In addition to information available here on the PNZ website a number of emails have been sent to PNZ members regarding COVID-19. For reference these are available below, in order of most to least recent
Subject: Student placements in COVID-19
Sent on 23 September 2020 to all PNZ members
PNZ has received a notification from the Ministry of Health regarding their policy for students completing training placements during COVID-19 Alert Levels 1 – 4.
This policy applies to students from all health professions who are completing training placements while nationwide or regional COVID-19 Alert Level restrictions are operating.
Thanks to all our members who have been supporting physiotherapy student placements this year. It has been a challenging time for all. On behalf of current and future physiotherapists we are grateful for PNZ members who mentor students. There’s more about how the year is working in our October Physio Matters out soon.
Please read the full Ministry of Health document here.
Subject: COVID-19 Resurgence Business Information
Sent on 17 September 2020 to PNZ business contacts
Kia ora tātou
I think we can safely say none of us predicted the way 2020 would happen. This year has tested our resilience, our ability to plan for contingencies and then re-plan again. So thanks for your support and engagement as physiotherapy business leaders. A few updates that may be of interest are below.
COVID-19 Resurgence Planning
As Government once again look to reduce alert levels it’s timely to consider what might happen next. National and international modelling suggests that New Zealand’s COVID-19 monitoring and management will be ongoing for the at least the next 12 to 18 months. This means we need to be prepared that regions or all of Aotearoa may again be in higher alert levels at short notice. PNZ and the Physiotherapy Board of New Zealand have been advocating for the Ministry of Health (MoH) to review and update guidance for physiotherapy, particularly in Alert Level 3.
Our position is that physiotherapists already use infection control processes, are familiar with the use of PPE and the health outcomes for ongoing treatment justify being open. We’ll keep you informed of any progress. As you know, until now the public health imperative about reducing in-person contact has driven MoH decisions. While we appreciate the requirement for swift clear direction in March, now we need to look at long term pandemic response and be ready for not just a COVID-19 resurgence but whatever might happen in any future pandemic.
This year’s PNZ Remuneration Survey was undertaken in July, when all of the country was in Alert Level 1. You may recall specific questions about the impact of COVID-19. Early indications confirm an impact on business over April and May with a quick bounce back in June. Given the resurgence just after this survey we have added further business impact questions in the 2020 PNZ Member Survey which will be in field shortly. We’ll continue to monitor business impact over the rest of this financial year so we can ensure our advocacy is accurate and targeted.
PNZ Support for Business Owners
We’re committed to working with you on resources and services for both COVID support and long term sustainable outcomes. Physiotherapy business models, like other primary care services, have changed greatly in recent years and we have a diverse group of business owners. To meet the shared needs of all businesses we’ve engaged Andrew Cameron from HealthiNZ to consult with members who have identified as business owners on the PNZ member database. This will identify priorities for PNZ business support, highlight existing resources that meet these needs, consider the requirements of particular sectors and explore the best channels for ongoing engagement. We’ll tell you more about this work over the coming months.
Find a Physio
While the Find a Physio section of the PNZ website is well-used, we’ve been aware of its shortcomings and have been working on improvements for the past year. The updated site is now live and based on Google Maps, all designed so the public can more easily find member practices. Individual PNZ members will also soon be able to link to where they work, so your team can feature on your listing. More information will be available on this in the next couple of weeks.
ACC Next Generation Case Management
Since mid-2019 ACC has been rolling out its next generation case management model (your patients will see this as MyACC) and we’ve increasingly been hearing concerns from physiotherapy providers about this system. Many of you are reporting hours, days or weeks spent waiting for responses to phone calls or emails. We have raised this several times with ACC and over the past month received an acknowledgement that the system is overloaded. What we can’t provide at the moment is any sense of a time frame for resolution. Please do continue to let us know your experiences, including if you think it’s getting better!
We’re in the early stages of an exciting Physiotherapy Outcomes Registry project, that will help all of us demonstrate the benefits of physiotherapy. The proposed approach is to work with an IT software developer to create a physiotherapy outcomes registry using de-identified information collected through existing patient management systems. Individual clinicians and practices would receive regular dashboard reporting to show their results compared to national data and the collated information would support PNZ advocacy work. Researchers could also apply for access to the data to support specific research proposals. We know that demonstrating outcomes is the way of the future, with funders like ACC also working in this space, and are looking for a system to make collecting outcomes seamless. We’ll again keep you informed as the project progresses and are very grateful to the PNZ members who have been working with us on this.
Subject: Respiratory physiotherapy guidelines for managing patients with COVID-19 infection
Sent on 7 September 2020 to all PNZ members
On the eve of World Physiotherapy Day, where the focus is on the vital role of physios in COVID-19 recovery, it is perhaps fitting that long-awaited respiratory physiotherapy guidelines for managing patients with COVID-19 infection have now been published on the Ministry of Health website and Āwhina app.
Given we’re living in a world where resurgence of COVID-19 is possible for the foreseeable future these guidelines are a great resource. Cardio-Respiratory Special Interest Group (CRSIG) members have worked hard and shown commitment to the process through six months since they first identified the issue. It has been a privilege for Chris Bloomfield and I from the PNZ Office to support the CRSIG in working with various parts of MoH to get traction for the guidelines.
Subject: COVID Alert Level 2
Sent on 28 August 2020 to all PNZ members
All of New Zealand will be at Alert level 2 from Monday 31 August
Kia ora tatou
Another week has passed in our new normal. To those physios in Auckland we stand beside you as you live through an extended lockdown to try and manage the outbreak. The Ministry of Health have growing confidence that the cluster is being contained. Ka rawe!
Once again we thank our members who are at the front line and recognise the impact on you and your family/whanau as you work in this high stress environment.
At midnight on Sunday 30 August Auckland will move from Alert Level 3 to Alert Level 2. All of New Zealand will then be in Alert Level 2 until at least Sunday 6th September. There are additional limitations on gathering sizes in Auckland. The information from the COVID-19 website is here.
Working at Alert Level 2
The work we have done with the Physiotherapy Board to create guidance for working at Alert Level 2 is here.
We do note that the Ministry of Health still recommend virtual consultations as a preference. Where a face to face consultation is required screening for respiratory illness symptoms is required; every business must show the NZ COVID Tracer QR code; good hygiene and infection control procedures need to be put in place for all people and the decisions regarding the use of PPE is based on risk. The advice for health professionals is screening and good hand hygiene are essential. A mask is not essential but note that the Ministry advice is "consider wearing a mask in situations where physical distancing is not possible".
Thanks to the Paediatric SIG who have put out guidance today for physios working in schools. You can find this here.
In the meeting with Martin Chadwick, Chief Allied Health Professions Officer, this week he stressed that the Ministry are looking at a 12-18 month horizon in terms of resurgence planning. This is sobering as we recognise that we may again have parts of New Zealand that move into Alert Level 3 to contain another outbreak. There are discussions regarding "tweaks" for any future Alert Level 3. There are several areas we are keen to see such tweaks and this is our continuing advocacy focus. This includes:
- Physiotherapy to be considered as a face to face service in alert level 3. Physiotherapists are already using infection control processes; are familiar with the use of PPE and the health outcomes for ongoing treatment would justify being open.
- Standardisation in the aged residential care settings with access for physiotherapists to ensure well being of aged residential care dwellers. Experience over the last three months is there is no consistency and this vulnerable group are losing mobility and experiencing increasing morbidity as a result. This is a population that does not bounce back.
- The impact of ongoing elective surgery and the impact this has on hospital capacity; discharge planning and continuing care whether this be in the DHB setting or in the community.
- The need for proactive treatment to address co-morbidities in long term non communicable diseases. One of the stand out lessons from the latest community outbreak is the impact on the Pacific community in South Auckland. Addressing some of the pre-existing comorbidities would have reduced the health burden for this community. Physio has very important role in this at primary care level and it requires funding.
Once again my thanks to the members who have been in touch to let us know how the latest lockdown is affecting you. We continue to work on behalf of all our members.
Sent on 21 August 2020 to all PNZ members
Kia ora tatou
Another week down, and we can see that the lockdown in Auckland is starting to impact on the spread of the community cluster.
With Auckland currently in Alert Level 3 and the rest of the country in Alert Level 2 please be aware of the most recent Government updates from the Ministry of Health and support available to businesses.
Thank you once again to all our members for your continued support and commitment at this time. We are in contact with many of you working across the health system.
A special acknowledgement to all of our members working in DHBs around the country. A big shout out to our colleagues in Waitematā, Auckland and Counties Manukau in particular. In our regular meeting with DHB managers, ironically just a week prior to this resurgence, we were hearing how much work has been happening in trying to get back to business as usual.
Let's also acknowledge all the physiotherapists in DHBs and private practice who have been supporting student clinical placements this year. The Schools of Physiotherapy and the Physiotherapy Board are very conscious of working to ensure that the current 4th year 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. Please let us know if you have any specific concerns that we can support.
