Earlier this week, the Chief Provincial Public Health Officer, Dr. Brent Roussin, issued the following Directive Regarding Non-Essential Services:
“All non-essential and elective health services should immediately be ceased or reduced to minimal levels. Allowable exceptions include: emergency services; time-sensitive services necessary to avert or avoid negative patient outcomes OR avert situations that would have direct impact on patient safety.”
Of importance to note is that the Directive is not stating which profession is an essential service. Rather it recognizes that all professions can be providing essential (and non- essential services), including physiotherapy.
CPM staff have been in contact with other physiotherapy regulators across Canada, some of whom have already issued messages about essential services, following Directives from their respective government. The following information is intended to provide you guidance, not a directive, on what can constitute essential or urgent physiotherapy services. This information does not apply to physiotherapists providing patient care in designated facilities or institutions which are regulated by other legislation.
Determining what essential services are, in the context of physiotherapy practice, is challenging due to the diversity of physiotherapy practice. Registrants must consider their practice context and use independent professional judgment to make responsible decisions. The following are some suggestions to define essential services:
- Essential services include assessment and therapeutic intervention or services for conditions/situations where not receiving physiotherapy services (whether in-person or virtually) would put the patient’s safety at risk. There is potential for significant harm, adverse patient outcomes or suffering.
- Services to address a decline in functional independence or safety of those beginning to fail at home including risk of: falls, deterioration of mobility or transfers, respiratory distress, hospital
(re)admission, disabling chronic pain, or the ability to care for dependents.
- Services specified as urgent by a referral source or deemed urgent to prevent a poor outcome following a recent fracture, surgery, chest infection.
- Services for clients with complex care needs who require a co-ordinated team approach.
- Services to support clients in critical roles remaining at work i.e. health professional, emergency services in the community, essential services employees.
Specific situations which could be considered as essential physiotherapy services include but are not limited to:
- A patient who is currently experiencing incapacitating neuromusculoskeletal dysfunction or pain.
- Any scenario where the inability to initiate care or the withdrawal of care would lead to the significant deterioration of a patient’s condition and the patient is at risk for imminent hospital admission or re-admission.
- Follow-up immediately post-discharge from hospital to the community to ensure safe return to home and prevent re-admission to the hospital.
- A patient who has suffered from severe musculoskeletal dysfunction, pain or burns.
Telerehabilitation remains a viable method to provide treatment to patients. Whether Telerehabilitation should only be used for essential services at this time is not known. Several provinces are looking into the issue and CPM will seek clarification from Shared Services.
The message from government is “Go home Stay Home”. Continue handwashing. Don’t travel.
Stay safe and healthy