COVID-19 Member Emails

In addition to information available here, a number of emails have been sent to PNZ members regarding COVID-19. For reference these are available below starting with the most recent. Please note this is a summary of current guidance as we understand it and not a substitute for legal advice. Please seek advice from a lawyer should you wish to understand how this applies to your specific circumstances.


Subject: COVID-19 requirements removed

Sent on 15 August 2023 to all PNZ members

Kia ora

The Government announced yesterday that as of Tuesday 15 August all COVID-19 requirements have been removed. This includes the seven day mandatory isolation period, and wearing of face masks for visitors in healthcare facilities. Please read the full announcement here with more information available at covid.govt.nz.

Isolation Periods

While not mandated, the Ministry of Health guidance is to stay at home for five days if you’re unwell or have tested positive for COVID-19. More on recommended isolation is available here.

Infection Prevention

Wearing of face masks is also no longer mandated, although recommended by Government when visiting healthcare services and when in closed, crowded and confined spaces. As of 15 August Te Whatu Ora COVID-19 infection prevention and control recommendations for health and disability care workers is that “use of PPE, including masks, is considered part of Standard Precautions which are a set of infection prevention and control (IPC) measures required by healthcare workers for all healthcare interactions”.

COVID-19 Leave Support Scheme

Eligibility for the Leave Support Scheme ended on 15 August, with the requirement to self-isolate due to COVID-19. However, you can still apply for the scheme if your employee (or you, if you're self-employed) started self-isolating before 13 August. Read more at workandincome.govt.nz.

Thank you

As always, thank you to everyone for your support through COVID-19. We acknowledge this continues to impact members, patients, and practices.

We will look to share further detail as this becomes available, including from the Ministry of Business, Innovation and Employment who note their COVID-19 website for businesses is currently being updated, and Manatū Hauora Ministry of Health.

Ngā mihi


Subject: COVID joint update - (Non-Te Whatu Ora Physiotherapists)

Sent on 14 September 2022 by the Physiotherapy Board

Tēnā koe

We have received the following email from Allied Health's Chief Allied Health Professions Officer Martin Chadwick regarding interpretation of the latest health order and mask wearing. Please note this is advice from the Ministry's Health Legal team and any request for clarification or other questions should be referred to the Ministry at healthorders@health.govt.nz.

Allied Health note pertaining to masks and the most recent Order

COVID-19 Public Health Response (Masks) Order (2022)

Mask wearing is a requirement in certain health service premises under Section 5(1) of the COVID-19 Public Health Response (Masks) Order (2022). Refer to legislation.govt.nz/regulation/public/2022/0255/latest/LMS748432.html for full details.

Masks are strongly recommended in high risk settings

  • While health workers and patients/residents on the premises of a health service are not required to wear a mask under COVID-19 Public Health Response (Masks) Order (2022), practitioners should still complete a risk assessment to determine the appropriate use of PPE for their own clinical environment.
  • Mask use may still be indicated where there is a risk of transmission or (for example) where there may be vulnerable patients. PPE is considered as part of Standard Precautions which are a set of IPC measures required for all healthcare interactions. A risk assessment is required before every interaction, and/or every session, with a patient/client or resident by the healthcare worker. When a patient/client or resident is suspected or confirmed to have a transmissible infectious disease, then Transmission-based Precautions should be followed.
  • It is strongly recommended that healthcare workers follow the infection prevention and control recommendations for health and disability care workers available at: https://www.health.govt.nz/covid-19-novel-coronavirus/covid-19-information-specific-audiences/covid-19-personal-protective-equipment-central-supply/infection-prevention-and-control-recommendations-health-and-disability-care-workers.
  • Some premises may establish additional mask requirements if they feel necessary based on their own circumstances and local assessment of degree of risk and relevant legal requirements.
  • If you are at higher personal risk or you want to reduce your risk of becoming unwell mask use is strongly recommended.
  • If you are in situations where the ‘three Cs’ make the spread of the virus most likely mask use is strongly recommended:
    • closed spaces with poor ventilation (e.g., small meeting rooms)
    • crowded places with many people nearby (e.g., crowded buses or trains)
    • close-contact settings, especially where people have close-range conversations, (including sin­­ging or shouting).

The risk increases when you’re in a setting that involves one or more of the ‘three Cs’ for a prolonged period of time.

  • Having a highly vaccinated workforce continues to be one of our strongest tools to prevent the spread of COVID-19 in the workplace. In addition, we strongly encourage you to wear a mask in the workplace in situations where the ‘three Cs’ apply, if you’re at higher risk of severe illness, you want to reduce your risk of becoming unwell, or if you’re a household contact during the 5 days you are testing. Please also keep up good hand hygiene, and if you’re unwell please stay home and test.

Ngā mihi

Dr Martin Chadwick (he/him)
Chief Allied Health Professions Officer
Office of the Chief Clinical Officers

Ngā mihi and stay safe


Subject: COVID-19 Vaccine Update

Sent on 1 July 2022 to all PNZ members

Kia ora

The Government have today announced that the COVID-19 Public Health Response (Vaccinations) Order 2021 is being amended, so that vaccine mandates for some health and disability sector workers are being removed.

Read the full Ministry of Health update here.

“From 11:59 pm on 7 July, workers who are not public facing in certain healthcare environments and/or do not provide healthcare services directly to patients, will no longer be required to be vaccinated against COVID-19.”

Who is still mandated?

  • Health practitioners, under the HPCA Act, providing health services to patients in person including physiotherapists will continue to be covered by the Vaccinations Order.
  • Workers in practices (such as receptionists, assistants) and whose role involves being within two metres or less of a health practitioner or a member of the public for a period of 15 minutes or more will be covered by the Vaccinations Order.
  • Workers who are employed or engaged by certified providers – which includes hospitals, rest homes, or residential disability care facilities – and who, as part of their ordinary duties, come within two metres or less of a health practitioner or a person to whom health care services are provided for a period of 15 minutes or more will continue to be covered by the Vaccinations Order.

Our understanding of this is that physiotherapists in contact with patients in person, and close contact colleagues (“within two metres or less . . . for a period of 15 minutes or more”), remain mandated.

We are seeking further clarity on this from the Ministry of Health.

Please read this message as a summary of current guidance as we understand it and not a substitute for legal advice. Seek advice from a lawyer should you wish to understand how this applies to your specific circumstances.

Ngā mihi


Subject: Allied Health Strike Action

Sent on 3 May 2022 to PNZ members identifying a DHB as their employer

Kia ora

With our members in District Health Boards under ongoing pressure, including strike action this month, we again acknowledge your commitment at this time when many of you are already fully extended and working hard to support colleagues.

As negotiations to address fair pay, low wages and safe staffing continue between DHBs and the PSA, we’re also aware of Omicron’s impact across the profession and uncertainty around health and disability system review changes.

This is a lot to navigate, in addition to the challenges faced in recent years by individuals, whānau and communities through COVID-19, and we thank you for all your work.

Ngā mihi nui


Subject: Moving to Orange

Sent on 13 April 2022 to all PNZ members

Kia ora

Following today’s review of traffic light settings, the government has announced this afternoon that all of New Zealand will move to traffic light orange at 11.59pm tonight.

Given this change, members are encouraged to check the requirements of each traffic light setting available at covid19.govt.nz. Very broadly, at orange there are no capacity or distancing requirements at venues and an update to general face mask requirements.

We are again in contact with the Ministry of Health (MoH) to understand how this change in traffic light settings impacts the MoH phased response to Omicron.

Vaccine mandate

Please note that the health and disability sector vaccine mandate remains unchanged. For reference, MoH information on mandatory COVID-19 vaccinations is available at health.govt.nz.

Like many of you, we’ve followed the recent High Court decision on the vaccine mandate which determined “at the time mandates were introduced, there was a clear justification that existed in the health and disability sector.” We’ll continue to stay across this and share any update with members, including when the vaccine mandate may be reviewed by government.

DHB staff

We’re conscious as we read about Omicron in public hospital settings that this has impacted those working permanently in or those who joined the surge workforce. To our members who have been working long hours and been moved around the hospital to fill COVID-19 critical roles, we can only say thank you. Your work and contribution to the health of all Aotearoa is valued and acknowledged. We hope that as the Omicron tail moves through the country you can see a return to something you recognise as normal. You and your families have given up a great deal to support your fellow New Zealanders.

Please read this message as a summary of current guidance as we understand it and not a substitute for legal advice. Seek advice from a lawyer should you wish to understand how this applies to your specific circumstances.

Ngā mihi


Subject: Staying in red

Sent on 5 April 2022 to all PNZ members

Kia ora

Having reviewed traffic light settings, the government announced yesterday that all of New Zealand will stay at traffic light red until the next review on 14 April. We also remain at phase three of the Ministry of Health (MoH) Omicron response plan, as outlined on the MoH website.

Members are reminded that the requirements of each traffic light setting have been updated as of 4 April and available at covid19.govt.nz. This includes that some vaccine mandates have been removed, although notably not for the health and disability sector.

Physiotherapists in schools

With the education sector vaccine mandate removed from 4 April but remaining for the health and disability sector, PNZ has asked how this impacts allied health professionals working in schools. The MoH view is that the Order is sector-agnostic and relates to the type of work being conducted, with registered health professionals still expected to comply with the health order as they are providing a health service in this case within an education setting.

Further support

Employment New Zealand have general guidance for employees and employers on COVID-19 vaccination requirements in the workplace, available at employment.govt.nz.

Please also be aware that applications for the third round of the government COVID-19 Support Payment (CSP) are now open. Noting that applications for all three rounds of the CSP will close in early May, this is a payment to help support businesses which have experienced a 40% or more drop in revenue as a result of COVID-19.

Ngā mihi


Subject: Traffic Light System Changes

Sent on 24 March 2022 to all PNZ members

Kia ora

With the government announcing yesterday that the COVID-19 Protection Framework (traffic light system) will change over the coming weeks, like many of you we’re working to understand this for our profession.

As part of this announcement, from 11:59pm on 25 March people will no longer be required to scan QR codes in order to enter premises. From 4 April some vaccine mandates will also be removed, although notably not for health and disability, aged care, corrections and border workforces.

Operating through these changes

A number of questions arise with the announcement and we are in touch with the Ministry of Health (MoH) for clarification. This includes when vaccine mandates will be removed for physiotherapists, and how the MoH phased response to Omicron and Close Contact Exemption Scheme work within these changes.

We will update you on this and any other further information that is received as soon as we can.

Please read this message as a summary of current guidance as we understand it and not a substitute for legal advice. Seek advice from a lawyer should you wish to understand how this applies to your specific circumstances.

Ngā mihi


Subject: Feedback through Omicron

Sent on 23 March 2022 to PNZ business contacts

Kia ora

As Omicron cases have risen over the last month, we’re aware of the ongoing impact of COVID-19 on member practices.

Thank you to everyone who has been in touch during this time. Working for members through Omicron remains a priority and we’re interested in hearing how continued support can best be provided.

Business Owner Feedback

We have been advocating to ACC that the current reimbursement rate for services under both Cost of Treatment Regulations (COTR) and the Allied Health contract do not reflect the actual costs of doing business, particularly the costs related to COVID. Having been asked for more detail to support these claims, you are invited to participate in this short survey with results used to support our advocacy. Please use an estimate of actual costs. The survey will close on Monday, so we can get back to ACC quickly on this.

ACC Provider Updates

In our ongoing advocacy work with ACC, we’ve been reminded that not all PNZ members may be receiving their regular Provider Updates by email. If you did not get a 17 March update from ACC, please subscribe at acc.co.nz to access information directly from their team.

COVID-19 Support Payment

Please also be aware that applications for the second round of the government COVID-19 Support Payment (CSP) are now open to help support viable and ongoing businesses which have experienced a 40% or more drop in revenue as a result of COVID-19. Read more at ird.govt.nz. Employers are able to apply for the COVID-19 Leave Support Scheme to support staff who are self-isolating or have tested positive for COVID.

PNZ Job Listings

With COVID-19 impacting the availability candidates, PNZ job listings have been extended from one to three months until the end of November 2022. Thank you to members who have been in contact to encourage this extension, intended to provide even a little help at this time. Read more and list a position here.

Changes to COVID requirements

Following the Prime Minister’s announcement today, from Saturday people will no longer be required to scan into any premises. At this stage the vaccine mandate for health and aged care workers remains in place, although it will no longer be required for education. If you have staff members who are due for their booster vaccine but cannot have the booster because they contracted COVID-19 there has been changes made to the temporary medical exemption process to cover this contingency. More information is available at pnz.org.nz under the question what if I'm unable to receive a vaccination while recovering from COVID-19?

Please read this message as a summary of current guidance as we understand it and not a substitute for legal advice. Seek advice from a lawyer should you wish to understand how this applies to your specific circumstances.

Ngā mihi


Subject: COVID joint update - Omicron Response Phase Three

Sent on 25 February 2022 by the Physiotherapy Board

Tēnā koe

Omicron Response Phase Three

With all of New Zealand now in phase three of the Ministry of Health (MoH) response to Omicron, all of the profession is reminded to please be aware of the approach and requirements in this phase.

Overall, phase three is less restrictive than previous Omicron phases with a move to increased self-management and changes to testing, isolation and contact tracing. As outlined at covid19.govt.nz, this is intended to ease pressure on testing and contact tracing services and ensure delivery of critical services throughout the Omicron peak.

More detail and guidance for physiotherapists through phase three is provided in a MoH webinar on the shift to phase three of the Omicron response plan held last night and a sector update published today.

Close Contact Exemption Scheme

As many of you will already be aware, physiotherapists can access the Close Contact Exemption Scheme through phases two and three of the Omicron response to ensure critical physiotherapy services remain operational.

Information on the use of Rapid Antigen Tests (RATs) within the Close Contact Exemption Scheme is available at health.govt.nz, noting the scheme now applies to those staff members who are household contacts of a positive case. Please note that under the scheme critical workers report self-administered RATs through their My Covid Record.

Mask wearing

As identified by MoH in their public health operational changes to respond to Omicron, advice remains that a certified well-fitting medical mask is recommended for general health workers with a fitted P2/N95 particulate respirator for higher risk situations.

Surveillance RAT testing

Surveillance PCR/RAT testing may be required for healthcare staff working with immunocompromised patients, corrections or residential care facilities. Asymptomatic household contacts of a person with a positive COVID test registered under the Close Contact Exemption Scheme will use a daily RAT test and only work if the test is negative.

COVID-19 Support Payment

Inland Revenue have identified help for your business during the COVID-19 Omicron outbreak, outlining some of the financial support available. This includes a recently introduced COVID-19 Support Payment (CSP).

The Ministry of Business, Innovation and Employment also have general advice on managing the impact of COVID-19 cases at your business and PNZ’s employment support partner Humankind have provided a COVID-19 guide to supporting and paying your employees to help address how pay works in different case and close-contact situations.

Significant Service Disruption Exemption

MoH have sent a message regarding PCBUs (employers) who are covered by mandated vaccination dates and may be applying for a temporary Significant Service Disruption (SSD) exemption. These exemptions are temporary and granted to employers to allow their staff to keep working and avoid a significant service disruption usually for a period of between one to six weeks. More detail including the application process is available at health.govt.nz.

Ngā mihi and stay safe


Subject: Close Contact Exemption Scheme and RATs

Sent on 21 February 2022 to all PNZ members

Kia ora

As we seek to understand more about the Ministry of Health (MoH) phased response to Omicron, please find further information below from MoH on the Close Contact Exemption Scheme and Rapid Antigen Tests (RATs).

