A PDF version of this standard is available here

Introduction

Registered physiotherapists may choose to work in a specific or ‘defined field’ of practice within one or more core areas of physiotherapy, or within a subspecialty of those areas. The defined field in which a physiotherapist works may change throughout their career. This notwithstanding, all physiotherapists must ensure they have appropriate and current training, knowledge, and competencies to work safely within their chosen fields of practice.

The Board has described the Scope of Practice – Physiotherapist (general scope) sufficiently broadly to meet evolving healthcare needs. Over time, physiotherapists may change their field of practice, existing fields of practice may alter or expand, and new fields of practice may emerge.

In all cases, ensuring the health and safety of the public is paramount.

Definitions

A ‘defined field’ means a field of practice within one or more scopes of practice defined for the physiotherapy profession. Examples may include, without limitation: Musculoskeletal, Cardiorespiratory, Neurological Rehabilitation, Paediatrics, Sports, Pelvic health, Older Adults. Nonclinical examples may include education, case management, or research.

A defined field may be one or more areas of practice in which the physiotherapist works, irrespective of the title or description used by the physiotherapist to describe their practice.

References in this standard to practising in a defined field include physiotherapists working in:

• their current field of practice, a field of practice new to the physiotherapist, or one which has not been practiced recently by the physiotherapist
• existing, new or emerging fields of practice not included in physiotherapy undergraduate programmes. Examples may include, without limitation, hand therapy and acupuncture.

Physiotherapists who are unsure if their defined field falls within the general scope or meets the criteria described in this standard must contact the Physiotherapy Board for guidance.

New Zealand Law

Health Practitioners Competence Assurance Act 2003

Health Practitioners Competence Assurance (Restricted Activities) Order 2005

1. Adequate level of knowledge and competence

• As autonomous practitioners, physiotherapists choose the defined fields in which they practise. In all cases, a physiotherapist must demonstrate an adequate level of knowledge and competence in each of their fields of practice. They must also complete or be currently undertaking, relevant, sufficient, and appropriate education and training and continuing professional development (CPD) to maintain such knowledge and competence. This includes completing appropriate education, training, and CPD to maintain knowledge and competence for performing existing or evolving skills, techniques, and tools for assessing and treating. Examples may include, without limitation, injections, acupuncture or cervical manipulation, and the competencies, along with clinical reasoning required, to practice these within that defined field.

• Physiotherapists who perform activities within their defined field such as cervical manipulation, injections, acupuncture and other techniques must follow all applicable standards issued by the Board, and give due regard to: any guidance issued by the Board; evidence-based guidelines issued by experts within the physiotherapy profession including relevant Special Interest Groups of Physiotherapy New Zealand; and relevant standards issued by recognised professional organisations outside the physiotherapy profession.

2. Education, training and CPD

• Physiotherapists must ensure they undertake and maintain appropriate, and recognised, education and training programmes as necessary to maintain their competence to practise in their defined field, including by undertaking relevant and ongoing CPD and peer reviews.

3. Self-evaluation

• Physiotherapists must undertake self-evaluation as necessary to obtain an informed perspective on the safety and competence of their practice in their defined field. Self-evaluation may include the following questions:

• Is the education and training I have undertaken or am currently undertaking in my defined field recognised by my peers as being appropriate for safe, evidence-informed practice?
• Am I continuing to update and maintain my knowledge in my defined field of practice? Clear evidence for this must be included in any recertification documentation requested by the Board.
• Am I continuing to undergo suitable peer reviews with a professional colleague who has appropriate knowledge and experience in my defined field?
• Have I good reason to consider that I am competent to undertake the physiotherapy services I perform in my defined field?

If any answer to the above questions is no, it can be concluded that the physiotherapist is not competent to provide physiotherapy services in that defined field and should cease doing so. Physiotherapists must recognise situations outside their expertise or competence and take appropriate and timely action to refer the work to other health practitioners with suitable expertise and competence.

4. Notifications or complaints

• When a notification or complaint arises concerning the competence of a physiotherapist practising in a defined field, the Board will consider whether the education, training, and CPD activities undertaken by the physiotherapist are appropriate for the physiotherapist’s practice activities.

Related resources

Aotearoa New Zealand Code of Ethics and Professional Conduct (2018) Principles 5, 7.1 and 7.5

Cervical manipulation standard

Physiotherapy health records standard

Physiotherapy practice thresholds in Australia & Aotearoa New Zealand (2015) Key competencies 2.2, 4.1, 4.5.

Physiotherapy Board Continuing Professional Development Audit Resource Centre

Issued: 26 July 2021

This standard is scheduled for review in 2026. Legislative changes may make this statement obsolete before this review date