Ministry of Health
Many thanks also to the Cardio-Respiratory Special Interest Group (CRSIG) who have worked tirelessly since the early days of COVID to develop Respiratory Physiotherapy Guidelines for Managing Patients with Suspected or Confirmed COVID-19. This week the Ministry of Health Technical Advisory Group signed off the agreed guidelines and these are awaiting publication. We will share these as soon as they are available as they provide guidance for the use of PPE in aerosol generating procedures during respiratory physiotherapy and rehabilitation of patients with compromised health. A great outcome in what for the Ministry of Health is a short time frame. We also can see here the value of the Chief Allied Health Professions Officer in the Ministry. Because this went through Martin Chadwick's office it got through to the right people in the Ministry.
The latest MOH COVID-19 information is found at health.govt.nz. If you haven’t already please also subscribe their Health Workforce Sector Updates. The latest edition covers topics including the COVID-19 surge workforce, Āwhina app and 0800 support for frontline health and disability workers.
- Resurgence Wage Subsidy
The COVID-19 Resurgence Wage Subsidy applies nationally to any business with a 40% decline in revenue for any consecutive period of at least 14 days within 12 August and 14 September. Applications open on 21 August.
- Wage Subsidy Extension
The Resurgence Wage Subsidy is in addition to the COVID-19 Wage Subsidy Extension for business still significantly affected by the business downturn. This has been extended to allow for applications until 1 September.
- Leave Support Scheme
The COVID-19 Leave Support Scheme provides a payment to businesses to help pay workers if they need to stay away from work and cannot work from home due to COVID-19 public health guidance.
- Business Advice
Your local Regional Business Partner Network can offer access to expert advice through COVID-19 including cash flow and finances, HR issues, health and wellness, business continuity planning and digital upskilling.
Like you, we will be waiting to hear what happens regarding any changes to current Alert Levels next week. We will keep you updated.
Subject: Changes to Alert Levels
Sent on 14 August 2020 to all PNZ members
The Government announced this evening that the current COVID-19 alert levels will remain in place until Wednesday 26th August. Auckland will remain in Alert Level 3 while the rest of New Zealand remains in Alert Level 2.
Following new cases of COVID-19 the Government has acted swiftly and we will remain in the current restrictions for the total of two weeks, or one viral cycle.
Please find guidance on operating in these alert levels below as well as answers to some of your frequently asked questions and a reminder to look after your wellbeing at this time.
We note that the review of the Alert Levels is planned for 21 August. We will keep you updated.
Guidance for non-DHB physiotherapists seeing patients in alert levels 2 and 3 is available at physioboard.org.nz. This now includes a flow chart to help you determine if you can provide physiotherapy services during Alert Level 3. Members working in District Heath Boards are asked to please keep following the advice of your DHB.
Frequently Asked Questions
Answers to some of our COVID-19 member queries are also 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. Our ongoing discussions with MoH, ACC and the Physiotherapy Board of New Zealand allow us to advocate on behalf of the profession as well as provide you with the most recent information possible. We’ll continue to update members through emails and the PNZ website.
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 and Te Pou o te Whakaaro Nui have resources to help you cope with COVID-19. Please look after the wellbeing of you and your whānau as we unite once again as a profession through the alert levels.
PNZ and NZMPA Offices
Our team members are following government advice and will be working from home at Alert Level 3; some people will be in the office provided we can get there safely at Alert Level 2. Our systems have allowed a seamless transition. Thanks to those of you who have made contact to express support.
I hope you have a good weekend
Nga mihi nui
Subject: Operating in alert levels 2 and 3
Sent on 13 August 2020 to all PNZ members
With the country changing COVID-19 alert levels yesterday, please find updated information below for physiotherapists operating in alert levels 2 and 3. This includes shared guidance from PNZ and the Physiotherapy Board of New Zealand on seeing patients (in a non-DHB setting) and notification from ACC that telehealth provisions remain in place.
For physiotherapists working in the DHBs please follow the advice of your DHB. Do stay in touch if there are questions you have.
We are in ongoing discussions with ACC, the Physiotherapy Board of New Zealand and the Ministry of Health, and will keep members updated with any further information on the updated alert levels.
Guidance for Physiotherapists
PNZ has worked with the Physiotherapy Board of New Zealand on guidance for the profession. This is available at physioboard.org.nz including information on seeing patients for Auckland practices in Alert Level 3 and the rest of the country in Alert Level 2.
Please continue to follow Ministry of Health guidance on COVID-19 including the display of QR codes, screening patients and good infection prevention control measures. MoH also has advice on the use of masks in the community.
ACC: Telehealth Treatment
ACC sent a message to physiotherapists yesterday evening notifying recipients that telehealth provisions remain in place. Part of the message is below with the full email available here. Other ACC provider COVID-19 email updates are available on the ACC website.
“Telehealth consultations continue to be enabled, where it is clinically appropriate and used within guidelines, for most services at all COVID-19 alert levels. Completing the verbal consent process with your patient is an important part of any telehealth consultations that take place and you can find more information on our website.”
Please also be aware of general Government information to help stop the spread of COVID-19. In addition to rules for businesses at alert levels 2 and 3, this includes:
- “People in Auckland should wear face coverings when outside their home during Alert Level 3. In other areas of the country, wear a face covering if physical distancing is difficult.”
- “We need everyone to record their movements using the NZ COVID Tracer app, or by making a note of where they've been and who they've seen.”
- “Travel in and out of Auckland is restricted to essential travel only — you cannot pass through Auckland by road during this time.”
Subject: COVID-19 Alert Level Changes
Sent on 12 August 2020 to all PNZ members
The New Zealand Government announced that COVID-19 Alert Levels will change at 12 noon on Wednesday 12 August. Your Alert Level will depend on where you are in New Zealand. Please find a summary of the regional alert levels and links to further Government information below.
PNZ has been in ongoing contact with Government agencies through the COVID-19 alert levels including the Ministry of Health, ACC and the Physiotherapy Board of New Zealand. We will continue to work with these groups following this change in alert levels to provide guidance for the profession as quickly as possible.
Thank you once again to all members for your commitment at this time. Previous alert levels have shown that we are strongest when united and your support is much appreciated.
Alert Level Changes
Auckland. At 12 noon on Wednesday 12 August the Auckland region will move to Alert Level 3. This will last for at least 3 days. Read an overview of restrictions in Auckland.
Rest of New Zealand. The rest of New Zealand will move to Alert Level 2 from 12 noon on Wednesday 12 August. Read about Alert Level 2.
Ministry of Health
The Ministry of Health website outlines the current situation including a link to their 11 August media release regarding four new positive cases of COVID-19 of unknown origin.
Please keep following current MoH advice and Government information on covid19.govt.nz. PNZ will link to further information for physiotherapists operating in the updated alert levels as it becomes available.
Please continue to contact us as usual on 04 801 6500 or email@example.com, although be aware that we may be receiving higher call volumes at this time.
Subject: Stay united against COVID-19
Sent on 6 July 2020 to all PNZ members
Along with other health organisations, PNZ received the email below on Friday afternoon from Director-General of Health Dr Ashley Bloomfield. This is a reminder to please stay vigilant as a profession and follow MoH advice including that on contact tracing.
Kia ora koutou
Over the last few months, we’ve all pulled together to unite against COVID-19 and stop the spread of the virus within New Zealand. However, COVID-19 is a serious pandemic that continues to affect many countries around the world, and we must continue to be vigilant.
As part of our protection against the spread of COVID-19 it’s important we all continue to keep track of where we’ve been and who we’ve seen. This will help ensure that if needed, our contact tracing team can quickly identify and isolate anyone who may be exposed to the virus.
The NZ COVID Tracer app supports contact tracing by allowing New Zealanders to create a digital diary of the places they’ve been. Over half a million New Zealanders have downloaded the app, and every day more businesses and organisations are getting on board by displaying the official QR codes.
We recently introduced a new self-service webform to make it really easy to generate the QR codes, and there’s a bulk-upload option for businesses and organisations that have a large number of premises.
I encourage you to support your members to generate and continue to display the QR codes on their premises during Alert Level 1. This is an important tool to speed up the contact tracing process in the event of a further outbreak of COVID-19.
You can find a range of further information on our website at www.health.govt.nz/nz-covid-tracer-qr, and the team is also available to help with any queries on 0800 800 606 or at firstname.lastname@example.org.
Ngâ mihi nui
Subject: MoH Alert Level 1 Guidance
Sent on 15 June 2020 to all PNZ members
PNZ was in an update meeting with the Ministry of Health Chief Allied Health Professions Officer last Friday, in which MoH clarified COVID-19 Alert Level 1 guidance for physiotherapists.
Continue to be vigilant
MoH do not have a timeframe for the end of Alert Level 1. While COVID-19 is still prevalent across the rest of the world there are good reasons for New Zealanders to stay vigilant. Although physical distancing is no longer required it should be encouraged.
Use screening questions
All health professionals should use the screening questions below at first point of contact – preferably by phone or signage before the person enters a clinic. If that is not possible, there should be 1 metre physical distancing while asking them. If the person answers yes to one or both of these questions consider delaying the appointment, offering telehealth or using PPE.
a. Do you have new or worsening respiratory symptoms including one of the following: cough, sore throat, shortness of breath, runny nose or temporary loss of smell with or without a fever?
b. In the last 14 days have you either travelled overseas or been in close contact with someone who is a probable or confirmed COVID-19 case?
