On 26 August 2026 the Royal Australian College of General Practitioners published the sixth edition of its Standards for general practices, the first full rewrite since 2017. In a GP clinic, the Standards are what an accreditation surveyor works through, and the reason a practice keeps the policies, registers and evidence it keeps.

Someone has to carry that. In most practices it is the practice manager. If you already run a practice, the sixth edition changes what sits in your evidence folder. If you are thinking about moving into practice management as a career, it is a clear window into what the job is made of.

The sixth edition is organised into four standards, plus an optional fifth for practices that carry out point-of-care testing.

Terminology changed with it. What the fifth edition called indicators are now criteria, and the requirements underneath them are sub-criteria. According to the RACGP, the new framework is focused on outcomes, with criteria setting out what a practice is expected to achieve rather than prescribing how to achieve it. Aspirational criteria are labelled as such and are not required for accreditation.

So a small solo clinic and a large multi-site group can meet the same criterion in different ways, and each has to be able to explain its own approach. That is a different skill from following a template.

The sixth edition introduces a criteria set for artificial intelligence with no equivalent in the fifth edition. It covers the safe and accountable use of AI, and the evaluation and monitoring of that use. A separate new criterion covers the governance of digital health technologies more broadly, taking in telehealth, patient portals, remote monitoring and secure messaging.

This is the change most likely to catch a practice off guard, because AI arrived in general practice faster than the paperwork did. Ambient scribes are now common in Australian consulting rooms. Under the sixth edition, a practice using them needs to show how patients are told and consent is obtained, how clinicians stay accountable for decisions supported by an AI tool, how patient data is handled, and how the tool is reviewed over time.

In practical terms that comes down to a documented process, a consent step, a review date and a named owner. It is work, and it lands on the practice manager. Our guide to the RACGP Standards for practice managers covers how the fifth edition worked, which is a useful baseline for reading what has moved.

Paper-based systems on their own are no longer accepted. Hybrid arrangements are still recognised, such as care delivered in residential aged care, but a practice’s own system needs to be digital.

Record content has been tightened alongside it. Coded health summaries and a recorded allergy status are both expected, and consultations and clinical communications belong in the patient’s record.

Cyber security sits with information continuity and recovery under the Foundations standard, and it has been expanded. If your practice has never written down what happens when the clinical system goes offline, that is a gap worth closing. Our guide to practice management software in Australia covers the systems side in more depth.

New criteria cover climate resilience, sustainability strategies, and sustainability leadership and accountability, and the theme runs through several of the standards rather than sitting in one corner. Monitoring of environmental performance now sits under continuous quality improvement, with environmental impact measurement as an aspirational criterion.

Accountability is the part to act on first. A practice needs someone whose job includes this, which is a name against a responsibility, exactly the kind of thing a practice manager sets up.

Small practices are not expected to start with a formal programme. RACGP explanatory material does not prescribe particular actions, and reducing energy use, cutting waste and choosing better suppliers all count.

Several criteria in the planning and governance area are new, and they are practice-manager work almost by definition:

Strategic and operational planning were already there in some form, but both have been expanded. Informed consent for procedures and treatments is new under the patient participation standard, and results, recalls and reminders have been strengthened around documenting each attempt to contact a patient.

As a list it looks like more paperwork. As a job description it is why practice management is a career rather than a set of admin tasks.

Not yet. The Standards are published, but the accreditation timetable is not set. RACGP has said implementation arrangements under the National General Practice Accreditation Scheme will be communicated by the Australian Commission on Safety and Quality in Health Care. Practices will need to meet the sixth edition after a transition period, and the detail of that period is what to watch for.

That gap is useful. Five things are worth doing now, before any deadline is announced:

Practices mid-way through an accreditation cycle have a natural window for this work. Our explainer on the GP practice accreditation cycle sets out how that rhythm runs.

Interested in the role that turns a new set of Standards into a working practice? Explore the HLT57715 Diploma of Practice Management, delivered 100% online and self-paced over 12 months with daily intakes, or read the practice management career guide.

TalentMed Pty Ltd, RTO 22151. Nationally recognised training delivered online across Australia. This article summarises publicly available material about the RACGP Standards for general practices sixth edition and is not a substitute for the published Standards or accreditation advice.

An email lands on a Tuesday morning. A private health insurer is auditing claims your practice has submitted, and it wants clinical records. Not the notes for one disputed episode, but the full history for a list of patients. The contract you signed says you will co-operate with audits. The Privacy Act says a patient’s health information does not go to a third party without that patient’s consent. Those two things point in opposite directions, and someone has to decide what happens next. In most Australian practices, that someone is the practice manager.

In August 2026 the ABC reported that hospitals, dentists, physiotherapists and specialists have been asked for far more clinical detail than the claim under audit would seem to require. If you are considering a career in practice management, this is a good example of what the job actually involves.

Health information is treated as sensitive information under the Privacy Act 1988. That gives it stronger protection than an address or a phone number, and the rules about sharing it are stricter.

