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A refresh on the refresh

Some of you may be wondering why we are undertaking a refresh of the core occupational therapy documents: the Competencies, Scope of Practice and Code of Ethics.


The Competencies and Code of Ethics were last reviewed in 2015. At that time, the then seven competencies were refined into the current five. The main change was the inclusion of competency 2 – Practising appropriately for bicultural Aotearoa. The Scope of Practice was first published in 2004.

Over the last two audit cycles between 2016-2020 the ePortfolio has provided an opportunity for the Board to understand how practitioners are responding to the five competencies. Reviews of portfolios have shown that there is a need for further clarity of the performance outcomes, especially competency 2.


There has also been significant change across the health sector since 2015. This can be seen in the uptake and focus on digital health, work force capability and expectations of health practitioners to be actively addressing the large inequities that exist in health outcomes, particularly for Māori. The changes recommended in last year’s Health and Disability System Review will have an impact on the profession, such as having more inter-professional teamwork.


Legislative reasons for the refresh

The Board and practitioners’ work under the Health Practitioners Competence Act 2003 which was amended in 2019. Two changes to the Board’s function are highlighted in bold below:

Health Practitioners Competence Assurance Amendment Act 2019:




1. “to set standards of clinical competence, cultural competence including competencies that will enable effective and respectful interaction with Māori, and ethical conduct to be observed by health practitioners of the profession.”


2. to promote and facilitate inter-disciplinary collaboration and co-operation in the delivery of health services


The Board needs to adhere to these law amendments and refreshing its core documents is a way to achieve this.


Meanwhile Section 11 of the HPCAA requires the Board to specify the scope of practice for occupational therapy. The scope is evolving, and societal factors necessitate that changes in practice be identified, and legislative changes be responded to as referred to above.


The Board accredits and monitors educational institutions offering degree programmes for occupational therapy practice (HPCAA section118 (a). The curriculum for pre-registration is based on the Competencies and Code of Ethics, enabling graduates to work within the Scope of Practice. It is important that these programmes comply with the competencies and code enabling graduates to register and practice safely.


Parallel to legislation, the findings from the Wai 2575 Health Services and Outcomes Inquiry by the Waitangi Tribunal into health inequity for Māori also need to be addressed in the way occupational therapists’ practice.


These are all important reasons.

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