Testing a consistent approach for concussion

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We’ve been trialling several pathways to improve how concussion is managed in New Zealand. Our aim is to ensure that treatment is consistent, timely and client focused.

In primary care, we have been trialling the Primary Care Concussion Pilot. The aim is to empower GPs and Nurse Practitioners to manage mild concussions in the primary care setting.

We’ve been testing the use of consistent education, a Brain Injury Screening Tool (BIST), and follow-up consultations to track client progress, and the outcomes this has for our clients.

The Pilot is currently being trialled by three Primary Health Organisations (PHOs): WellSouth (Otago/Southland), Pegasus (Canterbury), and ProCare (Auckland/Northland).

The pilot began in May 2022 and 869 BIST assessments have been completed in the pathway so far. Initially, we planned to run it for a year but have extended the timeframes to further test changes made to the BIST and pathway based on user feedback.

Trialling physiotherapist involvement

As part of the pathway clients are eligible for an initial GP appointment and two fully-funded follow-ups, with a BIST assessment completed at each appointment.

We’re expanding the Primary Care Concussion Pilot to enable physiotherapists to deliver the follow-up appointments and complete the second and/or third BIST assessments. This means:

• Participating PHOs will subcontract a limited number of physiotherapy practices, who will then be able to deliver the follow-up appointments in the pathway
• Physiotherapists will need to have an agreement in place with their local PHO and complete the education requirements for the pathway
• If GPs refer a concussion client, the subcontracted physiotherapist will be required to complete the BIST assessment at the appointment and send it to ACC and the referring PHO for reporting, as well as the GP
• PHOs will be responsible for paying physiotherapists for the BIST assessments.

As this is a pilot, we’re asking participating PHOs to cap physiotherapy involvement to a limited number of practises to ensure ACC can deliver the necessary support. If successful, this could be expanded at a later date.

Enabling physiotherapists to perform follow-up appointments within this Pilot will help us understand how it improves access for clients to be seen in primary care. Benefits may also include reduced pressure on General Practice and reduced client wait times for treatment, while maintaining patient safety by ensuring GPs have visibility of client progress.  

If you have questions about the pilot in your region, please contact your nearest participating PHO:

WellSouth (Canterbury/Southland) – concussion@wellsouth.org.nz

Pegasus (Canterbury) – concussion@pegasus.org.nz

ProCare (Auckland/Northland) – concussion@procare.co.nz 

We look forward to keeping you updated as this work progresses.