Physiotherapy services report released
16 November 2007 Media Statement
Physiotherapy services report released
ACC Minister Maryan Street today
released the report into the Review of the way in which
physiotherapy services are funded and accredited by
ACC.
The review forms part of the Labour-led government’s confidence and supply agreement with New Zealand First. The report makes recommendations regarding the funding and accreditation arrangements for physiotherapists, the relationship between ACC and the physiotherapy profession, and ACC processes relating to monitoring, audit and investigation activities.
“The government will work promptly with ACC and physiotherapists on the recommendations related to non-fiscal measures. Other recommendations which have funding implications will need to be considered in conjunction with other budget priorities. A formal government response to the report will now be developed and considered,” said Maryan Street.
“The Labour-led government’s priorities for the ACC scheme are to maintain it as a fully public social insurance scheme which focuses on injury prevention, along with fair and effective treatment and rehabilitation provisions.
“I am grateful to David Goddard QC for the excellent work he has done to produce this report and to New Zealand First deputy leader Peter Brown for his commitment and cooperation,” said Maryan Street.
New Zealand First
deputy leader Peter Brown said this is an issue which has
been of particular concern to New Zealand First since
physiotherapists first raised it, “which is why we
negotiated it into the Confidence and Supply
Agreement.”
“Having said that I must compliment the
Government, particularly former ACC Minister Ruth Dyson, for
encouraging and implementing a thorough review. David
Goddard QC and all those who assisted have done an excellent
job. The issues have been properly and thoroughly
identified, the report recommends reasonable and practical
solutions and I look forward to working with the new ACC
Minister Maryan Street on them”, said Peter Brown.
The full report and associated documents are available at: http://dol.govt.nz/consultation/physiotherapy/index.asp
Contact: Peter Fitzjohn Acting Press Secretary, phone (04) 471 9427, 021 227 9427
Background questions and answers
What has led to the review?
The Confidence and Supply Agreement between the Government and New Zealand First includes a review of the way in which physiotherapy services are funded and accredited.
The review addresses a number of concerns that have been expressed in recent years about the funding and accreditation by ACC of physiotherapy services.
Over recent years there have been a number of changes to how ACC funds physiotherapy services and this review is being conducted to ensure that those that need physiotherapy following injury have affordable access to treatment, and that funding arrangements are sustainable and fair to physiotherapists.
What did the review assess?
The review
assessed the adequacy of the current regulatory and
purchasing arrangement for physiotherapists within the ACC
regime.
The review focused on the differing payment and
contractual regimes for physiotherapists contracted under
the Endorsed Provider Network and those who receive payments
regulated under the IPRC (Liability to Pay or Contribute to
Cost of Treatment) Regulations 2003.
The primary concern was the sustainability of provision of physiotherapy services under the present ACC regime, in the long term interests of ACC claimants.
How was the review conducted?
The review was conducted by David Goddard, QC
and included wide consultation with stakeholders in the form
of written submissions and a number of hearings and
conferences.
The written submissions, oral hearings and
reports of David Goddard, QC will be made publicly available
on the Department of Labour website.
Who was
involved?
A wide range of key stakeholders affected by
the current accreditation and funding arrangement were
consulted in the course of the review.
This included
(among others):
• ACC
• The New Zealand Society of
Physiotherapists
• New Zealand College of
Physiotherapists
• New Zealand Private
Physiotherapists’ Association
• Physiotherapy Trust
of New Zealand
• Occupational Physiotherapists Special
Interest Group
• A number of physiotherapy
practitioners
• A number of claimant
representatives
• The Office of the Health and
Disability Commissioner
• District Health Boards’
Physiotherapy Advisors, Leaders and Managers
Group
• The Office of the Privacy
Commissioner
• New Zealand Law Society ACC
Sub-Committee
Parties to the review also provided expert
reports on pricing and remuneration issues
from:
• Deloitte
• KPMG
• Strategic Pay
Ltd
What did the review find?
The review makes a number
of recommendations that provide options for promoting the
sustainable funding of physiotherapy services, and fairness
to physiotherapists.
The review notes that current
levels of funding should be increased in order to address
sustainability issues for the physiotherapy sector.
The
review proposes two options on the topic of whether to allow
co-payments or not:
• To retain the existing funding
arrangements that prohibit co-payments for Endorsed Provider
Network providers but to increase the payments made under
those agreements; or
• To remove the prohibition on
co-payments and increase payments as far as
affordable.
The Review also made recommendations
about:
• Adopting alternative entry criteria for EPN
providers, based on postgraduate qualifications and
experience;
• Changing the name of the EPN contracts to
remove the reference to ‘endorsed’;
• Giving
providers a longer termination period for EPN
contracts;
• Establishing guidance, transparency and
improved culture around ACC’s processes for monitoring,
audit and investigation of providers, and the use of
treatment profiles for this purpose;
• Improving
processes and guidelines for identifying the appropriate
number of treatments for each claimant;
• Improving the
efficiency and fairness of processes for approving funding
for claimants who require additional treatment outside
standard guidelines;
• Improving communication about
referrals to Activity-Based Programmes;
• Establishing
a clear complaints process for providers;
• Developing
better processes in relation to provision of patient
clinical notes to ACC for the purpose of provider audit,
monitoring and investigation. ACC and the Privacy
Commissioner have agreed to work together to address these
issues;
• Creating better communication between ACC and
physiotherapists through a partnership model and a
consultative approach, with consideration being given to an
‘independent’ Chair of the Physiotherapy Liaison Group
with six-monthly reporting; and
• Improving the
quality of information used for the purpose of
decision-making on contracts and
regulations.
Ends