|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.
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
- the Ministry of Health:
- Oranga Tamariki—Ministry for Children:
- the Ministry of Social Development:
- the Department of Corrections:
- a district health board:
- Veterans’ Affairs New Zealand:
- 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
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.