This notice replaces the Notice of Scopes of Practice and Related Qualifications Prescribed by the Osteopathic Council dated the 20th day of October 2011 and published in the New Zealand Gazette, 20 October 2011, No. 159, page 4569.
This notice will take effect from 31 January 2013.
Scopes of Practice
Pursuant to section 11(1) of the Health Practitioners Competence Assurance Act 2003 ("the Act"), the Osteopathic Council ("the Council") specifies the following scopes of practice:
1. General Osteopathic Scope of Practice
All registrants currently registered in the Scope of Practice: Osteopath will, from 31 January 2013, become registered in the General Osteopathic Scope of Practice.
Osteopaths are primary healthcare practitioners. Central to the competent practice of osteopathy is an understanding of the role of the primary care team and referral routes within the primary care team and to hospital based services.
Osteopathy is a person-centred form of manual medicine informed by osteopathic principles. Osteopathic medicine is not confined to historical osteopathic knowledge; rather osteopathic philosophies and concepts inform the interpretation and application of interdisciplinary knowledge and the basic medical sciences. Osteopathic medicine is an evolving field of knowledge and incorporates new concepts as our understanding of health and disease progresses.
Osteopaths treat people and conceptualise health and disease within a broad holistic bio-psycho-social and environmental context. Osteopaths have a particular interest in conditions of the neuro-musculoskeletal system and the management of pain. Osteopaths seek to prevent disease and promote health by empowering patients through sharing knowledge on lifestyle choices that improve health outcomes.
Osteopathic practice may be situated within a continuum of healthcare and wellness, with osteopaths applying evidence-based approaches to the management of named pathologies and conditions through to promoting well-being through supportive treatment.
The competent practice of osteopathy clearly requires broad diagnostic competencies and a differential diagnosis is required to determine if a structural diagnosis and the use of osteopathic manual treatment (OMT) is appropriate. Although osteopathic practice is often defined by OMT, the practice of osteopathy is not limited to a structural diagnosis and OMT. Whilst there may well be a somatic component to disease, OMT may not be indicated or the principal modality in every presentation.
Osteopaths work across the lifespan and may treat individuals from birth to old age, or deliver services in group settings. Professional knowledge may be applied in a range of settings not limited to clinical practice, such as health promotion, education and research, health policy and healthcare management.
Protection of Title: Those registered in the General Osteopathic Scope of Practice are entitled to use the title of osteopath.
The formulation of the Osteopathic Principles endorsed by the Council as underlying the above scope of practice may be found on the Council’s website www.osteopathiccouncil.org.nz
Pursuant to section 12 of the Act, the Council has prescribed the following qualifications for registration in the General Osteopathic Scope of Practice:
All applicants must:
(1) hold a Master of Osteopathy awarded by Unitec New Zealand;
or
(b) hold a Master of Osteopathy awarded by Royal Melbourne Institute of Technology or Victoria University, Melbourne, or Southern Cross University, New South Wales, Australia, provided those qualifications remain accredited by the Australian and New Zealand Osteopathic Council;
or
(3) pass the overseas assessment process endorsed by the Council;
or
(4) be registered under the Competent Authority Pathway endorsed by the Council, which means that an applicant is registered with the General Osteopathic Council of the United Kingdom and holds a qualification from one of the following institutions:
British College of Osteopathic Medicine (as validated by the University of Westminster since 9 May 2000);
British School of Osteopathy (as validated by the University of Luton since 9 May 2000);
College of Osteopaths (as validated by Keele University since 1 September 2007);
College of Osteopaths (as validated by Middlesex University since 1 October 2001);
European School of Osteopathy (as validated by the University of Greenwich since 9 May 2000);
Leeds Metropolitan University (since 1 September 2007);
London College of Osteopathic Medicine (since 1 October 2001);
London School of Osteopathy (as validated by the University of Brighton or Anglia Ruskin University since 9 May 2000);
Oxford Brookes University (since 1 October 2003);
Surrey Institute of Osteopathic Medicine (as validated by the University of Surrey since 1 January 2003).
