Summarised highlights for Aotearoa New Zealand context

A PDF version of this summary with the changes for 24/25 marked up is available here

The Physiotherapy practice thresholds describe the threshold competence required for initial and continuing registration as a physiotherapist in both Australia and Aotearoa New Zealand

The Physiotherapy practice thresholds expand on each of the seven roles at three levels:

“Role definition” describes the essential characteristics of physiotherapy practice encompassed by the corresponding key competencies. When combined, the seven role definitions describe the essential characteristics of a competent registered physiotherapist in both Australia and Aotearoa New Zealand.

“Key competencies” are described for each role. The key competencies are the practices necessary for a physiotherapist to safely and effectively perform the central role of physiotherapy practitioner in a range of contexts and situations of varying levels of complexity, ambiguity and uncertainty.[1] An individual should demonstrate threshold competence for all key competencies relevant to their field of practice.

“Enabling components” describe the essential and measurable characteristics of threshold competence for the corresponding key competency. Threshold competence requires an individual’s practice to comprise all the enabling components for the corresponding key competency.

The key competencies and enabling components embed the complex conceptual, analytical and behavioural elements that integrate foundational abilities, such as the knowledge, skills, attitudes, values and judgements, that may be learnt in entry-level programmes. The Physiotherapy practice thresholds do not explicitly identify the corresponding foundational abilities (knowledge, skills, attitudes, values and judgements) that may be learnt in entry-level programmes at the level of task-oriented elements that, in isolation, do not assure threshold competence in practice.[2]

Behaviours listed below are essential components of threshold competence for initial registration and continuing practice as a physiotherapist in Australia and Aotearoa New Zealand. These apply across the key competencies and enabling components but are described below to avoid repetition.

Physiotherapists in Australia and Aotearoa New Zealand always:

• behave professionally and ethically
• consider each client as a whole, adopt client-centred and family/whānau focused (where relevant) approaches and prioritise cultural safety and cultural respect
• obtain the client’s informed consent before acting and acknowledge the inherent power imbalance in the physiotherapist–client therapeutic relationship
• reflect on their practice, recognise the limits of their clinical expertise and competence and take timely action to effectively manage risk in their practice
• use evidence-based practice to support clinical decision-making
• integrate knowledge of pathology, anatomy, physiology and other core biomedical sciences relevant to human health and function, encompassing cardiorespiratory, musculoskeletal, neurological and other body systems, within the context of physiotherapy and the client’s needs.

Cultural competence and safety

Physiotherapists in Australia and Aotearoa New Zealand must be able to work effectively with people whose cultural realities are different from their own.

Te Tiriti o Waitangi, and the Treaty of Waitangi

Te Tiriti o Waitangi (Māori text), and the Treaty of Waitangi are founding documents of Aotearoa New Zealand and informs legislation, policy and practice. The Crown has a responsibility to meet its obligations under Te Tiriti o Waitangi to see all people of Aotearoa New Zealand living longer, healthier and more independent lives.

The Health Practitioners Competence Assurance Act 2003 (NZ) requires health regulatory authorities, such as the Physiotherapy Board, to ensure registered health professionals set standards of clinical competence, cultural competence (including competencies that will enable effective and respectful interaction with Māori).

To practise effectively in Aotearoa New Zealand, a physiotherapist therefore needs, in addition to meeting cultural competence, to understand the relevance and be able to demonstrate contemporary application of Te Tiriti o Waitangi, and the Treaty of Waitangi’s three articles plus the declaration of the Māori text as well as the principles and incorporate the four cornerstones of Māori health, which are whānau (family health), tinana (physical health), hinengaro (mental health) and wairua (spiritual health).

Under Article 1 concepts of Kāwangatanga (Governance) Mana motuhake

Under Article 2 to enable Māori to exercise authority over their health and wellbeing

Under Article 3 to have equal rights – access and achieve equitable health outcomes for all

Ritenga Māori declaration in ways that enable Māori to live, thrive and flourish as Māori.

The principles include:

Equity requires the Crown to commit to achieving equitable health outcomes for Māori.

Active protection involves the Crown working with Māori to have at least the same level of health as non-Māori and safeguarding Māori cultural concepts, values and practices.

Options requires the Crown to provide for and resource kaupapa Māori health and disability services and ensures services are provided in a culturally appropriate way recognising and supporting the expression of hauora Māori models of care.

Partnership involves working together with mutual benefits with non-Māori iwi, hapū, whānau and Māori communities to develop strategies for Māori health gain and appropriate health and disability services.

Participation requires Māori to be involved at all levels of the health and disability sector, including in decision-making, planning, development and delivery of health and disability services.