Welcome to practice in Aotearoa New Zealand

Section Two: Overview of the healthcare system in Aotearoa New Zealand

When you start working as a healthcare provider in Aotearoa New Zealand, there are some unique features of the healthcare system that you need to know about, particularly the Accident Compensation Corporation (ACC).

In Aotearoa New Zealand, there are three main areas that service healthcare:

Health New Zealand | Te Whatu Ora

Health New Zealand | Te Whatu Ora delivers public health services across New Zealand. You can view a map of the different regions and districts here.

Te Whatu Ora also contracts primary health organisations (PHOs) to provide primary health services for the enrolled population within their geographical area. You can view the PHOs here.

Around one out of six physiotherapists are employed by Te Whatu Ora. Please see their information for health providers here.

Te Whatu Ora delivers physiotherapy services in public hospitals (inpatient and outpatient) and in the community.

Private Healthcare Services

Generally, private healthcare services are funded by the patient | kiritaki, or through private health insurance. This includes appointments with GP’s, physiotherapists, dentists and other health services.

There are some primary health subsidies available where people meet the criteria, as outlined here.

People can self‐refer to privately funded physiotherapy, with the physiotherapist commonly being the first point of contact. People can also be referred by other health professionals, most commonly their GP or specialist.

In Aotearoa New Zealand, around 5 out of 6 physiotherapists work in the community, mostly within private physiotherapy practices. Physiotherapists also work in other private services, including private hospitals, aged residential care and onsite services at schools and workplaces.

Accident Compensation Corporation (ACC)

ACC provides no‐fault injury cover for people living in Aotearoa New Zealand, as well as visitors. When someone gets injured in Aotearoa New Zealand as a result of an accident, they can receive support from ACC. The support can come in many forms and will depend on what the person needs to get them back to independence. It could include ambulance services, physiotherapy treatment, weekly compensation, rehabilitation equipment, counselling for mental injury or help getting back to work. ACC provides this support by partnering with health providers such as physiotherapists. Te Whatu Ora and private health services both deliver ACC services.

There are specific criteria for what is and is not covered by ACC. If an injury doesn’t meet the criteria for ACC, the person will need to fund the health service privately or get a referral from their GP to access publicly funded services.

Physiotherapists in Aotearoa New Zealand work under different contracts or agreements with ACC and this will depend on the agreements that your employer has with ACC. For the majority of ACC funded services (including physiotherapy and GP appointments), part of the treatment cost is funded by ACC and the patient | kiritaki pays the remainder of the cost – referred to as a surcharge.

People can self‐refer to ACC‐subsidised physiotherapy services and physiotherapists are commonly the first point of contact for the patient | kiritaki. Physiotherapists can lodge a claim directly with ACC. 

ACC Resources

The ACC website has extensive resources, webinars and videos to help you to learn their systems. The following resources are a good starting point; however, we recommend that you take the time to explore the ACC website and resources in full.

Getting Started as a Health Provider

https://www.acc.co.nz/for-providers/getting-started

Webinar: The beginner’s guide to ACC for physiotherapists

Webinar: Clinical records – what you must include for ACC clients

Understanding Claims and Causation

https://www.acc.co.nz/for-providers/lodging-claims/understanding-claims-and-cover#understanding-causation

Section Three: Working as a physiotherapist in Aotearoa New Zealand

All physiotherapists in Aotearoa New Zealand need to understand the Physiotherapy Standards Framework and how this should be applied to your work as a physiotherapist. You can read the framework in full here.

Frequently asked questions

The New Zealand Healthcare system is unique, and this has an impact on what it looks like to work as a physiotherapist. We’ve spent time speaking to international physiotherapy graduates to understand the sorts of questions they had when they first started working in Aotearoa New Zealand.

What things can be helpful when preparing to become a physiotherapist in New Zealand?

International physiotherapy graduates have advised that these things can be helpful.