MoH have provided an Omicron Sector Update which includes an explanation of the scheme and process to access RATs. They’ve also shared slides and a recording from their latest webinar and an Omicron Q+A document.

Close Contact Exemption Scheme

A key detail to note is that the Close Contact Exemption Scheme only applies at a point when those registered have insufficient workers who are neither COVID-19 cases nor close contacts. This includes the use of RATs under the scheme.

We’ve received enquiries about notifying clients that you’re part of the scheme. While this is an individual decision we refer to the information above and suggest that even if your service is at that point and clients are seeking appointments, such a notification may be unnecessary as your staff will likely be taking notable infection prevention and control measures like wearing visible PPE and increased screening.

Rapid Antigen Tests

More on RATs is available on health.govt.nz including a product guide and how critical workers can report self-administered RATs under the Close Contact Exemption Scheme. RAT locality links are also available at healthpoint.co.nz.

A reminder that guidance on what to do if a client notifies you they have tested positive to COVID-19 is on the MoH website under Guidance for situations where healthcare workers are COVID-19 cases or contacts during an Omicron outbreak. There is also guidance for workplaces that have a case of COVID-19 and advice on COVID-19 general cleaning and disinfection.

As always, please read this message as a summary of current guidance as we understand it and not a substitute for legal advice. Seek advice from a lawyer should you wish to understand how this applies to your specific circumstances.

Ngā mihi


Subject: Critical Health Services

Sent on 15 February 2022 to all PNZ members

Kia ora

With the government announcing all of New Zealand will move to Omicron response phase two at 11:59pm tonight, members are reminded to please be aware of the Ministry of Health (MoH) phased response to Omicron including how to register as part of the Close Contact Exemption Scheme. This is within COVID-19 Protection Framework traffic light red.

Close Contact Exemption Scheme

As identified in our joint message with the Physiotherapy Board sent last Friday, physiotherapists and their staff can access the Close Contact Exemption Scheme to ensure critical physiotherapy services continue to function through the MoH response to Omicron. Please refer to health.govt.nz for MoH guidance on collecting and undertaking Rapid Antigen Tests within the scheme.

In phases two and three workers at registered critical services who are vaccinated and asymptomatic close contacts of a COVID-19 case will be able to continue to work, as long as they return a negative Rapid Antigen Test prior to each day/shift they are at work during the isolation period, and follow specific health protocols. They will only be allowed to go to work – not anywhere else. We are expecting MoH information on how to access Rapid Antigen Tests will be updated today, as this has not yet been released.

COVID-19 cases and contacts

At each phase of the Omicron response, there are different isolation and quarantine requirements for cases and contacts. Information on managing workers who are COVID-19 cases, contacts or have symptoms is available at business.govt.nz. If a patient informs you they are a case, contact or have symptoms, MoH have guidance for situations where healthcare workers are COVID-19 cases or contacts during Omicron as well as for workplaces that have a case of COVID-19.

Omicron webinar tonight at 6pm

We’ve been advised today that a MoH webinar for health professionals is being run this evening from 6 to 7pm. Please see the message below, received from MoH this morning.

“Following the announcement by the Prime Minister yesterday about the national shift to Phase Two of the Omicron response, the Director-General of Health is hosting a Webinar at 6:00pm on Tuesday 15 February to outline the changes. This session will be for the broader health sector. This will be recorded and shared afterwards for those who are unable to attend. Please find the link to the livestream below – recommended browsers are Google Chrome, Firefox, Safari. Please note this link will not work on Internet Explorer or Microsoft Edge.”

livestream.com

Please read this message as a summary of current guidance as we understand it and not a substitute for legal advice. Seek advice from a lawyer should you wish to understand how this applies to your specific circumstances.

Ngā mihi


Subject: Critical Health Services

Sent on 9 February 2022 to all PNZ members

Kia ora

Like much of our profession right now we’re keeping across Omicron in the community and its impact on members. Under the COVID-19 Protection Framework all health and disability services and their workers can continue to operate during green, orange and red traffic lights.

With the country currently in phase one of the Ministry of Health (MoH) phased response to Omicron, we’ve been working to understand the definition of “critical workforce” mentioned at health.govt.nz. MoH have published guidance for critical health services during Omicron which includes definitions of Critical Health Services and a Critical Worker. Physiotherapy services are identified in the list of Critical Health Services and are considered to be Critical Workers. If we enter phase two or three of the Omicron response, critical health workers can isolate for a shorter period of time and use rapid antigen tests (RATs) to return to work once they’ve produced a negative test.

The Ministry of Business, Innovation and Employment (MBIE) have indicated they are setting up a register of critical workers that will require all critical workers to sign up. Although not yet active further information is on the MBIE website. The register is expected to be launched this month and will be the vehicle for RATs to be distributed. In addition to our regular contact with MoH, we are attending their Microsoft Teams sessions about Omicron for allied health professionals at 11am on Tuesdays and Fridays and will share any updates with members.

Thanks again for your support and patience as we find out more about the critical worker register.

As always please read this message as a summary of current guidance as we understand it and not a substitute for legal advice. Seek advice from a lawyer should you wish to understand how this applies to your specific circumstances.

Ngā mihi


Subject: COVID joint update - Non DHB Physiotherapists

Sent on 31 January 2022 by the Physiotherapy Board

Tēnā koe

Note that physiotherapists working in DHB’s, may have different requirements and each DHB will specific guidance.

We hope you are doing OK as we are now facing the wave of the new variant Omicron.

Guidance for critical health services during an Omicron outbreak

Following publication of the Ministry of Health (MoH) phased approach to Omicron, MoH has today shared their Guidance for critical health services during an Omicron outbreak (dated 28 January 2022).

Please note this is a summary of current guidance and not a substitute for legal advice. Please seek advice from a lawyer should you wish to understand how this applies to your specific circumstances. Physiotherapists working in DHB’s may have different requirements. This guidance is for non-DHB settings.

The MoH approach to Omicron mentions critical workforces in phases two and three (noting the country is currently in phase one). The Guidance provides a definition of:

  • a critical worker; and
  • critical health services and the criterial for these.

Physiotherapy services are identified in the list of critical health services.
Critical services in the health system are those that meet one or more of the following five criteria:

  1. A health and disability service that provides direct, hands-on care and support that maintain a person’s necessities of life.
  2. A health and disability service that ensures the safety of the critical workforce.
  3. Disability Support Services (DSS) and Aged Care services, including Home and Community Support Services (HCSS), that support high-risk and vulnerable client groups.
  4. Crisis support for people who feel unwell or are unsafe (eg, funded helplines, refuges and family violence services, sexual violence crisis services).
  5. A health and disability service that enables the delivery of equitable care to those people most at risk of harm.

We understand that you may have some questions regarding the five criteria above and will be making decisions on a client-by-client basis. Please use your clinical judgement in your decision making and document your decision(s).

If you have any questions regarding this guidance please contact MoH at info@healthworkforce.govt.nz.

Mask use

To date MoH has advised the use of medical masks at a minimum for physiotherapists in private practise. We understand many physiotherapists wish to use a “higher grade” mask and that of course is your clinical decision.
If we receive any further information or guidance on masks we will share this as soon as we get it.

Rapid Antigen Testing

We have no further information on Rapid Antigen Testing (RAT), including when or if they will be provided or how. Once we receive further detail this will also be shared.

Working in Education

For those working in education please also refer to the Ministry of Education Advice for Schools and Kura at Red, which indicates physiotherapists in schools should be able to continue to provide services.

Please take care and if we can assist you further please let us know.

PNZ contact: pnz@physiotherapy.org.nz
Physiotherapy Board contact: Covid-19@physioboard.org.nz

Ngā mihi and stay safe


Subject: MoH Response to Omicron

Sent on 28 January 2022 to all PNZ members

Kia ora

The Ministry of Health (MoH) have provided slides and a recording from their most recent webinar on responding to Omicron as well as a document outlining their response phases.

This identifies the overall MoH approach to Omicron and highlights their current priorities as use of masks and face coverings, vaccination, and Rapid Antigen Testing, which they intend to provide more information on next week.

We are aware there are a number of questions from the session and MoH have let us know they’re collating answers to circulate as soon as possible. This includes a definition of “critical workforces” (as mentioned in the MoH slides and document) and whether all physiotherapists are regarded as such – with access to Rapid Antigen Testing (RAT) linked to the definition of critical worker.

Face masks

The Government have also updated face masks requirements coming into effect at 11:59pm on 3 February. These identify that “workers who are mandated to be vaccinated will need to wear a medical grade mask when working in public facing roles. For example a Type IIR/Level 2 mask or above.” Mask requirements in healthcare settings are on the MoH website under Interim guide for PPE selection to protect primary and community health and disability care workers. We will update members if this guidance changes.

Thank you

As always please read this message as a summary of current guidance as we understand it and not a substitute for legal advice. Please seek advice from a lawyer should you wish to understand how the rules apply to your specific circumstances.

We appreciate all your ongoing work through COVID-19 and have been asked by members to again share links to resources on mental health and wellbeing support. These are available here.

Ngā mihi


Subject: MoH webinar on Omicron strategy

Sent on 26 January 2022 to all PNZ members

Kia ora

The Ministry of Health have notified PNZ this afternoon that they will be hosting an Allied Health Sector webinar on their Omicron strategy, tomorrow 27 January at 1pm. Please see the invitation from MoH below.

Subject: Allied Health Sector webinar: Omicron Strategy
When: Thursday, 27 January 2022 1:00 pm-2:00 pm (UTC+12:00) Auckland, Wellington.
Where: Microsoft Teams Meeting

This is an invitation to a webinar where a presentation will be shared that will walk through the Omicron strategy and component parts. This session is developed for the Allied Health sector, and hosted by Martin Chadwick, Chief Allied Health Professions Officer to address any specific queries you may have.

Microsoft Teams meeting
Join on your computer or mobile app
Click here to join the meeting
Or call in (audio only)
+64 4-280 2674,,419045635#

Ngā mihi


Subject: COVID-19 Booster Vaccinations

Sent on 25 January 2022 to all PNZ members

Kia ora

Our thoughts are with all members as we’ve moved to traffic light red and thank you again for your ongoing support of the profession.

As noted last week the revised amendments to the Public Health Order on vaccinations came into effect at 11:59pm on Sunday 23 January. The amendment adds a booster dose as part of the requirements for various workforces to be considered fully vaccinated, and while the Order covers a range of workforces the information below applies to the health and disability workforce.

More is available from the Ministry of Health website, noting that because of the delay in passing the legislation the dates for mandated boosters have changed from earlier information.

This is a summary of current guidance as we understand it and not a substitute for legal advice. Please seek advice from a lawyer should you wish to understand how the rules apply to your specific circumstances.

Key points from the legislation:

  • All health practitioners and those working in health services, if eligible must have a booster dose by 15 February 2022. If not eligible for a booster by 15 February, because it is less than 4 months since the second dose then a booster dose is required within 6 months (183 days) of the primary dose.
  • For most people a booster dose will be the third vaccination. People who are immune compromised and required a third dose will require a fourth dose as the booster.
  • Boosters are required for all staff members aged 18 or over. Boosters are not required for people under 18 years.
  • The same exclusions and exemptions processes apply as per the previous legislation. For people applying for an exemption based on adverse reactions to previous vaccination the application must come through an approved medical practitioner.

Business Owners/PCBUs are required to:

  • Inform all workers of the requirements for a booster.
  • Allow staff members to access vaccinations in work time if vaccinations are available in that shift.
  • Update the Covid vaccination records of workers to record the third dose. Note this requires the “My Vaccine Record” which details the vaccine type and date. The My Vaccine Pass is not considered sufficient for record keeping.
  • Ensure all workers comply with the Order. Note this may require people on long term leave, such as parental leave, to have their booster within the time frame in order to return to work.

Ngā mihi


Subject: Preparing for Omicron

Sent on 21 January 2022 to all PNZ members

Kia ora

With the Omicron variant of COVID-19 having an impact internationally our Government is advising that everyone prepare for Omicron and that once there is evidence of this transmitting in the community the country will move into traffic light Red within 24 to 48 hours.

A recent COVID-19 update recommends “people should prepare now for Omicron to be widespread in the community by making sure they have enough supplies to isolate at home for a period of time if they catch it or are a close contact of someone who does.

Businesses should think about:

  • what PPE they will need and distancing requirements in the workplace
  • how they can support workers to get a booster
  • contingency planning, should parts of the workforce need to stay at home.”

The Ministry of Business, Innovation & Employment (MBIE) has information to support planning for Omicron at business.govt.nz, including what to do if a case occurs at your business and links to Work and Income for financial support to pay self-isolating staff.

N95 Mask Guidance

The PNZ Cardio-Respiratory Special Interest Group (CRSIG) are receiving queries about medical masks and particulate respirators. CRSIG advise that particulate respirators (P2/N95) are recommended when treating an individual with suspected or confirmed COVID-19, noting that particulate masks will not be effective without a tight seal. Mask-fit testing is a process that ensures a tight seal is achieved and is an essential process to ensure each wearer is protected. Information on masks and particulate respirators is available from the Ministry of Health (MoH) and those who need to be fit tested can find more on providers at nzohs.org.nz.

Vaccination Order Webinar

MoH are advising there has been a further delay to the COVID-19 Public Health Order amendment on vaccinations and they now anticipate Health and Disability workers, if eligible for a booster, will be required to have this by 15 February 2022 (please note this is yet to be confirmed). To discuss the Vaccination Order changes MoH are hosting a webinar on 25 January at 10am. A Zoom link is available here and a recording will be available after the session.

Ngā mihi


Subject: COVID-19 Booster Vaccinations

Sent on 19 January 2022 to all PNZ members

Kia ora

Following last week’s message to members about amendments to the COVID-19 Public Health Order, PNZ has received further information from the Ministry of Health (MoH) on COVID-19 booster vaccinations for physiotherapists.

A document provided by MoH on Boosters and Changes to the Mandatory Vaccination Order identifies probable dates for mandated boosters (to be confirmed) including vaccination for Health and Disability workers by 31 January 2022 or six months from the date of completion of their primary vaccination course.

Please note these dates are draft only and we’re working with MoH on confirmation. We will continue to update members as we receive more detail.

Ngā mihi


Subject: Mandatory COVID-19 Vaccination Order booster requirement for health workers

Sent on 14 January 2022 to all PNZ members

Tena koutou katoa,

Happy New Year and welcome back for 2022. I hope you had a safe and restful time over the holiday period with your friends and whānau.

We have received advance information from the Ministry of Health that the current Vaccination Order is being amended at the end of this week to specify requirements for booster vaccination. The amendment will come into effect at 11.59pm on Sunday 16th January.

While the details around this amendment are yet to be confirmed, we understand that physiotherapists and all other health workers covered by the Order will then be required to have their booster shots. Details of the time frames for the booster shots will be announced along with the amendment.

We will continue to keep you updated as more information on this amendment is released by the Ministry of Health. In the meantime, please remember to visit pnz.org.nz for our latest COVID-19 information.

Ngā mihi nui


Subject: Guidance for Co-located Premises

Sent on 10 December 2021 to all PNZ members

Kia ora

Members working within the COVID-19 Protection Framework has been a focus for PNZ this week and many of you will have read yesterday’s joint email with the Physiotherapy Board updating answers to FAQs in the traffic light system.

