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Psychologists’ client records: a summary of State and Territory requirements . Psychologists have responsibility for the information recorded about individuals in ...

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Published by , 2016-03-19 20:48:03

Psychologists’ client records: a summary of State and ...

Psychologists’ client records: a summary of State and Territory requirements . Psychologists have responsibility for the information recorded about individuals in ...

Psychologists’ client records: a summary of State and Territory requirements

Psychologists have responsibility for the information recorded about individuals in their care. The
Commonwealth Privacy Act and National Privacy Principles do not stipulate a specific timeframe in which
health records can be destroyed. The guidelines suggest that legal requirements of individual States and
Territories must be followed in relation to the retention of health information by health service providers.
As such, each of the States and Territories in Australia has different requirements regarding the retention
of health records.

This table is current as at November 2012. It is recommended that psychologists inform themselves of the
record keeping requirements in their State or Territory as there are variations in each jurisdiction based
on age, public/private sector, public hospital/community health, or indigenous/non-indigenous.

Please note, where private sector requirements are not legislated or regulated in your State/Territory, the
APS recommends that you refer to the APS Code of Ethics:

B.2. Record keeping
B.2.1. Psychologists make and keep adequate records.
B.2.2. Psychologists keep records for a minimum of seven years since
last client contact unless legal or their organisational requirements
specify otherwise.
B.2.3. In the case of records collected while the client was less than 18
years old, psychologists retain the records at least until the client attains
the age of 25 years.

State/Territory general health record retention requirements

State/Territory Legislation Requirement(s) Timeframe

New South Wales Health Records and Section 25 of the HRIPA requires private sector persons who are health Seven years in general
Information Privacy Act providers to retain health information relating to an individual as follows: across public and private
2002 (HRIPA) Adults: in the case of health information collected while the individual was sector
an adult, for seven years from the last occasion on which a health service
was provided to the individual by the health service provider;
Children: in the case of health information collected while the individual
was under the age of 18 years, until the individual has attained the age of
25 years.

Health Practitioner Consistent with the HRIPA , under regulation 10 of the Health Practitioner
Regulation (New South Regulation (New South Wales) Regulation:
Wales) Regulation 2010 (1) A record must be kept for at least 7 years from the date of last entry in
the record, unless the patient was less than 18 years old at the date of last
entry in the record.
(2) If the patient was less than 18 years old at the date of last entry in the
record, the record must be kept until the patient attains or would have
attained the age of 25 years.

State Records Act 1998 Like the Commonwealth Archives Act 1983, the State Records Act requires
state and local government agencies to maintain public records, and grants
the public a right of access to some records, including some personal
information, after 30 years. However personal health records held by NSW
health agencies are closed to public access for 110 years (as per Attorney-
General’s Guidelines, Making Access Directions under the State Records Act
1998).

Victoria Health Records Act 2001 The Health Records Act Schedule 1 sets out the Health Privacy Principles Seven years in general; 15
(HPPs) and HPP 4.2 imposes specific requirements for the retention of years in public hospitals
personal health information:
- Adults - seven years from the last entry;
- Children - for records created when a patient was less than 18 years,

until they reach 25 years.
The retention requirements specified above do not apply where the Public
Records Act 1973, the regulations or any other Act specifies a minimum
retention period that is of a longer or shorter duration.

Public Hospitals - The General Retention and Disposal Authority for Public
Health Services Patient Information Records (‘the Authority’) was
established under section 12 of the Victorian Public Records Act 1973. The
effect of the Authority is that the medical records of individuals who
receive treatment as admitted patients in Victorian public hospitals must
not be destroyed until 15 years after the last attendance, or 15 years from
the last access on behalf of the patient, (provided the patient has reached
25 years of age).

Australian Capital Health Records (Privacy Under the Health Records (Privacy and Access) Act, health records are Seven years in general
Territory and Access) Act 1997 required to be retained by the record keeper until: across public and private
- Children - if the consumer is under 18 years old when the information sector

is collected, the day the consumer turns 25 years old; or
- Adults - if the consumer is an adult when the information is collected,

seven years after the day a service was last provided to the consumer
by the record keeper.

Queensland Public Records Act 2002 As required by section 13 of the Public Records Act, disposal of public 10 years in general,
records can only be undertaken with the authorisation of the State specified for public sector
Archivist. In line with these requirements, Queensland Health has an only
approved retention and disposal schedule which allows for the disposal of
adult health records 10 years after the last patient/client service provision
or medico-legal action. In the case of minors, disposal is allowed 10 years
after the patient/client has turned 18 .

Western Australia State Records Act 2000 The State Records Act places obligations on state and local government 15 years in general,
agencies to keep and retain public records for a certain period by specified for public sector
developing record-keeping plans which outline these retention periods, e.g. only
WA Health Patient Information Retention and Disposal Schedule, which
must be approved by the State Records Commission.

According to the schedule, health records of discharged patients and
outpatients from acute hospitals are generally allowed to be disposed 15
years after the date of last attendance or last access (provided the patient
has reached the age of 25 years). Under section 49 of this Act access to
personal medical and disability information held in the State Archive is not
normally allowed unless the person concerned has consented or the
information is at least 100 years old.

Tasmania Archives Act 1983 The Archives Act provides that disposal of public records can only be 15 years in general,
undertaken with the authorisation of the State Archivist. Accordingly, the specified for public sector
Archives Office has given approval through Disposal Schedule Number only
DS20 to the relevant authorities to manage the disposal of health records. 7 years in community
The disposal requirements vary in different settings. health settings
Hospitals:

- For discharged patients and outpatients records may be

destroyed 15 years after the last attendance or last access on
behalf of patient (provided the patient has attained the age of 30
years)
- Casualty or Accident and Emergency Patient Records of any public
hospital allows 7 years after attendance
Community health
- Client records may be destroyed 7 years after last attendance or
official contact between facility and client (including access on
behalf of client) (provided client has attained age of 25 years).

South Australia State Records Act 1997 The State Records Act imposes obligations on state and local government Public sector only
agencies to keep and retain public records. (retention schedule not
publicly available)

Northern Information Act 2002 Section 134 of the Information Act requires public sector organisations to 15 years in general, public
Territory keep records and make arrangements ‘for the records service and archives sector only (retention
service to monitor the management of its records’. schedule not publicly
available)
Whilst the Records retention and disposal schedule is not publicly available,
NT Department of Health and Families have a guide for archiving and
disposal of records based on the schedule which states:

- Adults: Individual client records may be destroyed 15 years after
last attendance or last access on behalf of the client for whatever
reason (provided that the client has attained the age of 25 years)

- Indigenous Australians: Individual medical records of Indigenous
Australians born before 1980 shall not be destroyed and should
be kept in secondary storage.
Medical records of Indigenous Australian born after 1980 are
dealt with as for ‘Adults’ above

Adapted table from yourhealth.gov.au


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