• Setting up a good orientation with your employer, including information on the healthcare system, ACC (where applicable), referral processes and available services that your kiritaki can access
• Learning about the Physiotherapy Standards Framework
• Speaking to a physiotherapist from your home country who is working in New Zealand and can talk to you about the differences between the healthcare systems and the role of physiotherapists in New Zealand
• Taking time to learn about the ACC system, including what injuries are and are not covered; what services physiotherapists can be involved with; what ACC can contribute to in addition to physiotherapy treatment (equipment, splints and braces, home support, weekly compensation etc).
• Upskilling and learning more about Māori and Pasifika cultures
• Learning basic Te Reo (Māori language)
• Learning kiwi slang
• Listening to the kiwi accent before coming
• Learn about farming words, techniques and tools. For example, sheep shearing. https://www.youtube.com/watch?v=oUQ4RMAZw7Y

Can people see a physiotherapist without a referral?

In private practice, most patients | kiritaki self‐refer to see a physiotherapist. Others attend following referral from their GP or a specialist. If the injury is covered under ACC, the physiotherapist can lodge the claim directly with ACC.

Physiotherapists are autonomous practitioners and will often be the first healthcare provider to see the patient | kiritaki about their presenting condition. This means that the physiotherapist will make the initial diagnosis and decide whether any onward referral is required.

What fields can you work in as a physiotherapist?

Many registered physiotherapists in Aotearoa New Zealand choose to work in a ‘defined field’.

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.

Physiotherapists must be able to demonstrate the following, within their defined field: Adequate level of knowledge and competence; Appropriate and recognised education, training and CPD; Ongoing self‐evaluation of the safety and competence of their practice.

To read more about working in a defined field, you can read the Physiotherapists practicing in a defined field standard.

Can physiotherapists refer for radiology and view findings of radiology investigations?

A physiotherapist working in private practice can refer for X‑rays and Ultrasounds. They can also recommend an ultrasound guided corticosteroid injection if indicated by ultrasound findings.

Physiotherapists can view radiology reports and images by registering with the radiology services who provide the services in the geographical area they are working in. This includes ACC‐funded and privately funded imaging.

Results for imaging completed through a Te Whatu Ora hospital can be requested by contacting the hospital directly.

What other health professionals do physiotherapists work alongside?

Physiotherapists can work alongside, or have interactions with several health professions, including doctors, specialists, occupational therapists, pharmacists, dieticians, speech language therapists, nurses and podiatrists, among others.

Interdisciplinary (IDT) or multidisciplinary (MDT) teams are common in some physiotherapy settings. The physiotherapist plays a key role in these teams and these teams have a collaborative approach.

There can be some cross‐over with the services that the different professions provide, so it is worth talking to the health professionals you are working with to learn more about their role. 

Our international physiotherapy graduates often comment that the workplace in New Zealand is friendly, more relaxed and with less noticeable hierarchy when compared to other countries they have worked in.

Does physiotherapy have more of an impairment or functional focus in New Zealand?

For the most part, physiotherapy in New Zealand has an overarching functional focus more than an impairment focus, however the impairments do still play a key role in specific assessments and treatments. Goal setting is viewed with a functional focus.

What role does physiotherapy play in return‐to‐work programmes in New Zealand?

Several private practices hold contracts to deliver return to work programmes for ACC (either directly or through a sub‐contract relationship with a contract holder). The main contracts that physiotherapists are working under in this space are the Integrated Care Pathways or Vocational Rehabilitation Services. Some physiotherapists also deliver these services privately, for non‐ACC conditions.  

The physiotherapist can be involved with delivering functional rehabilitation, as well as planning and writing return‐to‐work plans. This can include assessments within the client’s workplace and communication with their employer.

Physiotherapists also work alongside Occupational Therapists in this area.

Do physiotherapists complete on‐call duties?

Yes – within some hospital settings, physiotherapists will be on call to assist with patients requiring urgent respiratory physiotherapy input. 

What CPD do I need to do while I am working as a physiotherapist?

To hold an Annual Practicing Certificate (APC), physiotherapists need to complete a minimum of 100 hours of CPD over a three‐year period. A logbook should be kept, and this can be in any typed format. There is more information about the CPD requirements here, including the Recertification Programme Guidelines.