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Tuesday, January 10, 2012

Revised Professional Indemnity Insurance Arrangements Registration Standard

The Nursing and Midwifery Board of Australia has distributed the following message:
A revised Professional Indemnity Insurance Arrangements Registration Standard for nurses and midwives will be in place from the 10 January 2012. ... The registration standard was approved by the Australian Health Workforce Ministerial Council on 11 November 2011.


The revised registration standard:

• will ensure all nurses and midwives are able to practice in accordance with legislative and professional practice requirements

• will be included in the NMBA Safety and Quality Framework for the regulation of midwives including privately practicing midwives providing planned homebirths, and

• is supported by updated and comprehensive guidelines for midwives.

The registration standard can be accessed at http://www.nursingmidwiferyboard.gov.au/Registration-Standards.aspx

The Guidelines for Professional Indemnity Insurance Arrangements for Midwives can be accessed at: http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-Guidelines.aspx 
Q&A DISCUSSION added 11 January 2012 

Some midwives who have read the new PII Registration Standard have questioned the meaning of the statement:
Requirements: ...

3. Nurses and midwives in different types of practice will require different levels of PII cover, according to their particular level of risk.  The following PII cover should be considered:
a). civil liability cover
b). unlimited retroactive cover and
c). run-off cover.

The definition of ‘retroactive cover’ is given: “Retroactive cover means PII arrangements which cover the insured against claims arising out of, or as a consequence of, activities that were undertaken in the course of the practitioner’s professional practice, prior to the date of commencement of the insurance.” (emphasis added)

Q: What does this mean, in reality, for a privately practising midwife?

A: The requirement in the standard says this ‘unlimited retroactive cover’ should be considered. [Note: this statement has not changed since the earlier draft of the document, circulated for comment.]

Q: How would a midwife would come to the conclusion that unlimited retroactive cover is necessary or not in private midwifery practice? How would a midwife weigh up their “particular level of risk” and conclude that retroactive cover is necessary? 

A: These questions are theoretical, because there does not seem to be any indemnity insurance product for midwives that offers anything like retroactive cover. When midwives apply for insurance we are required to disclose any incidents that may lead to legal action. 

I don’t mean to trivialise the matter. It’s difficult to explore these issues, because they are very emotive.

This standard says
“4. It is the responsibility of nurses and midwives to understand the nature of the cover under which they are practising” 
As I see the situation around this revised registration standard, it doesn’t change anything.

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