More broadly the Ministry of Health (MoH) have made slides available from their Allied Health Quarterly Webinar held on 8 December, which includes information on the COVID-19 Public Health Response (Protection Framework) Order and what this means for Allied Health services.

A recording of last night’s PNZ hosted webinar on delivering physiotherapy under the COVID-19 Protection Framework is also available at pnz.org.nz. With the protection framework leading to a number of questions for physiotherapy businesses this webinar includes information from law firm Duncan Cotterill and our insurance partners BMS .

Co-located Premises

Following ongoing advocacy from PNZ and Exercise New Zealand for guidance on COVID-19 vaccination certificates (CVCs) at co-located premises, the MoH Chief Allied Health Professions Officer provided a letter yesterday clarifying clause 33 of the COVID-19 Protection Framework. This identifies that clause 33 would “allow access to a designated premise through somewhere that is otherwise requiring CVCs to operate”, noting that “there should be reasonable systems and processes in place to ensure that it is only the designated premise being accessed”.

We’ve also been working with local government on clarity for access to physiotherapy practices based in fitness facilities including Council gyms and pools. A message has gone to all local government Councils confirming that access to physiotherapy practices must be provided to all people without requiring a vaccine pass as part of the Council responsibilities. Please check with your local Council for further guidance on this.

This makes the situation much clearer than it was last week and hopefully has created a workable access option for practices that are co-located in other premises. We are aware that gyms are the most common issue but these principles apply with any co-located premises.

Government Support

The COVID-19 financial support tool remains available at covid19.govt.nz and Inland Revenue have a fact sheet on current help for your business. A one-off COVID-19 Protection Framework transition payment is available for eligible business with details on this and other support available at business.govt.nz.

ACC Provider Update

The latest ACC provider update is available here including information on providing services under the COVID-19 Protection Framework and treatment injury claims for COVID-19 vaccinations.

Please note this message is a summary of current guidance as we understand it and not a substitute for legal advice. Please seek advice from a lawyer should you wish to understand how the rules apply to your specific circumstances.


Subject: COVID joint update - "Traffic Light" Order FAQ - updates

Sent on 9 December 2021 by the Physiotherapy Board

IMPORTANT: Information in this update is based on the COVID-19 Public Health Response (Protection Framework) Order 2021 that came into effect at 11:59pm 2 December 2021.

For DHB physiotherapists and those working with the Ministry of Education – please seek advice and direction on these issues from your line leader.

Tēnā koe

The Physiotherapy Board and Physiotherapy New Zealand (PNZ) continue to receive a large number of queries from practitioners relating to the COVID-19 Public Health Response (Protection Framework) Order 2021 (Order).

Below are some of the frequently asked questions and our responses as at 9 December 2021. It is likely that the rules will change with amendment Orders from the Ministry of Health that amend requirements or correct errors – as relevant changes come to our attention, we will endeavour to keep pace with them and provide updates and relevant information.

The Order is very new and has been released without substantial guidance on its effect. These FAQs have been provided to support the profession - they must not be considered definitive answers as to how the new Order will be interpreted or enforced.

If you are in doubt as to your legal obligations under the Order or any related legislation (including your health and safety at work obligations), we recommend you obtain legal advice.

The Board and PNZ are continuing to raise issues with the Ministry of Health arising from the Order.

Can physiotherapists require unvaccinated patients to be seen via telehealth?

While physiotherapists may have legitimate health and safety concerns about coming into close contact with unvaccinated persons, caution is necessary around physiotherapists requiring unvaccinated patients to be seen by telehealth. In some cases, telehealth may be an appropriate and effective means of delivering the services required by unvaccinated patients. Nevertheless, physiotherapists must take care not to refuse patients access to designated premises, or to refuse to provide services patients require at those premises, because of the patient’s vaccination status.

Physiotherapists should conduct a risk assessment to identify what measures are appropriate and justified to enable them to work safely with unvaccinated patients. This may include requiring additional PPE; requiring a negative COVID-19 test (if clinically justified) before seeing a person or adjusting the services.

Adjustment to the services may involve offering unvaccinated patients telehealth appointments, or potentially offering to refer them to another physiotherapist who is better equipped to see them in person.

However, physiotherapists dealing with patients in this way should have good reasons -- as part of their risk assessment -- for doing so and should be satisfied that a telehealth assessment (or referral) is appropriate in the circumstances.

If a patient insists on being seen by a particular physiotherapist for a service that requires close contact, refusing to do so on vaccination grounds is likely to contravene the Order.

Can physiotherapists require masks to be worn by all patients and those accompanying them in the clinic?

Patients - Where supported by a risk assessment, a physiotherapist may require all patients to wear masks in the clinic.

Visitors and those accompanying patients - Clause 23 of Schedule 6 & 7 of the Order requires persons to comply with face covering rule ‘when on the premises of a health service other than a pharmacy, but only if the person is not a patient or worker of the health service’.

This means those visitors and those people accompanying patients must wear a mask.

Can physiotherapists require those (patients and those accompanying them) who have mask exemptions to wear a mask in the clinic?

Yes. However, physiotherapists should take into account people who cannot wear masks for legitimate reasons (such as disabilities or breathing difficulties) as part of their risk assessments, and identify whether there are other ways (e.g., increased staff PPE) in which they can treat the patient safely.

Can physiotherapists allocate a separate space either within their existing clinic or at a different location/premises for unvaccinated clients?

The Order does not prohibit physiotherapists from allocating a separate space within their existing premises to see unvaccinated patients. However, if this step is taken it should be justified by a risk assessment.

Where physiotherapists operate multiple ‘designated premises’, they must be cautious about seeing unvaccinated patients only at certain premises. The Order prohibits refusing access to designated premises, or refusing to provide services from those premises, on vaccination grounds.

When supported by a risk assessment, physiotherapists may decide to book unvaccinated patients in at certain ‘designated premises’ in the first instance – particularly if those premises are safer for all involved.

For patients who insist on being accommodated at particular premises (e.g., because it is the only convenient location), physiotherapists should, as above, refer to their risk assessment to identify what measures are appropriate and justified to enable them to work safely with that patient.

Can physiotherapists ask the vaccination status of a patient?

In short, we do not consider that it would be unlawful for a physiotherapist to ask for a patient’s vaccination status, noting that the patient may refuse to answer this question.

The COVID-19 Public Health Response (Protection Framework) Order 2021 prevents a business or service in control of ‘designated premises’ from denying a person, other than a worker, entry to the premises on vaccination grounds. It also prevents a business or service in control of ‘designated premises’ from denying a person, other than a worker, access to those goods or services on vaccination grounds.

However, we do not interpret the Order as preventing physiotherapists from asking about the vaccination status of persons who are seeking access to health services. Put simply, clauses 31 and 32 prohibit the denial of access or services, but they do not prohibit questions asking for vaccination information.

In our view, obtaining information about the vaccination status of persons in their premises will continue to be an important part of health providers meeting their health and safety obligations, and different measures (e.g., additional PPE) may be warranted when providing services to unvaccinated persons. Therefore, you may request a patient’s vaccination status for reasons such as part of a health and safety screening to determine the most appropriate way of delivering health services to patients who may be unvaccinated.

Note: You must not ask a patient their vaccination status and then use that information as the reason to deny them access to designated premises or access to services at designated premises – that would be unlawful.

Disclaimer

This document provides a brief summary of the current rules as we understand them. It is likely that these rules will change as a result of amendment Orders from the Ministry of Health that change requirements or correct errors.

Please refer to the Order at the link provided above and consult the Ministry of Health for more detailed information.

Please note that the advice we provide is general in nature and is not a substitute for legal advice. You should seek advice from a lawyer should you wish to understand how the rules apply to your specific circumstances.


Subject: Physiotherapy services and gyms/exercise businesses sharing a space

Sent on on 3 December 2021 to all PNZ members

Kia ora tatou

A joint message from PNZ and Exercise New Zealand is below on physiotherapy services and exercise businesses sharing a space within the COVID-19 Protection Framework. Please note this is a summary of current guidance as we understand it and not a substitute for legal advice. Please seek advice from a lawyer should you wish to understand how the rules apply to your specific circumstances.

Background

The government recently released a new Health Order regarding the COVID-19 protection Framework. As a part of that order those providing health services wholly or partly funded by government, including physiotherapy are not permitted to request vaccination certificates from clients/patients.

In order to operate at Orange and Red, gyms and other indoor exercise businesses must limit access to those with My Vaccine Passes.

The Issue

This means that where physiotherapy services share a space with a gym there are conflicting rules.

The Ministry of Business, Innovation and Employment (MBIE) have advised that the Health Order sections that relate to access to health services must take precedence (clause 33 of the COVID-19 Public Health Response (Protection Framework) Order 2021 (SL 2021/386) – New Zealand Legislation refers).

The MBIE guidance is:

1) Where the physio and gym share a reception space but otherwise have separate spaces (eg the physio room is off the reception area) then both can operate, with the one restriction that while the gym is in operation physio clients cannot use the gym space unless they are members of the gym and have a My Vaccine Pass

2) Where the physio room/space is inside the gym’s exercise space, you have two options:

a) create a walkway from the entrance to the physio room that does not have direct airflow with the gym area, for example, this can be achieved with floor to ceiling partitions.

b) The same space can be a ‘gym’ for some hours, and a ‘physiotherapy treatment space’ for others as long as there is cleaning between each session and that when the physiotherapy business is operating no exercise activities are taking place that are not related to the physiotherapy operation

If you cannot create arrangements that can comply with the legal requirements, then the two activities are incompatible and one should stop.

Exercise NZ and Physiotherapy New Zealand understand this is not ideal. We continue to work together and seek pragmatic solutions with the Government agencies including MBIE, MoH and the DPMC.

Ngā mihi


Subject: COVID joint update - "Traffic Light" Order FAQ

Sent on 3 December 2021 by the Physiotherapy Board

IMPORTANT: Information in this update is based on the COVID-19 Public Health Response (Protection Framework) Order 2021 that came into effect at 11:59pm 2 December 2021.

It is likely that the environment will change with amendment Orders from the Ministry of Health that amend requirements or correct errors – as relevant changes come to our attention we will endeavour to keep pace with them and provide updates and relevant information.

Tēnā koe

We have received many questions regarding the Protection Framework Order that came into effect at 11.59, 2 December 2021. Below are some frequently asked questions and our responses.

Am I allowed to ask a patient’s vaccination status

In short, we do not consider that it would be unlawful for a physiotherapist to ask for a patient’s vaccination status.

The COVID-19 Public Health Response (Protection Framework) Order 2021 prevents a business or service in control of ‘designated premises’ from denying a person, other than a worker, entry to the premises on vaccination grounds. It also prevents a business or service in control of ‘designated premises’ from denying a person, other than a worker, access to those goods or services on vaccination grounds.

However, we do not interpret the Order as preventing physiotherapists from asking about the vaccination status of persons who are seeking access to health services. Put simply, clause 31 and 32 prohibit the denial of access or services, but they do not prohibit questions asking for vaccination information.

In our view, obtaining information about the vaccination status of persons in their premises will continue to be an important part of health providers meeting their health and safety obligations, and different measures (e.g., additional PPE) may be warranted when providing services to unvaccinated persons. Therefore, you may request a patient’s vaccination status for reasons such as part of a health and safety screening to determine the most appropriate way of delivering health services to patients who may be unvaccinated.

Note: You must not ask a patient their vaccination status and then use that information as the reason to deny them access to designated premises or access to services at designated premises – that would be unlawful.

Good reasons for which vaccination status may be requested might include:

  • As part of an overall health and safety assessment for at-risk physiotherapists, which could result in offering the patient the services they require an alternative physiotherapist or other health professional

In order to allocate suitable times for unvaccinated patients receiving services to protect the health and safety of at-risk patients who may attend the designated premises.

Can I offer telehealth to unvaccinated patients as an alternative?

As stated above, the Order prevents a business or service in control of ‘designated premises’ from denying a person, other than a worker, entry to the premises on vaccination grounds. It also prevents a business or service in control of ‘designated premises’ from denying a person, other than a worker, access to those goods or services on vaccination grounds.

This means if physiotherapists see patients for in-person appointments at designated premises, they must make these services available to both vaccinated and unvaccinated patients. You cannot triage patients to telehealth based on their vaccination status, if in-person services are required to meet their health needs. To do so would be to deny them access to health services.

Telehealth is still a recommended option for some patient groups, for example those who have reported any concerning answers (other than vaccination status) on a COVID-19 screening assessment e.g., signs and symptoms of COVID-19, recent close contact with a COVID-19 case etc. In those cases the denial of service would not be based on vaccination grounds.

At my clinic I see mainly private clients and only a few ACC clients – is my clinic ‘designated premises’?

Yes, the definition of ‘designated premises’ includes:
“…premises of health services that are partly or wholly funded by—

  1. the Ministry of Health:
  2. Oranga Tamariki—Ministry for Children:
  3. the Ministry of Social Development:
  4. the Department of Corrections:
  5. a district health board:
  6. Veterans’ Affairs New Zealand:
  7. the Accident Compensation Corporation:”

Therefore, premises of physiotherapy services that have any ACC clients, or clients funded by any of the above agencies will be considered ‘designated premises’. Premises of health services that are not funded by any of the agencies listed in clause 10 are not ‘designated premises’.

As part of my work, I see both ACC and private patients in their homes – are these homes ‘designated premises’?

Where the services provided at the patient’s home are not funded by any of the public agencies listed in clause 10, the patient’s home is unlikely to be “premises of health services” under the definition of ‘designated premises’.

Furthermore, even if the patient’s home is considered “designated premises” (e.g., because the health services provided at the home are funded by ACC) the physiotherapist providing the service would not be “a business or service in control of designated premises” under clause 32. It follows that physiotherapists could refuse treatment of unvaccinated patients at the patient’s homes if they do so in accordance with principle 4.5 of the Code of Ethics and Professional Conduct.

I have a close contact business within our physiotherapy service. They share the same waiting room. What are the rules for them and their clients accessing our premises? 

If you are a business or service in control of designated premises, you will be able to continue to operate at all levels of the Protection Framework as long as the requirements of the Order are met (contact tracing including scanning etc.)

If non-health services are located within your designated premises, they will need to operate under the framework as it applies to their services (close contact business etc.). Depending on how the framework applies to their services, they may only be able to see vaccinated clients.

The requirement to comply with different rules for different business co-located in the same premises may cause some challenges if both vaccinated and unvaccinated clients waiting to access services share waiting rooms, bathrooms or other facilities.

We understand that MBIE has advised that business should take all practicable steps to ensure separation of physiotherapy clients from the “non-health business” clients.

We offer classes within our physiotherapy service. What are the requirements around having vaccinated and non-vaccinated clients in the same class?

The term ‘health service’ is very broadly defined as: ‘a service provided for the purpose of assessing, improving, protecting, or managing the physical or mental health of individuals or groups of individuals’ s. 5(1) HPCAA (2003). This includes one to one, group rehabilitation and exercise classes, pool sessions etc. In our view, the term ‘health service’ is likely to include most, if not all, of the services that physiotherapists provide.

Whether the person delivering the class in ‘designated premises’ is a physiotherapist or not, participants in the class cannot be denied access on the grounds of vaccination status.

I already have collected vaccine certificates - can I still keep that information?

Vaccine certificates are personal information. You may collect personal information for a lawful purpose connected with an activity of your business where the collection of the information is necessary for that purpose. However, you must not keep that information for longer than is required for the purposes for which the information may lawfully be used.

