Some doctors have warned their regulator, the Health Profession’s Council of SA (HPCSA), against creating an administrative nightmare that could potentially delay doctor registrations and cost medics even more in future.
This after the HPCSA made it mandatory for doctors to submit records of their continuous professional development (CPD) activities.
To ensure that health professionals maintain and update their professional competence in the interest of the public and for the safety of their patients, the regulatory body requires that practitioners meet certain requirements by submitting evidence of their learning activities such as conference presentations and workshops as well as structured courses that have helped them acquire new or updated knowledge.
While doctors had always been required to record this knowledge to remain compliant, they say in the past only doctors who were randomly selected for audit, were required to tender such records.
But during the Covid-19 pandemic, they allege, the HPCSA has introduced a new online portal that makes the submission of these documents mandatory, resulting in backlogs at the council. They claim that the new administrative requirement has the potential of delaying registrations as it is linked to the registration of doctors. While the council hasn’t prevented doctors from registering, some fear that the backlog of certificates that need to be verified would result in an administrative nightmare.
“I think that they are creating a perfect storm. They’re building a system which is ultimately not going to be able to function or it’s going to cost so much more in order to make the system function and add layers of administrative complexity that are not worth the change to the process,” said a Cape Town academic and a specialist in the private sector.
The SA Medical Association (Sama) said it is aware of backlogs at HPCSA since the portal had been introduced. Sama chairperson Dr Angelique Coetzee said the doctor unions remain concerned about approval delays, and are currently working with the HPCSA to fast-track he processing of these essential documents.
“Sama is aware of the new process and is working with the HPCSA to integrate Sama’s online CPD management system. This will ensure that Sama members are not affected by the implementation of the HPCSA’s upload system. We have held numerous discussions with the HPCSA to ensure that the process is fast-tracked, and reassurance has been given that the process will be managed without causing challenges to professionals.”
To test the efficiency of the new portal the Cape Town academic said he uploaded his CPD certificates more than two months ago. However, his profile on the HPCSA portal still indicates that he’s non-compliant with the requirement for skills development.
“I think fundamentally for me dealing with all this, such as checking, verification and approval of these activities, is going to be incredibly labour-intensive. They are going to have a whole team of people working full-time just on checking certificates and ratifying them on the system. And, you know, maybe that’s why I’ve had stuff that’s been uploaded for two months and the status hasn’t changed because obviously we’re going to have this enormous backlog of certificates that have not been checked.”
The academic said given capacity constraints at the HPCSA there was no point in changing a system that’s working, which currently is managed by doctors based on trust. Currently if doctors are chosen for audit and are not in compliance they are usually given six months to get the outstanding points. “From my perspective the system looks like it is working. The HPCSA have to demonstrate that the system is not working before they unilaterally impose a change to the system.
“I think that the principle of making people undergo summative assessments is fine. But most of these CPD activities, the courses in particular, have got assessment built into them. My concern is, what they’re doing is building a system that is going to be incredibly administratively heavy and is actually going to be untenable to keep it running,” he said.
HPCSA spokesperson Christopher Tsatsawane said while the uploading of documents to the online portal, which was activated in October 2020, had resulted in a substantial backlog due to the sheer number of doctors submitting their certificates, this process didn’t impede renewal of registrations.
“The CPD compliance is not linked to registration or renewal of registration. Practitioners can finalise their registration without consideration of continuous professional development.
“The large number of submissions received could not be expeditiously processed, leading to a substantial backlog. The HPCSA plans to clear the CPD backlog soon,” said Tsatsawane.