Notifying and reporting

Notifiable diseases

• Notification law is state-based. Doctors and laboratories notify listed diseases to the state or territory public health unit, and national data go to the National Notifiable Diseases Surveillance System.
• By phone, on clinical suspicion, without waiting for tests: measles, meningococcal disease, diphtheria, botulism, poliomyelitis, haemolytic uraemic syndrome, cholera and viral haemorrhagic fevers.
• In writing or by the laboratory: most sexually transmissible infections, hepatitis B and C, salmonellosis and pertussis.
• Also notifiable: tuberculosis, acute rheumatic fever (in every state, with rheumatic heart disease in several), and most of the distinctly Australian infections, such as Q fever, Ross River virus and melioidosis.

What public health units do

• Trace contacts and give prophylaxis: antibiotics such as ciprofloxacin for close contacts of meningococcal disease; MMR within 72 hours, or immunoglobulin within 6 days, for measles contacts.
• Set exclusion periods, following the NHMRC Staying Healthy guidance:
• food handlers with gastroenteritis: until 48 hours after symptoms stop;
• chickenpox: until all blisters have crusted;
• scarlet fever: until 24 hours of antibiotics;
• slapped cheek: no exclusion once the rash appears.
• Investigate outbreaks. Control measures can start at any stage.

Children at risk

• Every state and territory makes doctors mandatory reporters of child abuse and neglect.
• Report a reasonable belief of risk of significant harm to the child protection agency, whatever the parents want and without needing proof.
• Children living with family violence are at risk too, even if they are not hit.

Colleagues

Doctors must notify Ahpra of a reasonable belief that another practitioner has engaged in notifiable conduct:

1. practising while intoxicated by alcohol or drugs;
2. sexual misconduct in connection with practice;
3. an impairment placing the public at substantial risk of harm;
4. a significant departure from accepted professional standards.

• When the colleague is your patient, the threshold is higher: notify only a substantial risk to the public. For sexual misconduct the threshold stays low.
• Western Australia keeps a broader exemption for treating practitioners.
• Notifications made in good faith are protected.

Deaths reported to the coroner

• Unexpected, unnatural or violent deaths.
• Deaths after an accident or injury, including a fall with a fracture in an older person.
• Deaths related to health care that were not reasonably expected.
• Deaths in custody or care, including involuntary mental health patients.
• Deaths where the cause is unknown, a death certificate cannot be issued, or the person's identity is unknown.

Drivers

• The patient has the legal duty to tell the licensing authority about a condition that affects driving. Advise them not to drive, and document it.
• If a patient keeps driving and is a danger, doctors may report, with legal protection for reports made in good faith.
• Reporting is mandatory for doctors only in South Australia and the Northern Territory.

Family violence

• Only the Northern Territory requires adults to report serious domestic and family violence to police.
• Elsewhere, adult victims are supported to make their own decisions, unless children are at risk or there is a serious threat to life.

Medicines and safety

• Report suspected adverse drug reactions to the TGA, especially for black triangle medicines (new to the market, for 5 years).
• Open disclosure after an adverse event should begin within 24 hours. Victoria has a statutory duty of candour.
• Serious data breaches are reported under the Notifiable Data Breaches scheme.
• Aged care providers must report serious incidents, including abuse of residents.