Therefore, you may keep records of vaccination certificates to avoid making repeated requests of patients for this information where there is a valid reason to collect the information, (e.g., in accordance with your risk assessment and risk management plans). However, you must dispose of this information when vaccination grounds are no longer relevant to the delivery of services to those patients.

As I am now seeing vaccinated and unvaccinated patients, I am beginning to use more PPE. I am a private service. Am I expected to fund this myself?

Yes. While some services such as DHBs, educational facilities, private hospitals and aged care facilities are able to provide staff with PPE, to our knowledge there is no provision for Government/DHB funding of PPE for private businesses.

Disclaimer

This document provides a brief summary of the current rules as we understand them. It is likely that these rules will change with amendment Orders from the Ministry of Health that amend requirements or correct errors. You should refer to the Order at the link provided above and consult the Ministry of Health for more detailed information.

Please note that the advice we provide is general in nature and is not a substitute for legal advice. You should seek advice from a lawyer should you wish to understand how the rules apply to your specific circumstances.


Subject: COVID Update: Implementing the Health Order

Sent on on 2 December 2021 to all PNZ members

Kia ora tatou

We are very aware of the confusion the Health Order created yesterday. Note this Health Order was released at 10am yesterday morning and as we all know implementation is from 11:59pm tonight. There are three areas we are seeking further clarification

  1. The ability to include screening for vaccination status as part of a clinical risk assessment.
  2. How to balance the requirements of business owners to protect staff under the Health & Safety at Work Act with the requirements under the Heath Order that physiotherapists cannot deny entry to premises or services on the basis of vaccination status of the patient/client.
  3. Co-location of services in gyms or other shared space.

Today we have been working closely with the Physiotherapy Board, the Ministry of Business Innovation and Employment (MBIE), the Ministry of Health and Exercise New Zealand to ensure that the information is correct and consistent. We are committed to sharing this information as soon as we can, but we can't do this until we have some certainty.

Please note this is the information as we understand it and not a substitute for legal advice. Please seek advice from a lawyer should you wish to understand how the rules apply to your specific circumstances.

Ngā mihi nui


Subject: Physiotherapy Services under the Covid Protection Framework (the Traffic Lights)

Sent on on 1 December 2021 to all PNZ members

Kia ora

As of this afternoon we have received the awaited Public Health Order regarding the COVID-19 Protection Framework and Ministry of Health (MoH) guidance. You should have received a joint communication from PNZ and the Physiotherapy Board outlining the requirements for services under the Covid Protection Framework (the Traffic Lights).

With the protection framework to be introduced by government on Friday, the MoH guidance includes both a guidance statement and flowchart for determining how to operate through the framework.

Operating in the COVID-19 Protection Framework

Importantly the guidance statement notes that physiotherapy is exempt from the heath order and “exempt health services can continue to operate and are still required to meet certain requirements, including requirements to display QR codes, maintain contact tracing records. In addition to the requirements specified in the Order, infection prevention control precautions remain the primary mechanism to protect yourself and the people you see.”

Requiring vaccination certificates

The MoH guidance statement also identifies “to ensure that New Zealanders can access essential health services, a more limited subset of health services are prohibited from requiring vaccination certificates or vaccination. These health services must not deny access to premises or provision of goods and services on vaccination grounds. The health services that are subject to this prohibition are health services that are partly or wholly funded by certain government entities” and include ACC. Members are advised to be familiar with the MoH flowchart to determine how to operate through the framework regarding requiring vaccine certificates from patients.

Please note this means you cannot now ask vaccination status. You can screen for Covid symptoms and risk.

Further detail

Given this information has only just been shared by MoH, we are continuing to work with the Physiotherapy Board to understand further details.

This Order means that physiotherapy premises can operate regardless of the traffic light setting in your region. Because all practitioners and staff at the physiotherapy service are vaccinated the risk of Covid transmission is considered low regardless of vaccination status for patients.

Practices co-located in premises requiring a Vaccine Pass

This has been a question for many of our members. Clause 33 of the Health Order specifies that people need to have access to health services without being asked their vaccination status. This may require a separate entrance for access to the physiotherapy clinic.

We are very aware of how late this comes for your preparations. We remain committed to getting information out to members as soon as we have it. We will update with any amendments or clarifications.

There is a second webinar being planned with Duncan Cotterill and BMS in the next two weeks to consider the Framework implementation. Please do send through any questions between now and then.

Ngā mihi


Subject: COVID joint update - "Traffic Light" Order Issued

Sent on 1 December 2021 by the Physiotherapy Board

Tēnā koe

The Physiotherapy Board and PNZ have now received the COVID-19 Public Health Response (Protection Framework) Order 2021. We have provided the key points below.

Orders

The COVID-19 Public Health Response (Protection Framework) Order 2021 made by the Minister for COVID-19 Response has now been released. The Order comes into effect on 11:59 pm Thursday, 2 December 2021.

What does the Order mean for mean for Physiotherapists?

The Code of Ethics requires physiotherapists to have a full understanding of and comply with the laws and regulations that govern and impact on the practice of physiotherapy in New Zealand (principle 5.8). Physiotherapists therefore need to understand and comply with the Order.

What does this mean for physiotherapy services?

Physiotherapists providing health services are not included in the Order except under clause 103, which sets out COVID-19 provisions that apply to health services.

Health Services is very broadly defined as: ‘a service provided for the purpose of assessing, improving, protecting, or managing the physical or mental health of individuals or groups of individuals’ HPCAA (2003) 5(1). This includes one to one, group rehabilitation and exercise classes, pool session etc. and therefore includes most, if not all, of the services that physiotherapists provide.

The definition of ‘designated premises’ in clause 10 is critical because a business or service in control of designated premises must not deny a person, other than a worker, entry to the premises on vaccination grounds (see clause 31).
Designated Premises include premises of health services that are partly or wholly funded by

  1. the Ministry of Health:
  2. Oranga Tamariki—Ministry for Children:
  3. the Ministry of Social Development:
  4. the Department of Corrections:
  5. a district health board:
  6. Veterans’ Affairs New Zealand:
  7. the Accident Compensation Corporation

Furthermore, a business or service in control of designated premises from which health services are provided must not deny a person, other than a worker, access to those services (whether for that person or on behalf of others) on vaccination grounds (clause 32).

Under principle 4.5 of the Code of Ethic, physiotherapists are able to refuse treatment to patient with good reason. Arguably, the effect of this Order is to remove the ability of physiotherapists to rely on this principle when refusing treatment to patients at designated premises on vaccination grounds.

Other important points

  • Clause 33 states that a business or service in control of a premises must allow people access to designated premises for the purpose of accessing designated premises, or goods or services from those designated premises.

For example, if a physiotherapy clinic is situated within a gym setting, the gym must allow access for all patients to the physiotherapy clinic.

  • Section 103 requires physiotherapists
  • to have a QR code displayed
  • an alternative tracing record system and processes
  • systems and processes to ensure that the QR code or alternative contact tracing is completed.

Can I choose not to see unvaccinated patients for face-to-face appointments?

Under the Order physiotherapists are no longer able to deny access into designated premises based on vaccination status.

Importantly, patients may be denied access to services for other good reasons, which may include health and safety requirements of the service e.g., mask wearing, concerns following a COVID screening questionnaire, apparent Covid-19 symptoms, recent contact with Covid-19 infected people, or inappropriate or abusive behavior by the patient or their support persons.

What precautions do I need to take under the Protection Framework?

Infection protection control (IPC) precautions are the primary mechanism to protect yourself, your colleagues, and your patients. Clinical reasoning and risk assessment remain fundamental principles when considering how to provide face to face appointments.
It is recommended that physiotherapists continue with the following:

  • screening for COVID-19 symptoms prior to face-to-face appointment
  • infection prevention control measures including PPE where required
  • transmission precaution measures including consideration of ventilation

Face coverings

Under schedule 6 and 7 of the Order (cl 23):

Person must comply with face covering rule in specified premises or circumstance: (f) when on the premises of a health service other than a pharmacy, but only if the person is not a patient or worker of the health service.

While the Order does not require mask wearing by patients you may elect to require mask wearing on the premises as part of a risk assessment and management protocol.

Disclaimer

This document provides a brief summary of the current rules as we understand them. You should refer to the Order at the link provided above and consult the Ministry of Health for more detailed information. Please note that the advice we provide is general in nature and is not a substitute for legal advice. You should seek advice from a lawyer should you wish to understand how the rules apply to your specific circumstances.

If you have any queries that we can assist with, please contact us at Covid-19@physioboard.org.nz or call us on 04 471 2610.

Staying in touch

We have been really pleased to see practitioners supporting each other though our Facebook group and have welcomed your calls and emails.

If you have applied to join the Facebook group but have not yet been confirmed it may be because we cannot confidently identify you as a registered physiotherapist. This may be because your Facebook name is different to the name you are registered under, because you are applying via a business page, or because you have a very common name. The best way to ensure you are confirmed to the group is to supply your NZ registration number.

In the meantime, if you have any questions or feedback, or just need to have a supportive conversation, please get in touch.

Ngā mihi and stay safe


Subject: The COVID Protection Framework Announcement

Sent on on 29 November 2021 to all PNZ members

Kia ora

With the COVID-19 Protection Framework (traffic light system) taking effect this Friday, we’ve been strongly advocating for guidance from the Ministry of Health (MoH) and awaiting an updated health order so members know how to operate through the framework.

While PNZ is yet to see the protection framework health order, the government announced the settings this afternoon. Previous information is that health practitioners are exempt from the vaccine passes, unless they are based inside a facility that requires a vaccine pass to enter such as a gym. Our understanding is that physiotherapists can therefore operate across the protection framework without requiring COVID-19 vaccine certificates from patients, noting an ongoing emphasis on infection prevention and control processes.

It is anticipated that MoH will publish their detailed guidance for working within the framework over the next few days. We’ve advocated to MoH to ensure this considers the vital role of physiotherapists and includes clear direction for members.

When finally provided these will be on the Ministry of Health website here. If you have already downloaded the Awhina app the information will be uploaded here also. We appreciate members require more information on the framework and will share this once available.

Auckland, Northland and large segments of the central North Island will be at the Red setting on Friday 3 December. The rest of the North Island and all of the South Island will be at Orange, at least until 17 December. The settings will be reviewed on 13th November for the month from 18th December. From 17th January 2022 these settings will be reviewed fortnightly.

Booster shots

Many physiotherapists will have received their second vaccination at least six months ago. There new advice is that a booster shot is advisable. The Prime Minister noted health workers as a priority for the booster shots which are available from today.

Rapid Antigen Testing

The Ministry of Health have put out an update on Rapid Antigen Testing here.

One of the concerns for Rapid Antigen Testing (RAT) is these require a higher quantity of the virus to be present in the sample than other COVID‑19 testing methods. As a result, RATs are less sensitive at detecting cases, especially in asymptomatic people or people who are early in their infectious period. A positive result in any RAT requires a confirmation test by RT-PCR swab undertaken by a healthcare professional.

A RAT is ideally under the supervision of a healthcare professional, for example at GP clinics, pharmacies, school health clinics, and long-term care facilities. While these can be used the costs need to be borne by the business.

Thank you for your support

Ngā mihi nui


Subject: No Progress on Traffic Lights

Sent on on 26 November 2021 to all PNZ members

Kia ora tatou

We had expected that today we would have been able to provide some sort of guidance physiotherapy services outside of the DHBs under the Covid Protection Framework. Unfortunately there has been no clarity from either a Health Order or the Ministry of Health.

The latest Covid-19 Response (Vaccinations) Legislation was passed under urgency this week, but does not specify health service delivery. The Link is Here.

The Framework will take effect from Friday 3 December. The Prime Minister said that Minister Little and Minister Verral would be making announcements on health services under the Framework on Thursday, but so far these announcements have not been forthcoming.

We know these time frames are really tight and hard to manage. We are committed to sharing information as soon as it becomes available. We still don't have enough information to provide any guidance.

Ngā mihi nui


Subject: COVID Update - COVID Protection Framework

Sent on on 23 November 2021 to all PNZ members

Kia ora

We are very aware that as members you are keen to know the impact of the Covid Protection Framework on your practice.

So far this has been very unclear and we are advocating strongly to ensure that the messages that are coming from government that health services will be open under the Covid Protection Framework are a reality. This afternoon the Prime Minister has announced that the Covid Protection Framework will take effect from Friday 3rd December.

We continue to work with the Ministry of Health (MoH) to get clear guidance for physiotherapists working within the COVID-19 Protection Framework and were part of a meeting with MoH on 18 November, where the Chief Allied Health Professions Officer shared draft guidance on allied health professionals operating through the framework. Our feedback is that this MoH guidance is not currently adequate for physiotherapists and requires further refinement and clarity before publication. We look forward to this being updated and shared with the profession.

While we are committed to advocating to MoH to provide this guidance for members, we also anticipate that an updated Government Heath Order will be made enabling physiotherapists to provide health services through the protection framework (this would replace the current Alert Level Requirements Health Order). We expect this updated Health Order will be announced by Government this week, but cannot guarantee this. The Health Order will set the mandate and we will work with the Physiotherapy Board to clarify its legal impact for the profession. The Prime Minister has also said that Minister Little and Minister Verral will be making announcements on health services under the Framework on Thursday.

I know that you would like something more concrete to help your planning, but in this fast changing environment this level of certainty just doesn't exist, nor do the legal frameworks for us to create these.

Physios in DHB and education settings

Once again our thanks to those physios working in the DHBs around the country. Our Auckland based colleagues have been working with Covid realities for several months now. As the Covid numbers increase physios in other DHBs are also being affected. Please do check out the resources and work done by the Cardiorespiratory SIG including the updated guidance on PPE. DHB guidance for staff will override any messages from PNZ.

The lack of coordination between health and education has been a huge challenge for physiotherapists working in education settings. The Ministry of Education guidance for face-to-face meetings with students has a much higher barrier than the health guidance, despite advocacy requesting consistency. The Paediatric SIG do have some updates on this so please do check in with them. Again the Ministry of Education guidance will override any health guidance- sadly.

You can expect another message later this week as soon as we have something we can share.

Ngā mihi nui


Subject: COVID joint update - treatment of unvaccinated patients

Sent on 19 November 2021 by the Physiotherapy Board

Tēnā koe

As you may know, the Ministry of Health has released a position statement on pre-consultation testing of unvaccinated individuals in healthcare settings. This document is not mandatory but offers guidance for health practitioners regarding in person consultations with unvaccinated patients, and the issue of requiring a negative test for COVID-19 prior to a non-urgent consultation.

The Ministry’s view is that in in most cases, with vaccinated staff and other precautions in place, the risks are unlikely to be high enough to provide sufficient justification to not provide services in accordance with the HDC Code of Health and Disability Services Consumers’ Rights. The position statement points out that individuals seeking healthcare cannot be refused care because of their beliefs and that a practitioner’s personal beliefs regarding individuals who refuse to be vaccinated should not influence that practitioner’s duty of care for those individuals. The joint Board/PNZ Code of Ethics states the circumstances under which you are able to refuse to treat a patient.

