Rehabilitation therapy

Whether in hospital, in the community or at home, good rehabilitation from injury or illness makes a tremendous difference to people’s outcomes; and to the risk of more serious future treatment being needed.

A cluster of allied professions focus on supporting rehabilitation: physiotherapists (or physios) , occupational therapists (OTs) and speech language therapists (SLTs):

Many other professionals also work in rehabilitation contexts, including kaiāwhina and healthcare assistants; these workforces are discussed further below, as they also work in other settings.

We expect to require growth in our rehabilitative allied professions over the next decade. This growth is likely to be driven by:

• New Zealanders aging. As people get older, they have a growing need for rehabilitative care to stay mobile and independent.
• An aging workforce, and relatively lower numbers of new entrants to these professions compared to expected population demand.
• Growing demand for rehabilitative care. Rehabilitation is a focus of many of our new models of care, moreso than it has been in the past.

Some of these are focused on avoiding more serious interventions like surgery – for example, appropriate musculoskeletal care (usually requiring a physiotherapist or occupational therapist) can help some people avoid orthopaedic surgery. Others are focused on improving outcomes following surgical or medical care – requiring more specialist rehabilitative support – or on better support people living with frailty. These shifts are likely to create mounting care demand into the future.

Because our rehabilitative workforces are likely to be so central to new models of care over years to come, if we can get the right number of practitioners in our workforce we’ll be much better placed to manage the pressures of an aging and more frail population.

Our rehabilitative professions also offer significant diversity of practice across different settings – making them attractive for New Zealanders from many walks of life. The lived experience of disabled people means that other jurisdictions have strong representation in rehabilitative workforces; we have an opportunity to do better. The significant influence of ACC in the market for rehabilitation services also helps with the sustainability of our community sector.

To grow and retain our rehabilitative workforces, over the next three years we will need to:

• Improve our use of student placements. Student placement capacity is a limit on how many physiotherapists and speech language therapists we can train – and shifting to best practice models of training alongside our new, national student placement system will help us train more.
• Support progression in rehabilitation careers. We want to establish new roles around our rehabilitation professionals to support progression (to advanced practice roles), and allow them to support increasingly complex care settings – such as musculoskeletal pathways to avert demand for orthopaedic surgery, or specialist work in mental health and addictions settings.
• Grow assistant workforces. By developing new assistant workforces, we can lift work off specialists to allow them to focus on the highest impact work; meaning the workforce we have can go further.

Long-term we expect these professions to continue growing – so we will need a sustained focus on domestic training capacity over time. As more of our rehabilitative professionals come to work outside traditional settings, or become more closely integrated with the provision of other clinical services, we will need to continually review pathways, contract models and employment models to ensure we’re applying our workforce’s capacity to the areas of highest impact.