2. Extended Scopes of Practice
The purpose of an extended scope of practice is to permit holders of the general osteopathic scope of practice to extend their clinical skills. The Council wishes to make explicit that the prescribed qualification for the general osteopathic scope of practice is not adequate to ensure competent practice and protect the health and safety of the public for areas of practice where an extended scope has been developed.
Only those that are registered in the extended Scope of Practice: Western Medical Acupuncture and Related Needling Techniques and have maintained a current annual practising certificate may lawfully incorporate the relevant techniques or approaches into his or her practice.
Scope of Practice: Western Medical Acupuncture and Related Needling Techniques
All registrants previously registered in the Scope of Practice for Osteopaths using Western Medical Acupuncture and Related Needling Techniques will, from the date this notice takes effect, become registered in the Western Medical Acupuncture and Related Needling Techniques Scope of Practice
Osteopaths registered in the Scope of Practice: Western Medical Acupuncture and Related Needling Techniques are primary healthcare practitioners who hold the General Osteopathic Scope of Practice, and who are qualified to perform Western medical acupuncture and related needling techniques, such as "dry-needling", intra-muscular stimulation or other skin penetrating techniques using a fine filiform (acupuncture) needle.
Western medical acupuncture (WMA) is a therapeutic modality involving the insertion of fine needles; it evolved from traditional based acupuncture systems. Its practitioners no longer adhere to concepts such as Yin/Yang and circulation of qi, and regard acupuncture as a modality rather than a complete "alternative medical system". WMA is an evolving
inter-disciplinary form of practice drawing on contemporary knowledge of anatomy, physiology and pathology, and the principles of evidence based medicine rather than traditional systems of knowledge. It is mainly used to treat musculoskeletal pain (including myofascial trigger point pain), postoperative pain and nausea. Holders of the scope are bound to practise according to the Code of Practice for Osteopaths using Western Medical Acupuncture and Related Needling Techniques.
Protection of Title: Those registered in the Scope of Practice Western Medical Acupuncture and Related Needling Techniques are entitled to use the title of Osteopathic - Western Medical Acupuncture Practitioner.
Pursuant to section 12 of the Act, the Council has prescribed the following qualifications for registration in the Scope of Practice: Western Medical Acupuncture and Related Needling Techniques.
All applicants must:
(1) hold one of the qualifications prescribed for registration in the Scope of Practice - Osteopath;
and
(2) hold one of the following qualifications:
Post Graduate Certificate in Western Acupuncture, Auckland University of Technology
Post Graduate Certificate in Western Medical Acupuncture, University of Hertfordshire (United Kingdom);
or in addition to paragraph (1) above
(3) in accordance with section 15(2) of the Act, satisfy the Council that they hold an overseas qualification that is, in the opinion of the Council, equivalent to, or as satisfactory as, one of the qualifications prescribed in paragraph (2) above. If necessary in the opinion of the Council, the applicant will be required to complete further training in Western medical acupuncture.
3. Vocational Scopes of Practice: Gerontology and Pain Management
The purpose of a vocational scope is to allow members of the public / referring healthcare professionals to identify osteopaths on the Register with advanced standing in a sub-domain of practice. Council recognises that there is a continuum of skill and expertise acceptable in the area of practice and it is explicit that the pre-professional training / registration in the General Osteopathic Scope of Practice gives the registrant adequate skills to be competent but that mastery of a particular area of practice may develop overtime and with further study. The vocational scopes allow post-graduate study combined with clinical experience to be reflected on the Register. Patients and referring healthcare professionals will be able to identify registrants that are well suited to meet the particular healthcare needs of patients.
Gerontology
Pursuant to section 12 of the Act, the Council has prescribed the following qualifications for registration in the Gerontology Scope of Practice.
All applicants must:
(1) be registered in the General Osteopathic Scope of Practice;
and
(2) hold one of the following qualifications:
Postgraduate Diploma in Health Science in Older Adult: Health and Wellness, Auckland University of Technology or other courses of study at New Zealand tertiary institutions deemed by Council to be of similar standard and content (Current registrants who possess relevant tertiary qualifications that are not prescribed may make an application to Council up until date 31 December 2015. Council may grant registration in the scope or recommend further study.);
or
(3) in addition to paragraph (1) above, and in accordance with section 15(2) of the Act, satisfy the Council that they hold an overseas qualification that is, in the opinion of the Council, equivalent to, or as satisfactory as, one of the qualifications prescribed in paragraph (2) above. If necessary in the opinion of the Council, the applicant will be required to complete further training in gerontology.