Australian Privacy Principle 6 covers use and disclosure. Broadly, a practice can use health information for the reason it was collected, which is providing care. Sending it somewhere else is a disclosure, and that generally needs either the patient’s consent or a specific exception written into the law. The Office of the Australian Information Commissioner puts it plainly in its health privacy guidance: where a request for records comes from a third party, the practice should only release the information if the patient has consented.

Consent also has to be worth something. For sensitive information it needs to be express rather than assumed, and the patient needs to understand what is being released and to whom. A signature collected years ago at new-patient registration is thin ground to stand on.

The point that catches practices out is the relationship between a contract and a statute. A provider agreement can oblige a practice to co-operate with a reasonable audit. It cannot rewrite the Privacy Act. Dr Bashi Kumar-Hazard of the University of Sydney Law School told the ABC that a contract cannot contain terms which contravene existing law, and that requesting patient notes outside the episode of care without consent should void it. Our guide to the Privacy Act for Australian medical practices covers the obligations in more detail.

The worst outcome is the one where nobody owns it. A request arrives, it gets forwarded to whoever is at the front desk that day, and files go out because the sender sounded official and impatient.

A practice that handles this well has decided in advance who receives these requests, and the answer is usually the practice manager, working with the principal or owner. From there the sequence is consistent:

• Get it in writing. A phone call is not a request. Ask for it in writing, naming the specific claims it relates to and the basis being relied on.
• Log it. Date received, who sent it, what was asked for, and what was provided. This log is your evidence if the request is later disputed.
• Check the scope against the claim. If the audit concerns three item numbers billed in March, work out what an auditor would reasonably need to verify them.
• Deal with consent properly. Contact the affected patients, explain in plain terms what is being requested and by whom, and record their answer. A refusal is a valid answer, and the practice needs a process for what follows.
• Release only what was agreed, and record it. Note what was sent, when, in what format, and to whom.

None of that is glamorous. All of it is what lets a practice explain its decisions later.

Audits are a normal part of a system that pays out large sums. Private Healthcare Australia chief executive Rachel David has defended audit activity as responsible management of roughly 27 billion dollars in annual healthcare payments, and noted that audits do find incorrect claiming. Refusing outright is not realistic.

The productive move is to narrow rather than refuse. A written reply that says the practice will co-operate, sets out what it can release for the claims in question, and asks the auditor to explain why anything beyond that is needed, is a co-operative response. It is also a written record that the practice took its privacy obligations seriously.

Practical questions are fair too. Who will receive the records, and are they qualified to assess the clinical decisions being reviewed? Merv Saultry of the Independent Dentist Network told the ABC about a case where auditors did not hold the dental qualifications needed to assess complex work. How will the records be stored and destroyed once the audit closes?

The Australian Private Hospitals Association has been blunt about the pattern, with chief executive Brett Heffernan describing some audit conduct as rogue behaviour, and in March 2026 the association joined Catholic Health Australia in calling for a mandatory code of conduct covering insurer contracting. Whether that arrives or not, the practice still has to answer the email sitting in the inbox today.

A practice manager runs the process but does not carry the legal risk alone.

Escalate when the request goes well beyond the episodes under audit, when patients have declined consent and the requester keeps pressing, when there is a threat of a repayment demand or removal from a provider network, or when you are not confident of the right answer. Go to the principal or owner first, then the practice’s professional indemnity insurer or medico-legal adviser, the relevant association, and a lawyer with health privacy experience. Patients who believe their information was mishandled can complain to the Office of the Australian Information Commissioner, and practices can seek guidance from the same office.

Knowing where your authority ends is part of the skill, not a gap in it. Handling private billing, WorkCover and DVA claims takes the same instinct: resolve what you can, and route the rest.

This article is general information, not legal advice. A practice facing an audit dispute should get advice about its own circumstances.

People still picture practice management as rosters and reception. The insurer audit story shows what it has become. One request can involve privacy law, a commercial contract, patient communication, records governance, revenue, and a relationship with a funder the practice depends on.

That is why the role is a serious career with a serious skillset behind it. The HLT57715 Diploma of Practice Management covers the operational, financial, legal and people-management side of running a healthcare practice, including managing information and working within legal and ethical frameworks. It is 100 percent online and self-paced over 12 months with daily intakes, and it suits people already working in reception, administration or nursing, as well as managers moving into health from other industries.

Interested in the role that answers the hard email? Explore the HLT57715 Diploma of Practice Management or read the practice management career guide.

TalentMed Pty Ltd, RTO 22151. Nationally recognised training delivered online across Australia.

Ask a practice owner what keeps them up at night in 2026 and payroll tax will be near the top of the list. In the past few years, state revenue offices have started treating some payments to contractor GPs as wages, which can make a practice liable for payroll tax on money it only ever passed through to its doctors. The RACGP has called it a threat to practice viability and campaigned hard for relief. It is one of the biggest financial questions in Australian general practice right now, and it has landed squarely on one desk in particular: the practice manager’s.

