In order to be efficient and effective with our support to members, links to current COVID-19 information and resources are on this web page. These are informed by our regular contact with Government agencies including the Ministry of Health, ACC and Physiotherapy Board of New Zealand.
COVID-19 Alert Levels
Updated 1 March 2021
As of 28 February Auckland is in Alert Level 3 and the rest of New Zealand in Alert Level 2. This is in place for seven days.
Please note that personal travel into and out of an Alert Level 3 area is strictly limited. The covid.govt.nz website has an alert level boundaries map and information on applying for a personal travel permit. Refer to Auckland Regional Public Health for testing locations in Auckland and healthpoint.co.nz for testing locations nationwide.
Operating in Alert Levels 3 and 2
In addition to Government information available at covid.govt.nz, PNZ has worked with the Physiotherapy Board on guidance for operating at Alert Level 3 and Alert Level 2 in a non-DHB setting. Please follow your employer advice if working in a DHB.
Alert Level 3
- Virtual appointments should be provided where possible and is the preferred method of service delivery. Face-to-face appointments may be provided for urgent care only so long as professionals can take appropriate measures to manage public health.
- Under Level 3, telehealth will be used for the majority of patients. It is only urgent cases where you can consider in your clinical judgement that you will undertake a face-to-face consultation. This means physiotherapy clinics cannot open their doors to see patients on a ‘business as usual’ basis.
- Full Alert Level 3 guidance is available here.
Alert Level 2
Practitioners are able to see patients in person if the following processes are in place:
- Screening for COVID-19 symptoms prior to in person appointment.
- Physical distancing measures.
- Infection prevention control measures including PPE where required.
- Practitioners will be able to travel within and to the neighbouring regions to provide care to patients and receive training.
- Group treatment (e.g. exercise classes) can occur so long as physical distancing is in place’. Please note regional restrictions on gatherings and class sizes may vary.
- Full Alert Level 2 guidance is available here.
Details of the Government COVID-19 vaccine strategy are available here. Current advice from the Ministry of Health (MoH) on the role of physiotherapists in helping administer vaccines is below, to be updated as further information becomes available from MoH. Please also read the February 2021 MoH COVID-19 Vaccine and Immunisation Programme sector update.
Will physiotherapists administer COVID-19 vaccinations?
MoH is training vaccinators now. General Practitioners, nurses and pharmacists are the first vaccinators. If there is a greater need than this then recently retired GPs, nurses and pharmacists will be Tier 2. Physiotherapists may be called in as part of a surge workforce if additional capacity is required.
Physiotherapists who take up this training would expected to be those who are already competent in injections, within current scope. If this is required there will be a call on the Awhina app which is what MoH are using for comms to health professionals. Information for anyone interested in being a vaccinator in available at health.govt.nz.
Please note that the Physiotherapy Board has a position statement on New Zealand registered physiotherapists practising in a defined field, outlining when a physiotherapist is deemed to be competent in an area of practice.
Will the current BMS insurance cover this modality?
At present the answer is No. As per questions we received in 2020 regarding COVID-19, if a physiotherapist was taking on this role for MoH or a DHB our expectation is that the DHB involved would be carrying the insurance to cover the vaccination staff. Read more here on insurance cover if working from the Ministry COVID-19 Surge Workforce register.
Face Coverings on Public Transport
Please note that as an additional precaution, the Government are requiring face coverings on public transport at all alert levels.
Locations of Interest
The latest Government information for businesses is available at business.govt.nz. This includes a summary of financial support and COVID-19 financial support tool to identify what financial help may be available to you. A COVID-19 Business Helpline, 0800 500 362 (North Island) or 0800 505 096 (South Island), is also available to provide support and advice on:
- Government financial support.
- What different alert levels mean for your business.
- Business continuity.
- Finding expert help, like a business mentor or advisor.
- Team management including staffing changes and employee wellness.
Advocating for Physiotherapy in Alert Level 3
While the results of the MoH consultation and PNZ submission on their approach to Allied Health services through COVID-19 are yet to be released, Chief Allied Health Professions Officer Martin Chadwick confirmed at our meeting on Tuesday that there are no changes planned for the list of essential service providers or service delivery at Alert level 3.