Principle 4.5 of the Code of Ethics requires physiotherapists to have good reasons for refusing treatment to patients based on an objective assessment of relevant risks. If a patient poses a risk to your own health and safety or that of other patients or staff, you should take all reasonable steps to minimise the risk before providing treatment. Where treatment is refused, the patient should be informed of the reasons, alternative options of care and, where appropriate, referred to another healthcare provider. Therefore you are, as an autonomous practitioner, able to refuse to provide services to an unvaccinated patient based on their vaccination status (so long as you have taken the above matters into account). However, you are not able to refuse based solely on their beliefs.

The Ministry’s position statement confirms that health care workers have a right to be safe in their workplace and employers have a duty to ensure that their staff are able to work in a safe environment, in accordance with the Health and Safety at Work Act 2015. This means that appropriate actions should be in place to recognise risks and to reduce recognised risks to an acceptable level. The position statement advises that the actions taken to mitigate any risks must be reasonable and proportionate to that risk and, wherever possible, based on evidence. The Board has provided information on the management of Covid-19 related risks.

The remainder of the Ministry’s position statement addresses the risks of transmission from unvaccinated individuals and actions that may be taken to mitigate the risk of transmission. Physiotherapists may consider the Ministry’s guidance when conducting their risk assessments.

Get the full MOH position statement here.

Staying in touch

We have been really pleased to see practitioners supporting each other though our Facebook group and have welcomed your calls and emails.

If you have applied to join the Facebook group but have not yet been confirmed it may be because we cannot confidently identify you as a registered physiotherapist. This may be because your Facebook name is different to the name you are registered under, because you are applying via a business page, or because you have a very common name. The best way to ensure you are confirmed to the group is to supply your NZ registration number.

In the meantime, if you have any questions or feedback, or just need to have a supportive conversation, please get in touch. You can email us at physio@physioboard.org.nz or phone us on 044712610.

Ngā mihi and stay safe


Subject: COVID Update

Sent on 15 November 2021 to all PNZ members

Kia ora

As the Government continues to make changes to COVID-19 alert levels and Health Orders, we’re aware this is having an ongoing impact on members and are committed to keeping you updated with relevant information.

Thanks again for your ongoing support through these changes. Please see below for more on the COVID-19 Protection Framework, a reminder about PNZ membership instalment payments, a vaccination webinar for physiotherapy businesses and Resurgence Support Payments.

COVID-19 Protection Framework

With the Government indicating the COVID-19 Protection Framework will be introduced once 90% of eligible New Zealanders are fully vaccinated, PNZ is seeking clarification from the Ministry of Health (MoH) on physiotherapists operating within the framework. Without reference to physiotherapists or allied health currently in the COVID-19 Protection Framework, our Chief Executive is meeting with MoH as part of a working party on Thursday to clarify its introduction for the profession.

PNZ Membership Instalment Payments

Given the impact of alert levels, instalment options are available for members impacted by COVID-19. Individuals who are unable to pay the PNZ membership subscription in full at the time of application can pay in instalments. Please email pnz@physiotherapy.org.nz for more information.

Vaccination Business Webinar

PNZ members are invited to a webinar on the mandatory COVID-19 vaccination order and its impact on physiotherapy businesses. This has created questions for businesses who employ or contract physiotherapists and other support staff, including where employees are unwilling to be vaccinated, the impact of exemptions, bill of rights and privacy. To consider these issues, PNZ has organised for law firm Duncan Cotterill and our insurance partners BMS to conduct a one hour webinar this Wednesday at 6pm. Register here.

Resurgence Support Payments

In an October press release the Minister of Finance announced an increase in the amount and frequency of the Resurgence Support Payment. From 12 November this will be paid at a base rate of $3000 per business and $800 per FTE, up to a maximum of 50 FTE, until Auckland moves into the COVID-19 Protection Framework. For more visit Inland Revenue.

Clinical Guidance for COVID-19

Please be aware of updated National Institute for Health and Care Excellence (NICE) guidance on managing the long-term effects of COVID-19 available at nice.org.uk. Thank you to the PNZ Cardio-Respiratory SIG (CRSIG) for sharing these.

MoH have updated the PPE guidance for respiratory physiotherapists managing patients with COVID or of unknown COVID status. The CRSIG have contributed to this guidance document as part of their commitment to supporting the COVID response.

Ngā mihi


Subject: COVID Update

Sent on 2 November 2021 to all PNZ members

Kia ora

With the country currently in different alert levels, including the 3-step approach to Alert Level 3, and the Government introducing the COVID-19 Protection Framework, please see a summary of guidance for physiotherapists below to help clarify operations at each level.

As identified in an October message from PNZ and the Physiotherapy Board, the COVID-19 Public Health Response (Alert Level Requirements) Order enables physiotherapists to provide health services in person through Alert Level 3 provided they comply with actions identified at physioboard.org.nz.

Given the recent Government announcement that Auckland and parts of Waikato will soon move through the 3-step approach to Alert Level 3, please be aware that this Order is applicable through all of Alert Level 3 regardless of which step a region is in.

COVID-19 Protection Framework

Members are also encouraged to be aware of the Government COVID-19 Protection Framework to be introduced once 90% of eligible New Zealanders are fully vaccinated. While we don’t know exactly when this will apply, it’s important to be familiar with the framework as we understand this will replace the current alert level system.

ACC Payments in Alert Level 3

PNZ has been in contact with ACC regarding payments to physiotherapists treating patients in person through Alert Level 3. ACC have said that payments are released automatically under Alert Level 3, with no checking of the context of the appointment, and this has been the case since 10 September.

PNZ Position Statement: COVID-19 Vaccination for Physiotherapists

We recognise the news of mandatory vaccination for physiotherapists, as well as teams working in services, has created pressure for physiotherapists and their colleagues. PNZ has published a Position Statement on this available here. The Ministry of Health have also collated a guidance document for Persons Conducting a Business or Undertaking (PCBUs) and workers about the Order, including the process for reviewing vaccination status and guidance for managing staff who are unvaccinated.

Ngā mihi


Subject: COVID Update

Sent on 24 October 2021 to all PNZ members

Kia ora

Very late on Friday night, 22 October, the Public Health Order was passed. It comes into effect from 11:59pm on Monday 25 October. This Order requires health, education and corrections staff to be vaccinated for Covid-19 as part of the public health measures to prevent the spread of Covid-19.

The full Order is here.

The Physiotherapy Board and PNZ are likely to put out more information early next week. As promised this is the information we have for those who are preparing for the week ahead.

The Public Health Order

The following are the main points that relate to physiotherapists - it is not intended to be a full summary of the Order. Nor is this intended as legal advice.

  • Physiotherapists are included in the order as health practitioners registered under the HPCA Act. This covers all physiotherapists wherever they work. It applies equally to sole practitioners and to people working in large multi-disciplinary teams.
  • The order also includes all staff or volunteers working with health practitioners - "Workers who carry out work where health services are provided to members of the public by 1 or more health practitioners and whose role involves being within 2 metres or less of a health practitioner or a member of the public for a period of 15 minutes or more".
  • An exemption is possible provided that a GP, or other medical practitioner considers that the vaccination is clinically contradicted for the person; and provides this in writing. A physiotherapist or staff member who receives an exclusion can continue to work in their role.
  • Limited exclusions are possible. This requires an application to Hon Chris Hipkins as the Minister for Covid-19 Response for named individuals and will be required to show significant disruption to the health service and that role cannot be filled by a vaccinated worker. We have been told these have been very few in the existing mandatory vaccination orders and time limited.
  • The business owner is required to collect and store evidence of vaccination. MyCovidRecord is one way to do this. This shows only New Zealand vaccination records.
  • Any person who has not provided evidence of the first vaccination by 11:59pm on 15 November must be stood down.

Guidance For Businesses

The Ministry of Health have collated a guidance document for businesses to help implement the mandatory vaccination requirement. You can find this document here. It includes information for business owners including the process for reviewing vaccination status and the guidance for managing staff who are unvaccinated.

Note at present the only vaccine licensed in New Zealand is the Pfizer vaccine. There are no vaccines currently waiting for Medsafe registration.

The Ministry have committed to updating this as required. Please do let PNZ know if there is information missing or unclear in this document.

Ngā mihi


Subject: MoH Health Order for Vaccinations

Sent on 21 October 2021 to all PNZ members

Kia ora

To provide more detail on the current Order for Mandatory COVID-19 Vaccinations in the Health Sector, PNZ attended a webinar held by the Ministry of Health (MoH) yesterday afternoon.

MoH has now made available a webinar presentation and recording about the Order.

Key information, as identified in the presentation, is that:

  • The COVID-19 Public Health Response (Vaccinations) Order 2021 is expected to be updated to require workers in the health and disability sector to be fully vaccinated by 1 December 2021.
  • The Order is expected to come into effect at 11.59pm on 25 October 2021 and include professions currently registered under the HPCA Act.
  • The Order is expected to include roles by people who are in frequent contact, face-to-face contact, or are in close proximity to healthcare workers providing a health service.
  • My Covid Record is where you can see the date and dose for the COVID-19 vaccinations you’ve had in New Zealand.

If you have any questions please email healthorders@health.govt.nz.

We will keep PNZ members updated if we receive further information from MoH about the Order.

Ngā mihi


Subject: Operating in Alert Level 3

Sent on 20 October 2021 to all PNZ members

Kia ora

Following our 15 October joint email from PNZ and the Physiotherapy Board on how physiotherapists can see their patients under Alert Level 3, the information below is intended to provide further clarity for the profession on operating through this alert level.

Services at Alert Level 3

There have been significant changes to what services can be offered in Alert Level 3 over the last week. This is the result of concerted advocacy from PNZ, the Physiotherapy Board, practitioners and members of the public, and we thank everyone for your support. With a government Health Order providing an exemption for health services to operate in Alert Level 3, the Physiotherapy Board have said “there are no restrictions on whom you choose to provide physiotherapy services [and] it is your clinical judgement whom you choose to see.” Please read their full guidance here.

The Ministry of Health has now also updated their guidance for allied health. Notably references to urgent care have been removed. The Chief Allied Health Professions Officer has said this is part of the ongoing review of guidance which balances protecting the public and ensuring access to health services. As vaccination rates in the general population increase other levels of restrictions may ease. This revised guidance is a useful clinical tool and while this currently applies to Auckland and Waikato, it will be the new guidance for any region going into Alert Level 3 in the future.

Vaccinations

There is no further information on mandatory vaccination to what was announced by Minister Chris Hipkins on 11 October, although we understand an update is expected to come out this week. We’ll share more detail as soon as we have it and will again look to do so in a joint communication with the Physiotherapy Board. Mandatory vaccination, as currently advised by government, applies to staff in health services but not to patients. As such it is a practice decision regarding whether patients need to be vaccinated before a face-to-face service can be offered.

Ngā mihi

Thank you again for your support through alert levels and patience as information is made available by the government.


Subject: COVID update - seeing patients at Level 3

Sent on 16 October 2021 by the Physiotherapy Board

Tēnā koe

Before you consider seeing patients face to face under current Level 3 – please read

Physiotherapy at Level 3: Key requirements to re-open safely under the COVID-19 Public Health Response (Alert Level Requirements) Order (No 12) 2021.

As we have informed you of the recent COVID-19 Public Health Response (Alert level) Order it is possible for non-DHB physiotherapy clinics to start re-opening under Level 3. The Order requires physiotherapy practices to comply with the following under all Alert Levels:

  • Display of QR codes in workplaces (clause 9)
  • Workplace systems and processes to enable keeping of contact records (clause 11)

The above order is the mandatory legal requirements.

In addition there is a requirement as health professions you to take all the required precautions to practice safely AND mitigate risk related to the COVID-19 pandemic. Vigilance in meeting all infection control and protection is required during this time

We have provided advice for opening under Level 3 Alert level and before you considering opening safety for your patients please ensure you have read and are able to meet this advice.

Here are the ‘reopening points’, the advice in full can be found here.

  • Risk Assessment Screening must be used prior to the appointment (and re-checked on arrival) for all patients and support people attending
  • Use outcome of the Risk Assessment Screen questions to determine whether patient should be seen Face-to-Face OR Telehealth based on COVID -19 risk
  • Clinic environment prepared for seeing screened patients
  • Physio and patient to wear mask
  • QR code scanning and appointment book for contact tracing
  • Overarching Public Health precautions taken include:
  1. Ensure good ventilation
  2. Use of appropriate PPE
  3. Hand hygiene
  4. Cleaning protocols rooms and touch points between consults
  5. Waiting room precautions and maintaining physical distance of 2 metres within the waiting room

Contact us

If you have any queries, please contact us: physio@physioboard.org.nz or pnz@physiotherapy.org.nz

Ngā mihi and stay safe


Subject: COVID Joint update - How Physiotherapists Can See Their Patients Under Alert Level 3 (non-DHB settings)

Sent on 15 October 2021 by the Physiotherapy Board

UPDATE as at 15 October 2021 - please read this update here.


Subject: MoH Alert Level 3 Guidance

Sent on 13 October 2021 to all PNZ members

Kia ora

In our ongoing advocacy for physiotherapists to see patients in person through Alert Level 3 our Chief Executive and Professional Advisor met with the Ministry of Health (MoH) yesterday as part of a working group to address their Alert Level 3 guidance.

We again strongly stated our position during this meeting and the MoH Chief Allied Health Professions Officer agreed to a more permissive interpretation of the Alert Level 3 guidance, including that MoH will:

  • Change the current definition of Alert Level 3 urgent care.
  • Provide detailed responses to the 3-step approach to Alert Level 3 – we suggest adoption of recommendations in the PNZ and Physiotherapy Board letter to the Minister of Health.
  • Include reference to staff being fully vaccinated in the MoH Alert Level 3 flow chart.
  • Clarify PPE requirements for allied health professionals.
  • Clarify mask wearing for patients, particularly those with mask exemptions.

We’ve pushed for these changes to be ready for publication by the end of this week and look forward to the current MoH advice for community allied health, scientific and technical providers in Alert Level 3 being updated.

As you will have seen from the Physiotherapy Board message today, overnight there has been clarification that the proposed changes to the Public Health Orders for mandatory vaccination includes all health workers registered under the HPCA. This will include physiotherapists and all people working in physiotherapy practices. This Order has not yet passed through government but is expected this week.

Please also be aware that there is an online meeting for allied health professionals to meet with the Minister of Health at 6pm tomorrow, as part of World Allied Health Day. Please pre-register for this event here.

Ngā mihi


Subject: Continued Advocacy in Alert Level 3

Sent on 12 October 2021 to all PNZ members

Kia ora 

With Northland, Auckland and parts of Waikato in COVID-19 Alert Level 3, PNZ continues to advocate for physiotherapists. We’ve commenced this week by resuming our call for the Ministry of Health (MoH) to update their current advice for community allied health, scientific and technical providers in Alert Level 3 so that physiotherapists can see patients in person.

Following meetings with the Ministry last week, our Chief Executive met with the MoH Chief Allied Health Professions Officer yesterday and will do so again today. MoH have acknowledged recommendations in last week’s letter to the Minister of Health and we’ll be pushing for them to update the Level 3 guidelines in today’s meeting.

Support for our position

Thank you to all our members for your support. This continues to be in the media, including on One News over the weekend and Radio NZ yesterday, and other health professions have been in contact to extend their support. ACT Deputy Leader Brooke van Velden has also been in the news having written to Chris Hipkins asking the Government to allow physiotherapy under Auckland's Alert Level 3.

Vaccinations

We’re seeking further clarity on vaccinations for allied health professionals. In yesterday’s Government press release it is noted that high-risk workers in the health and disability sector are to be fully vaccinated by 1 December 2021 and to receive their first dose by 30 October. We’ll be raising this in discussions with MoH to understand the impact for physiotherapists across the profession.

