Summary
A practice with twelve staff can easily be covered by three different modern awards at once. Reception and administration and most allied health staff fall under the Health Professionals and Support Services Award 2020; nurses fall under the Nurses Award 2020; employed doctors fall under the Medical Practitioners Award 2020. Different classifications, different penalties, different allowances, one payroll.
And underneath that sits a problem specific to clinical work: the appointment book is not a timesheet. Practices are scheduled by patient sessions, but staff are paid for hours — and those two things diverge every single day.
The gap between the session and the shift
Consider an ordinary day. The practice opens at 8.30am; the first patient is at 8.30am. Which means the nurse arrived at 8.10 to unlock, turn on the autoclave, restock rooms and check the fridge temperature log. The last patient is at 5pm; the clinic runs fifteen minutes late; then there is cleaning, sterilising, and reconciling.
If the roster says 8.30 to 5.00 and payroll pays 8.30 to 5.00, roughly 45 minutes a day per clinical staff member has been worked and not recorded. Across a year and a small team that is a substantial and entirely systematic underpayment — and it is systematic precisely because it is built into how the practice thinks about time.
Three specific categories go missing:
- Setup and pack-down. Sterilisation cycles, room turnover, instrument processing and stock checks are work, and in dental practice they are a significant part of the day.
- Overrun. Clinics run late. The staff member cannot leave mid-procedure, and the time is worked.
- Handover and administration after the last patient — recalls, results, correspondence.
The fix is not complicated and it is not about trusting people less: record when staff actually start and finish, rather than inferring it from the appointment book. Under the strengthened underpayment provisions, a practice-wide pattern like this is exactly the shape that turns into a systemic finding rather than an individual one.
Getting award coverage right in a small practice
Because several awards operate side by side, classification errors here are common and durable. A few points that resolve most of them:
- Coverage follows the work, not the employer. Being employed by a medical practice does not put someone under a "medical" award; a receptionist is covered by the award that covers reception work in that setting.
- Practice managers need particular care — the classification depends on the actual duties and level of responsibility, and this is a role that grows without anyone revisiting the level.
- Allied health professionals sit at classification levels driven by qualifications and experience, and progression is a payroll event that has to be actioned.
- Allowances for first aid, qualifications and specific duties apply where the award provides them, and they are frequently just not paid.
Write down, per employee, which award and which classification, and the reasoning. That record is the difference between a defensible position and an assumption, as our Fair Work compliance guide covers.
After-hours, on-call and recall
Practices offering extended hours or on-call arrangements need to look specifically at the on-call and recall provisions in the relevant award. Being available is often compensated separately from being called in, and a recall usually attracts a minimum payment period regardless of how long the actual work took.
This interacts with the right to disconnect in a way that matters clinically: a practice that expects staff to answer calls after hours without an on-call arrangement is relying on goodwill that is now backed by a legal right to decline. Formalising it — a named person, a roster, an allowance — is better for everyone, and it is what makes the availability expectation enforceable.
Casual reception and the minimum engagement
Practices commonly use casuals to cover leave and busy sessions. Two provisions bite. Minimum engagement means a two-hour session may cost more than two hours. And casual employees who work a regular and systematic pattern acquire casual conversion rights — which for a "casual" who has worked the same Tuesday and Thursday for two years is not a theoretical question.
Two record-keeping regimes, and they are not the same
Health practices are already fluent in records — but patient records and employment records are governed by entirely different rules, and being excellent at one creates false confidence about the other.
Employment records must be kept for seven years, in a form that is legible and in English, covering hours worked, rates paid, leave, and superannuation. And the consequence of not having them is the one covered in our record-keeping guide: without records, the burden shifts to the employer to disprove an underpayment claim.
The practical point for practices specifically: your clinical software holds sessions, not shifts. It is not an employment record and it will not answer the questions a Fair Work inspector asks.
What to do
- Record actual start and finish times rather than deriving hours from the appointment book.
- Measure the gap between session times and worked times for one ordinary fortnight. That number is your exposure.
- Document award and classification for every employee, and review when duties change.
- Check allowances in each applicable award — first aid and qualifications especially.
- Formalise on-call with a roster and the award's allowance.
- Review long-standing casuals for conversion obligations.
- Keep employment records for seven years, separately from clinical systems.
Where the system helps
NestedClock records actual clock-in, clock-out and break times per person per location, so setup before the first patient and the overrun after the last one appear as worked time rather than disappearing between appointments. Because rostered hours and worked hours sit side by side, the daily gap between the session plan and reality is visible as a number — which is the argument for fixing the roster, not just the payroll.
Where to check the detail
The Health Professionals and Support Services Award 2020, Nurses Award 2020 and Medical Practitioners Award 2020 are all on the Fair Work Commission website. Record-keeping requirements are in the Fair Work Regulations 2009; health record obligations are separate and sit under privacy and health records legislation in your jurisdiction.
This article is general information, not legal advice.