Physiotherapy — Hawke's Bay

Conditions seen

Any musculoskeletal condition of any duration which is impacting on quality of life or ability to function.

Musculoskeletal injuries covered by ACC where the patient is unable to afford the co-payment for private physiotherapy.

Referral information

To make a referral send an email to outpatientsphysio@hbdhb.govt.nz

Include the following information in your referral:

• body part
• problem summary
• onset (sudden or insidious and timeframe)
• impact on function
• previous and current medical history
• current medications
• any cognitive or communication issues.

Service information

The adult respiratory outpatient physiotherapy service is offered in both Hastings and Napier with some availability in Wairoa.

• The Hastings clinic is based in the Physiotherapy outpatient department in the hospital grounds.
• The Napier clinic is based at Napier Health Centre on Wellesley Road.
• Wairoa clinics are held in Wairoa hospital outpatient department as the need arises.

A contract with Plus rehab in Central Hawke's Bay also includes some outpatients requiring respiratory physiotherapy. Patients can be seen in the community, including in Central Hawke's Bay if required.

Conditions seen

• New diagnosis of bronchiectasis requiring education regarding management of their condition, airway clearance assistance or both.
• Known bronchiectasis requiring an update in airway clearance techniques, for example, those with more than 3 exacerbations per year, or following a recent hospital admission.
• COPD where the patient is not already engaged with the Pulmonary Rehabilitation (Better Breathing Hawke's Bay) team.
• Breathing pattern disorders or hyperventilation syndrome with a Nijmegen score of 23 or more, or persisting breathlessness when other causes have been excluded.
• Neuromuscular conditions with increased secretions or difficulty clearing secretions, following discussion with the MDT or appropriate specialist.
• Persisting breathlessness or loss of function following lung surgery.

We do not see patients already engaged with the Pulmonary Rehabilitation (Better Breathing Hawkes Bay) team.

Referral information

To make a referral send an email outpatientsphysio@hbdhb.govt.nz and include FAO Respiratory Service in the subject line.

• Include the following information in your referral:
• reason for referral (presenting condition)
• previous and current medical history
• current medications
• any relevant investigations completed such as Spirometry, CXR, sputum samples.

Conditions seen

• Urinary incontinence
• Overactive bladder
• Pre and post-operative bladder surgery
• Pelvic organ prolapse
• Pelvic pain
• Pelvic girdle pain during pregnancy
• Assessment for hydrotherapy classes, with prior LMC or medical clearance
• Rectus diastasis rehabilitation
• Caesarean or episiotomy scar rehabilitation
• Pelvic floor muscle training
• ACC coverage for maternal birth injuries

We do not see conditions related to men's pelvic health.

Referral information

To make a referral send an email to outpatientsphysio@hbdhb.govt.nz and include FAO Pelvic service in the subject.

Include the following information in your referral:

• current symptoms
• onset — sudden vs long standing or insidious
• diagnosis (where available)
• relevant medical history.

Conditions seen

Patients must have a confirmed diagnosis of lymphoedema and at least one of the following:

• surgery with lymph node dissection or removal — including sentinel node biopsy
• radiation therapy to lymph nodes
• advanced cancer with metastases to lymph nodes
• onset of oedema immediately following Taxane chemotherapy
• congenital malformation of the lymphatic system, for example, diagnosed Noone-Milroy’s disease or Meige's Disease
• lymphatic obstruction caused by trauma
• lymphatic filariasis.

We do not see the following conditions: 

• arterial ulcers or oedema with arterial disease (abnormal Ankle Brachial Pressure Index)
• oedema caused by heart failure
• acute oedema caused by cellulitis
• management of DVT, post thrombotic syndrome or both
• diabetic neuropathy
• oedema caused by obesity.

Referral information

To make a referral send an email to outpatientsphysio@hbdhb.govt.nz

Include the following information in your referral:

• HOPC with diagnosis
• surgical or radiation history
• medical plan if treatment is ongoing
• PMH including any conditions with potential to impact skin integrity, sensation and circulation, or potential to impact ability to comply with therapy such as mobility or cognitive issues.

Conditions seen

• Acute oedema management
• Wound care and scar management
• Fractures — below elbow
• Nerve compressions such as carpel tunnel, cubital tunnel and SRN
• Nerve injury and repairs
• Soft tissue conditions, tendonitis — De Quervain’s, trigger finger
• OA and RA
• Tendon injuries
• Amputations
• Neuropathic pain and CRPS
• Thumb sprains
• Volar plates and dislocations
• Chronic stiffness and oedema
• Burns — hands and forearms
• Elbow conditions

We do not see the following conditions:

• central nervous system pathology such as stroke, parkinsons or multiple sclerosis
• patients need to have a rehabilitation goal, patients who are unlikely to gain a lasting benefit from therapy will be declined.

Referral information

To make a referral, send a completed referral form to handtherapy@hbdhb.govt.nz

Hand therapy referral form

Include the following information in your referral:

• presenting condition — injury or diagnosis
• date of injury or onset
• ACC number
• surgery (if applicable) including date, type and precautions
• treatment requests
• PMH
• return to work.

Referrals are triaged.

If insufficient information is supplied or there is no clear rehabilitation goal the referrer will be contacted for more information and a decision made regarding whether the referral is accepted or declined.

Call us on 06 878 8109 extension 2717 if you have any questions.

Service information

People requiring treatment or rehabilitation due to neurological and vestibular disorders can be seen by a dedicated neuro physiotherapy service, at clinics around Hawke's Bay. Some services are contracted out to private providers.

Conditions seen

Including but not limited to:

• BPPV
• vestibular hypofunction
• stroke and sub arachnoid haemorrhage
• Parkinson’s disease
• Multiple sclerosis
• progressive ataxias
• motor neuron disease
• muscular dystrophy
• functional neurological disorder — with a clear diagnosis the patient accepts
• brain tumours
• Guillain Barre
• post-polio
• cerebral palsy.

We do not accept neuro physiotherapy referrals for:

• patients without the potential for rehabilitation and clear goals for therapy
• ACC clients seen by private providers — refer directly to ACC
• people who do not have the ability or support to participate in rehab, or the desire to complete home-based programme
• outpatient service — need to be able to be brought to clinic. If client is physically housebound, clearly state this in the referral and the referral will be considered for community physiotherapy.

Referral information

To make a referral for Hastings and Napier patients, either send:

• a referral using the 'Engage Community Allied Health referral form in your software such as Medtech or Indici
• an email to engagereferrals@hbdhb.govt.nz

To make a referral for Central Hawke's Bay patients send an email to Chballiedhealth.referrals@hbdhb.govt

To make a referral for Wairoa patients send an email to Wairoa.alliedhealthreferrals@hbdhb.govt.nz

Include the following information in your referral:

• diagnosis
• current functional level
• goals for rehabilitation and reason for referral
• contacts of other people or services involved in care related to neurological condition and function
• past medical history.

This referral will be triaged by clinical coordinators and referred on to contracted private providers, or the Central Hawke's Bay and Wairoa providers if appropriate.

Respiratory conditions — seen only by consultant for confirmed diagnosis and optimisation of medication.

Long standing neurodevelopmental conditions — refer to Child development service.

MSK conditions — refer to MSK outpatient service.

People in hospital are seen by physiotherapists to help prevent complications from their admission and speed recovery.

Physiotherapists have an important role to play in treating and preventing breathing problems as well as regaining strength and balance after illness or injury.

Physiotherapists work with patients and whānau to help optimise recovery during and after hospital admission.