Source: Physiotherapy New Zealand
Minor law change needed to take pressure off GPs and return people to work faster
Physiotherapy patients are waiting too long to be allowed to return to work, likely costing ACC millions of dollars in compensation payments it should not be paying because of delays in getting GPs to sign return to work certificates.
Physiotherapy New Zealand (PNZ) is calling on the Government to amend the law to allow physiotherapists the same power as GPs to certify that a patient who is under ACC care is ready to return to work.
“New Zealand physiotherapists have the skills and experience to ensure people can return to work safely and with GPs under more pressure than ever, now is the time to remove the bottleneck,” said PNZ President Kirsten Davie.
“Physiotherapists write the return to work plans now for their patients which GPs sign off on so it’s just common sense to give physiotherapists the same authority. They already do this for employers who need a return-to-work certificate for workers who are not on ACC compensation to ensure they are meeting health and safety requirements.
“These days getting a timely appointment with a GP is harder than ever, especially in remote parts of New Zealand. We have heard of cases where people without a GP have been forced to wait hours in A&E to get a return-to-work certificate.
“And even if a patient can get to a GP, they may be charged for the visit.
“None of this makes sense when a simple amendment to the Accident Compensation Corporation Act giving physiotherapists the power to sign return to work certificates would get people back to work quickly and safely.
Business supports change
“Businesses agree with us – they want their staff back to work as soon as possible, as long as they are fit and healthy, and likewise patients who are fit again, want their lives to return to normal as well.”
The construction industry is keen to see physiotherapists given the authority to return workers to building sites.
“It just makes good sense,” said Chris Alderson, chief executive of Construction Health and Safety New Zealand which works to raise the standard of health, safety and wellbeing in construction.
“Many of the injuries construction workers suffer are musculoskeletal related, which physios are well placed to remedy. GPs often refer a worker to a physio who understands the treatment a worker needs and exercises that will help get them back to work fit and well.
“We know many construction workers don’t have easy access to a GP, so may end up just not getting the treatment they need until the pain is too bad or end up at emergency departments for conditions that should have been dealt with earlier. Giving physios the ability to sign off the return to work will take pressure off primary health care and get workers back to sites far more quickly. It’s just not good for anyone’s mental health and well-being to sit at home when they are ready to go back to work.”
Cost of compensation
The cost of compensation that should not be paid out by ACC when people are ready to return to work runs to millions of dollars every year. A Physiotherapy New Zealand survey of members in August 2024 showed how big the problem is. 454 members identified at least 4,400 days of delay for their patients getting a return-to-work certificate in one month alone (equivalent to 628 weeks).
ACC stipulates the minimum rate of weekly compensation payable is $740.80, based on a 40-hour week (ACC weekly compensation information here). That amounts to $4,656,457, just under half a million in weekly compensation from our member survey in one month alone.
“Cost savings for ACC in returning people to work as soon as possible are likely to be significant. Right now, ACC is under pressure to reduce costs and be sustainable, so this change makes good financial sense too. ACC weekly compensation claim payments have risen 70% within the last five years, and are projected to rise further.
“We want to take pressure off GPs and continue working together with them to get Kiwis back to work safely and well.
“This is a no-brainer – good for people’s health, good for economic growth, good for government finances.”
Patient example – Robyn, nurse
Robyn (not her real name) is a nurse in Gisborne (not her real name). She fractured her foot slipping on stairs, which prevented her from returning to work at the local hospital. She rested and after six weeks the fracture clinic discharged her and referred her to physiotherapy for a supported return to work. Robyn was able to do some temporary office work at this time.
Her physiotherapist assessed her and developed a return to work plan. In order to begin this planned return to work, Robyn needed a signed certificate from a GP. Robyn couldn’t get to see her GP for three weeks as the clinic was only taking emergency cases given how busy it is.
Without the certificate Robyn was unable to begin the return to her usual clinical duties or continue with the office work. She needed to be either given full clearance for her usual work or be certified partially fit to return to office work and begin the plan with her physiotherapist.
Since Robyn’s current certificate had expired, ACC compensation stopped.
Robyn worried she would not have any income for these three weeks, being neither on ACC compensation nor back at work. This left her in limbo until her physiotherapist intervened, called the GP clinic, explained the urgent need, and the GP clinic issued the certificate including the plan the physiotherapist had provided.
“This was really frustrating – I was facing weeks without income sitting around at home because I couldn’t get to see a GP. It shouldn’t take a call from my physio to make this happen. And we have a real shortage of nurses here so having a nurse out of action for longer than necessary just puts more pressure on the hospital when it doesn’t need to be that way. Physios should be able to do the paperwork to get people back to work as soon as they are fit and well.”