MoH accept there is an impact on wellness for many people and Dr Chadwick stressed that all health services, including GPs, are expected to deliver telehealth as the first option in Alert level 3. Physiotherapists and all other community based allied health providers can provide urgent care, with the definitions of urgent set out here. The Government response on early, short lockdowns in part recognises that longer lockdowns have the greater impact on wellness.
PNZ will continue to advocate on this issue, and for physiotherapy access to aged residential care at all alert levels. In aged residential care even a short term change can be irreversible and facilities have had stricter conditions than the general community. Read more about our advocacy work here.
ACC are still covering telehealth under Cost of Treatment Regulations and the physiotherapy contract. There is a regular meeting with ACC this afternoon in which we will check on any changes.
PNZ has been in ongoing contact with agencies including MoH, ACC and the Physiotherapy Board through the COVID-19 alert levels. We will continue to work with these groups to provide updated guidance as it becomes available and advocate for the profession.
For reference, all emails sent to PNZ members regarding COVID-19 are available here.
Ngā Mihi Nui
Thank you once again to all members for your commitment through COVID-19. Previous alert levels have shown that we are strongest when united and your support is much appreciated. A special acknowledgement to all of our members working in DHBs around the country. In our regular meeting with DHB managers we've heard how much work has been happening in trying to get back to business as usual.
We also acknowledge all the physiotherapists in DHBs and private practice who have been supporting student clinical placements. The Schools of Physiotherapy and Physiotherapy Board are very conscious of working to ensure students have sufficient clinical practice to meet the thresholds. This only happens because physiotherapists already working under pressure are sharing their expertise with the next generation of physios.
Guidance for Physiotherapists
PNZ has worked with he Physiotherapy Board on guidance for the profession through COVID-19 alert levels. Please refer to physioboard.org.nz for information on seeing patients in a non-DHB setting. For physiotherapists working in District Heath Boards please follow the advice of your DHB. The PNZ Paediatric Special Interest Group have also have guidance for physios working in schools.
Please continue to follow MoH guidance on COVID-19 including advice on the use of masks in the community and If you haven’t already please subscribe to their Health Workforce Sector Updates. Many thanks to the Cardio-Respiratory Special Interest Group (CRSIG) who have worked to develop Respiratory Physiotherapy Guidelines for Managing Patients with COVID-19 Infection. These provide guidance for the use of PPE in aerosol generating procedures during respiratory physiotherapy and rehabilitation of patients with compromised health.
PNZ also has a web page with COVID-19 Business Information and FAQs that you may find helpful. This includes information on Government financial support.
Advocating for Physiotherapy
Modelling suggests that New Zealand’s COVID-19 management will be ongoing into 2021 and PNZ continues to advocate for increased health funding of physiotherapy. We also need to be prepared that Aotearoa may again be in higher alert levels at short notice.
Together with the Physiotherapy Board we have asked MoH to broaden the conditions in which physiotherapists can operate at higher alert levels. 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 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. The aged care sector are currently erring on the side of preventing infection, but we can see this is not being consistently applied. It is another ongoing conversation.
With MoH releasing a discussion paper on their continued approach to Allied Health services through COVID-19 and this partly a result of our advocacy work, PNZ sought member feedback on the paper and made a submission. Thank you to everyone 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 and Health & Wellbeing.
Frequently Asked Questions
Answers to some of our COVID-19 member queries are available at pnz.org.nz. These have been developed with the Physiotherapy Board to cover a range of topics including telehealth, face masks, QR codes and insurance, and are intended to complement Ministry of Health guidance.
PNZ guidelines for telehealth treatment through COVID-19 are available here. ACC sent a message to physiotherapists in August 2020 notifying recipients that telehealth provisions remain in place for most services at all COVID-19 alert levels, with more information on their website. Other ACC provider COVID-19 email updates are available here.
It’s important to acknowledge that the change in alert levels can result in increased stress and anxiety. The covid19.govt.nz website offers advice for looking after your mental wellbeing, Te Pou o te Whakaaro Nui have resources to help you cope with COVID-19 and the Mental Health Foundation of New Zealand have a web page on looking after mental health and wellbeing during COVID-19. This includes free call and text numbers to speak with a trained counsellor. Please look after the wellbeing of you and your whānau.