If you are thinking about a career in practice management, this is worth understanding, because it is a clear example of what the role is really about. Not booking appointments, but keeping a business compliant and viable while the rules shift underneath it. Here is what the payroll tax issue is, and why it puts a skilled practice manager at the centre of a modern clinic.

For decades, most general practices ran on a simple arrangement. Doctors worked as independent contractors, not employees. The practice provided the rooms, staff, software and billing and took a service fee, while the doctors billed Medicare in their own right and kept the rest. Because the doctors were contractors, practices generally assumed payroll tax, a state tax on employee wages, did not apply to them.

A run of tribunal and court decisions challenged that assumption. The most cited is Thomas and Naaz Pty Ltd v Chief Commissioner of State Revenue in New South Wales, where a medical practice was found liable for payroll tax on payments to its contractor GPs. The reasoning turned on how the money actually flowed. Where the practice collected the Medicare benefit and then paid the doctor their share, revenue authorities argued those payments looked enough like wages to fall inside the payroll tax net, even though the doctor was a contractor on paper.

That single shift in interpretation changed the maths for thousands of practices. A tax nobody had budgeted for could suddenly apply, potentially backdated across several years. For a sector already under pressure from flat Medicare rebates and rising costs, the prospect was serious enough that the RACGP made it a headline advocacy issue, describing the flow-through effect on patients as a “patient tax”.

What makes payroll tax hard to manage is this: it is a state and territory tax, so there is no single national rule. Each jurisdiction sets its own thresholds, its own rates, and its own position on contractor GPs, and those positions have kept changing.

Broadly, states have responded in different ways. Some have introduced amnesties covering past periods, giving practices a window to get their arrangements in order without being pursued for historical liabilities. Some have legislated exemptions for the wages tied to bulk-billed GP services, so that the more a practice bulk bills, the more of its GP payments fall outside payroll tax. Others have taken a broader approach to exempting contracted GP payments altogether. The exact mechanism, and whether it applies to your practice, depends on which state you are in and what the current rules say.

The practical upshot is that a practice manager in Queensland, one in Victoria and one in New South Wales can be working to three different sets of rules for the same kind of arrangement. Because the settings keep moving, the reliable move is always to check the current position with your own state or territory revenue office and your practice’s accountant, rather than assume the rule you remember still holds.

This is where the role earns its keep. Payroll tax is not something a practice can solve once and forget. It sits across contracts, billing, record-keeping and accreditation all at once, and holding those threads together is practice management work.

In practice, a capable manager is usually the person who:

• Understands how the practice’s service agreements are structured, and can explain to the owners where those arrangements sit relative to the current state rules.
• Keeps clean documentation of how doctors are engaged and how money flows, so the practice can substantiate its position if a revenue office ever asks.
• Tracks the numbers that matter, including the practice’s bulk-billing rate, because in several states the payroll tax exemption is tied directly to bulk-billed services.
• Works closely with the practice’s accountant and, where needed, its lawyers, translating professional advice into day-to-day systems the front and clinical teams can actually follow.
• Watches for change, so a new ruling or a new exemption is picked up and acted on rather than missed.

It also connects to the wider compliance picture. The definition of a “contractor” at the heart of the payroll tax question is the same one that shapes how a practice reads the RACGP Standards, structures its staffing and engagement models, and handles its Medicare billing. Get the engagement model right and several problems get easier at once. Get it wrong and the same mistake shows up in several places.

None of this means a practice manager needs to be a tax lawyer. It means being the person who understands the business well enough to ask the right questions, keep the right records, and make sure expert advice actually gets implemented.

Payroll tax is a useful window into the modern practice manager’s job because it shows the level the role now operates at. A clinic is a small business with tight margins, real regulatory exposure and a team of clinicians who need to be free to focus on patients. Somebody has to hold the operational and compliance side together, and that somebody is now, more often than not, a qualified, professional practice manager rather than whoever happened to be at the front desk longest.

That is the skill set the HLT57715 Diploma of Practice Management is built around. It covers the finance, operations, human resources, compliance and quality foundations that let a practice manager step into exactly these situations with confidence, from billing and business systems to workplace policy and risk. It will not turn you into a tax specialist, and it does not need to. It gives you the grounding to run a healthy practice and to know when and how to bring in specialist advice.

Practice management also travels well. The same core skills apply across general practice, specialist rooms, allied health, dental and beyond, and career changers are welcome, because the diploma teaches the role from the ground up.

This article is general information about the practice manager’s role and is not tax, financial or legal advice. Payroll tax rules differ by state and territory and change over time. Practices should confirm their obligations with their own state or territory revenue office and their accountant.

Sources: Royal Australian College of General Practitioners (RACGP) payroll tax advocacy and resources; Thomas and Naaz Pty Ltd v Chief Commissioner of State Revenue (NSW); state and territory revenue office guidance on payroll tax and medical practices.

TalentMed Pty Ltd, RTO 22151. Course information is current at the time of writing. For current fees, intakes and entry requirements, see the course page.