New Zealand Physiotherapy Accreditation Scheme

The New Zealand Physiotherapy Accreditation Scheme (NZPAS) was first mooted in 1986 and following initial planning, was set up by New Zealand Private Physiotherapists’ Association (NZPPA) in 1989. An Accreditation Co-ordinator was appointed to administer the Scheme under contract to NZPPA, and a four-person Council was appointed to develop policy and to act as both arbiters and adjudicators in awarding accreditation status. Three of the members were physiotherapists (one of whom must be a member of the NZPPA Executive), and the fourth member was a lay person.

The NZPAS became the trading division of NZPPA and was supported by the parent association with personnel and funds. The NZPPA wholly owned the NZPAS. The NZPPA underwrote and accepted overall financial liability for the Scheme.

Initially, practices had access to a Guide to learn about the requirements for accreditation and, although assistance was given if requested, the core activity of the Scheme at that stage was the survey for which a fee was paid.

Over the ensuing years NZPAS was improved and enhanced resulting in a membership scheme where members (practices) paid an annual fee which, over three years, made up the survey fee, education support and other associated costs. An agreement was signed between the NZPPA (on behalf of the Scheme) and the practice which clearly stated the obligations of both parties. Ninety-five percent of the membership of NZPAS are also NZPPA members.

The Scheme continued to be managed by an appointed co-ordinator who in turn contracted and trained peer physiotherapists who could undertake surveys against the standards and recommend accreditation. The NZPAS Council was responsible for determining if accreditation status was awarded or not and the Scheme Co-ordinator reported to the NZPPA Executive Committee quarterly on Scheme performance and operational matters.

The NZPAS worked closely over the years with Quality Health New Zealand to ensure that structures and systems conformed with best practice for accreditation bodies.

Physiotherapy was a leader in the allied health sector in recognising the value of quality improvement and in initiating the NZPAS to provide a vehicle for physiotherapy practices to gain recognition for their commitment to quality systems.

In 1996, PNZ formally endorsed the NZ Physiotherapy Accreditation Scheme.

In 2000, ACC developed and piloted the endorsed provider programme. The programme recognised the advantages to ACC of accredited practices by rewarding them at different rates to non-accredited practices.

The NZPPA recorded in the minutes of an Executive Committee meeting of 24 August 2000:

The NZPPA supports the idea of piloting a scheme to trial proposed regulation. However, the format and manner under which the scheme is being piloted is not entirely satisfactory to this organisation. The NZPPA has concerns about the concept of a capped fee and the amount offered, and will continue to discuss the pilot scheme and related issues with NZSP and ACC.

The NZPPA recognises the commitment (time and financial) made by accredited practices and supports such practices being financially rewarded. The NZPPA has developed and operated the NZ Physiotherapy Accreditation Scheme over the past 10 years to encourage and assist all physiotherapy practices to standardise and improve the quality of physiotherapy service. Those practices who have voluntarily worked towards and achieved accreditation are now well-positioned for the introduction of higher fee for treatment payments, should this eventuate. The NZPPA therefore commends those accredited practices and encourages all others to consider seriously the accreditation process.

The NZPPA also, at this time, began to review the Scheme structure and operation with a view to establishing a clearer separation between the Scheme and NZPPA. The administrative and financial functions were separated off and NZPPA sought accounting and legal advice on how to establish the NZPAS as a separate entity.

In 2003, the NZPAS was registered as an incorporated society.

In “rolling out” the EPN framework nationwide, ACC recognised it needed to put in place a set of standards which all physiotherapy practices and clinics could be audited and certificated against. The NZPAS was owned by NZPPA and, while NZPPA comprised membership from over 65% of practices nationally, it was not in itself a standards setting body.

ACC did however recognise that to purchase the NZPPA-NZPAS standards as the basis for the development of a new national standard was a prudent, expedient and cost effective investment.

The relationship between NZPAS and NZPPA and the ownership of the standards was formally recorded in an agreement between the two parties in September 2004.

Later that year, a formal agreement between ACC and NZPPA was signed for the sale and purchase of the physiotherapy accreditation standards.

Standards New Zealand then developed the Allied Health Services Sector Standard (AHSSS) 8171 and the NZPAS standards, now owned by ACC, became the basis for the Standards NZ AHSSS Physiotherapy Audit Workbook.

ACC also established Conformity Assessment Bodies – independent agencies with responsibility to independently audit practices against the new standard.

From 1 January 2007, physiotherapy practices wishing to participate in the EPN framework need to be certificated against the new AHSSS. Practices previously accredited under the NZPAS standard will, upon expiry of the accreditation period, need to be re-certificated against the new standard in the future.

These significant changes in the past few years resulted in the NZPAS having a limited “life”. The last practices accredited under the NZPAS standards in 2006, will be re-certificated against the new standard in 2009 and therefore finally exit the Scheme.

The NZPAS membership and Council resolved in 2006 to wind-up the incorporated society and transfer member responsibilities back to NZPPA.

A liquidator was appointed and a deed of assignment formally terminated the NZPAS on 6 October 2006.