NZ COVID Tracer App
MoH advise that fast and effective contact tracing is essential to stopping any further spread of COVID-19 in New Zealand. NZ COVID Tracer supports this by creating a digital diary of the places you visit. More about the app is on the MoH website and business.govt.nz has information for businesses.
Older Adult Super Seven Strength and Balance Exercises
In response to COVID-19, a team of DHB clinical leaders identified a need for an exercise programme designed to be done safely at home for older adults known to community services. Collated by Liz Binns and Denise Taylor (AUT University), with input from Ricky Bell (Waikato Institute of Technology), John Parsons (The University of Auckland) and a number of DHB colleagues, the Super Seven Strength and Balance Exercises are available here.
Physiotherapists in the UK have recently developed and released the educational ONCALLbuddy app, aimed at physios and other healthcare professionals working in respiratory settings. Promoted by the Chartered Society of Physiotherapy and supported by Health Education England, the app is available to download at no cost and provides clinicians with easy information and advice about common respiratory conditions, assessment and treatment techniques, and some COVID-19 specific resources. Read more at oncallbuddy.co.uk.
Personal Protective Equipment (PPE) Suppliers
Please follow the Ministry of Health guidance on the use of PPE. If you are looking to purchase PPE or COVID-19 signage, there are suppliers below who have made it known they can provide equipment for physiotherapists.
- Whiteley Allcare: The team at Whiteley Allcare are long-time supporters of PNZ and the physiotherapy profession through their partnership in helping deliver Physiotherapy Conference. Please visit allcare.co.nz or email email@example.com.
- Exhibition Hire: Having helped set-up exhibition hall trade stands at Physiotherapy Conference, Exhibition Hire are offering print packages for COVID-19 signage. Email firstname.lastname@example.org.
Rehabilitative Interventions in COVID-19 Survivors
This document provides an expert-based opinion on Early and Short-Term Rehabilitative Interventions (After the Acute Hospital Setting) in COVID-19 Survivors. Please note that this is a living document published fortnightly. Information is contained in the document about how input from peers can be sent to the group.
Additional funding available to support the wellbeing of disabled people including people with health and mental health conditions
PNZ received the following information from Work and Income in April 2020.
The Government has made additional funding available to support the wellbeing of disabled people including people with health and mental health conditions by trying to limit the impacts of anxiety and loneliness during the Covid-19 response. This funding is to enable organisations to continue providing support during alert level 4, alert level 3 and any periods of self-isolation.
How can the funding be used?
Organisations can use the funding to:
- employ additional staff to provide regular support to disabled people and their families/whanau. This support can be provided through a variety of channels including face to face (for essential service providers and following Ministry of Health Guidelines) email, Facebook, texts or phone calls
- develop resources to provide activities for people at home. This can include setting up and managing private Facebook groups, developing YouTube videos, video conferencing, creating and sending hard copy activity packs, sending art supplies and supporting the develop of peer support networks. We’ve pulled together some ideas from MSD funded providers and have attached them to this email.
Who is the funding for?
Priority will be given to funding organisations supporting disabled people including people with health or mental health conditions who:
- live alone
- live with family/whanau
- are in Contract Board
- live in a flat; or
- live in rural or isolated areas
If your application meets the funding criteria you will receive a one of payment of $18,500. You may receive more if you are supporting a large number of people in the priority groups. The funding will be paid as a lump sum.
You will be asked to provide a brief report detailing how you have used the funding in early July.
How to apply
Complete the application form and send it to email@example.com. We will review your application and get back to you if we need more information.
Cardio-Respiratory Special Interest Group (CRSIG)
The PNZ CRSIG issued the following statement in April 2020 relating to a video posted by News Hub/The Herald
Coronavirus: UK doctor offers breathing technique advice to assist in alleviating COVID-19 symptoms. A clip has been shared worldwide over the last few days of a doctor from the UK demonstrating a breathing technique and claiming that it assists in alleviating COVID -19 symptoms. Unfortunately the technique demonstrated in this clip is scientifically inaccurate and for a large percentage of the population it could in fact worsen their respiratory symptoms. The Association of Chartered Physiotherapists in Respiratory Care (ACRPC) of the UK have tweeted that they “are not in support of this technique for COVID-19 as presentations vary dramatically”. The Physiotherapy New Zealand Cardio-Respiratory Special Interest Group also does not endorse this video or the techniques demonstrated in it. Read the full statement here.