Given we are currently days away from being able to declare COVID-19 eliminated (28 days with no new cases) these screening questions are more likely to pick up people with non COVID-19 respiratory illness. MoH hope that by practising good infection control and practices we can reduce the health burden associated with the winter cold and flu season.
Follow infection prevention
Infection control measures remain the first line of defence and routine infection prevention measures should be maintained. MoH have Standard Precautions for routine infection prevention and all people, especially health professionals, are encouraged to stay at home if you are sick. Businesses are also encouraged to have the NZ COVID Tracer app QR codes in place, with individuals encouraged to use the app.
Subject: ACC Alert Level 1 Update
Sent on 10 June 2020 to all PNZ members
A message was sent from ACC on 9 June, notifying physiotherapists that “most services will continue to have access to telehealth solutions for as long as Alert Levels 1, 2, 3, or 4 are in place.” ACC will also “continue working to enable many of our telehealth services on a permanent basis” and are “committed to maintaining telehealth solutions where they make sense and they support client recovery.”
Please read part of the ACC message below, with the full email available here.
PNZ is in ongoing discussions with ACC and has advocated for the retention of telehealth rates through the COVID-19 alert levels. We are continuing the discussions regarding telehealth provisions at the same rates for ongoing services. Thank you once again to all members for your support in influencing these decisions.
Use of telehealth at Alert Level 1
“ACC will retain the telehealth consultations enabled for all services for COVID-19 Alert Levels 2, 3 and 4 when New Zealand is at Alert Level 1, except for circumstances listed below.
Telehealth provisions will be removed, in Alert Level 1, for the following services or parts of services:
- Clinical Services contract: Telehealth removed for Medical Case Reviews and Single Discipline Assessments from Alert Level 1.
- Impairment Assessment contract: Telehealth removed for all assessments at Alert Level 1.
- Vocational Medical Services: Telehealth removed for Initial Medical Assessments (first assessments only, telehealth for follow-up assessments remains enabled).
- Vocational Independence Medical Assessments and section 103 and 105 assessments: Telehealth removed for all consultations at Alert Level 1.
Telehealth for group therapies under the Integrated Services for Sensitive Claims contract will be enabled on a pre-approval basis only from Alert Level 1 to ensure that patient safety and confidentiality can be met.”
* Please note that the Clinical Services contract mentioned above covers medical specialist services. Initial telehealth consultations for the Physiotherapy contract and CoTR physiotherapists remain in place for Alert Level 1.
Subject: COVID-19 Alert Level 1
Sent on 9 June 2020 to all PNZ members
Like the rest of the country, we’re very pleased that New Zealand has moved to COVID-19 Alert Level 1 as of 11:59pm on Monday 8 June. Thank you again for all your support through the Government alert levels and commitment to our profession.
The following outlines information for physiotherapists operating at Alert Level 1 and ongoing work by PNZ to support members through COVID-19.
Operating at Alert level 1
The Ministry of Health identifies that the move to Alert Level 1 enables physiotherapists to provide services similarly to pre COVID-19. At Alert Level 1 community allied health services can return to normal with the following recommendations:
- Enable contact tracing e.g. NZ COVID-19 tracer app.
- Discouraging patients to attend appointments when they are sick e.g. screening prior to appointment, public messaging
- Good infection prevention control measures are in place such as frequent hand washing and cleaning
- Physical distancing is not required but is encouraged where possible
The Physiotherapy Board of New Zealand has indicated that there will not be more detailed guidance for physiotherapists operating at Alert Level 1 beyond those provided by MoH above.
Health and Disability Services
MoH acknowledge that people attending a health or disability service may be more vulnerable to COVID-19 for a range of reasons. That is why it is important for health and disability services to continue to maintain infection prevention and control measures, and to collect information from patients and other people interacting with patients at their services.
Health and disability services will be running as normal under Alert Level 1 but some precautions will be in place to protect people who are vulnerable to severe COVID-19 from exposure to the virus. Read more on the MoH website.
Advocating for Physiotherapy
We continue to advocate for ACC to maintain current telehealth rates through Alert level 1 and will share official announcement on this, as well as decisions regarding any permanent changes to telehealth provisions, when available from ACC.
PNZ is also advocating for increased health funding of physiotherapy through and beyond the COVID-19 alert levels. A positioning statement has been written for Government on the essential value of Physiotherapy for New Zealand and encouraging further investment. The statement is available at pnz.org.nz and follows a report from economic consultancy NZIER.
Thank you and take care.
Subject: ACC Alert Level 2 Update
Sent on 13 May 2020 to all PNZ members
With the country moving to COVID-19 Alert Level 2 on 14 May, the message below was sent from ACC yesterday evening notifying physiotherapists that “during level 2, face-to-face treatment (video or in-person consultation) is supported”.
Thanks again to everyone across PNZ who has worked to influence this decision. Other ACC provider COVID-19 email updates are available on the ACC website.
ACC COVID-19 update 12 May: Alert Level 2 information
We can now prepare for the move to Alert Level 2, following the Prime Minister’s announcement yesterday. Many of you may have questions in relation to the provision of Telehealth services at Alert Level 2 and I hope today’s message provides some assurance.
Thank you for your continued commitment to our clients and for ensuring their health and safety remains a top priority.
Nāku noa, nā
Head of Provider Service Delivery
Moving to Alert Level 2 on 14 May 2020
We continue to take guidance for the provision of Telehealth solutions from the Ministry of Health and regulating national bodies as we transition through COVID-19 alert levels. The current advice is that Telehealth is the default wherever possible. Telehealth resources and support are available on the NZ Telehealth Leadership Group’s website.
Our focus remains on ensuring ACC clients have access to safe, appropriate, and high-quality injury support and recovery services. Alert Level 2 will be about starting the move back to a ‘normal’ way of operating, while maintaining physical distance and vigilance with infection control precautions. Telehealth will remain a preferred option for consultations during alert level 2, especially for at risk clients.
During level 2, face-to-face treatment (video or in-person consultation) is supported. Clinicians will continue to have the ability to obtain verbal consent for Telehealth consultations and will now have the option of obtaining verbal consent for in-person consultation. This will minimise infection risk by avoiding clients having to physically sign an ACC45. Verbal consent will need to be clearly recorded in the clinical notes.
We will review Telehealth and the issue of verbal consent if there are any changes to requirements during Alert Level 2.
Up-to-date information on our response to COVID-19 may be found on our website.
Changes at Alert Level 2
There is only one substantive change to delivery of ACC service in the move from Alert Level 3 to Alert Level 2: on Thursday, 14 May 2020, at 12:01am, the standard 14-day time-off-work allocation will be reintroduced to align with Vocational Rehabilitation Services and Vocational Medical Services service delivery.
Subject: COVID Alert Level 2 announcement
Sent on 11 May 2020 to all PNZ members
Moving to Alert level 2
The Government has announced that the country will move to COVID-19 Alert Level 2 from Thursday 14th May. The following outlines information for physiotherapists operating at Alert Level 2, including Ministry of Health guidelines and processes for conducting in-person appointments.
Alert Level 2 Guidelines
In preparation for the move to Alert Level 2, PNZ has been working with Government agencies including the Ministry of Health (MoH), ACC and the Physiotherapy Board of New Zealand. MoH Alert Level 2 guidance, available here.
MoH are requesting that all health services think twice about face to face contact. Telehealth remains the preferred treatment option. This should not prohibit face to face treatments where this is clinically required.
Information from GPs suggests they expect half of appointments will still be telehealth.
Before a face-to-face appointment the following processes need to be in place:
- Triaging for telehealth as an option
- Screening for COVID-19 symptoms prior to in-person appointments.
- Physical distancing measures.
- Infection prevention control measures including PPE where required.
Specific processes for seeing patients in Alert Level 2 are on the Physiotherapy Board of New Zealand website. These identify the specific measures physiotherapy practices are required to take for clinic appointments.
Please remember that until 14 May the country remains in Alert Level 3. Ministry of Health information for Alert Level 3 identifies that most physiotherapy services are online or over the phone, with some face-to-face services provided for urgent appointments. Guidelines regarding urgent appointments are available here.
Beyond Alert Level 2
An outline of the COVID-19 Alert System is available at covid19.govt.nz. PNZ is in ongoing contact with the Government about funding through Alert Level 2 and beyond. This includes discussion with ACC regarding telehealth rates, which we’ve asked to be maintained, and 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. We will have a review of the current alert level in two more weeks.
Work has also now started on guidelines for Alert Level 1, so that we are again ready for when the Government announces further movement.
Thank you for your support and take care.
Nga mihi nui
Subject: COVID-19 Alert Level 2 guidance
Sent on 8 May 2020 to all PNZ members
The long awaited guidance from the Ministry of Health for health and disability sector operations under Alert Level 2 was released this afternoon. It can be found on our website in the COVID-19 updates.
Note this guidance applies across all of the allied health sector.
