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Compliance Readiness Report
Northbank Family Practice · General Practice · Newcastle, NSW
Prepared 23 September 2026
AGPAL accreditation is scheduled for 14 May 2027 (233 days away).
Section 01
Executive summary
As at 23 September 2026, Northbank Family Practice is tracking at 85% readiness across 2 compliance frameworks, with 51 of 60 requirements met. 2 critical requirements remain outstanding.
85%
Readiness
51 of 60
Requirements met
2
Critical outstanding
Section 02
Framework performance
RACGP Standards 5th Edition
89%
39 of 44 requirements met · 2 critical outstanding
Privacy Act 1988 (APPs)
75%
12 of 16 requirements met · 0 critical outstanding
Obligations, and the records that prove them
Managing clinical risks
The practice monitors, identifies, responds to and reports near misses and adverse events in clinical care, and maintains an incident or event register.
RACGP Standards 5th edition, QI3.1
RACGP 5th Edition
AllCritical 2In Progress 3Complete 39QI3Clinical risk management2/3 completeQI3.1bNear miss analysisDoneQI3.2aOpen disclosure policyDoneQI3.1aIncident reporting systemOpenFramework score
89%39 of 44 items complete2 critical openThe RACGP checklist, open at QI3 Clinical risk management Security of personal information
Take reasonable steps to protect personal information from misuse, interference and loss, and from unauthorised access, modification or disclosure; in Victoria and NSW the state health records Acts apply as well.
Privacy Act 1988 (Cth), APP 11
Privacy Act / APPs
75%12 of 16 items complete
APP11Security of personal informationAPP1.1Privacy policy publishedDoneAPP5.1Collection notice providedDoneAPP11.1Security measuresEvidence linkedState add-on
Health Records Act 2001 (Vic)ActiveHealth Records and Information Privacy Act 2002 (NSW)AvailableThe Privacy Act checklist at APP 11, with the Victorian and NSW Acts beside it Notifiable data breaches
Assess a suspected data breach within 30 days; once there are reasonable grounds to believe it is eligible, notify the OAIC and the people at risk as soon as practicable.
Privacy Act 1988 (Cth), s 26WH, s 26WK and s 26WL
NDB breach response plan
Step 5 of 9Internal Notification ChainPractice nameNorthbank Family PracticePrivacy officerSarah ChenRole / TitlePractice ManagerEligible data breachs 26WENotify the OAIC and affected individuals as soon as practicable.
The NDB breach response plan wizard and its eligible breach verdict Reportable incidents
A registered NDIS provider notifies the NDIS Commission of most reportable incidents within 24 hours of key personnel becoming aware, then lodges the 5 Day Form within 5 business days.
NDIS (Incident Management and Reportable Incidents) Rules 2018
Incident register
All statusesNDISReportableINC-2026-0005Treatment room 2NDIS reportableNotify the Commission23h 58mINC-2026-0004Under investigationModerateNDIS reportable incidentINC-2026-0005Immediate notification23h 58m remaining5 Day Form6d 23h remainingA more detailed 5 Day Form must also be submitted within 5 business days for every reportable incident.
The incident register, with the Commission's 24-hour clock running Worker screening, CPR and first aid
Workers in risk assessed roles hold a current NDIS Worker Screening clearance, valid for five years, and staff keep their CPR and first aid certificates current.
NDIS Worker Screening; HLTAID009, HLTAID011
Jordan Lee
Registered Nurse · Clinical (GP / nurse)
2 Current1 Expiring0 ExpiredCredentials & training
CurrentNDIS Worker Screening Check
NDISExpires 12 Mar 2027Expiring soonCPR / Basic Life Support (HLTAID009)
RACGP / ClinicalExpires 7 Oct 2026CurrentFirst Aid (HLTAID011)
RACGP / ClinicalExpires 2 Jun 2027Today
Jordan Lee: CPR / Basic Life Support (HLTAID009) expires in 14 daysRenew this staff credential before it expires to keep your training register audit-ready.A staff record in the training register, and the reminder 14 days out Information security
The practice protects its computer systems and the information held in them. Security documentation from its IT providers and software vendors is how it evidences that protection.
RACGP Standards 5th edition, C6.4
IT vendor portal
HIAwaiting reviewHarbour IT Services
MSP / IT Provider
1 of 3 documents verified33%IT Security PolicyAcceptedBackup ProcedureAwaiting reviewMFA PolicyPendingSecure upload link
/vendor/upload/8f3c2aNo login neededExpires in 6 daysThe IT vendor portal: requests, their status, and an upload link that needs no login Written policies and procedures
The standards expect policies in writing and kept current, starting with the clearly expressed, up-to-date privacy policy that APP 1.3 requires.
Privacy Act 1988 (Cth), APP 1.3; RACGP Standards 5th edition, C6.3
Template
Privacy PolicyFree.docxThis policy sets out howPractice namecollects, uses, stores and discloses your personal and health information.
Privacy questions and complaints go to our privacy officer,Privacy officer namewho will respond within 30 days.
AnswersAPP 1.3andRACGP C6.3Template library
82 templates44 freeCited to the current instruments
The Privacy Policy template, one of 82 (44 free)
The readiness report
One sheet with numbered sections that states where the practice stands, exported to PDF with the same sentences.
Compliance Readiness Report
Northbank Family Practice · Prepared 23 September 2026
Section 03
Governance registers
The practice maintains incident, complaint and conflict of interest registers. Activity over the last 12 months:
Section 04
Training and workforce
12 active staff members. 47 of 48 credentials current (98%). 1 credential falls due for renewal in the next 60 days.
Section 05
Evidence library
64 documents on file. 52 of 60 requirements carry linked documentary evidence (87%). 1 IT vendor under security document requests; 0 fully verified.
It keeps itself current
- Before anything lapses. Reminders arrive in the app and by email before a document or credential expires, and before a policy falls due for review.
- The right people. Four roles, and practice access for managers and staff, keep each person on the records that are theirs.
- A score that moves. The compliance score changes as each item closes, so the number on the dashboard is today's.
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