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COVID-19 Update – 9 April, 2020

Update and summary of guidance and information

As you, your friends, family, whānau and other colleagues are all coming to grips with life in Alert Level 4 there is an unwavering commitment to do our bit, stay in our bubble and find ways to look after ourselves and those around us.

Some physiotherapists are working in hospitals, some are providing telehealth services to their patients, others are providing care that is critical while others have closed their practice and are waiting it out.  No matter what the situation – it is stressful, worrying and has so many unknowns.

There are lovely stories we are told of physiotherapists volunteering in their community and delivering food to the elderly, doing grocery shopping for others, lawns being mowed and how they are caring for their elderly parents. There are so many stories of amazing physiotherapists stepping out and doing amazing things.We all have loved ones or those we cherish.  Some have brought them into your bubble, others are not able to do that and that in itself is difficult for some.  We have a significant number of internationally trained physiotherapists practising here – contact with their families overseas is severely constrained and difficult.  The conversations over the last week have been full of emotion and just having someone to talk to we hope has helped. The skills of physiotherapists are amazing and this includes being very good listeners.  Keeping connected is so important at this time. Physiotherapists are a community that we are wanting to facilitate the ability for you to connect up with each other for some collegial support.  We have therefore set up a closed Facebook group for New Zealand Registered physiotherapists to connect with each other and with us during the COVID-19 response. You can click here to join it.

JOIN THE GROUP
We are also still here at the end of the phone or email and more than willing to talk to you – we have connected with so many of you.  We are saddened by the stories and the situation but it is so much worse for you going through it. We do understand and we do care and will do what we can to help.

Our Priority

Our main priority is to have as many physiotherapists able to practise. 

This means we have done things we have not done before:

  • Waiving some fees
  • Payment for an APC by instalment
  • Being on the phone listening and consoling physiotherapists in distress
  • Developing a list of physiotherapists with capacity to help
  • Working with the Ministry of Health, PNZ and ACC to establish the definitions of essential and non essential for physiotherapy during this time
  • Practical advice on telehealth
  • Encouraging the full extent of the Board Standard on Telehealth
  • Connecting physiotherapists with colleagues so they have someone to talk to
  • Providing emotional and mental health service help links

We hope they help as we all find our way through this strange and difficult time.

ACC – Telehealth, Essential Services, and Personal Protective Equipment

Over the last weeks, the COVID-19 response has been constantly evolving and changing. One of the most challenging and confusing situations was the ACC funding of telehealth. Physiotherapy New Zealand and the Board have been working proactively to have telehealth funded by ACC as per the Physiotherapy Board Standard.

ACC have now confirmed telehealth funding rates. You can find these rates and other ACC information on telehealth here.

ACC have also issued an email update to health professionals regarding PPE and what roles are essential during the COVID-19 response. We have provided a copy of this here.

ACC have been updating their advice on a daily basis we recommend visiting their COVID-19 site for the latest information.

There are further telehealth resources here.

COVID related clinical resource

Dr Julie Reeve, from AUT’s physiotherapy school has sent through very helpful guidelines for the physiotherapy management of patients affected by COVID 19. The full document is here.

Many thanks to Physiotherapy New Zealand’s Cardio Respiratory Special Interest Group for identifying the following resources.Physiotherapy Management for COVID-19 in the Acute Hospital Setting
This document outlines recommendations for physiotherapy management for COVID-19 in the acute hospital setting. It includes recommendations for physiotherapy workforce planning and preparation, a screening tool for determining requirement of physiotherapy, recommendations for the selection of physiotherapy treatments and personal protective equipment

Respiratory physiotherapy in patients with COVID-19 infection in acute setting: Italian Respiratory Physiotherapists
Consensus between Italian Physiotherapists with specific expertise in respiratory care working with COVID 19 patients in the north of Italy.

Joint statement on the role of respiratory rehabilitation in the COVID 19 crisis– the Italian position paper

Open access online cardiorespiratory physiotherapy courses

The Coronavirus Disease Programme is a four part course hosted by Physiopedia and is free to sign up and access for a month.
1. Introduction to Coronovirus
2. Infection prevention and control
3.The role of physiotherapy in COVID-19 and
4.Respiratory management of people with COVID-19.