Business Support

Applications are open for a new round of the Wage Subsidy and Resurgence Support Payments. More about these and other COVID-19 financial support is available at business.govt.nz. Also, the deadline to pay and file GST and provisional tax will be extended to 4 November subject to an Order in Council being passed. Read more at ird.govt.nz.

Health Reform Roadshow

PNZ has received an email from the Department of the Prime Minister and Cabinet (DPMC) regarding information sessions on the future health system. Sessions will be held in the South Island during October. Read more here.

Ngā mihi


Subject: Advocacy Through Alert Levels

Sent on 8 October 2021 to all PNZ members

Kia ora 

Our Chief Executive again met with the MoH Chief Allied Health Professions Officer yesterday to further push for physiotherapists to see patients in person during COVID-19 Alert Level 3, following our letter to the Minister of Health on Tuesday.

Through our advocacy, supported by members, the Physiotherapy Board and other allied health professions, MoH have now said they are open to updating their current advice for community allied health, scientific and technical providers in Alert Level 3.

As communicated in an email from the Physiotherapy Board yesterday, we have been involved in a working group with MoH again today where the guidelines were reviewed. At present the guidelines are unchanged, but some minor amendments have been suggested which need to be reviewed within the Ministry. The physiotherapist needs to exercise clinical judgment when considering which patients meet the criteria especially regarding deterioration of known conditions or functional impairment and cannot be delivered through telehealth. We should see an update to the MoH guidelines early next week. PNZ and the Physiotherapy Board noted that we need the next steps, and we’ll continue to advocate for how physiotherapists can operate safely in Auckland and the Waikato. Next week is shaping to be as busy as this one.

The MoH Chief Allied Health Professions Officer has said “my belief is that we can meet much of what you have outlined in the letter to Minister Little”. We are still working to ensure that is so.

Physiotherapists being able to operate through Alert Level 3 also continues to be mentioned in the media, including on yesterday’s Radio NZ Checkpoint. We appreciate this support.

Ngā mihi


Subject: Operating in Alert Level 3

Sent on 6 October 2021 to all PNZ members

Kia ora 

PNZ continues to advocate strongly for physiotherapists to be able to see patients in person within the Government’s 3-step approach to Alert Level 3. We appreciate all your support and since yesterday morning have met with the Ministry of Health (MoH), written to the Health Minister and been in the news advocating for physiotherapists to see patients in person.

Guidelines for Physiotherapists

While MoH has still not yet updated advice for community allied health, scientific and technical providers in Alert Level 3, our Chief Executive has met with the MoH Chief Allied Health Professions Officer to clearly state our position. To further reiterate that physiotherpists should be able to see patients in person in Level 3, we have sent a letter with the Physiotherapy Board to the Minister of Health raising concerns with the current situation and the lack of timely direction for Auckland non-DHB physiotherapists.

Our Chief Executive has also been in the media alongside Auckland-based member Yousif Mansour highlighting how physiotherapists and patients are suffering by being unable to operate during Alert Level 3 and, with other allied health professions supporting our message, we look forward to MoH updating their guidelines.

Please contact us at pnz@physiotherapy.org.nz if we can support your own communication to local Members of Parliament at this time.

Resurgence Support Payment

For everyone impacted by alert levels, please be aware that the Minister of Finance has confirmed a third payment of the Resurgence Support Payment (RSP) for the alert level increase that started on 17 August. Applications will open for the third payment on Friday 8 October, with more information available at ird.govt.nz.

Ngā mihi


Subject: COVID Update

Sent on 5 October 2021 to all PNZ members

Kia ora 

With the Government introducing a 3-step approach to ease Alert Level 3 restrictions in Auckland we’re working to understand the impact on how physiotherapists can operate and advocating that physiotherapists should be able to see patients in person from Alert Level 3 Step 2.

3-Step Approach

The Government has announced that from 11:59pm on 5 October Auckland is in COVID-19 Alert Level 3 Step 1. However, no dates have yet been provided for when the region will move to Steps 2 and 3.

Guidelines for Physiotherapists

As of this morning (5 October) the Ministry of Health has not published additional advice for community allied health, scientific and technical providers in Alert Level 3 and PNZ has requested an urgent meeting with the Ministry to state our position and clarify guidelines for physiotherapists operating at each Alert Level 3 step. We’re also working with the Physiotherapy Board to provide consistency in the guidelines.

Our position is that physiotherapists can make the clinical decision regarding care and take measures required to meet safety precautions, so should be able to see patients in person from Alert Level 3 Step 2.

We agree with members that there is a lack of clarity for the profession and will keep you updated on our continued advocacy through alert levels.

Ngā mihi


Subject: COVID Update

Sent on 1 October 2021 to all PNZ members

Kia ora tatou

What was meant to be a short sharp lockdown in mid-August now feels never ending for people in Auckland. Below is an update on what PNZ is doing at this time.

Working in the DHB

There are a large group of PNZ members who are working through this lockdown. To our members working in the DHBs we thank you for your efforts. We acknowledge the impact this has on you and your family members as each day you face the potential exposure to Covid. This outbreak, even more than the last year, has highlighted the daily challenges, especially those that are stepping forwards to work with the Covid positive and exposed patients! Working on these wards in PPE is tough, both physically and emotionally.

Impact on Private Practice

We know the impact ranges from huge to catastrophic.

You are working under the Alert Level 3 guidance which restricts face to face treatment. Telehealth remains the preferred treatment provision, but the take up of telehealth is not huge. One of the significant gains made last year was that ACC telehealth rates are the same as the rate for in-person treatment.

There are a number of government funded provisions to support business owners. The links to these are on the PNZ website here. If your premises are leased and the lease is based on the ADLS standard contract you may be eligible for rent relief. While this is an individual discussion with your landlord PNZ is aware of rent relief being offered at a range of 30-50%.

The current Level 3 guidelines were updated from last year. PNZ was involved in the redevelopment and we included the input from practitioners in this process. Lockdowns at both Level 4 and 3, were only expected to be for a short time. Obviously this is not the current Delta outbreak.

The guidelines are the same for all allied health providers – including dentists, physiotherapists, chiropractors and audiologists. If practitioners are not following the guidelines, they can be prosecuted. This would be initiated by a complaint to the Police and/or the appropriate regulatory authority.

What is PNZ doing?

We have been working on regular communication to members and keeping our website updated with the latest information. We work closely with the Physiotherapy Board of New Zealand (PBNZ), ACC and the Ministry of Health to ensure that the information is consistent.

We are currently advocating to the Ministry of Health around provisions for an extended lockdown and the impact on the profession. We are advocating to the Ministry of Business Innovation and Environment (MBIE) for bespoke support for allied health providers not able to operate at full capacity due to Alert Level 3 restrictions.

Unfortunately there is not much to report on these discussions at the moment, but the work is ongoing.

As we head into another weekend at Alert Level 3 with all of the uncertainty hanging over what announcement might be made on Monday our thoughts are with you, our Auckland based colleagues.

Ngā mihi nui

Sandra

Sandra Kirby

CEO


Subject: Alert Levels 3 and 2

Sent on 21 September 2021 to all PNZ members

Kia ora

With Auckland moving to COVID-19 Alert Level 3 at 11:59pm tonight and the rest of the country remaining at Alert Level 2, a reminder of the guidance for physiotherapists operating within these alert levels in a non-DHB setting is summarised below.

Please continue to follow your employer advice if working in a DHB, and thank you to all our members as we continue to move through alert levels. For more information visit covid.govt.nz and the PNZ website.

Alert Level 3

  • Virtual appointments should be provided where possible and is the preferred method of service delivery. Face-to-face appointments may be provided for urgent care only so long as professionals can take appropriate measures to manage public health.
  • Under Level 3, telehealth will be used for the majority of patients. It is only urgent cases where you can consider in your clinical judgement that you will undertake a face-to-face consultation. This means physiotherapy clinics cannot open their doors to see patients on a ‘business as usual’ basis.

Please refer to the Ministry of Health website for the current definition of urgent care for community allied health in Alert Level 3 and full COVID-19 Guidance for Community Allied Health, Scientific and Technical Providers in Alert Level 3.

Alert Level 2

Clinical reasoning and risk assessment remain the fundamental principles for considering care at Alert Level 2. Telehealth and virtual appointments are still the preferred option and please exercise extra caution when treating vulnerable groups. Clinicians will be able to see patients face to face if the following processes are in place. Please refer to the Ministry of Health website for further advice.

  • Screening for COVID-19 symptoms prior to face-to-face appointment.
  • Physical distancing measures.
  • Infection prevention control measures including PPE where required.
  • Transmission precaution measures including consideration of ventilation.
  • When considering travel within and between regions ensure all risks have been taken into account before undertaking to provide care to patients and traveling to receive training.
  • Group treatment (e.g., exercise classes) can occur so long as physical distancing is in place.

Upper Hauraki

There are special requirements for those who live in or have been to the Upper Hauraki area. This includes staying home, wearing a face covering when you leave home for necessities, and keeping 2 metres distance from people outside of your bubble.

Business Support

Please remember the Government has a range of COVID-19 financial support and a COVID-19 Business Helpline. There are also resources for looking after your mental wellbeing as well as that of your family, colleagues and employees. Travel across an alert level boundary remains strictly limited. However, if you do have employees needing to cross an alert level boundary you can apply for a Business Travel Document.

Ngā mihi nui


Subject: COVID Joint update - practicing at COVID Level 2

Sent on 7 September 2021 by the Physiotherapy Board

Tēnā koe

On Wednesday 8th September those outside of the Auckland boundary move into Alert Level 2. We again acknowledge the ongoing commitment of those in the Auckland region who are still in Alert Level 4, to keeping us all safe as we work towards getting this current outbreak under control. Kia kaha anō.

The Ministry of Health (MoH) informed us last night of the final guidance for community allied health, scientific and technical providers in Alert Level 2.

As with previous COVID-19 guidance from MoH this is for physiotherapists working outside of the DHB sector. Physiotherapists working in DHBs continue to provide essential services under all levels and each DHB operates its own pandemic plan.

As stated in the MoH guidance at Alert Level 2 telehealth and virtual appointments are still the preferred option. Extra caution is also to be exercised when treating vulnerable groups due to the transmissibility of the Delta variant.

Physiotherapists are to continue following MoH Guidance and the Physiotherapy Board Serious Events Standard alongside sound clinical judgement when deciding whether to see patients for face-to-face consultations.

Advice for community allied health, scientific and technical providers in Alert Level 2 (from MoH)

‘Clinical reasoning and risk assessment remain the fundamental principles for considering care at Alert Level 2. Telehealth and virtual appointments are still the preferred option and please exercise extra caution when treating vulnerable groups
Clinicians will be able to see patients face to face if the following processes are in place:

When considering travel within and between regions ensure all risks have been taken into account before undertaking to provide care to patients and travelling to receive training.

Group treatment (eg, exercise classes) can occur so long as physical distancing is in place.’

With many physiotherapists now beginning to commence providing services under COVID-19 Alert Level 2 it is imperative to have read and understood all relevant and current guidance and requirements, and have a plan in place as to how they will keep their patients, themselves, whānau and families safe.

There is guidance for face to face consultation here.


Subject: COVID Alert Level 3 Joint Board / PNZ update

Sent on 1 September 2021 by the Physiotherapy Board

Tēnā koe

On Wednesday 31 August those south of the Auckland boundary moved into Alert Level 3. We acknowledge those in the Auckland and Northland regions who are still in Alert Level 4. Kia kaha.

There has been ongoing work with the Ministry of Health (MoH) following the last lock down in 2020 and on Monday 30 August MoH released revisions to the ‘COVID-19 Guidance for Community Allied Health, Scientific and Technical (AHST) Providers in Alert Level 3’.

As with previous COVID-19 guidance from MoH this is for physiotherapists working outside of the DHB sector. Physiotherapists working in DHBs are providing essential services under all levels and each DHB has its own pandemic plan operating.

There are differences between the MoH guidance for COVID-19 Alerts Level 3 in 2020 and August 2021. This communication is to assist in the interpretation of the revised COVID-19 Alert Level 3 guidance; it does not replace the full MoH release. Please check the Physiotherapy Board and MoH websites regularly for updates and changes.

At Alert Level 4 MoH issued a Notice which was mandatory. At Alert Level 3 they have provided Information and Guidance that specifically defines what urgent is and under what circumstances a face-to-face appointment may be considered.

As stated in the MoH guidance at Alert Level 3 telehealth and other virtual methods of assessing and treating patients are the main method of service delivery in the community, due to the transmissibility of the Delta variant.

Physiotherapists are to follow MoH Guidance as well as the Physiotherapy Board Serious Events Standard and use sound clinical judgement as to whether their patient meets the criteria for a face-to-face consultation.

Covid-19 Alert Level 3 guidance - From the MoH 30 August 2021

MoH has updated the ‘Urgent Care’ criteria for AHST services delivered in Alert Level 3 [dated 30 August 2021].

The criteria have been expanded for use in the delivery of effective treatment, preventing deterioration or sustaining the progress of healing in other health conditions, while protecting the public from COVID-19.

The following statements in bold have been added to the scope of ‘Urgent Care’ services for Alert Level 3:

  • a condition which is life or limb threatening; or
  • treatment required to maintain the basic necessities of life; or
  • treatment that cannot be delayed or carried out remotely without risk of significant harm or permanent and/or significant disability, or
  • where failure to access services will lead to an acute deterioration of a known condition; or
  • where delay in access to services will impact the consumer’s ability to maintain functional independence and significantly negatively impact quality of life

AND

  • which cannot be delivered by a service which is currently operating or by clinicians that are already in contact with the patient for ongoing care.

Clinical Reasoning

At all times during Alert Level 3 the provider needs to ensure their clinical reasoning for choosing an ‘in person’ contact is within the scope of ‘Urgent Care’ criteria and can be justified in line with protecting the consumer.

The workforce is therefore asked to:

  1. Consider and weigh up the risk of contact to the consumer versus the risk of not seeing them, and the impact of deterioration on the consumer. (note: Refer to the Risk Assessment Guidelines for PPE on the MoH website. This will guide you on the level of PPE required.)
  2. Consider the appropriate use of digital technologies to facilitate delivery of services.
  3. Prepare an alternate plan for treatment and be equipped to respond to changed circumstances.

The full MoH guidance is available here (PDF).

In using this revised COVID-19 Alert Level 3 guidance:

  • deliver physiotherapy services via telehealth
  • if telehealth is not possible or has failed, use clinical reasoning and judgement to determine if the patient is urgent and meets the MoH criteria for a face-to-face consultation

There is guidance for face to face consultation here.


Subject: Moving Alert levels

Sent on 30 August 2021 to all PNZ members

Kia ora

You’re no doubt aware the Government has announced that all of New Zealand is in COVID-19 Alert Level 4 until 11:59pm this Tuesday 31 August. From Wednesday all areas south of Auckland are to move to Alert Level 3, with Auckland and Northland remaining in Alert Level 4.

Guidance for operating within these alert levels in a non-DHB setting is summarised below. Please continue to follow your employer advice if working in a DHB. For more information visit covid.govt.nz and the PNZ website.

Alert Level 4

  • Alert Level 4 advice from the Ministry of Health for all allied health and technical services is available here.
  • If you have a client that needs urgent face to face treatment they should be directed to the DHB services as emergency treatment. Telehealth is the only treatment that should be provided by community services.