Alert Level 2 advice for physiotherapy
PNZ has been working with the Physiotherapy Board of New Zealand (the Board) and the Ministry of Health to develop physiotherapy specific guidelines. You should have received an email from the Board this evening with this information which will also be on their website
Note that the emphasis remains on telehealth at Alert Level 2. We are awaiting an ACC decision on funding telehealth through the continued de-escalation (and beyond). We will share this decision as soon as we have it.
But we remain in Alert Level 3 for now
Please remember that until we hear the announcement from the Prime Minister next week the country remains in Alert Level 3. Ministry of Health information for Alert Level 3 identifies that most physiotherapy services are online or over the phone, with some face-to-face services provided for urgent appointments. Guidelines regarding urgent appointments are available here.
Thanks again for your committment to the profession and the people you care for over the last six weeks. We at PNZ have been heartened by the messages of support as we work with you to promote physiotherapy.
Expect more information as soon as we know more about Alert Level 2.
Subject: ACC Alert Level 3 telehealth
Sent on 24 April 2020 to all PNZ members
An email was sent from ACC to physiotherapists yesterday evening notifying recipients that, given the guidance issued by the Ministry of Health this week, an extension of the telehealth provisions already made by ACC will apply to COVID-19 Alert Level 3.
Thank you to everyone across PNZ and the profession who have helped influence this decision. Please read the full email below and continue to refer to the ACC website for provider COVID-19 email updates.
We have information to share from the Ministry of Health to guide health and disability sector operations within Alert Level 3. Fundamentally, the Ministry’s advice means we will see little change from the Level 4 response. With this new guidance, we do not anticipate a material difference in the provision of services when moving from Alert Level 4 to Alert Level 3.
We appreciate your commitment to our clients in these unusual times, and your willingness to continue to adapt to ensure we provide care where and when it’s needed.
Ngā mihi nui,
Head of Provider Service Delivery
Alert Level 3 advice for the health and disability sector
Yesterday the Ministry of Health confirmed that delivery of services by the health and disability sector will see minimal change in the move from Alert Level 4 to Level 3.
At Alert Level 3 the following guidance from the Ministry remains:
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.
‘Urgent care’ for community allied health professionals is defined as:
- a condition which is life or limb threatening
- treatment required to maintain the basic necessities of life
- treatment that cannot be delayed or carried out remotely without risk of significant harm or permanent and/or significant disability
- treatment which cannot be delivered by a service which is currently operating or by health professionals that are already in contact with the patient.
If you do need to see a patient face to face, please do the following:
- Practice good infection prevention control procedures.
- Use the appropriate personal protective equipment (PPE).
- Keep accurate documentation of the appointment to aid contact tracing if required.
- Let your Responsible Authority know that you are treating a patient face to face.
More information is available on the Ministry of Health website.
Moving from Alert Level 4
ACC has enabled providers to deliver services differently and relaxed some restrictions during the COVID-19 Alert Level 4 response period. Given the guidance issued by Ministry of Health yesterday, the extension of Telehealth provisions already made by ACC will also apply to Alert Level 3.
We moved quickly over the past few weeks to ensure providers were enabled to adopt more flexible service delivery models, where clinically appropriate by enabling;
- Telehealth consultations
- Remote lodgement (ACC45)
- Increase in time of work (ACC18)
- Increase in DNA allowance
- Reduced contractual compliance
For information on the provision of Telehealth services for ACC’s clients, please visit our website.
Subject: COVID-19 update
Sent on 22 April 2020 to all PNZ members
Following the Government announcement that the country will be at Alert Level 3 from Tuesday 28 April, PNZ is receiving enquiries about what this will look like for physiotherapists particularly regarding whether businesses will be open. Please find information below on COVID-19 Alert Level 3 as well as related resources including:
- Government Updates
- Telehealth Guidelines
- Business Support Funding
Alert Level 3
Alert Level 3 advice on covid19.govt.nz (current 22 April 2020) identifies that businesses cannot offer services that involve face-to-face contact. The Ministry of Health guidance for all health services, including physiotherapists, is now available here. The Ministry of Health (MoH) expectation is that most physiotherapy, and other allied health, services will continue to be mainly online or over the phone. Some face-to-face physiotherapy services may be provided for urgent appointments only, so long as professionals can take appropriate measures to manage public health risks. We are working on guidance for physiotherapists regarding urgent appointments and this will come through in an email from the Physiotherapy Board of New Zealand as soon as it is complete. PNZ will also add this to our COVID-19 web page.
We are in continuing discussions with ACC regarding funding for services in Alert Level 3. Our position is that while there is restricted face-to-face contact telehealth funding needs to be maintained at Alert Level 4 rates. ACC have also been waiting for the MoH guidance. Again, we will share the decision about funding as soon as we can. PNZ continues to work with MoH, ACC and the Physiotherapy Board of New Zealand regarding physiotherapy through the alert level system. This includes advocating strongly for the profession to provide services to the public. We are committed to sharing information with members as quickly as possible, but the information needs to be from official sources and agreed so we can ensure you get the right information.
Please refer to the covid19.govt.nz website for Government information and be aware of ACC provider updates and emails. The covid19.govt.nz website includes resources for looking after mental wellbeing to help take care of yourself, family, colleagues and employees at this time. business.govt.nz is the Government’s central resource for COVID-19 business information including guidelines for all businesses through the Government alert levels, a wage subsidy eligibility tool, information on business finance support and tailored advice for your business.
In addition to the marketing campaign launched this week to let the public know your physio can still see you online, PNZ has collated resources to help members deliver services through telehealth. Available at pnz.org.nz this includes key documents, links and information on BMS insurance cover.
Business Support Funding
PNZ's employment support partner, Humankind, have let us know privately held organisations with fewer than 50 employees may be eligible for funding to support HR to the value of $2,500 under the Regional Business Partner Network.
Over the past few weeks Humankind have been working with organisations to interpret how the wage subsidies apply while also ensuring employers are making the right decisions for their workforce. This includes running a webinar for PNZ members. They’re also supporting businesses through the challenges of leading remote teams and adapting to new ways of working as well as focusing on maintaining a great culture. For more about their services go to humanityatwork.nz.
To apply for this funding and HR support, go to regionalbusinesspartners.co.nz to register. A Growth Advisor will then contact you to assess your eligibility and approve your application. Once approved, you’ll need to log in and match your voucher to the Humankind event titled “COVID-19 Business Support”. Lastly, email email@example.com.
Take care and thank you again for your support.
Subject: telehealth campaign
Sent on 17 April 2020 to all PNZ members
YOUR PHYSIO CALL STILL SEE YOU ONLINE
With the country currently moving through COVID-19 alert levels, many physiotherapists are only available to see patients through telehealth. While practices may be set-up for this, for much of the public telehealth is a new way to engage with their physio that they may not know is available.
To address this PNZ is running a campaign to increase public awareness that their physio can still see them through telehealth. The campaign focuses on a clear and consistent message targeted at new and existing patients – your physio can still see you online.
PNZ marketing activity, both paid and through our own social media accounts, will drive the public to physio.org.nz where they can Find a Physio. Members are encouraged to add their own information, such as areas of expertise, to the campaign material to drive people to their practice.
Campaign material – available in different sizes for social media
PNZ is using paid media channels to get this message out including social platforms, website advertising, radio and Google search. We’re also posting this material on the PNZ Facebook and Twitter accounts – so please look out for our posts and share with your networks. In addition, a media release has been issued supporting the message that your physio can still see you online particularly as people take on new activities and ways of working.
Support the campaign
The campaign images are available HERE formatted to share through your social accounts. When using the material feel free to tag PNZ (Facebook: @PhysiotherapyNZ, Twitter: @PhysioNZ). We’ll then share your posts to reach more people. If you’d like access to any of the campaign images for your own paid advertising please contact firstname.lastname@example.org.
Thank you for your support and take care.
Subject: COVID-19 information for physiotherapy students
Sent on 15 April 2020 to PNZ student members
Kia ora tatou
Hasn’t the year turned on its head? In the last couple of months the PNZ team met with groups of physio students talking about the year ahead and we all assumed we knew the pattern of 2020. COVID-19 was in the news affecting China but the spread and the response have been unprecedented. Going viral in every sense of the term.
Much of our focus over the past weeks has been on our PNZ members working in the private sector where services were cut off very quickly. However we are also aware that for you in training the rapid cut in clinical placements for fourth year students and lectures for other years makes the future look hazy. Please do let us know how you are getting on and what impact the government sanctions are having for you – short and long term.
WCPT seeks your experiences over COVID-19 disruption
World Physiotherapy (WCPT), our global association, is collaborating with ENPHE (European Network of Physiotherapy in Higher Education), ACAPT (The American Council of Academic Physical Therapy) and CLADEFK (Centro Latinoamericano para el Desarrollo de la Fisioterapia/Kinesiologia) to gather information about the impact of COVID-19 outbreak in physiotherapy entry-level education. This is to learn from everyone about the challenges, opportunities and alternative strategies being used and considered. The results will be collated and shared to highlight experiences and solutions from different perspectives and contexts.