CRSIG also provided the following resources for all physiotherapists.
As we wait to see how the COVID-19 pandemic will play out in New Zealand, we have an opportunity to ensure we are ready to help out if needed, should we be willing and able to. Being willing is, of course, determined by all manner of considerations, and is a hugely personal decision.
Being able requires us to have the necessary skills to be competent in either an acute care or rehabilitation capacity. If you have a respiratory background and/or previous ICU experience and are considering helping out and feel you would benefit from upskilling or refreshing your skills here is a selection of relevant information collated by the Cardio-Respiratory Special Interest Group.
Cardio-Respiratory Special Interest Group Committee
Physiotherapy in COVID-19 management guidelines
- Physiotherapy Management for COVID-19 in the Acute Hospital Setting. This document outlines recommendations for physiotherapy management for COVID-19 in the acute hospital setting. It includes recommendations for physiotherapy workforce planning and preparation, a screening tool for determining requirement of physiotherapy, recommendations for the selection of physiotherapy treatments and personal protective equipment
- Respiratory physiotherapy in patients with COVID-19 infection in acute setting: Italian Respiratory Physiotherapists. Consensus between Italian Physiotherapists with specific expertise in respiratory care working with COVID-19 patients in the north of Italy.
- Joint statement on the role of respiratory rehabilitation in the COVID 19 crisis– the Italian position paper
Open access online cardio-respiratory physiotherapy courses
The Coronavirus Disease Programme is a 4 part course hosted by Physiopedia and is free to sign up and access for a month.
- Introduction to Coronovirus
- Infection prevention and control
- The role of physiotherapy in COVID-19 and
- Respiratory management of people with COVID-19.
NSW Physiotherapy Virtual Cardiorespiratory ICU Update with focus on physiotherapy in COVID 19 cases is a 2 day recorded audio with PowerPoint and course resources. The purpose is to provide physiotherapy staff with an update in cardiorespiratory physiotherapy practice for intensive care, and planning for potential roles of physiotherapy in the management of COVID-19 patients in this environment. This two day virtual training course provides a refresher and update for physiotherapy staff working in ICUs with increasing cases of COVID-19 and ventilated patients. This course combines key topics from the APA Cardiorespiratory Physiotherapy Level 2 – ICU course and incorporates COVID19 respiratory management based on The Australian and New Zealand Intensive Care Society (ANZICS) COVID-19 Guidelines and COVID-19: Respiratory Physiotherapy On Call Information and Guidance from NHS. Training is best suited to base-mid grade physiotherapists who have prior skills and experience in Intensive Care Units / High Dependency Unit.
The Clinical Skills Development Service is committed to healthcare improvement through training, collaboration and innovation. It has a number of free online cardiorespiratory physiotherapy courses (as well as other physiotherapy courses).
Physiotherapy and Critical Care Management is a course run by the Clinical Skills Development Service and is suited to those with a respiratory skill set. PaCCMan contributes to the learning and development of physiotherapists for work in the intensive care environment and expands their knowledge of contemporary, safe clinical practice. It includes practical sessions on assessment and clinical skills, as well as simulated experiences in providing respiratory care and rehabilitation.
New Zealand Specific COVID-19 resources
Keep up to date with the latest information from the Ministry of Health and review the information around PPE to familiarise yourself see below.
World Physiotherapy Resources
World Physiotherapy have collated information and resources about COVID-19 for physiotherapists on their website. This includes:
- A Telehealth Toolbox guide on How to use telehealth to care for your patients during COVID-19.
- World Physiotherapy and INPTRA joint report on digital physical therapy practice.
- The Physiopedia free online programme of COVID-19 courses: Understanding COVID-19, Infection Prevention and Control, Role of Physiotherapy in COVID-19 and Respiratory Management of COVID-19.
- 30 days free access to Physioplus.
- The World Physiotherapy network for physiotherapy educators Facebook group.
A document from BMS on COVID-19 is available here. Please note the following advice regarding BMS insurance and telehealth services. Telehealth is an acceptable practice provided it’s considered within the scope of your individual practice. Your professional indemnity policy with BMS has a jurisdictional limitation within New Zealand. The policy terms and conditions will still apply in the event of a claim." BMS can be contacted at 0800 999 267 and firstname.lastname@example.org.
