A PDF version of this standard is available here

Introduction

Ngā kiritaki hauora-health consumers have the right to expect delivery of safe, competent and contemporary services at all times, including when care is being provided under supervisory arrangements.

By incorporating whanonga mātāpono a te Māori: Māori principles, values and concepts into the delivery of Board-ordered supervision the aim is to enhance the outcomes of supervision for physiotherapists (whether Māori or otherwise). It equally applies to all physiotherapists subject to a Board order of supervision.

One tool available to the Physiotherapy Board and the Health Practitioners Disciplinary Tribunal to ensure the safety of the public is supervision under the Health Practitioners Competence Assurance Act.

This Standard includes the principles the Board considers central to safe and effective Board-ordered supervision. It applies only to supervision required as a result of a Board or Tribunal decision or order. For example, it does not apply to supervision as agreed between practitioners or as part of an employment or contractual relationship.

For clarity, “supervision” in terms of the HPCAA Act is a legal phrase with a specific meaning. While it is permissible to characterise other professional relationships as supervision, this does not bring them within the meaning of the term as defined in the HPCAA or this Standard.

Definitions

Board-ordered supervision means supervision ordered by the Board (or the Registrar as the Board’s delegate) or the Tribunal which has an educative/practice improvement element such as a competence programme or return to practice programme.

Practice means any role, whether remunerated or not, in which the individual uses his or her skills and knowledge as a physiotherapist.

Supervision has the same meaning as in the Health Practitioners Competence Assurance Act 2003, which is “the monitoring of, and reporting on, the performance of a health practitioner by a professional peer”.

Supervisor is a physiotherapist with current general registration who has agreed to assess and monitor a physiotherapist undertaking supervised practice and report to the Board about the performance of the physiotherapist under supervision and who, in the opinion of the Board, is suitably qualified and experienced.

Supervisee is a physiotherapist holding registration and an APC with conditions that require supervision and who is practising under the supervision of a supervisor to meet the objectives of a supervision plan.

Supervision Plan is a plan that is approved by the Board or Registrar as the Board’s delegate. It sets out the objectives and amount of supervision required, and how the supervision is to occur. Supervisors may also propose amendments to a supervision plan after the start of supervision, where change is justified.

Supervision report (interim or final) is a document detailing progress against the Supervision Plan. Supervision reports include information about whether or not the elements of the Supervision Plan are or have been achieved and, if not, measures to address them. Also included are any emerging issues and changes in supervisory arrangements. Supervision reports are to be submitted to the Board at agreed intervals and at the conclusion of the supervision. Additional supervision reports may be required where there are changes in circumstances or concerns about the physiotherapist under supervision.

1 – General Principles of Supervision

The following general principles apply to all Board-ordered supervisions:

1.1 A physiotherapist remains an autonomous practitioner even while under supervision. Accordingly, a Supervisee remains accountable for their professional conduct as a physiotherapist even if that conduct arises as a result, in whole or in part, from another physiotherapist’s breach of this Standard.

1.2 While the onus is on the Supervisee to adhere to the Supervision Plan, the Supervisor also has a responsibility to appropriately supervise the practice of the physiotherapist under supervision.

1.3 Supervision must be carried out in an atmosphere of respect, working collaboratively and to enhance the mana of the physiotherapist under supervision.

1.4 The Supervisor and Supervisee must be engaged with and treated with respect, as professional colleagues (and, for the avoidance of doubt, Supervisors and Supervisees are required to extend such respect). However, the Supervisee must also acknowledge and respect that the Supervisor has been put in place by the Board and must respond to the guidance and direction of the Supervisor within the supervision plan.

2 – Requirements of Supervisors

2.1 All supervisors must:

2.1.1 take all reasonable steps, in the context of the supervision plan’s requirements, to ensure that the Supervisee is practising safely;

2.1.2 ensure that the supervision is carried out in a way that is mana enhancing, non-judgemental, culturally safe and appropriate for the Supervisee’s particular circumstances;

2.1.3 follow any directions from the Board or Registrar in relation to the delivery of supervision including reports on the supervision;

2.1.4 engage respectfully with the Supervisee as a professional peer;

2.1.5 keep all matters related to the supervision confidential and not disclose them to parties other than the Board, except if required to obtain third party consent (for example to observe a treatment) or otherwise as required by law;

2.1.6 work collaboratively with the Supervisee to engage in the supervision plan;

2.1.7 provide reports on the supervision accordance with any guidelines issued by the Board;

2.1.8 be clear about how and when the Supervisor can be contacted by the Supervisee whenever he/she is practising;

2.1.9 ensure that, in the context of the supervision, the Supervisee understands their legal responsibilities and the constraints within which they must operate; follows the Code of Ethics and Professional Conduct that apply to the profession; and acts in accordance with the directions of the supervisor and the supervision plan;

2.1.10 disclose to the Board any potential conflict of interest, such as personal or professional relationships or business relationships with the Supervisee;

2.1.11 notify the Board immediately if:

• the relationship with the Supervisee deteriorates to a dysfunctional level or is ineffective;
• there are concerns that the performance, conduct or health of the Supervisee is placing the public at risk;
• the Supervisee is not complying with conditions imposed, and/or undertakings accepted by the Board;
• the Supervisee is not complying with the supervision plan or there are any significant changes proposed to that plan; or
• the supervisor is no longer able to provide the level of supervision that is required by the supervision plan.

2.1.12 understand the significance of supervision as a professional undertaking and commit to this role including regular, protected, scheduled time with the Supervisee, which is free from interruptions and as required by the supervision plan.

2.2 Supervisors who are delivering Board-ordered supervision must, in addition to the requirements above, ensure that the supervision is delivered in accordance with any Board guidance on Board-ordered supervision.

2.3 Supervisors must not:

• alter the Supervision Plan, or the Board’s requirements as set out in the Plan, without the Board’s prior written permission (although they may request changes to the Plan)
• seek information, documents or records, or require physiotherapists to do anything as part of the supervision, that is not set out in the Supervision Plan or rationally connected to the requirements of the Plan.

3 – Requirements of Supervisees

Physiotherapists under supervision must:

3.1 at the outset and in conjunction with the Supervisor, establish their learning needs, the context relevant to the need for supervision and any other issues that may impact on an effective supervisory arrangement;

3.2 participate in the supervision in a way that is mana maintaining, respectful, non-judgemental, culturally safe and appropriate for the Supervisor

3.3 take joint responsibility for establishing a schedule of regular meetings with the Supervisor and make all reasonable efforts within the Supervisee’s control to ensure that these meetings take place

3.4 be adequately prepared for meetings with their supervisor

3.5 participate in assessments conducted by the Supervisor to assist in determining future supervision needs and progress

3.6 seek guidance and assistance, and follow directions and instructions from their supervisor as required

3.7 familiarise themselves and comply with regulatory, professional and other legal responsibilities applicable to their practice under supervision

3.8 advise their supervisor immediately of any issues or incidents during the period of supervision which could have an adverse impact on public safety ( e.g. professional conduct, ethics and competence)

3.9 reflect on, critically analyse, and respond to constructive feedback provided during the supervision

3.10 inform the Board and Supervisor if the conditions or requirements of their supervision are not being met, or if the relationship with the Supervisor becomes dysfunctional.

3.11 notify the Registrar if the relationship with the supervisor becomes ineffective or has broken down