NSW Physiotherapy Virtual Cardiorespiratory ICU Update with focus on physiotherapy in COVID 19 cases  is a two day recorded audio with powerpoint and course resources
The purpose is to provide physiotherapy staff with an update in cardiorespiratory physiotherapy practice for intensive care, and planning for potential roles of physiotherapy in the management of COVID-19 patients in this environment.
This two day virtual training course provides a refresher and update for physiotherapy staff working in ICUs with increasing cases of COVID-19 and ventilated patients. This course combines key topics from the APA Cardiorespiratory Physiotherapy Level 2 – ICU course and incorporates COVID19 respiratory management based on The Australian and New Zealand Intensive Care Society (ANZICS) COVID-19 Guidelines and COVID 19: Respiratory Physiotherapy On Call Information and Guidance from NHS.
Training is best suited to base-mid grade physiotherapists who have prior skills and experience in Intensive Care Units / High Dependency Unit

The Clinical Skills Development Service is committed to healthcare improvement through training, collaboration and innovation.  It has a number of free online cardiorespiratory physiotherapy courses (as well as other physiotherapy courses)

Physiotherapy and Critical Care Management is a course run by the Clinical Skills Development Service and is suited to those with a respiratory skill set.
PaCCMan contributes to the learning and development of physiotherapists for work in the intensive care environment and expands their knowledge of contemporary, safe clinical practice. It includes practical sessions on assessment and clinical skills, as well as simulated experiences in providing respiratory care and rehabilitation.

New Zealand Specific COVID 19 resources

Keep up to date with the latest information from the Ministry of Health and review the information around PPE to familiarise yourself see below.

 

Your wellbeing

This is an extremely stressful time for all of us. The Institute of Wellbeing and Resilience has developed some tools for coping with the mental impact of the COVID response. This is available here.

If you just want to connect with other practitioners via social media you can join our Facebook group here.

There’s also useful information about maintaining mental health available here.

Guidelines for critical / life and limb threatening care during lockdown

We are still getting a few  questions of what is critical/ acute/life and limb threatening.

We have developed a flowchart  to assist you here – if you have other questions just give us a call or an email – we are happy to discuss and assist you in your decision.

Logging Essential Service (non-Hospital) work

If you do need to travel for essential work and do not have an employer letter to confirm this you can log your name with the Board. This is to provide you with confirmation of your role if you are stopped by Police.

The situations we are seeing are primarily self-employed who do not have verification from an employer or ID to verify they are a physiotherapist providing an essential critical / life and or limb preserving service.  The Police have supported this initiative which is great so this will assist you in the event you are pulled over when you are on your way to see your critical patient.

If you have any concerns, queries or wish to discuss the situation of providing essential care– please call the Board on +64 4 471 2610 to speak to one of the Professional Advisors or email them at physio@physioboard.org.nz.  They will discuss the situation with you and provide you further guidance if required.

Annual practising certificates (APCs)

There have been 5,203 APC’s issued for the 1 April 2020 until 31 March 2021. This is lower than this time last year by 485.  There is usually about 190 who we “lose” and have generally gone overseas and not let us know they will not be back. The numbers are a bit higher this year and we will be contacting those who have not updated to see if they intend to or need assistance.

There are a number of options available so if you are unsure please contact us and speak to one of the Registration Team and they can discuss with you those options.
We understand that deciding whether to renew your APC may be stressful for some practitioners at this time. The Board has therefore:

  • Waived the Late Application Fee for an APC, which would otherwise apply after 1 April 2020 for the 2020/2021 practising year
  • Offered an instalment payment option for the APC application fee payable for the 2020/21 practising year. This option involves an initial payment of 10% of the fee upon application with the balance payable by instalments (yet to be determined by the Board) after 1 October 2020 and prior to 31 March 2021. This instalment payment option became available from 24 March 2020 and will remain available for physiotherapists wishing to renew their APCs until 30 September 2020.

Financial Support and advice

Please refer to the Government’s COVID-19 financial support page for information about support if you are experiencing financial difficulty at this time or talk with your employer.

We are at the end of a phone or an email (or a Facebook post)

We want to help the physiotherapists and do what is right for the profession.  Many of you will be reaching out to colleagues, friends, family and whānau – you can also give us a call.

We have professional advisors and others on the team who are more than happy to take a call, give you a ring, listen and provide any guidance we can.

Being connected is important as we all move through this period. Once again, you can join our private Facebook group here.

Working together

We have been so grateful for the lovely messages – thank you to those who have taken the time to do that.  We really appreciate them.

Positive feedback is so nice – we do not mind if there is something less positive and you wish to discuss that with us.  We do want to hear from you if there is anything we can do to assist you.

Please keep letting us know if our messaging and guidance is working for you and if you have any ideas – we are open to hearing them. You can let us know by sending us an email at physio@physioboard.org.nz.  Or if you want to talk to one of us please ring +64 4 471 2610. We will do our best to get back to you as soon as we can.

Thank you for taking the time to read this,

Noho ora mai,

Janice Mueller
Chairperson (Physiotherapy Board)

Jeanette Woltman-Black
Chief Executive (Physiotherapy Board)