In short
A clinical care, or performance, concern is about the quality and safety of your care, measured against Good Medical Practice and the standard expected by your peers and the community. Clinical care is the most common concern in notifications about doctors. A poor outcome is not the same as substandard care, and a different but reasonable clinical approach is not a departure from the standard. At assessment, the Medical Board weighs your reflections and actions, so a considered, evidenced response matters. Most matters resolve with education or no further action.
What is a clinical care or performance concern?
It is a concern that the quality or safety of your clinical care fell short of the expected standard.
Australian regulation views a notification through one of three lenses: conduct, performance or health. A performance concern asks whether your clinical care met the standard reasonably expected of a doctor. Clinical care is the most common concern raised about doctors, though many notifications also involve communication and record keeping. The benchmark is Good Medical Practice, the code of conduct for doctors. Our guide to what happens after a notification to the Medical Board sets out the overall process.
What standard is your care measured against?
Whether your performance or conduct is at or below the standard expected by your peers and the community.
The test
When a notification is determined, the relevant sections of Good Medical Practice are used to consider whether a practitioner's performance or conduct is at or below the standard expected by peers and the community.
This matters because the standard is not perfection, and it is not the best possible outcome with hindsight. It is what a reasonable body of your peers would regard as acceptable in the same circumstances. Framing your response around that peer standard, rather than the outcome, is often the key to explaining your care well.
Is a poor outcome the same as substandard care?
No. A poor outcome, a known complication, or a different but reasonable approach is not a departure from the standard.
This is the single most important distinction for doctors, and one the regulator recognises explicitly. A significant departure from accepted professional standards is one that is serious, not slight or moderate, and would be obvious to any reasonable practitioner. Different clinical decision-making, or innovative practice that still meets accepted standards, does not fall below the bar.
Not substandard
- A reasonable clinical judgement that did not work out
- A known, disclosed complication
- A different but accepted treatment approach
- Innovative practice that still meets the standard
May be a concern
- A serious departure, obvious to any reasonable peer
- Care clearly below the accepted standard
- A pattern of similar shortfalls
- A failure to act on a clear clinical risk
What does the Medical Board weigh at assessment?
The concern against the standard, and crucially your own reflections and actions in response.
At assessment, Ahpra considers whether the conduct or care appears below standard, whether your reflections and actions in response to the event are appropriate, responsible and professional, and whether your workplace can support ongoing safety. It aims to finish the assessment within around 60 days. The regulator distinguishes a single, serious one-off concern that has not been appropriately dealt with from a genuine pattern. The part within your control is your response, so demonstrating insight and evidenced change directly shapes how your matter is viewed.
What outcomes can follow?
Most commonly education and support, with conditions where a genuine gap is found.
Performance matters are frequently resolved through a focus on education rather than punishment, because the aim is safe practice. Where a gap is found, the Board may impose conditions such as supervised practice, mentoring, or further education, which are removed once the risk is addressed. Poor record keeping identified during a notification, for example, may result in a caution or a condition to undertake education in communication and record keeping. Our guide to notification outcomes explains the full range, and where there is a serious risk the Board can take immediate action.
How should you respond to a clinical care notification?
Explain your care against the peer standard, reflect honestly, and evidence remediation for any genuine gap.
Set out your clinical reasoning clearly, mapped to the relevant parts of Good Medical Practice, and explain the standard your peers would apply. Where care did fall short, show honest insight in a reflective statement and back it with targeted remediation. For matters that may become serious, take advice from your medical defence organisation before responding.
Illustrative example
The concern: A doctor was said to have missed a diagnosis, and the outcome was poor.
Explaining the standard: The doctor sets out their reasoning at the time and shows it was a reasonable approach that a body of peers would accept, given the presentation.
Reflection: Where a specific step could have been stronger, they reflect on it honestly rather than becoming defensive.
Remediation: They complete targeted CPD on the relevant clinical area and adjust their safety-netting, evidencing the change.
What if you have had more than one notification?
A single notification is very different from a pattern, and the Board pays particular attention to doctors with multiple substantiated concerns.