Alert Level 3

  • Virtual appointments should be provided where possible and is the preferred method of service delivery. Face-to-face appointments may be provided for urgent care only so long as professionals can take appropriate measures to manage public health.
  • Under Level 3, telehealth will be used for the majority of patients. It is only urgent cases where you can consider in your clinical judgement that you will undertake a face-to-face consultation. This means physiotherapy clinics cannot open their doors to see patients on a ‘business as usual’ basis.

PLEASE NOTE this Alert Level 3 guidance was current at 30 August 2021. We have been advised that there is new guidance coming but this has not yet been received. We will update the website as soon as we are advised by the Ministry of Health. Please refer to the Ministry of Health and Physiotherapy Board websites for any updates.

Business Support

The Government has a range of COVID-19 financial support to help businesses including the Resurgence Support Payment, Wage Subsidy Scheme, Short-Term Absence Payment and Leave Support Scheme. There is also a COVID-19 Business Helpline and resources for looking after your mental wellbeing as well as that of your family, colleagues and employees.

If you have employees needing to cross an Alert Level Boundary you can apply for a Business Travel Document. Businesses can’t re-use travel documents applied for during previous alert level changes.

Ngā mihi nui


Subject: Thank you to our members in DHBs

Sent on 25 August 2021 to PNZ members identifying a DHB as their employer

Kia ora tātou

On behalf of all at PNZ, thanks to our members in DHBs during this sudden move to Alert Level 4. We’re conscious that many messages over this time focus on private practice and this certainly doesn’t mean we don’t recognise the critical importance of your work.

Our understanding is that each DHB implements a pandemic response that meets the community they serve and your guidance will be coming from your DHB.

We appreciate changes as the Ministry of Health responds to learnings from the international management of the delta variant and that with physiotherapists in DHBs regarded as essential workers this places additional challenges on you and your families.

Section 70 Notices

You may have seen the Ministry of Health media release from Monday 23 August. When people are identified as having been at a location of interest the Section 70 notice (from the Health Act 1956) places a legal requirement on people who were at locations of interest at the relevant times to follow instructions regarding isolation and testing. As essential workers, you are asked to regularly check the locations of interest, isolate immediately and get tested if you have been at any of these locations at the relevant times.

However please be aware there is a difference for you as essential workers if it is a member of your household who has been in a location of interest. You are not required to self-isolate if a household member has been at a location of interest or been categorised as a close contact, provided you are fully vaccinated, the household member in question has a negative test result and displays no symptoms.

Clinical Placement Supervisors

Particular thanks to DHB staff supporting physiotherapy students in clinical placements at this time. Given the current challenges to do this, your support for the future of the profession cannot be underestimated.

World Physiotherapy Day 8 September

The theme for this year’s World Physiotherapy Day is Long COVID. Thank you to the CRSIG committee who have provided a webinar on Long COVID and worked with PNZ to target GPs with information about the vital role of physiotherapists in assessing and treating Long COVID in New Zealand. You can read more about World Physiotherapy Day and watch the webinar here.

Keep in Touch

We’re in regular contact with our DHB Leaders SIG and hear about your work through other PNZ groups. We are also keen to hear from individual members. PNZ services are available for all members and if you do have particular queries, now or at any other time, please contact us through pnz@physiotherapy.org.nz.

Kia kaha, look after yourself and those closest to you.


Subject: COVID-19 Support

Sent on 23 August 2021 to all PNZ members

Kia ora

With the country in Alert Level 4 until at least Tuesday night our thoughts and thanks are again with all members.

The last week has been a challenge across the profession, particularly for our colleagues in DHBs facing an increasing number of moving issues including patient contact, staffing and places of interest.

Our private practice members and business owners are also again navigating highly restricted operations, and physiotherapy schools have moved to online learning and remote support.

Further to guidance available on the PNZ website and at covid.govt.nz, please find advice below on vaccinations and business support.

COVID-19 Vaccinations

With members asking about what to do if staff are vaccine hesitant, please be aware of Ministry of Business, Innovation and Employment advice on vaccines and the workplace available at employment.govt.nz.

Based on employment law and Ministry of Health guidance, the most appropriate approach is talking with the staff member about their concerns and the health and business benefits of vaccination. If they still choose not to be vaccinated the employer is within their rights to suggest they’ll not be able to treat patients due to health, safety and infection control concerns and therefore alternate duties will need to be considered.

It’s also recommended that members watch the PNZ hosted Immunisation Advisory Centre webinar with Dr Nikki Turner.

Business Support

The Government has made various COVID-19 financial support schemes available to businesses including the Resurgence Support Payment, Wage Subsidy Scheme, Short-Term Absence Payment and Leave Support Scheme. Please refer to business.govt.nz for current information.

Please also remember to call the COVID-19 Business Helpline if you have questions or require support: North Island 0800 500 362 and South Island 0800 505 096. This includes advice on employees, financial support, business continuity and finding expert help.

Navigating alert levels is a challenge and members are encouraged to access Government resources for looking after your mental wellbeing and that of your family, colleagues and employees.

Ngā mihi nui


Subject: Alert Changes to Service Provision at Alert Level 4

Sent on 19 August 2021 to all PNZ members

Kia ora tātou

Hope you are managing day two of this lockdown. Already with the rise in positive cases we can see the impact of the Delta variant.

The speed of the lockdown and knowledge gained about COVID, particularly this Delta variant, has meant that the guidance we had yesterday dated from May 2020 has been reviewed.

Late yesterday the Ministry of Health released new advice for all allied health and technical services, available here.

Dr Martin Chadwick’s message is:

With the move to Alert Level 4 it has given us the opportunity to review access to services in light of the Delta variant of COVID-19. This notice intends to minimise the confusion of multiple messages.

  • The Alert Level 4 health services scope of provision is to preserve life or limb only.
  • Level 4 is an emergency measure and has been put in place to be a transmission circuit breaker.
  • Health service provision should not be face to face other than to preserve life or limb.
  • Where possible all consultations should be via methods of telehealth.

We must not underestimate the transmissibility of the Delta variant; this is significantly different to the last outbreak. If your patient needs are urgent/acute and cannot be assessed, or treated via telehealth, please contact your local DHB and refer them to these services.

This status will not change until the Alert Levels drop and face to face consultations resume. Please consider your scope of practice, develop, and prepare alternate care plans and connect with your colleagues. We need to continue to protect each other, reduce risk and prevent transmission.

This notice will also be posted on the COVID-19 allied health, scientific and technical providers web page.

We will get through this together, working in partnership as a team of 5 million, kia kaha.

Martin Chadwick’s message to community providers is clear: if you have a client that needs urgent face to face treatment they should be directed to the DHB services as emergency treatment. Telehealth is the only treatment that should be provided by community services.

The Physiotherapy Board sent a similar message to physiotherapists on Wednesday 18 August. PNZ has worked with the Physiotherapy Board, Ministry of Health, ACC and the Allied Health Association to ensure that the guidance was consistent for all allied health services, not just physiotherapists. We are now confident this message is the same for all allied health professionals and the Ministry of Health website will be updated to reflect this position.

The other change since May last year that affects physiotherapists is the Serious Event Standard, which was recently adopted by the Physiotherapy Board. Alert Level 4 is considered a serious event under this standard. Please familiarise yourself with this standard as any guidance provided by the Physiotherapy Board under this standard is enforceable.

The ACC Provider update dated 18 August also reflected last year’s position. We expect this will be amended to be in line with the Ministry of Health guidance. We also remain hopeful that the swift and strict measures New Zealand imposes result in a shorter time spent in lockdown and a better health and economic outcome for all.

Ngā mihi nui


Subject: Alert Levels Update

Sent on 18 August 2021 to all PNZ members

Kia ora tātou

As of 11.59pm last night (17 August) all of New Zealand is in COVID-19 Alert Level 4. Auckland and the Coromandel Peninsula are Alert Level 4, likely for a period of 7 days. The rest of New Zealand is at Alert Level 4 initially for a period of three days.

This move is in response to a positive case of COVID-19 in the community in Auckland. The Ministry of Health website has published locations of interest. If you have been at any of these locations please follow public health advice.

Physiotherapy in Alert Level 4: What this means for you

PNZ has worked with the Physiotherapy Board on guidance for operating within COVID-19 alert levels in a non-District Health Board setting.

  • 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.
  • Please refer to the Physiotherapy Board guidance on seeing patients during Alert Level 4.
  • Telehealth services are in place allowing many patients who would usually have a face-to-face consultation to be assessed and treated during the Alert Level 4.

Please follow your employer advice if working in a DHB.

Government updates

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 and a wage subsidy eligibility tool. 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.

Ngā mihi nui

Thank you once again to all members for your commitment through COVID-19. Previous alert levels have shown that we are strongest when united and your support is much appreciated.

Stay home, stay safe, look after yourself and those closest to you.


Subject: Alert Level Update

Sent on 23 June 2021 to all PNZ members

Kia ora,

With Wellington moving into COVID-19 Alert Level 2 from 6pm tonight (Wednesday 23 June) and the rest of New Zealand remaining in Alert Level 1, links to Government financial support and details of the latest PNZ advocacy work are below.

For our Wellington members this is the first time we have experienced this for a while and we will follow our Auckland colleagues experience. At this stage we have till the end of this week at the current settings.

Please continue following guidance for physiotherapists operating at Alert Level 2 and Alert Level 1 in a non-DHB setting or your employer advice if working in a DHB.

PNZ Events

For events planned over the next week, the organisers will be making a decision around continuing or not. Please check your emails for any updates.

COVID-19 Government Support

After recent alert level changes the Government has announced the following additional payments and schemes for businesses. For a summary of all support visit business.govt.nz.

  • Short-Term Absence Payment to cover eligible workers needing to stay at home while awaiting a COVID-19 test result.
  • Leave Support Scheme helping businesses to help pay workers (including self-employed) told to self-isolate because of COVID-19.
  • As yet there has been no announcement regarding any specific wage subsidy schemes, but if this changes you will find the information here
  • Resurgence Support Payment helping businesses across the country affected by Alert Level increases. The Resurgence Support Payment is activated after each alert level change.

Small Business Cash Flow Loan Scheme through which businesses can borrow up to $10,000, or more if they have employees, and pay no interest if they pay back the loan within two years.

Physiotherapy In Alert Level 3

In our ongoing advocacy for physiotherapists to see patients in person during Alert Level 3, PNZ has been working with the Ministry of health on updated guidance for Alert Level 3. We are awaiting the final decision on this from the Ministry of Health. We will update our website information here as soon as we know. Hopefully we won’t need it this time.

Ngā Mihi Nui

Thank you again for all your ongoing work and support through the latest COVID-19 resurgence.


Subject: Bay of Plenty DHB COVID-19 Vaccination

Sent on 19 April 2021 to PNZ members in the Bay of Plenty region

Kia ora

PNZ has received the following email from the Bay of Plenty District Health Board regarding COVID-19 vaccination. If you have any questions about this process please email Covid.Immunisation@bopdhb.govt.nz.

BOP DHB Vaccine Update

Bay of Plenty District Health Board are working with health providers to ensure the COVID-19 vaccine is rolled out to whānau and communities throughout the Bay of Plenty region.

Currently, we are planning to book in Group 2 tier 2a and 2b. This is our frontline healthcare and social services providers. You can download a registration form template below for you to co-ordinate completion on behalf of your staff. Please do your best to complete all the fields including the NHI numbers and ensure you have a completed list of everyone in your organisation who is wanting to be vaccinated before you submit. Once completed, please submit your forms to Covid.Immunisation@bopdhb.govt.nz.

Each person on the Vaccination Registration form will be contacted directly by our booking team, who are scheduling the vaccinations. If you would like to make a block booking for your organisation, please indicate in your email when submitting.

Please remember when you send through the email to the booking centre, please send through the name and contact details (including a phone number) of the person who is willing to act as a liaison for the bookings for your organisation – our booking centre staff will then call you to liaise regarding times.

Link to the REGISTRATION TEMPLATE


Subject: Business Update

Sent on 7 April 2021 to PNZ business contacts

Kia ora

We hope you had a great Easter break and have started the week well. Please find a physiotherapy business owners update below including information on in-person treatments during Alert Level 3, New Zealand Immigration’s criteria for physiotherapists and PNZ business support research.

Physiotherapy in Alert Level 3

PNZ continues to advocate for in-person physiotherapy treatments during COVID-19 Alert Level 3, with our united voice now starting to have an impact. The Ministry of Health (MoH) position has been that health services should deliver telehealth as the first option in Alert level 3, unless the appointment is under a restricted definition of urgent care. Following last month’s letter and subsequent meeting between the PNZ Chief Executive and Minister of Health, MoH has now committed to reviewing their urgent care definitions under Alert Level 3 with the potential to broaden the definition of urgent care. Our PNZ Professional Advisor Chris Bloomfield is part of the MoH review working group on this and we look forward to updating members over the coming weeks. Our position remains that physios can make the clinical decision regarding urgency of care and take the measures required to meet COVID safety precautions. Read more about our advocacy work here.

Immigration Criteria for Physiotherapists

Anyone looking to hire physiotherapists during COVID-19 border restrictions should be aware that the New Zealand Immigration description of critical health and disability workers was updated in March. Whereas previously physiotherapists were not on the New Zealand Immigration critical list, they are now. Critical health and disability workers who are registered health practitioners, such as physiotherapists registered with the Physiotherapy Board may be able to travel to New Zealand while the border is closed. Read more at immigration.govt.nz.

Support for Business Owners

Following research to understand how PNZ can best support business owners, a report is now available at pnz.org.nz identifying which areas would be of most value. While PNZ already offers services in many of these areas this work has highlighted opportunities to strengthen our business owner offering. Thank you to everyone who contributed to this research. Your input is much appreciated and has informed how the physiotherapy business community is supported within PNZ’s new Strategy.


Subject: Alert Levels Update

Sent on 8 March 2021 to all PNZ members

With Auckland now in COVID-19 Alert Level 2 and the rest of New Zealand in Alert Level 1, links to Government financial support and details of the latest PNZ advocacy work are below.

Please continue following guidance for physiotherapists operating at Alert Level 2 and Alert Level 1 in a non-DHB setting or your employer advice if working in a DHB.

COVID-19 Government Support

After recent alert level changes the Government has announced the following additional payments and schemes for businesses. For a summary of all support visit business.govt.nz.

  • Short-Term Absence Payment to cover eligible workers needing to stay at home while awaiting a COVID-19 test result.
  • Leave Support Scheme helping businesses to help pay workers (including self-employed) told to self-isolate because of COVID-19.
  • Wage Subsidy March 2021 payment to support employers so they can continue to pay employees and protect jobs for businesses affected by the rise in alert levels on 28 February 2021.
  • Resurgence Support Payment helping businesses across the country affected by Alert Level increases. The Resurgence Support Payment is activated after each alert level change.
  • Small Business Cash Flow Loan Scheme through which businesses can borrow up to $10,000, or more if they have employees, and pay no interest if they pay back the loan within two years

Physiotherapy in Alert Level 3

In our ongoing advocacy for physiotherapists to see patients in person during Alert Level 3, PNZ has written to the Minister of Health and issued a press release highlighting that New Zealanders are being denied health treatment.

Having been told the Minister has noted our concerns, we'll continue to advocate on this and for physiotherapy in aged residential care at all alert levels. In aged residential care even a short term change can be irreversible and facilities have had stricter conditions than the general community.

