Contact Enable on 1800362253 or email enable@health.nsw.gov.au

Accreditation Guidelines

EnableNSW Prosthetic Limb Service

Guidelines for Accreditation of:

Introduction

The EnableNSW Guidelines for Accreditation of Amputee Units and Prescribing Specialists, Prosthetists and Prosthetic Service Providers have been reviewed by the Accreditation Committee comprising representatives of:

  • metropolitan, rural, public and private amputee clinics incorporating medical and allied health clinic members
  • the Australasian Faculty of Rehabilitation Medicine (AFRM)
  • the Prosthetic Manufacturers Association (PMA)
  • Australian Orthotic and Prosthetic Association (AOPA) and
  • EnableNSW

Applications for accreditation and re-accreditation of Amputee Units, Prescribing Medical Specialists, Prosthetists and Prosthetic Service Providers are assessed in accordance with the Guidelines for Accreditation (Guidelines). The Guidelines document the criteria used to determine eligibility to provide services to EnableNSW prosthetic consumers.

Accreditation Process

The accreditation cycle for Amputee Units, Prescribing Medical Specialists, Prosthetists and Prosthetic Service Providers is five years. An applicant can apply for provisional accreditation at any time within the cycle. Provisional accreditation is for a period of 12 months at which time the applicant must apply for full accreditation status. After obtaining full accreditation status the applicant will be included in the normal accreditation cycle.

It is the responsibility of the accredited Prescriber, the Director of the Amputee Unit, accredited Prosthetist or Prosthetic Service Provider to inform EnableNSW of any changes that may affect their accreditation status with EnableNSW.

Review and Appeals (RAP)

It is expected that applications for accreditation will be managed within the Guidelines. If an application is received, and a determination cannot be made, further information and clarification will be sought from the applicant. Advice may also be sought from the appropriate professional body in regard to qualifications and experience.

Where an application is declined, the applicant may appeal the decision in writing to the EnableNSW Appeals Panel. Appeals for applications that fall outside the Guidelines will only be considered when the applicant is able to provide new or additional supporting evidence of compliance. The EnableNSW Review and Appeals Process (RAP) for accreditation is outlined at Appendix A.

Quality Improvement and Review

EnableNSW routinely reviews compliance with the Guidelines to ensure the provision of quality services. Reviews occur through the use of audits or as the result of a specific investigation into an area of non-compliance. EnableNSW will contact an accredited individual and/or facility to address any areas of non-compliance and will work with services to ensure that they are able to meet the standards for accreditation.

EnableNSW can withdraw accreditation status if there is repeated failure to comply with the Guidelines by an individual and/or facility.

Amputee Units

An Amputee Unit is a unit run under the auspice of an Area Health Service incorporating a number of associated amputee clinics at different facilities throughout the Area. These clinics have similar personnel across different facilities.

Where Amputee Units have not been established, individual amputee clinics at a specific facility will undergo accreditation as per the criteria for Amputee Units below.

Preliminary Accreditation

In order to obtain preliminary accreditation with EnableNSW, Amputee Units will be required to:

  • 1. Function within a public or private Hospital that has Australian Council of Health Care Standards (ACHS) Accreditation.
  • 2. Function within a multidiciplinary rehabilitation service classified as level 5 or 6 under the NSW Role Delineation Guidelines according to current best practice.
  • 3. Be able to provide service on both an in-patient and outpatient basis.
  • 4. Nominate the site(s) of each individual Clinic run by the Unit.
  • 5. Have appointed to the Amputee Unit "core members" ie:
    • 5.1 A prescribing doctor(s)
    • 5.2 A visiting prosthetist(s)
    • 5.3 A physiotherapist(s)
  • 6. Nominate all of the Amputee Unit's prescribing doctors individually to EnableNSW.
  • 7. Have one of the Amputee Unit's prescribing doctors nominated to EnableNSW as Director of the Unit.
  • 8. Have access to an occupational therapist and social worker as required.
  • 9. Provide documentation supporting an ongoing commitment to adhere to and obtain the relevant sections of the NSW Health Policy Directive PD2008_015 "Amputee Care Standards in New South Wales", paying particular attention to those standards classified as "A".

Criteria for Re-accreditation:

In order to obtain re-accreditation with EnableNSW, Amputee Units will be required to:

