Links to COVID-19 information and resources are on this web page, informed by our regular contact with Government agencies including the Ministry of Health, ACC and Physiotherapy Board of New Zealand. For the most current and accurate information we advise that members refer to Government websites.
COVID-19 Alert Levels
Updated 20 October 2021
Auckland and parts of the Waikato are currently in COVID-19 Alert Level 3. The rest of New Zealand is in Alert Level 2.
Please refer to covid.govt.nz for Government information including the 3-step approach to ease Alert Level 3 restrictions in Auckland, an alert level boundary map and when current alert levels are to be reviewed. The Ministry of Health website also has locations of interest.
Ministry of Health guidance for physiotherapists operating at each alert level in a non-DHB setting is below, with further information available from the Physiotherapy Board. Please follow your employer advice if working in a DHB.
For reference, all PNZ member emails regarding COVID-19 are available here.
Alert Level 3
As identified in a joint message from PNZ and the Physiotherapy Board on 15 October 2021, "current Alert Level requirements are set out in an Order that commenced on 21 September 2021. The Order specifies mandatory legal requirements for individuals, businesses, and services at various alert levels. Requirements for business and services include matters such as the number of customers and clients allowed in a workplace, physical distancing rules, and contact record rules.
Importantly, apart from a few specific exceptions, nothing in the current Order applies to health services (including physiotherapy). In other words, the Order enables physiotherapists to provide health services to the public provided they comply with those exceptions."
Please read the full joint message, including actions physiotherapists must take to operate in Alert Level 3. The Physiotherapy Board has more information on how physiotherapists can see their patients under Alert Level 3 at physioboard.org.nz.
Advocating in Alert Level 3
With the Government introducing a 3-step approach to ease Alert Level 3 restrictions in Auckland PNZ has advocated that physiotherapists should be able to see patients in person from Alert Level 3. This includes a letter with the Physiotherapy Board to the Minister of Health raising concerns with the current situation and the lack of timely direction.
This has been in the media, including on One News and Radio NZ, and the New Zealand Orthopaedic Association have written to the Minister of Health to extend their support. ACT Deputy Leader and Health spokesperson Brooke van Velden has also been in the news having written to Chris Hipkins asking the Government to allow physiotherapy under Auckland's Alert Level 3. Thanks to all our members for your support, as physiotherapists can now operate in-person through Alert Level 3.
Alert Level 2
Clinical reasoning and risk assessment remain the fundamental principles for considering care at Alert Level 2. Telehealth and virtual appointments are still the preferred option and please exercise extra caution when treating vulnerable groups. Clinicians will be able to see patients face to face if the following processes are in place. Please refer to the Ministry of Health website for further advice.
- screening for COVID-19 symptoms prior to face-to-face appointment.
- physical distancing measures.
- infection prevention control measures including PPE where required.
- Transmission precaution measures including consideration of ventilation.
- When considering travel within and between regions ensure all risks have been taken into account before undertaking to provide care to patients and traveling to receive training.
- Group treatment (eg, exercise classes) can occur so long as physical distancing is in place.
Guidance for sports physiotherapists working in Alert Level 2 is provided on the Physiotherapy Board website. COVID-19 posters including those for healthcare practices are available at covid19.govt.nz.
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.
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.
Details of the Government COVID-19 vaccine strategy are available here. Advice from the Ministry of Health (MoH) on the role of physiotherapists in helping administer vaccines is below.
When can physiotherapists be vaccinated?
We are following MoH direction on when physiotherapists across the country will be vaccinated. The Government has an online tool available at covid19.govt.nz for the public to identify when they may get the vaccine with links to relevant contacts for your DHB.
Do physiotherapy employees need to be vaccinated for their work?
This is a practice decision and employers should develop their own policies on employee vaccination. Worksafe Mahi Haumaru Aotaeroa have information on assessing whether a specific role needs to be performed by a vaccinated worker and business.govt.nz offer more general information on COVID-19 vaccinations and your workers. Our employment support partner Humankind also have a guide to navigating vaccine conversations at work.
Will physiotherapists administer COVID-19 vaccinations?
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.
MoH have paid and volunteer opportunities available in various locations as part of the COVID-19 vaccination workforce, including administration, vaccination, and support and liaison roles. Applicants can specify how far they’re willing to travel for work, and the days and hours they're available, by registering at health.govt.nz.
The Physiotherapy Board has noted that being a vaccinator is within the General Scope of Practice. Therefore, you must be registered, hold a current APC and have completed the vaccinator training. There is also 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.
The vaccine rollout is being run through DHBs and Public Health Units. Our experience to date is there is much regional variation in this interpretation and we are continuing to advocate for certainty in this space. The path to become vaccinators is also delegated to DHBs and therefore variable around the country. Please check your DHB website for more information.
Will the current BMS insurance cover this modality?
BMS have confirmed that COVID vaccination is included the PNZ scope of practice, list of modalities, on the basis the physiotherapist has evidence of completing the approved COVID vaccinator training. If your employer requires evidence of you having personal indemnity insurance prior to working as a vaccinator please contact BMS on 0800 999 267 or email email@example.com.
Will District Health Boards provide insurance cover for vaccinators?
If a physiotherapist is taking on a vaccinator role for the MoH or a DHB, MoH has advised that the determination of personal indemnity insurance cover will be on a DHB by DHB basis. Physiotherapy vaccinators should check with their DHB as to whether the DHB is carrying the insurance to cover vaccination staff. If your DHB does not provide indemnity insurance cover and you are required to show evidence of personal indemnity insurance prior to delivering vaccinations please contact BMS.
Employers should consider how they will handle international travel for staff when there is the potential for COVID-19 travel restrictions to occur. To help with this MoH has COVID-19 advice for international travellers.
Advocating for Physiotherapy in Alert Level 3
PNZ continues to advocate for in-person physiotherapy treatments during COVID-19 Alert Level 3. The MoH position has been that health services should deliver telehealth as the first option in Alert level 3 unless the appointment is under a definition of urgent care. Our position remains that physiotherapists can make the clinical decision regarding urgency of care and take measures required to meet safety precautions.
Following a PNZ submission to MoH, a letter to the Minister of Health Hon Andrew Little, press release and meetings between the PNZ Chief Executive, Minister Little and Chief Allied Health Professions Officer Dr Martin Chadwick, PNZ was part of a MoH Working Across Alert Levels group and MoH updated their urgent care definition in mid-2021.
We also continue to advocate for physiotherapy access to aged residential care in all COVID-19 alert levels, where even a short term change can be irreversible and facilities have had stricter conditions than the general community. Read more about our advocacy here.
ACC are still covering telehealth under Cost of Treatment Regulations and the physiotherapy contract.
Guidance for Physiotherapists
PNZ has worked with he Physiotherapy Board on guidance for the profession through COVID-19 alert levels. Please refer to health.govt.nz and 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.
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. The PNZ Paediatric Special Interest Group also have guidance for physiotherapists working in schools.
If you haven’t already please subscribe to the MoH Health Workforce Sector Updates. PNZ has a webpage with COVID-19 Business Information and FAQs that you may find helpful. This includes information on Government financial support.
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.
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 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.
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.
- 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 online cardio-respiratory 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
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 Cardio-Respiratory ICU Update
This two day recorded audio with PowerPoint and course resources provides physiotherapy staff with an update in cardio-respiratory 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 20 October 2021