The three New Zealand Schools of Physiotherapy have been sent a survey to complete by 18 April. WCPT is interested to hear your experience as undergraduate students and we encourage you to complete this survey HERE. Apologies for the short response time but we are trying to respond to the rapidly evolving situation.
The history and future of physio
Dr Dave Nicholls, from AUT, wrote a post for history.physio recently that reminded me of the significant role physiotherapy has played as part of recovery from polio epidemics, the 1918 flu epidemic and World War 1. He says “firstly, we should remember that physiotherapy exists as a profession because it was able to respond to some of history’s cataclysmic moments. How our foremothers and forefathers responded shaped the way we think and practice today.” COVID-19 will shape the profession – and you will be part of that shaping.
Finally, take care and thank you for your ongoing commitment to our profession.
Subject: COVID-19 resources incl. from the PNZ Cardio-Respiratory SIG
Sent on 7 April 2020 to all PNZ members
As we approach the end of our second week in Alert Level 4, please find links below to a number of COVID-19 resources and updates from across the profession. This includes:
- Cardio-Respiratory SIG resources
- Older Adult Super Seven Strength and Balance Exercises
- Information about the COVID-19 Alert System
- Access to a recording of the Humankind employer webinar
- A call to join the Physiotherapy Board of New Zealand
PNZ continues to work with Government agencies including ACC and the Ministry of Health to advocate for members through the COVID-19 Alert System. We will also keep updating information on our webpages for COVID-19 resources and business information.
Cardio-Respiratory SIG Resources
The PNZ Cardio-Respiratory Special Interest Group (CRSIG) have provided a number of COVID-19 resources for all physiotherapists and the message below. These resources are available at pnz.org.nz and include Physiotherapy in COVID-19 management guidelines, open access online cardio-respiratory physiotherapy courses and New Zealand specific COVID-19 resources. Many thanks to the CRSIG for providing access to this information.
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
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.
COVID-19 Alert System
With the Government review of Alert Level 4 approaching, PNZ is receiving questions about what happens at Alert Level 3. At this stage we think businesses will not be able to open in Alert Level 3. Government advice available at covid19.govt.nz (updated 6 April 2020) identifies the Alert Level 3 measures below. Please note the last two points.
- travel in areas with clusters or community transmission limited
- affected educational facilities closed
- mass gatherings cancelled
- public venues closed (eg libraries, museums, cinemas, food courts, gyms, pools, amusement parks)
- alternative ways of working required and some non-essential businesses should close
- non face-to-face primary care consultations
- non acute (elective) services and procedures in hospitals deferred and healthcare staff reprioritised.
While these measures could be applied regionally or nationally, given the spread of clusters at present we would anticipate this to be national. At Alert Level 3 non-essential businesses are still closed, nor are face-face consultations in primary care permitted. PNZ has been told there may be reviews of essential services when the alert level drops but for business planning purposes you are probably better to assume re-opening will be possible at Level 2, and even that comes with restrictions around client numbers.
PNZ's employment support partner, Humankind, hosted a webinar for members on 1 April, outlining employer obligations and options during COVID-19. A recording of the webinar is available here and links to resources discussed below.
- COVID-19 considerations for employers
- 1737 – free counselling services for New Zealanders
- Mental Health Foundation website
Call to join the Physiotherapy Board of New Zealand
The Ministry of Health is currently seeking applications/nominations to join the Physiotherapy Board of New Zealand. With this call occurring while the country is in Alert Level 4, applications are now open until 21 April 2020. If interested please read more here.
Subject: Increased Telehealth rates for physiotherapists
Sent on 3 April 2020 to all PNZ members
ACC emailed physiotherapists yesterday evening notifying the profession they have increased telehealth rates for allied health providers including physiotherapists. This is an excellent decision and PNZ would like to thank all our members who helped advocate for this increase. Please read part of the message from ACC below. The full ACC email is available here on their website.
“We are increasing Telehealth rates for allied health providers approved to deliver Telehealth services for as long as we remain at COVID-19 Alert Level 4 and this will be reviewed as alert levels change. Invoices for these services, from 20 March 2020, will be back paid using the updated rates. See important information about this below.
- Telehealth rates will be set at the equivalent in-person rates for providers working under the Physiotherapy Services Contract and Hand Therapy Contract.
- Telehealth rates for speech & language therapists, occupational therapists and physiotherapists working under the Cost of Treatment Regulations have been increased based on the initial and follow-up rates under the Physiotherapy Services Contract. The difference in rates reflects the additional compliance requirements under contracts. Telehealth is not payable under the Cost of Treatment Regulations, so these payments are made as non-contracted services.
The increased rates acknowledge:
- the extra time needed for providers and clients to adapt to the new way of working
- the increased time to undertake a subjective assessment of a client, as components of the objective assessment are unable to be completed
- the needs of complex patients.
Thank you to those getting in touch about your experiences of Telehealth and different ways of working under COVID-19. We hear that many of you are adjusting well to the use of Telehealth.
For further information regarding ACC requirements please refer to our website.
Back payment of Telehealth services
The new rates will apply for all services provided from 20 March 2020.
For vendors who have already invoiced ACC for Telehealth services provided from 20 March 2020, please re-submit these at the new rate when these are available through your PMS system.
- Services invoiced at the old rates have been declined and reversals will be undertaken for those services already released for payment.
Vendors yet to submit invoices may submit these at the new rates when these are available through your PMS system."
Subject: COVID-19 physiotherapists in DHBs
Sent on 2 April 2020 to PNZ members identifying a DHB as their employer
With us all currently in Alert Level 4, we are very conscious that there are over 600 PNZ members working in DHBs around the country. Alongside the rest of New Zealand we are incredibly proud of your frontline work and the personal impact of being a frontline worker. PNZ has been in touch with the Ministry of Health and have had messages from some of you regarding the issues that are specific to you in your situation. We’re aware each DHB will be taking their own precautions and have protocols for you to follow.
PNZ has COVID-19 web pages with information for the profession and links to Government resources as well as updates about who we are working with on your behalf and what we are strongly advocating for. These resources are available for all physiotherapists at pnz.org.nz. Our thoughts are with members at this time and we’re focussed on working for you through COVID-19.
As we come out of the current pandemic it will be important to record and share some of our experiences so we can learn what worked and what we could change for any future events. Your experiences will be particularly valuable. If you would like to share this with PNZ members please email email@example.com.
PPE for allied health staff
We have heard a few concerns from physiotherapists that allocation of PPE has been a challenge. One example is a physiotherapist being the only person not allocated PPE in an MDT with a patient with a respiratory condition. The Ministry of Health have told us there is sufficient PPE in the country, and they are expecting better distribution this week. They have also updated the guidelines for use of PPE. If you have not seen this, it is here
Your personal planning
PNZ was sent the following information from an anaesthetist, which you may have already seen. Being in the DHBs you are the members most likely to be in this situation.
Background: several of my colleagues were involved in looking after a patient in theatre who, unknown to anybody at the time, was actually on the MoH list of those suspected and was meant to be in strict self-isolation, but broke the rules, landing in hospital by accident. Here is some specific advice that these colleagues would like to share, so that if YOU, as a part of the early contact identification, are called by Occ Health, MoH, etc informing you that YOU have been unwittingly exposed to a suspected case, you are better prepared.
- Have a bag packed (toothbrush, phone charger, medication you take regularly, etc). That bag is to stay in the car that you take to work (and I think we are all taking the same car to work now, yes?).
- This is a very unsettling experience, so let’s recognise this and process it now, so that the psychological impact is hopefully less when it actually happens, or at least not underestimated.
- Have a plan in your head of where YOU will go if/when you have to isolate yourself SEPARATE from your family / current bubble.
- Talk to your department/practice: they need to know who does and who does not have places to go, they may want to develop a list of immediate but not necessarily long term options for those who cannot self-isolate at home.
- When you are called it may be DAYS after you dealt with that patient, you won’t remember the details, so:
start documenting all your procedures and details, including PPE worn.
- Lastly, but most importantly: Talk to your bubble tonight re: YOUR steps if this happens to you. There are two scenarios:
A: you have to self-isolate AWAY from your bubble
B: you have to self-isolate WITH your bubble (you may have unwittingly exposed them)
e.g. for me personally that means always having staples + baby formula in the house for the next 2 weeks, so that if I am to self-isolate from NOW, I can do it in my bubble if need be; and if my bubble is safe from me, they can bring me the supplies and leave them outside the door.
If you happen to be the designated person in charge of the departmental phone tree or similar for any direct information dissemination (remember, group WhatsApp will not be suitable for personal health info communication), please tell the staff members whom you are ringing that you will contact the others involved. In other words if you are a key person in a plan, make sure you tell those isolated what the plan is.
From all of the team across PNZ, thank you for your ongoing commitment to the profession and support at this time. We appreciate that your experience is different to the community-based physiotherapists. For some of you the work is more intense and there are others who are redeployed knowing your normal work is going untended. Each of these situations are stressful.
Please take care of yourselves and your families as you care for our communities.
Subject: PNZ Monthly Email - April 2020
Sent on 2 April 2020 to all PNZ members
The information below on COVID-19 was sent in the April 2020 PNZ Monthly Email.