  • 1. Function within a public or private Hospital that has Australian Council of Health Care Standards (ACHS) Accreditation.
  • 2. Function within a multidiciplinary rehabilitation service classified as level 5 or 6 under the NSW Role Delineation Guidelines according to current best practice.
  • 3. Provide service on both an in-patient and outpatient basis.
  • 4. Have appointed to the Amputee Unit "core members" ie:
    • 4.1. An accredited prescribing medical specialist(s).
    • 4.2. A visiting prosthetist(s) with EnableNSW ALS accreditation. Appointed according to the policies and procedures of the relevant Area Health Service and or Hospital running the clinic
    • 4.3. A physiotherapist(s).
  • 5. Nominate all of the Amputee Unit's prescribing medical specialists and other core members of the Unit individually to EnableNSW.
  • 6. Have one of the Amputee Unit's accredited prescribing medical specialists nominated to EnableNSW as Director of the Unit.
  • 7. Have access to an occupational therapist and social worker as required.
  • 8. Show that all Unit personnel have appropriate credentials.
  • 9. Hold a minimum of 6 amputee * "Prescribing Clinic Sessions" per clinic per year.
  • 10. Have >80% of "Prescribing Clinic Sessions" attended by the full core membership of the Unit.
  • 11. Show formal, documented evidence of ongoing commitment to Continuous Quality Improvement / Clinical Audit and Best Practice in the form of multidiciplinary quality and benchmarking activities.
  • 12. Show that each of the core members of the Amputee Unit have, within their own discipline, an ongoing commitment to Continuous Quality Improvement, Best Practice and Continuing Medical Education specifically related to Amputee management.
  • 13. Show a level of prosthetic prescribing for EnableNSW that would enable maintenance of prescribing skills.
  • 14. Have submitted to EnableNSW relevant Amputee Unit related data as requested.
  • 15. Provide documentation supporting commitment to adhere to and obtain the relevant sections of the NSW Health Policy Directive PD2008_015 "Amputee Care Standards in New South Wales", paying particular attention to those standards classified as "A".

* By definition a "Prescribing Clinic Session" is one where a patient(s) is assessed by the core multidiciplinary amputee team, ie the prescribing doctor, prosthetist, and physiotherapist for the purpose of having an EnableNSW ALS script raised if necessary, among other things. It is understood that for reasons of leave, sickness etc the three core members will not all always be in attendance and that at times other team members may attend eg OT, Social worker etc. In order to be classed as a prescribing clinic session a prescribing specialist must be in attendance along with at least one other of the three core team members.

Prescribing Medical Specialists

Criteria for Accreditation

Prescribing medical specialists applying for accreditation will be required to:

  • 1. Have General Registration with the Australian Health Practitioner Regulation Agency.
  • 2. Be a practicing Rehabilitation Medicine Physician with Fellowship of the Australasian Faculty of Rehabilitation Medicine or be able to show an equivalent level of training and experience in the rehabilitation management of limb amputees and limb prosthetics prescription.
  • 3. Have completed Australasian Faculty of Rehabilitation Medicine accredited courses in Lower Limb and Upper Limb Prosthetics. Where a prescriber has completed the lower-limb course, and is waiting to complete the upper-limb course, provisional accreditation may be granted provided the upper-limb course is completed within 12 months and appropriate supervision is provided for upper-limb prescriptions until full accreditation is obtained.
  • 4. Participate in the Continuing Professional Development Program of the Australasian Faculty of Rehabilitation Medicine or equivalent.

Criteria for Re-accreditation

In addition to maintaining the criteria of their initial accreditation (ie "grandfather" and general), in order to obtain re-accreditation, prescribing medical specialists will need to show:

  • 1. Formal, documented evidence of ongoing commitment to Continuous Quality Improvement and Continuing Professional Development in the area of Amputee management since the last accreditation assessment. It is expected that this would take the form of quality activities, conference attendances, research activities, membership of "Special Interest Groups" etc.
  • 2. An average of six (6) prosthetic prescriptions per year for the Prosthetic Limb Service to maintain prescribing skills.

Locum Accreditation

A register of Locum prescribers will be compiled and maintained by EnableNSW.

Locum prescribers will be able to prescribe in accredited Units in place of absent accredited prescribers for a period of up to 6 months. Only prescribers on the Locum list will be able to be nominated as locums in this way.

It is the responsibility of the accredited prescriber who is taking leave to contact EnableNSW prior to the commencement of the leave period to indicate:

  • The name of the locum.
  • The period of the locum.
  • The Clinics that will be covered.

Prescribers will generally be nominated to the Locum Register by an accredited prescriber but may apply on his /her own behalf in this regard.

Criteria for Locum Accreditation

  • 1. Have General Registration with the Australian Health Practitioner Regulation Agency.
  • 2. Have one of the following.
    • 2.1. Previous accreditation as a prescriber of the EnableNSW ALS, or
    • 2.2. Be a practicing Rehabilitation Medicine Physician with Fellowship of the Australasian Faculty of Rehabilitation Medicine or be able to show an equivalent level of training and experience in the rehabilitation management of limb amputees and limb prosthetics prescription. Have completed Australasian Faculty of Rehabilitation Medicine accredited courses in Lower Limb and Upper Limb Prosthetics.
  • 3. Participate in the Continuing Professional Development Program of the Australasian Faculty of Rehabilitation Medicine or equivalent.

The locum list will be updated yearly or as required.

Prosthetists

Criteria for Accreditation

Prosthetists applying for accreditation will be required to:

  • 1. Have eligibility for full AOPA membership.
  • 2. Present references from two prosthetic prescribers (EnableNSW accredited or equivalent) dealing with the prosthetist's clinical and manufacturing skills.
  • 3. Be employed/contracted or have an agreement with an EnableNSW accredited Prosthetic Service Provider.
  • 4. Participate in a professional development program, including supervision by an identified EnableNSW accredited prosthetist and ongoing education, commensurate with clinical skills and experience. This program should be documented and be aligned with the formal health accreditation system of the facility e.g. Australian Council of Healthcare Standards, or AOPA Continuing Professional Development program.