Most doctors who receive a notification never receive another. The regulator distinguishes clearly between a single, isolated concern and a series of concerns that may represent a pattern. As part of strengthening how it manages performance, the Medical Board gives closer attention to practitioners with multiple substantiated notifications, including through peer review of professional performance. If you have had more than one concern raised, that is a signal to reflect broadly, not just on the individual events, and to seek support early. Demonstrating that you have looked honestly at any common thread, and taken structured steps to address it, is far more persuasive than treating each matter in isolation.
How can CPD help with a clinical care concern?
Targeted CPD on clinical competence and patient safety gives dated evidence that you have addressed the specific area.
Good Medical Practice itself frames maintaining performance around self-reflection and continuing development, so CPD is a natural part of a strong response. Structured CPD aligned with your CPD registration standard, and matched to the specific concern, turns a claim of improvement into evidence a Board can verify. Paired with a clear reflective statement, it directly addresses whether the risk has been managed. Browse the range of CPD for doctors.
Matched to clinical care concerns
Courses for a clinical care notification
Structured CPD chosen for clinical care and performance concerns, to help you evidence remediation. Independent CPD you can use as evidence of remediation.
Ensuring Clinical Competence and Patient Safety
- Directly targets clinical care and safety
- Strengthen assessment and safety-netting
- Evidence competence for your response
Ensuring Effective Communication as Healthcare Professionals
- Address the communication side of care
- Improve handover, consent and rapport
- Evidence safer communication practice
How to Ensure a Mistake or Misconduct Is Not Repeated
- Show the Board the gap will not recur
- Turn reflection into a lasting change
- Evidence a sustained safeguard
How to Deal With a Notification or Investigation
- Understand each stage of the Board's process
- Prepare for a performance assessment
- Respond calmly and well prepared
Official sources
Frequently asked questions
What standard is a doctor's care judged against?
Whether your performance or conduct is at or below the standard expected by your peers and the community, measured against Good Medical Practice. The test is what a reasonable body of peers would accept, not the best possible outcome with hindsight.
Is a bad outcome the same as substandard care?
No. A poor outcome, a known complication, or a different but reasonable clinical approach is not a departure from the standard. A concern arises where care was clearly below what peers would accept, or shows a serious departure.
What is a significant departure from standards?
One that is serious, not slight or moderate, and would be obvious to any reasonable practitioner. Different clinical decision-making, or innovative practice that still meets accepted standards, does not amount to a significant departure.
Does the Board consider my response?
Yes. At assessment the Board weighs whether your reflections and actions in response are appropriate, responsible and professional, alongside whether your workplace can support ongoing safety. Your response is the part within your control.
Can I keep working during a clinical care notification?
Usually yes. Most doctors keep working while a performance matter is assessed. Your registration is only restricted if the Board takes immediate action, used in a small number of higher risk matters after a show cause process.
What outcomes are common for clinical care concerns?
Performance matters often focus on education. Where a genuine gap is found, the Board may impose conditions such as supervised practice, mentoring or further education, which are removed once the risk has been addressed.
How do I explain my clinical reasoning?
Set out what you knew and decided at the time, and show it was a reasonable approach a body of peers would accept, rather than judging it with hindsight. Where a step could have been stronger, reflect honestly on it.
Does CPD help with a clinical care notification?
Yes. CPD targeted at the specific clinical area, aligned with your CPD registration standard, gives dated evidence that you have addressed any gap. Good Medical Practice frames performance around self-reflection and continuing development.
Dr Richard
Course Facilitator
A practising clinician with over 21 years of experience and postgraduate training in healthcare law and ethics, so every course reflects both clinical reality and Australian regulatory standards.
Written and reviewed by Dr Richard. Last reviewed . Read full profile
AHPRA Courses is an independent training provider. Our courses are structured CPD that practitioners can use as evidence of remediation. We are not affiliated with, endorsed by, or acting on behalf of Ahpra, the Medical Board of Australia, or any other regulator. Courses provide evidence of remediation and do not determine the outcome of any matter. This article is general information, not legal advice. If you have received a notification, seek advice from your medical defence organisation or a health law solicitor.