Advocacy on behalf of members has been and continues to be a priority for PNZ. We know this is important to members and are committed to raising the profile of physiotherapy as well as the visibility of our advocacy work.
Like many organisations a core challenge is to use limited resources to effectively advocate for the profession. To do this our advocacy focuses on a few key areas and uses our unified structure to provide a single advocacy voice.
Our areas of advocacy are shaped by member feedback through channels such as PNZ’s annual surveys, research projects and leadership days. We also adjust for environmental factors, like COVID-19 and Government changes, as demonstrated in our current advocacy work below.
Physiotherapy for New Zealand
Commenced in 2019, PNZ has worked with the New Zealand Institute of Economic Research (NZIER) to identify the value of physiotherapy. In their report Better Outcomes through Increased Access to Physiotherapy NZIER found that greater use of physiotherapy can contribute to New Zealand healthcare’s Triple Aim Framework by:
- Reducing the overall cost of health system interventions through addressing lifestyle risk factors such as obesity.
- Empowering individuals to manage chronic long term conditions and risk factors.
- Contributing to the reduction in health system pressures associated with the burden of non-communicable diseases.
- Offering opportunities for advice and treatment that does not need to be funnelled via GP referrals.
Overall the report shows good returns from increased physiotherapy in three key areas and is a useful support in our advocacy work, demonstrating the cost effectiveness of targeted investment in physiotherapy treatments.
With COVID-19 impacting the work of physiotherapists, the report informed PNZ’s positioning statement written for Government on the essential value of Physiotherapy for New Zealand. This advocates for increased funding of physiotherapy through and beyond the COVID-19 alert levels and was sent to decision makers along with a public media release in June 2020.
We believe that improving funding for physiotherapy in primary care will help improve health outcomes for New Zealanders living with non communicable diseases such as osteoarthritis where national and international evidence shows physiotherapy led treatments are effective and efficient use of health funds. Such funding must include targeted funding to help address Māori health outcomes.
Using the findings of the NZIER report, PNZ continues to advocate for increased funding of physiotherapy in primary care through the Ministry of Health, Primary Health Organisations and Treasury.
Briefing for the Incoming Minister
With the 2020 General Election in October, we have worked with NZIER on a Briefing for the Incoming Minister (BIM). Government departments provide a BIM for the new Minister after an election and many other organisations such as PNZ write one to highlight key issues. New Zealand will have an incoming Minister for Health and ACC, so having physiotherapy positioned as a key stakeholder is important.
As a key stakeholder for the profession PNZ is in ongoing contact with ACC. This includes meeting regularly to discuss their activity, questioning policy and processes relating to physiotherapy, recommending policy and process changes, linking ACC to members and sharing information from their team.
ACC provide regularly updates in our member magazine Physio Matters and have been sponsors of key events including Physiotherapy Conference and the PNZ Business Symposium. This provides further opportunity for members to hear from and engage with their team.
From March 2020 PNZ advocated strongly to ACC for increased physiotherapy Telehealth rates through the COVID-19 alert levels. ACC subsequently increased Telehealth rates for approved allied health providers in Alert Level 4 and then for most services at all alert levels.
Through 2020 we have also asked ACC to review their updated provider engagement structure, following member feedback that ACC is less contactable within the new structure. ACC have indicated that they are not looking to change and we continue to advocate for this.
Payment processes from ACC remain an ongoing discussion. PNZ works directly with ACC on matters related to physiotherapy contracts – both the primary care contracts including the physiotherapy contract (formerly known as the EPN) and secondary care contracts such as the Vocational Rehabilitation contracts.
We also work with the Ministry of Business Innovation and Employment (MBIE) who are responsible for the Cost of Treatment Regulation (COTR sometimes known as Regs). Changes to COTR are dictated by Government and affect all the professions working for ACC.
Live Stronger For Longer
PNZ met with ACC’s Live Stronger For Longer programme lead in November 2020 and were pleased to be informed that ACC intend to continue funding the programme. This follows a meeting earlier in the year with the Hutt Valley District Health Board Allied Health Leadership Team, where the possibility of ACC ceasing to fund various DHB In-Home Strength and Balance programmes was raised.