Criteria for Re-accreditation

In addition to maintaining the criteria of their initial accreditation, in order to obtain re-accreditation, prosthetists will need to:

  • 1. Show formal, documented evidence of ongoing commitment to Continuous Quality Improvement and Continuing Education in the area of prosthetic manufacturing and clinical prosthetic practice since the last accreditation assessment. It is expected that this would take the form of quality activities, conference attendances, research activities, membership of "Special Interest Groups" etc. The minimum acceptable level of Continuing Education is to be equivalent to the minimum level required by the AOPA Continuing Professional Development Program. (Details of this program are available at www.aopa.org.au or http://aopa.org.au/index.php?option=com_content&view=article&id=61&Itemid=70).
  • 2. Show a level of prosthetic manufacture and clinical prosthetic practice for EnableNSW that would enable maintenance of clinical prosthetic skills.
  • 3. Remain employed/contracted or have an agreement with an EnableNSW accredited Prosthetic Service Provider.

Prosthetic Service Providers

Accreditation

Accreditation will be required for Prosthetic Service Providers to receive payment from EnableNSW in return for prostheses manufactured or repaired for EnableNSW consumers.

Criteria for Accreditation

In order to obtain accreditation, Prosthetic Service Providers will be required to submit written evidence of the following:

  • 1. Company details
    • 1.1. Name of Company
    • 1.2. Company contacts including their addresses, telephone, fax and E-mail contacts
    • 1.3. Australian Business Number
  • 2. Expertise
    • 2.1. All persons directly involved in the provision of Prosthetic services for the manufacturer who attend amputee clinics or have contact with EnableNSW consumers must be Prosthetists accredited by the EnableNSW ALS or must be under supervision of an EnableNSW accredited Prosthetist.
    • 2.2. The standard of craftsmanship of the Prosthetists referred to in point 2.1
    • 2.3. The qualifications, experience, role in the organisation and proportion of time to be spent in work related to EnableNSW of the administrative, professional, and manufacturing staff (other than those people referred to in point 2.1).
  • 3. Service Delivery
    • 3.1. The existence of suitable and readily accessible premises for the provision of ongoing services to amputees.
    • 3.2. Details of clinics to be serviced by the Prosthetic Service Providers employees.
    • 3.3. Evidence of customer service features eg. trading hours and courier services.
    • 3.4. Evidence of links to clinical support services.
  • 4. Insurance
    • 4.1. Third party property damage insurance or comprehensive insurance for all motor vehicles used in the provision of services.
    • 4.2. Product Liability Insurance.
    • 4.3. Worker's Compensation Insurance.
    • 4.4. Public Liability Insurance including cover for financial or economic loss.
  • 5. Financial Viability
    • 5.1. Corporate structure:
      • 5.1.1. Identify ownership structure
      • 5.1.2. List any parent or subsidiary companies and outline the business they undertake.
    • 5.2. Board of Directors / Board of Management:
      • 5.2.1. List the Directors / Board Members and their occupations.
    • 5.3. Information verifying that set up and ongoing costs can be met for
      • 5.3.1. Administration costs.
      • 5.3.2. Salaries and on costs for staff.
      • 5.3.3. Equipment.
      • 5.3.4. Componentry and incidental costs in the manufacture and repair of prostheses.
    • 5.4. Submission of the most recent financial years business plan
    • 5.5. Validation of Company registration
    • 5.6. Banking details
    • 5.7. Referees for credit check
  • 6. Compliance with NSW Commission for Children and Young People Act 1998
    • 6.1 Registration with Employment Screening and Review Unit (ESRU) at the NSW Department of Health
      • 6.1.1 Registration form is available by contacting ESRU on (02) 9391 9800
    • 6.2 Lodgement of appropriate forms:
      • 6.2.1 Prohibitive employment declaration form for existing employees with ERSU
      • 6.2.2 Working with child background check consent form for new employees with ERSU

Criteria for Re-accreditation

In addition to maintaining the criteria of their initial accreditation, in order to obtain re-accreditation Prosthetic Service Providers will need to:

  • 1. Show formal, documented evidence of ongoing commitment to Continuous Quality Improvement and Continuing Education in the area of prosthetic manufacturing and clinical prosthetic practice since the last accreditation assessment. It is expected that this would take the form of quality activities, conference attendances, research activities, membership of "Special Interest Groups" etc.
  • 2. Show a level of clinical prosthetic practice and / or prosthetic manufacture for EnableNSW that would enable maintenance of clinical and manufacturing skills.
  • 3. Show compliance with the NSW Commission for Children and Young People Act 1998.

The following image contains a flowchart describing about the approval and appeal processes. For detailed information contact us

EnableNSW Prosthetic Limb Service - Flowchart for Managing Reviews and Appeals