Ngā mihi nui

Thank you again for all your ongoing work and support through the latest COVID-19 resurgence.


Subject: Alert Levels 3 and 2

Sent on 1 March 2021 to all PNZ members

Kia ora

With the change in COVID-19 alert levels over the weekend, please find a reminder below about guidance for operating at Alert Levels 3 and 2.

As of 28 February, Auckland is in Alert Level 3 and the rest of New Zealand in Alert Level 2. This is in place for seven days.

Operating in Alert Levels 3 and 2

In addition to Government information available at covid.govt.nz, PNZ has worked with the Physiotherapy Board on guidance for operating at Alert Level 3 and Alert Level 2 in a non-DHB setting. Please follow your employer advice if working in a DHB.

Alert Level 3

  • Virtual appointments should be provided where possible and is the preferred method of service delivery. Face-to-face appointments may be provided for urgent care only so long as professionals can take appropriate measures to manage public health.
  • Under Level 3, telehealth will be used for the majority of patients. It is only urgent cases where you can consider in your clinical judgement that you will undertake a face-to-face consultation. This means physiotherapy clinics cannot open their doors to see patients on a ‘business as usual’ basis.

Full Alert Level 3 guidance is available here.

Alert Level 2

Practitioners are able to see patients in person if the following processes are in place:

  • Screening for COVID-19 symptoms prior to in person appointment.
  • Physical distancing measures.
  • Infection prevention control measures including PPE where required.
  • Practitioners will be able to travel within and to the neighbouring regions to provide care to patients and receive training.
  • Group treatment (e.g. exercise classes) can occur so long as physical distancing is in place’. Please note regional restrictions on gatherings and class sizes may vary.
  • Full Alert Level 2 guidance is available here.

Regional Travel

Please note that personal travel into and out of an Alert Level 3 area is strictly limited. The covid.govt.nz website has an alert level boundaries map and information on applying for a personal travel permit.

Business Support

COVID-19 information for businesses is available at business.govt.nz. This includes a COVID-19 financial support tool and Business Helpline, 0800 500 362 (North Island) or 0800 505 096 (South Island).

Advocating for Physiotherapy in Alert Level 3

In line with our Ministry of Health submission, we continue to advocate for more physiotherapists to be able to provide services in Alert Level 3 and for physiotherapy access to aged residential care at all alert levels. Read more about our advocacy work here.

Ngā mihi

Thank you again for all your support. More COVID-19 information is available at pnz.org.nz.


Subject: Alert Levels 2 and 1

Sent on 18 February 2021 to all PNZ members

Like many of you, we were pleased to hear from the Government yesterday that Auckland is now in COVID-19 Alert Level 2 and the rest of New Zealand in Alert Level 1.

In addition to information available at covid.govt.nz, guidance is outlined below for operating at Alert Level 2 and Alert Level 1 in a non-DHB setting. Please follow your employer advice if working in a DHB.

Alert Level 2

Practitioners are able to see patients in person if the following processes are in place:

  • Screening for COVID-19 symptoms prior to in person appointment.
  • Physical distancing measures.
  • Infection prevention control measures including PPE where required.
  • Practitioners will be able to travel within and to the neighbouring regions to provide care to patients and receive training.
  • Group treatment (e.g. exercise classes) can occur so long as physical distancing is in place’. Please note regional restrictions on gatherings and class sizes may vary.
  • Full Alert Level 2 guidance is available here.

Alert Level 1

  • Physiotherapy clinics and services are open for routine face-to-face consultations under Alert Level 1, however protocols should be maintained by physiotherapists and services to maximise patient and staff safety, including ongoing risk assessment and appropriate infection prevention control procedures.
  • Full Alert Level 1 guidance is available here.

Face Coverings on Public Transport

Please note that as an additional precaution the Government are now requiring face coverings on public transport at Alert Levels 1 and 2.

Advocating for Physiotherapy in Alert Level 3

While the results of the Ministry of Health (MoH) consultation and PNZ submission on their approach to Allied Health services through COVID-19 are yet to be released, Chief Allied Health Professions Officer Martin Chadwick confirmed at our meeting on Tuesday that there are no changes planned for the list of essential service providers or service delivery at Alert level 3.

MoH accept there is an impact on wellness for many people and Dr Chadwick stressed that all health services, including GPs, are expected to deliver telehealth as the first option in Alert level 3. Physiotherapists and all other community based allied health providers can provide urgent care, with the definitions of urgent set out here. The Government response on early, short lockdowns in part recognises that longer lockdowns have the greater impact on wellness.

PNZ will continue to advocate on this issue, and for physiotherapy access to aged residential care at all alert levels. In aged residential care even a short term change can be irreversible and facilities have had stricter conditions than the general community. Read more about our advocacy work here.

COVID-19 Vaccine

Details of the Government COVID-19 vaccine strategy are available here. Please also read the MoH COVID-19 Vaccine and Immunisation Programme sector update. Current MoH advice to PNZ on the role of physiotherapists in helping administer vaccines, along with other COVID-19 information, is available at pnz.org.nz.

Ngā mihi nui


Subject: COVID-19 Business Support

Sent on 16 February 2021 to PNZ business contacts

Kia ora tātou

Following this week’s COVID-19 alert level changes the Government has announced additional support for New Zealand businesses. Please find links to information below which may be relevant to physiotherapy business owners as well as an update from ACC and PNZ’s work with the Ministry of Health (MoH).

Government Support

A summary of COVID-19 financial support and a financial support tool are on business.govt.nz. Businesses can also call the COVID-19 Business Helpline, 0800 500 362 (North Island) or 0800 505 096 (South Island), for advice on what financial help is available. The latest Government support includes:

  • A Short-Term Absence Payment to cover eligible workers needing to stay at home while awaiting a COVID-19 test result.
  • The Leave Support Scheme helping businesses to help pay workers (including self-employed) told to self-isolate because of COVID-19.
  • A Wage Subsidy Scheme, which will be available if there’s a regional or national move to Alert Levels 3 and 4 for a period of seven days.

Telehealth

Following PNZ discussions with ACC, providers have been informed that they will continue to enable telehealth where clinically appropriate across contracted services and Cost of Treatment Regulations. More details are in an ACC provider update sent by their team yesterday.

Advocating to MoH

MoH Chief Allied Health Professions Officer Martin Chadwick is meeting with allied health leaders, including PNZ CEO Sandra Kirby, today to discuss operating in Alert Level 3. As mentioned in yesterday’s email to all members, PNZ has advocated in a submission to MoH for clinics to be open in Alert Level 3. Our position is that there are limitations to telehealth services on patient outcomes and that Alert Level 3 restrictions should be relaxed. We look forward to updating you further following today’s meeting.


Subject: COVID-19 Alert Level Changes

Sent on 15 February 2021 to all PNZ members

With the Government announcing yesterday that Auckland is in Alert Level 3 and the rest of New Zealand is in Alert Level 2 until midnight this Wednesday, thoughts are with all our members at this time.

Operating in Alert Levels 3 and 2

Please continue to follow Government advice at covid.govt.nz. PNZ has worked with The Physiotherapy Board on guidance for operating in Alert Level 3 and Alert Level 2 in a non-DHB setting. Please follow your employer advice if working in a DHB.

Alert Level 3

  • Virtual appointments should be provided where possible and is the preferred method of service delivery. Face-to-face appointments may be provided for urgent care only so long as professionals can take appropriate measures to manage public health.
  • Under Level 3, telehealth will be used for the majority of patients. It is only urgent cases where you can consider in your clinical judgement that you will undertake a face-to-face consultation. This means physiotherapy clinics cannot open their doors to see patients on a ‘business as usual’ basis.
  • Full Alert Level 3 guidance is available here.

Alert Level 2

Practitioners are able to see patients in person if the following processes are in place:

  • Screening for COVID-19 symptoms prior to in person appointment.
  • Physical distancing measures.
  • Infection prevention control measures including PPE where required.
  • Practitioners will be able to travel within and to the neighbouring regions to provide care to patients and receive training.
  • Group treatment (e.g. exercise classes) can occur so long as physical distancing is in place’. Please note regional restrictions on gatherings and class sizes may vary.
  • Full Alert Level 2 guidance is available here.

Locations of Interest

As outlined in the latest Government updates, the change in alert levels follows three new community cases detected in the Auckland region with a connection to Taranaki. The Ministry of Health (MoH) have identified Locations of Interest in Auckland and Taranaki.

Business Support

The latest Government information for businesses is available at business.govt.nz. This includes a summary of financial support and a reminder that all businesses are required to display the official QR codes for the NZ COVID Tracer app.

COVID-19 Advocacy

PNZ has advocated for clinics to be open in Alert Level 3 in our submission to MoH on their approach to Allied Health services through COVID-19. As of last week there was no update from MoH and we’re continuing to follow-up with them to share with members.

ACC are still covering telehealth under Cost of Treatment Regulations and the physiotherapy contract. There is a regular meeting with ACC this afternoon in which we will check on any changes. Read about our other advocacy work here.

Ngā mihi

As always, thank you for your support and commitment at this time.


Subject: COVID-19 Alert Level 1

Sent on 8 October 2020 to all PNZ members

Kia Ora

With Auckland changing alert levels this week the whole of the country is now in COVID-19 Alert Level 1. Thank you again for your support and united voice as we’ve worked through the most recent COVID resurgence. Please find guidance below for operating in Alert Level 1 and an outline of our continued advocacy work on behalf of members.

Operating at Alert Level 1

The Ministry of Health (MoH) website outlines COVID-19 advice for allied health providers. Members working in District Health Boards are asked to follow the advice of your DHB and those in a non-DHB setting refer to Physiotherapy Board of New Zealand (PBNZ) information on seeing patients in Alert Level 1. The Government is also reminding everyone to maintain COVID-19 precautions at level 1 including acting immediately if you are sick, washing hands frequently and recording movements using the NZ COVID Tracer app.

Advocatng for Physiotherapy

Modelling suggests that New Zealand’s COVID-19 management will be ongoing into 2021 and PNZ continues to advocate for increased health funding of physiotherapy. We also need to be prepared that Aotearoa may again be in higher alert levels at short notice.

Together with PBNZ we have asked MoH to broaden the conditions in which physiotherapists can operate at higher alert levels. PNZ met with Chief Allied Health Professions Officer Martin Chadwick to propose that in-person physiotherapy treatments be permitted in Alert Level 3. However this was not agreed and MoH guidance is that physiotherapists provide treatment via telehealth. Our position remains that the work of physiotherapists justifies being open in Alert Level 3 and will continue to revisit this with MoH.

In addition, we’re advocating to Ministry of Health and the Aged Care Association for physiotherapists to have increased access to patients in aged residential care during Alert Levels. This is a challenging balance between protecting the frail elderly from infection and ensuring that this vulnerable population are able to maintain existing levels of mobility and maintain health. The aged care sector are currently erring on the side of preventing infection, but we can see this is not being consistently applied. It is another ongoing conversation.

COVID is dominating the health policies for the general election. If you are speaking with candidates in your electorate do make sure you share the Physio4NZ messages.

2020 PNZ Member Survey

Members have received an invite to complete the 2020 PNZ Member Survey over the last week. Please do take the time to participate, particularly as this year's survey includes further questions on the impact of COVID-19. Check your junk folder and email physiotherapy.per@researchnz.com if you haven’t received your invite.

Please Vote on the PNZ Executive

Finally, voting on the PNZ Executive and position of PNZ President opens tomorrow. Please look out for your invitation from electionz.com and vote.

Ngā mihi


Subject: Student placements in COVID-19

Sent on 23 September 2020 to all PNZ members

Kia Ora

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.

Ngā mihi


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.

Member Surveys

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!

Physiotherapy Outcomes

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.

Ngā mihi


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.

Read PNZ’s World Physiotherapy Day media release here and access the 2020 toolkit at world.physio.

Ngā mihi

Sandra Kirby


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.

Future Planning

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.

Kia kaha

Sandra

Sandra Kirby

CEO


Subject: COVID-19

Sent on 21 August 2020 to all PNZ members

COVID-19 Resurgence

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.

Business Support

Visit business.govt.nz for the latest COVID-19 business information and register here to receive COVID-19 updates directly from the Government. Some of the support available to businesses is below.

  • 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.

Kia kaha

Sandra

Sandra Kirby

CEO


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.

Updated Guidance

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.

Mental Wellbeing

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.

Kia kaha

I hope you have a good weekend

Nga mihi nui

Sandra Kirby

CEO


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.”

Public Information

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.”

Ngā mihi


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.

PNZ Office

Please continue to contact us as usual on 04 801 6500 or pnz@physiotherapy.org.nz, although be aware that we may be receiving higher call volumes at this time.

Ngā mihi


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 help@covidtracer.min.health.nz.

Ngâ mihi nui

Ashley


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.

While the MoH website has much of this information, key points are below. There are also updated MoH FAQs regarding COVID-19, PPE and infection control here.

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?

and

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

Further information on Alert level 1 is in a letter from the Ministry of Health, with advice on the NZ COVID Tracer app available on the MoH website and business.govt.nz.

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

Kia  ora,

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

Jade Walker-Clark

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

Sandra Kirby

CEO


Subject: COVID-19 Alert Level 2 guidance

Sent on 8 May 2020 to all PNZ members

Kia  ora,

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.

Nga mihi

Sandra


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.

Kia  ora,

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,

Jade Walker-Clark
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.

Government Updates

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.

Telehealth Guidelines

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 enquiries@humankind.nz.

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

Channels

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 pnz@physiotherapy.org.nz.

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.

Kia ora,

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.

Ngā mihi

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.

Employer Webinar

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.

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.

  1. Telehealth rates will be set at the equivalent in-person rates for providers working under the Physiotherapy Services Contract and Hand Therapy Contract.
  2. 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 physiotherapy@pnz.org.nz.

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.

  1. 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?).
  2. 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.
  3. Have a plan in your head of where YOU will go if/when you have to isolate yourself SEPARATE from your family / current bubble.
  4. 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.
  5. 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.
  6. 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.

Thank you

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.

COVID-19 Updates

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.

Thank You

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 louise@humankind.nz

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 louise@humankind.nz 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.

ADVOCACY

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 certification 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 pnz@physiotherapy.org.nz 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 louise@humankind.nz 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.

THANK YOU

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.

Take care.


Subject: COVID-19

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:

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.

ADVOCACY

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 pnz@physiotherapy.org.nz 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.

Kia kaha

Liz


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 physioboard@physioboard.org.nz

Noho ora mai

Physiotherapy Board


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.

Tēnā koe

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. 

Level Alert

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.

    The Allied health best practice guide for telehealth is here
    The Board's telehealth standard is here

    Thank you

    If you, your family or whānau are on the frontline of the COVID-10 response. You have our sincere thanks.

    Noho ora mai,

    Janice Mueller
    Chairperson (Physiotherapy Board)

    Liz Binns
    President (PNZ)

    Jeanette Woltman-Black
    Chief Executive (Physiotherapy Board)

    Sandra Kirby
    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.

    Member Queries
    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.

    Telehealth Services

    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.


    Subject: COVID-19

    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.

    ACC

    • 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 certification 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.

    ACC
    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.

    Employment Support
    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 pnz@physiotherapy.org.nz with “Humankind webinar” in the subject line.

    Thank You
    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.


    Subject: COVID-19

    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.

    Take care

    Liz Binns

    President


    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.

    Practices
    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.

    Events
    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 August 2023