PNZ took a lead in coordinating a meeting with ACC Manager Targeted Investment Paul Kennedy and representatives from Age Concern, Bone Health NZ and Arthritis NZ, to strongly advocate for ACC’s ongoing funding of this programme given an ageing population as well as the need to prevent falls and fractures and the resulting poor health outcomes for the elderly.
Please read the ACC announcement that "following consultation with Live Stronger for Longer (LSFL) stakeholders, ACC is pleased to confirm it will continue to invest in the LSFL programme." Thank you to everyone across the profession who has helped advocate for this.
Advocacy regarding COVID-19 has been a key area this year and with modelling suggesting that COVID-19 management will be ongoing into 2021 we need to be prepared that Aotearoa may again be in higher alert levels at short notice.
In May 2020 PNZ made a submission to the COVID-19 Epidemic Response Committee highlighting the impact on physiotherapy businesses and reminding MPs about the importance of our profession within primary healthcare.
More recently together with the Physiotherapy Board of New Zealand we have asked the Ministry of Health (MoH) to broaden the conditions in which physiotherapists can operate at higher alert levels. In September 2020 PNZ met with Chief Allied Health Professions Officer Martin Chadwick to propose that in-person physiotherapy treatments be permitted in Alert Level 3. However this was not agreed and MoH guidance is that physiotherapists provide treatment via telehealth. Our position remains that the work of physiotherapists justifies being open in Alert Level 3 and will continue to revisit this with MoH.
In August 2020 the CRSIG, supported by PNZ successfully negotiated with MoH and the Infection Technical Advisory Group to develop and publish the Respiratory physiotherapy guidelines for managing patients with COVID19 infection here.
In October 2020 MoH released a discussion paper seeking feedback on their continued approach to Allied Health services through COVID-19. With this partly a result of our advocacy work asking the Ministry to review their COVID response, PNZ sought member feedback on the paper and made a submission. Thank you to all the individuals and groups across PNZ that provided input into this, allowing us to offer a united submission to MoH. MoH have noted that the outcome of this consultation will be a set of principles that help balance the trade-off between Protection & Prevention on one side and Health & Wellbeing on the other.
In addition, we’re advocating to MoH and the Aged Care Association for physiotherapists to have increased access to patients in aged residential care during alert levels. This is a challenging balance between protecting the frail elderly from infection and ensuring that this vulnerable population are able to maintain existing levels of mobility and maintain health. While the aged care sector are currently erring on the side of preventing infection this is not being consistently applied. It is another ongoing conversation.
The COVID response was the dominant theme in the recent general election. If you are speaking with the MP from your electorate, whether they are new or returning, do make sure to share the Physiotherapy for New Zealand messages.
The Physiotherapy Workforce
We need to ensure that we have enough physiotherapists in the country and in the right places. PNZ members have been concerned about recruitment and retention in the workforce. PNZ contracted independent researchers BERL to fully understanding potential workforce issues and how they can be addressed. You can read the reports and recommendations here.
The workforce issues that we are currently progressing include:
- Remuneration: we are tracking remuneration through our annual survey.
- The makeup of our workforce: Māori and Pacific people are under-represented in the physiotherapy workforce. While the overall workforce is young, there is a high degree of reported burnout and concerns over retention and attrition.
- The career pathway: PNZ, and in former years the College of Physiotherapy, had been working for some years towards a career pathway that included Advanced practitioner and Specialists scopes. Because physiotherapists work under the HPCA Act these scopes of practice are the responsibility of the Physiotherapy Board of New Zealand (PBNZ). PNZ members have been actively supporting PBNZ in the development of these scopes and PNZ has made submissions to PBNZ on scopes. We are delighted to see that PBNZ has recently approved the development of an Advanced Physiotherapy Practitioner scope of practice. We will continue to work with PBNZ on the development and implementation.
Page updated November 2020