between the supervisor and the psychologist is specified in the programme, as are the activities to be carried out.

Who pays for the costs of completing a competence programme?

Payment of costs of the Competence Programme is the responsibility of the psychologist undergoing the programme. If the services of a supervisor are required that supervisor will be paid directly by the psychologist undertaking the programme. A standard contract is available from the Board to formalise the relationship between the psychologist and their supervisor.