COVID-19 Advocating For Members
PNZ is in ongoing conversations with Government agencies including ACC and the Ministry of Health (MoH) as well as the Physiotherapy Board of New Zealand (PBNZ) regarding COVID-19.
Yesterday we gained agreement from ACC to accept telephone as a method of telehealth where video platforms are not available. This means all forms of telehealth consultations for ACC related matters that meet PBNZ guidelines around use of telehealth during COVID-19 will now be funded.
Areas we are still advocating for are the telehealth rates for primary care (cost of treatment regulations, physiotherapy contract and hand therapy contract). This is critical for us. ACC modelling says telehealth consultations are generally shorter than face-to-face consultations and therefore the prices for all primary care funding is based on shorter consultation times. We continue to argue that this is not the member experience. ACC tell us they have physiotherapy providers who say they have the rates “about right”. This is contrary to what we are hearing.
Physiotherapy practice audits are currently suspended during the Alert Level 4. We have recommended an extension of this moratorium to six months, given that it will take time for businesses to recover from the current shut down.
Please keep across ACC COVID-19 advice and updates here on their website.
There have also been lengthy discussions with the Ministry of Health (MoH) on essential services and we’ll continue to advocate on this. MoH essential services are listed here. We have sought Ministry support for efforts to ensure the whole of the primary care sector is assured of business sustainability following the recent announcement of additional funding for GPs.
Thanks again for supporting our advocacy and PNZ’s united voice for the profession.
While we’re in Alert Level 4, work continues across PNZ (albeit remotely, like much of the country) to provide members with up-to-date resources, information and advocacy. Our COVID-19 web pages have information for the profession and links to Government resources as well as updates about who we are working with on your behalf and what we are strongly advocating for. These resources are available for all physiotherapists at pnz.org.nz. Our thoughts are with members at this time and we’re focussed on working for you through COVID-19.
COVID-19 Business Information
The PNZ website has a COVID-19 Business Information and FAQs page with updated business information, including links to the Government economic response package and answers to Frequently Asked Questions. Our people and culture partners Humankind hosted a fully-booked webinar on 1 April with advice around obligations and options for employers during COVID-19. A recording of the webinar will soon be available at pnz.org.nz, with further webinars to come.
From all of the team across PNZ, thank you for your ongoing commitment to the profession and support at this time. We appreciate everyone who has contacted PNZ Office over the past few weeks, including your input into our advocacy and patience as we’ve worked through queries. Please take care of yourselves, your families and communities.
Subject: Employment Support Webinar – please email to register
Sent on 30 March 2020 to PNZ business contacts
With New Zealand now at Alert Level 4, there are implications for employers and business leaders who are having to consider the impact of COVID-19.
To help you navigate through these challenging times Physiotherapy New Zealand has partnered with people and culture consultants Humankind, to provide members with some clarity and guidance around your obligations and options in relation to your people. This may be particularly useful for members who manage private practices that are not on the Government essential services list.
Humankind will host a webinar at 1pm on Wednesday 1 April, facilitated by Charlotte Bates, Employment Relations Director. In this webinar, Charlotte will outline your employer obligations during COVID-19 and the options available to you during this time, as well as addressing any specific queries you may have.
This webinar is provided to you by Physiotherapy New Zealand at no cost.
Please register by emailing firstname.lastname@example.org
and a link to the webinar (via Zoom) will be emailed to you. This webinar is limited to 100 participants.
Any questions you’d like addressed during the session can be sent to email@example.com with PNZ Webinar in the email subject line by 12pm on Tuesday 31 March.
Subject: COVID-19 Business Information
Sent on 27 March 2020 to PNZ business contacts
With the New Zealand Government taking the country to Alert Level 4 this week in response to COVID-19, we are continuing to direct members to official information sources and advocate on your behalf.
To help direct members to useful and accurate business information, there is a PNZ web page with COVID-19 Business Information and FAQs. This page is being updated regularly and links to advice on a number of business-relevant topics including the Government economic response package. We are aware that New Zealand is taking a different approach to COVID-19 than other countries and will continue to work on linking you to New Zealand Government resources.
PNZ is in ongoing conversations with Government agencies including ACC and the Ministry of Health (MoH). You will have also seen from our joint communications with the Physiotherapy Board of New Zealand that we are working with them regarding COVID-19.
While ACC has communicated an expansion of telehealth services, we are in continued contact with them about telehealth rates as well as matters such as the signing of medical certificates and accreditation audits. We had a major win earlier this week with physios under the Cost of Treatment Regulations and Physiotherapy Specialists also being included in the telehealth delivery. We know there are four different rates for telehealth depending on your ACC relationship (you can find the current rates here). We have pushed back on the rates and will continue this pressure. Please be aware of ACC’s web pages with COVID-19 information for providers and Provider COVID-19 updates
There have also been lengthy discussions with MoH on essential services. We are assured that the important role of physiotherapy is recognised in MoH and will continue to advocate on this. We do not expect this will change during the current Level 4 alert stage but are working on the change as we come out. All of the arguments about the value of physiotherapy, particularly around supporting primary care manage musculoskeletal conditions and other non-communicable diseases are being used.
Thank you for supporting our advocacy. Do remember one of the drivers for creating a unified PNZ is to have a strong single voice going to Government. If you make contact with anyone across Government with regards to your work, either personally or as an organisation, please let PNZ know at firstname.lastname@example.org so that we can continue to engage with a united voice.
EMPLOYMENT SUPPORT WEBINAR
A webinar for members who manage private practices that are not on the Government essential services list is being organised with our employment support partner Humankind. This will be hosted by Humankind from 1pm to 2pm next Wednesday (1 April). Please look out for an invite to join. If you have any specific questions for during this session please send these to email@example.com with PNZ Webinar in the email subject line. While there will be an opportunity to ask other questions by chat during the webinar, this will help the Humankind team make the most of the time available.
Finally, thank you again for your continued support. The PNZ website is being used by members and we will keep making information available here as well as communicate regularly through email. Likewise our Find a Physio webpage continues to be visited by people searching for members. When contacted by the public please ensure that you let them know what services you can offer.
Sent on 27 March 2020 to all PNZ members
WHAT A WEEK
I hope this finds you and yours safe and well.
The New Zealand government response to Covid-19 moved further and faster than anyone could have predicted last week. New Zealand is taking a different approach to this pandemic than other countries. We are all in uncharted waters and that is uncomfortable.
Our PNZ staff have been inundated with email traffic as you can imagine and have also worked tirelessly to provide information to members and to advocate on your behalf to Ministry of Health and ACC.
The PNZ website is being used by members and we will continue to make information available here as well as communicate regularly with through email. There are 3 separate pages set up for the Covid-19 information:
- Novel Coronavirus (COVID-19) – for overall information and latest updates. This includes links to New Zealand and international resources and training.
- COVID-19 Business Information and FAQs – for business-specific information.
- COVID-19 Member Emails – includes all emails sent to members for reference.
Likewise our Find a Physio webpage continues to be visited by people searching for members. When contacted by the public please ensure that you let them know what services you can currently offer.
It is hard for us as a profession to hear our community based services are not considered essential. There have been lengthy discussions with the Ministry of Health on this topic. The public health imperative to reduce face to face contact to a minimum overrode any considerations about the important place of physiotherapy in the primary health system. If we get things under control the restrictions will be reviewed and we can expect change. The important role of physiotherapy is recognised in the Ministry of Health. The Chief Allied Health Professions Officer sits at the top table in the Ministry. We will continue to advocate on your behalf.
Sandra and her team have been grateful for information from members that supports them in advocating for the specific needs of physiotherapists and their clients/patients. The practical information and case scenarios are invaluable.
Do remember one of the drivers for creating a unified PNZ was to have a strong single voice going to government. If you make contact with anyone across Government with regards to your work, either personally or as an organisation, please let PNZ know at firstname.lastname@example.org so that we can continue to engage with a united voice for the profession.
INFORMATION FOR BUSINESSES
The impact of the Level 4 alert has hit community based physiotherapy practices hard. We, at PNZ, are all very aware of this. The PNZ Office team are collating information for businesses regarding COVID-19.
Please refer to the PNZ COVID-19 Business Information and FAQs webpage for updated advice on the Government economic response package, support of Māori communities and businesses, the financing guarantee scheme and mortgage repayment holidays.
A webinar for members who manage private practices that are not on the Government essential services list is also being organised with our employment support partner Humankind. Please look out for an invite to join this webinar and put questions to the team at Humankind.
I received a message of support this morning from Jonathan Kruger at WCPT and extending WCPT best wishes to all of us. He says the experiences of the french and Italian physiotherapists are "truly frightening". Hopefully the New Zealand response will protect us all from that.
In these times there are some simple messages we all need to hear and practice.
Be Kind. Stay home. Wash your hands.
Subject: Rest Homes / Aged Care Facilities – Guidance for Physiotherapists
Sent on 26 March 2020 to all PNZ members
The information below is being emailed to the profession by the Physiotherapy Board of New Zealand. To help ensure all physiotherapists receive this message, PNZ is also forwarding it to members.