The following online resources link to pages from New Zealand and the World Health Organisation. Links are provided to ensure members are directed to the latest information as these pages are updated.
New Zealand Government
- The New Zealand Government website (Govt.nz) links to Unite Against COVID-19 (covid19.govt.nz) intended as a single resource for COVID-19 information.
The Ministry of Health (MoH) – includes advice for health professionals
- Please visit the Ministry of Health website for the latest information from MoH on COVID-19, including media releases. MoH has pages for current updates and resources for health professionals.
- MoH have COVID-19 - information in multiple languages, including New Zealand Sign Language, and the Ministry for Pacific Peoples has information for Pacific People in New Zealand.
- A MoH poster on how to protect yourself and others is available here. The Canterbury District Health Board have also provided a poster for practices, available in a number of sizes and formats on the Canterbury Primary Response Group website.
The World Health Organisation (WHO)
- The World Health Organisation website also has a page with information about Novel Coronavirus (COVID-19), including advice to people on how to protect themselves and those around them.
- PNZ is in regular communication with ACC and our Clinical Partner Melissa Barry. The ACC website has a pages with important information about novel coronavirus COVID-19 as well as ACC COVID-19 information for providers and ACC Provider COVID-19 updates.
- ACC service item codes and rates for telehealth invoices are available here.
Information on International Travel
- For information on international travel, please refer to updates from Immigration New Zealand, The New Zealand Customs Service and Air New Zealand.
- NZTC INTERNATIONAL - The Translation Centre are offering online video and audio interpreting services as an alternative option to face-to-face interpreting. Please contact email@example.com.
A number of online courses and webinars have become available for physiotherapists at no cost to help the profession through COVID-19. Below are links to a number of these resources.
ONGOING COURSES AND WEBINARS
Physioplus is providing an online programme of courses on COVID-19 at no cost. The aim of the course is to provide a practicing physiotherapist with the knowledge, practices and skills to allow them to play a proactive role in global and local efforts to reduce the impact of this pandemic. Read more here.
University of Melbourne PEAK Programme
In light of the COVID-19 pandemic and the increasing use of telehealth to deliver physiotherapy services, the Centre for Health, Exercise & Sports Medicine at the University of Melbourne has fast-tracked the release of the PEAK (Physiotherapy Exercise and physical Activity for Knee osteoarthritis) programme training modules at no charge. Read more here.
The Clinical Skills Development Service is committed to healthcare improvement through training, collaboration and innovation. It has a number of no cost online cardiorespiratory physiotherapy courses (as well as other physiotherapy courses). Read more here.
Physiotherapy and Critical Care Management
Suited to those with a respiratory skill set, this course contributes to the learning and development of physiotherapists for work in the intensive care environment and expands their knowledge of contemporary, safe clinical practice. It includes practical sessions on assessment and clinical skills, as well as simulated experiences in providing respiratory care and rehabilitation. Read more here.
RECORDED COURSES AND WEBINARS
DJO Education Webinar Series
DJO are offering an Education Webinar series for physiotherapists at no cost, to maintain professional development during COVID-19. Starting on 21 April with content recorded to view later topics include Laser Therapy, Shockwave and Neuromuscular Electrical Stimulation (NMES). Read more here.
Humankind hosted a webinar for PNZ members on 1 April, outlining employer obligations and options during COVID-19. A recording of the webinar is available here. There are also links to resources discussed in the webinar including COVID-19 considerations for employers, 1737 – free counselling services for New Zealanders and the Mental Health Foundation website.
Dr Angela Cadogan has provided a Telehealth for Physiotherapists webinar for the profession and Dr Mark Fulcher has developed two telehealth consults webinars on Practical Tips to Get You Up and Running and Assessing the Knee. Read more here.
Physiotherapy Virtual Cardiorespiratory ICU Update
This two day recorded audio with PowerPoint and course resources provides physiotherapy staff with an update in cardiorespiratory physiotherapy practice for intensive care, and planning for potential roles of physiotherapy in the management of COVID-19 patients in this environment. Read more here.
Page updated 1 March 2021