The Order is very newand 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.