We are receiving a number of questions regarding physiotherapists providing services to rest homes and aged residential care facilities; and responsibilities of physiotherapists supervising physiotherapy assistants.
The latest information on the covid19 website (as at 12.30 pm 25 March 2020) includes the following services within the definition of essential service:
- Any person employed or contracted as a doctor, nurse, midwife, pharmacist, paramedic, medical laboratory scientists, kaiāwhina workers, social workers, aged care and community workers, and caregivers more generally
- Hospitals, primary care clinics, pharmacies, medical laboratories, care facilities (e.g. rest homes)
Rest Homes and Aged Care Facilities
As stated above rest homes and aged care facilities are an essential service.
Whether physiotherapists should continue to provide services to rest homes and aged care facilities depends on the nature of the services requested and how they will be delivered:
- Rest homes and aged care facilities should discuss the physiotherapy services they require with the physiotherapist
- The physiotherapist then needs to exercise their clinical judgement as to whether the service requested is essential having regard to need, urgency, and the requirement to assess risks to the health of the residents and the physiotherapist’s health and safety obligations towards their workforce.
If the physiotherapist agrees the request is essential, and cannot be delivered effectively by other means, such as via telehealth facilities, then they comply with the facility infection control requirements and provide the requested service.
Supervision of Physiotherapy Assistants by Physiotherapists
As above the judgement of what services physiotherapy assistants are providing is determined by the physiotherapists. The decision will be based on if it is essential or whether it can wait.
Supervision is required and the key here is needs to be appropriate supervision. Consideration of whether this is undertaken remotely or otherwise is again a clinical judgement based on what is being done.
The overriding message is that reduction of contact is vital in order to avoid the spread of COVID-19. The elderly are most notably vulnerable so any contact needs to be avoided wherever this is possible.
There will continue to be queries and one off situations – we are happy to discuss and provide guidance so please contact us on email@example.com
Noho ora mai
Subject: MoH call for allied health workers
Sent on 26 March 2020 to all PNZ members
The Ministry of Health (MoH) have been working to develop a system to nationally coordinate the matching of supply and demand for health care workers regarding COVID-19. They have indicated that this is a role where allied health workers who cannot undertake their own clinic work will be invaluable in supporting New Zealanders stay safe and stay well.
MoH are seeking people to work in both general and clinically specialised roles as we scale up the health and care workforce. People will be matched to roles based on their competencies, and appropriate training and oversight will be provided (where required) to ensure safe practice. This means understanding who is available to work, and matching them to roles that need to be filled in the sector. Some of these will be contact roles, while others will be supporting services such as Healthline and contact tracing, which can be done remotely.
The information required from allied health workers will include your availability, coordinating re-registration with the relevant regulatory board or council where required, and then supporting the process to get into employment quickly.
If you are able to assist with the COVID-19 response, the link to register your interest is HERE..
Please note if you have already provided your information to the Physiotherapy Board of New Zealand they will pass their register over to MoH so you don’t need to repeat the process. The Physiotherapy Board will no longer be collecting new registrations now this has been set up.
For more information, please see the full media release from MoH below.
Media release / website information for all health workers
25 March 2020
The Ministry of Health is moving to increase the capacity of the health workforce to deliver essential health services.
We are seeking expressions of interest from health and care professionals who are able and willing to work for a limited amount of time as part of the national strategic approach to managing COVID-19.
We have already been asking retired health professionals to express their interest in working within the health and disability system, and now we would also like to hear from current health workers who may be available as non-essential services are paused.
We are seeking people to work in both general and clinically specialised roles as we scale up the health and care workforce. People will be matched to roles based on their competencies, and appropriate training and oversight will be provided (where required) to ensure safe practice.The Ministry of Health has put in place a system to nationally coordinate the matching of supply and demand. This means understanding who is available to work, and matching them to roles that need to be filled in the sector. Some of these will be contact roles, while others will be supporting services such as Healthline and contact tracing, which can be done remotely.
The Ministry of Health is partnering with Accent Health to manage this process on our behalf. For health workers, they will be collecting information about their availability, co-ordinating re-registration with the relevant regulatory board or council where required, and then supporting the process to get into employment quickly.
Employers will be able to log their workforce requests, and then people will be matched to positions. We are aware that demand may exceed supply, and we are developing a prioritisation process to manage this. This will be communicated once finalised.
If you are a health or care worker who is able to assist with the COVID-19 response please register your interest here.
If you are an employer, further information will be available in the next 24 hours on how to log requests.
Subject: Physiotherapy Board and Physiotherapy New Zealand joint statement: COVID-19 update
Sent on 25 March 2020 to all PNZ members
The statement below is being emailed to the profession by the Physiotherapy Board of New Zealand. To help ensure all physiotherapists receive this message, PNZ is also forwarding it to all members.
We hope everyone is doing OK and taking care of yourself and your whānau as we quickly work through the implications of the recent announcements.
As you will be aware the Prime Minister has announced New Zealand is now at Level 3 for COVID-19 alert, Restrict - Heightened risk that disease is not contained.
The Prime Minister has also announced New Zealand's COVID-19 alert will increase to Level 4 at 11:59 pm Wednesday 25 March, Eliminate - Likely that disease is not contained. Measures needed locally and nationally include:
- People instructed to stay home
- Educational facilities closed
- Businesses closed except for essential services
- Rationing of supplies and requisitioning of facilities
- Travel severely limited
- Major reprioritisation of healthcare services.
Therefore the Physiotherapy Board and Physiotherapy New Zealand require all non-essential services to be suspended immediately to reduce community spread. This includes yourself, your staff and your patients.
The Physiotherapy Board and Physiotherapy New Zealand require all non- essential physiotherapy services to meet all applicable Level 4 measures by Wednesday 25 March.
What this means for you
Physiotherapists employed by District Health Boards (DHBs and other hospitals)
The requirements for your service and practice will be under the direction of your employer. Please follow their advice.
All other Physiotherapists (primary, community, workplace based, private i.e. all non - DHB settings)
Under Alert Level 4 you are no longer able to provide any face to face, clinic based or direct services.
You must close your clinic, remove yourself from the setting that you are working in and go home.
You can, if able to, provide electronic (telemedicine, Zoom, Skype, Facetime, phone call) services to your patients (within contractual requirements). Clinical records must be maintained recording that the consultation was via whatever means.
If you, your family or whānau are on the frontline of the COVID-10 response. You have our sincere thanks.
Noho ora mai,
Chairperson (Physiotherapy Board)
Chief Executive (Physiotherapy Board)
Chief Executive (PNZ)
Subject: Essential Services
Sent on 24 March 2020 to all PNZ members
The New Zealand Government has advised the following regarding essential services on covid19.govt.nz (current 24 March 2020).
“Entities and their workers carrying out the following services are considered essential. This also includes entities in their supply chains (eg those providing IT and data infrastructure to an entity providing an essential service). This list will evolve over time. It was last updated at 8pm, 23 March 2020.”
“Health - Lead agency: Ministry of Health
- District Health Boards (and all of their facilities), Pharmac, New Zealand Blood Service, Health Promotion Agency, Health Quality and Safety Commission
- Any person employed or contracted as a doctor, nurse, midwife, pharmacist, paramedic, medical laboratory scientists, kaiāwhina workers, social workers, aged care and community workers, and caregivers more generally
- Hospitals, primary care clinics, pharmacies, medical laboratories, care facilities (eg rest homes)
- Any entity providing ambulance services
- Any entity involved with the deceased/tūpāpaku (eg funeral homes, crematories, cemeteries)
- Any entity producing health sector equipment, medicines and PPE”
This advice identifies that physiotherapists not working in organisations listed above should only be engaging with the public over the phone or telehealth services.
PNZ is in ongoing contact with the Ministry of Health (MoH) to be able to inform members if they are working in an organisation providing essential services. We will continue to advocate for physiotherapy to be added to the list of essential services and keep PNZ members updated when more information from MoH is available.
Please be aware that PNZ is currently receiving a high volume of queries largely related to telehealth and essential services. In order to be efficient and effective with our support to members please look out for these regular email updates and information on the PNZ website, that is being informed by our regular contact with MoH and ACC. Thanks everyone for your patience at these unprecedented times. We are reviewing all of your emails to ensure we are considering all queries and helpful suggestions.
For anyone who missed our earlier email to members, as of March 23 ACC has communicated with PNZ that ACC has announced further expansion of telehealth services. Over the next few days ACC will make a detailed announcement that physiotherapy services, initial consultations and follow up appointments, delivered under CoT regulations and all other services will now be able to be delivered via telehealth services. The final details of the expansion of telehealth services are currently being worked through and will be released in the next few days.
Thank you all and take care.
Subject: Telehealth Services
Sent on 24 March 2020 to all PNZ members
As of yesterday evening (March 23 2020), ACC has communicated with PNZ that ACC has announced further expansion of telehealth services.
Over the next few days ACC will make a detailed announcement that physiotherapy services, initial consultations and follow up appointments, delivered under CoT regulations and all other services will now be able to be delivered via telehealth services. The final details of the expansion of telehealth services are currently being worked through and will be released in the next few days.
PNZ will continue to keep members updated with information on this as it becomes available.
Thank you for your continued commitment to our profession and for everyone’s work in advocating to ACC for telehealth services.
Sent on 23 March 2020 to all PNZ members
WE ARE WORKING FOR YOU
Thanks again to all our members for your dedication at this time. From when we first started receiving news of the Covid-19 virus in other countries PNZ Office and the PNZ Executive have been working to support members. Much of this advocacy is behind the scenes, here's what we've been focused on.
More detail is here on the PNZ website. This is being continually updated with the links to relevant resources and we'll keep communicating with you through the website and by email. Please note that because these official guidelines are changing as the situation evolves, we are linking to information on Government sites.
- We have been advocating strongly to ACC for telehealth across all physiotherapy services to be funded, and funded at normal follow up rates. This has been partially successful, in getting hand therapy and some other services funded from Friday
- Like you we're obviously disappointed that physiotherapy under cost of treatment regulations was excluded on Friday. We have immediately sought a review of this decision and will keep on advocating for this funding.
- There are other ACC questions we have put to ACC and are awaiting responses. This includes physiotherapists being able to sign off work certificates and delaying planned accreditation visits.
Ministry of Health (MoH)
- We've sought advice from MoH regarding what of physiotherapy is considered an "essential service". We now this is currently being considered by MoH and we will share this information as soon as we have it.
- We have also advocated to MoH for physiotherapy to be funded for non-injury related musculoskeletal conditions - this currently happens in some areas but not consistently and can take pressure off GPs and nurses. Given the rapidly changing nature of the alert levels this may be part of the return to normality now, but we will keep pushing.
Physiotherapy Board of New Zealand (PBNZ)
- PNZ Office has been talking with the PBNZ about how physiotherapists can work if the emergency situation evolves. PBNZ are currently working on a communication to the profession on this.
Ministry of Business, Innovation and Employment (MBIE)
- We are aware of the impact on physiotherapists for the immediate drop in work. Access to employer advice is critical and has been provided. We urge you to apply for the MBIE employer subsidy scheme for your staff to support people stay in employment if you can demonstrate a 30% drop in earnings.
AND WHAT CAN YOU DO?
It's an overused phrase this week but we are in unprecedented times for most of us. So as we tread the uncharted territory together we need to remember:
- Look after yourself and your family. Follow the health care advice you frequently offer to your clients.
- Find out if your employer offers EAP and use this if you need it.
- If you have professional supervision or utilise peer supervision use it. If you haven't accessed this yet consider starting peer supervision. We have resources to help here.
We're continuing to review PNZ courses and meetings (with the change in alert level this is daily). Please look out for updates on any courses or meetings you're attending.
Subject: COVID-19 information for physiotherapy businesses
Sent on 20 March 2020 to PNZ business contacts
As COVID-19 updates continue to be made by the New Zealand Government, please find a summary of current information for physiotherapy businesses below. This will also be posted on the PNZ website and reviewed as new resources become available.
From ongoing contact with members, every business is different and requires varied information. With this in mind, we are following advice from the New Zealand Government and directing members to official information sources. This includes information from ACC, the Ministry of Health (MoH), Ministry of Business, Innovation and Employment (MBIE) and New Zealand Government.
The New Zealand Government has information on their website covid19.govt.nz with links to information for employers including uniting against COVID-19 in the workplace, self-isolating staff, sick staff and employers supporting staff. In addition there is a PNZ webpage with answers to COVID-19 Business FAQs that you may find helpful.
PNZ Office is also working with key partners including ACC, the Physiotherapy Board of New Zealand (PBNZ), MoH and our insurance partner BMS on their activity regarding COVID-19. This includes encouraging ACC to fund telehealth access across all services, including the physiotherapy contract, as well as engaging with the PBNZ on Continuing Professional Development requirements and APC renewals.
The ACC website has a page with important information about novel coronavirus COVID-19 and updates are being provided on the ACC Newsroom. PNZ is in regular communication with ACC and our Clinical Partner Melissa Barry. As mentioned above, they are currently considering arrangements for telehealth and a position on this will be released in the next few days and communicated to the health sector when decisions have been made. For anyone new to telehealth, The Physiotherapy Standards Framework includes a telehealth standard and PNZ has contributed to the Allied Health Aotearoa NZ Best Practice Guidelines.
Economic Response Package
The Government has released an economic response package to help cushion the impact of COVID-19 and support the economy, with information available at MBIE’s business.govt.nz website. The package includes a wage subsidy scheme, leave and self-isolation support, business cash flow and tax measures, and wider $12.1 billion package. The Ministry of Social Development has details on their Work and Income website about applying for the wage subsidy or leave payment and definitions for wage subsidy qualifications. Like others, PNZ Office is working to understand how the economic response package applies to members.
Humankind, PNZ's employment support partner, have provided an Employer’s Guide to Managing Coronavirus. Please read their latest update here including answers to frequently asked questions. We’re also working with Humankind on a webinar for PNZ members who run businesses to ask employment questions. While this is organised please email any questions for their team to firstname.lastname@example.org with “Humankind webinar” in the subject line.
Thanks for your engagement with our team at this time. We are receiving ongoing information from members, which is contributing greatly to the availability of these resources and how PNZ can continue to work with key partners on behalf of the profession.
Sent on 19 March 2020 to all PNZ members
My thoughts and those of the PNZ Executive are with you all as we continue with daily updates from the New Zealand Government on COVID-19.
The pace of change in the response to the COVID-19 pandemic is faster than anyone could have predicted. I hope you and your family/whanau are well and are looking out for colleagues, vulnerable patients and neighbours.
This is an unprecedented, challenging time for everyone, including our physiotherapy profession. Physios are kind, compassionate, and empathic people and many of you are dealing with the impact and effect of COVID-19, while our colleagues in the DHBs are contributing to the preparedness that is occurring for hospitals to be able to cope if an influx occurs.
Please know that PNZ will do everything it can to support you, our members, and the PNZ Office team are proactively working on your behalf gathering information and advocating for you to ACC and the Ministry of Health. This includes encouraging ACC to fund telehealth – the same call is coming from physios in Australia and the USA; and understanding the support package that is available for businesses from the Ministry of Social Development in order to help you navigate the process.
World Physiotherapy (the new name for WCPT) have collated information and resources that may be of use and could be adapted. You can find these on the WCPT website.
The situation is extremely fluid, changing on a daily basis. While we will continue to monitor this, I urge you to use the Ministry of Health website for the most up to date information. We have to rely on the New Zealand Government guidelines as our most reliable information source. Check the date on anything you read – because it changes that fast (this is why we are linking members to the MoH website). This pandemic has touched, and will touch, the lives of many of us and the people we each care about.
Thank you for your resilience and ongoing commitment to the profession.
Subject: COVID-19 (Novel Coronavirus)
Sent on 16 March 2020 to all PNZ members
With the COVID-19 situation changing rapidly, Physiotherapy New Zealand is continuing to monitor updates to provide members with the latest information as it becomes available.
Current advice from the New Zealand Government, as of 16 March 2020, is below. We urge you to be vigilant for signs of the virus and be aware of Government information sources. The PNZ website has links to shared resources, including the Ministry of Health (MoH) and Ministry of Business, Innovation and Employment (MBIE). While our website is being updated regularly, please be aware that the latest information is on the Government pages.
Directing to Government Advice
The Government is following the Pandemic Planning guidelines developed post H1N1. This is based on the learnings from earlier pandemics, including the measles last year, that coordinated actions were preferable to differing guidelines from different organisations. As of this morning regional DHBs are also now providing information, supported by MoH. As we move through the pandemic stages the advice will change – for example if an area goes into lock down (like Northern Italy did then all of Italy) that advice could change overnight. These are reasons for us to not duplicate resources and rather direct to Government advice.
We encourage all members to be aware of their practice’s policy on pandemic planning and business continuity. It is time to ensure these are current and followed. There is a web page with information for businesses on business.govt.nz (part of MBIE), including how the coronavirus may affect New Zealand businesses. Humankind, our employment support partner, have also provided advice for employers.
Although some DHB areas have started creating posters (an example from CDHB is here), we are not aware of any current MoH advice on signage – so organisations are making their own decisions on this. Similarly, we have heard that some practices are adding a message to patient reminders the day before their appointment asking “if you have any flu/cold symptoms, please text back to change your appt.” Again, there is no specific advice on this from MoH.
PNZ Office has contacted ACC regarding COVID-19, including about engagement with patients via telehealth. We will let members know as soon as a response is received.
MoH has COVID-19 advice for public events and mass gatherings. At this stage, they do not propose altering arrangements for public events (for groups across PNZ this includes events such as seminars and meetings). However PNZ acknowledges the role individual event organisers have when deciding on whether to proceed or not with a planned seminar or event. With members of PNZ hosting events across the country, we are continuing to review this website for updates.
Advice for travellers is that people coming into New Zealand should check the MoH information for travellers arriving to New Zealand as all travellers except those listed on the countries and areas of concern under Category 2, will be required to self-isolate. Please be aware of this if you are hosting an event for both your presenters and attendees.
Page updated 23 September 2020