Pain Management
Pursuant to section 12 of the Act, the Council has prescribed the following qualifications for registration in the Pain Management Scope of Practice.
All applicants must:
(1) be registered in the General Osteopathic Scope of Practice;
and
(2) hold one of the following qualifications:
Postgraduate Diploma in Health Science endorsed in Pain & Pain Management, Department of Musculoskeletal Medicine, Otago University (Christchurch), or other courses of study at New Zealand tertiary institutions deemed by Council to be of similar standard and content (Current registrants who possess relevant tertiary qualifications that are not prescribed may make an application to Council up until date 31 December 2015. Council may grant registration in the scope or recommend further study.);
or
(3) (in addition to paragraph (1) above, and in accordance with section 15(2) of the Act, satisfy the Council that they
hold an overseas qualification that is, in the opinion of the Council, equivalent to, or as satisfactory as, one of the qualifications prescribed in paragraph (2) above. If necessary in the opinion of the Council, the applicant will be required to complete further training in pain management.
4. Special Purpose Scopes of Practice
The Osteopathic Council recognises that osteopathic practice is not limited to the direct provision of clinical services to patients. By recognising that activities other than clinical practice are legitimate applications of professional knowledge osteopaths are permitted to remain on the Register with a practising certificate.
Council will be able to acknowledge their contribution to healthcare and allow systems to be developed that do not penalise such individuals by imposing recency of practice requirements, professional development or recertification programmes that are not relevant to their area of professional practice. It is not the Council’s intention to create an additional protected title for this scope.
Holders of this scope may be required to engage with a return to competence programme if they have not engaged in clinical practice for three subsequent years and wish to return to clinical work. Council will use its discretion to determine how the scope holders’ activities might have contributed to the maintenance of competence in terms of clinical practice.
Pursuant to section 12 of the Act, the Council has prescribed the following qualifications for registration in the Special Purpose Scope of Practice.
To be granted the special purpose scope, a registrant will need to have been previously registered in the general osteopathic scope of practice, or meet the requirements for general registration and satisfy the Council that they have advanced standing or specialist skills in one of the designated areas:
1. Direct non-clinical relationships with patients such as in group exercise programmes, health promotion activities or health care management.
2. Clinical educators / clinical preceptors in pre-professional teaching clinics or practice-based settings.
3. Research - undertaking or directing research activities.
4. Teaching - faculty work in the tertiary sector on professional qualifications that will lead to registration as an osteopath or other regulated health professional and post graduate osteopathic / health science programmes.
5. Health policy development and regulation.
In order to be eligible, the registrants will generally be required to demonstrate that they hold qualifications, other than a prescribed qualification for general registration, relevant to their chosen area of special purpose practice, such as a tertiary level or professional qualifications in teaching and learning, research degrees or demonstrate that that they are working towards one such as being registered for a PhD.
Council will need to be satisfied that the registrant is applying their professional knowledge in a non-clinical setting for at least 60% of the working week. For example, a letter from an employer that the registrant has a 0.6 FTE appointment for the period that an APC is being sought will generally be required and a statutory declaration that clinical practice is limited to 10 hours or less per week.
5. Scope of Practice: Trainee Osteopath
Registered trainee osteopaths are primary healthcare practitioners who are enrolled in the prescribed qualification for the General Osteopathic Scope of Practice (the Unitec Institute of Technology Master of Osteopathy course or an overseas course deemed by Council to be substantively the equivalent in order to permit student electives).
The trainee osteopath will have submitted the final draft of the thesis for the purpose of marking. All other components of the required course will be completed to a satisfactory level. The council sees that this final marking stage of the thesis, and
the time that this takes, should not prevent practice of the student. The student will need to be working within a group practice to ensure peer support and is required to practise within the General Osteopathic Scope of Practice and comply with all related codes and practice standards.
The period of time that a trainee osteopath can practise under this scope of practice will normally be limited to six months, but may be extended at Council’s discretion.
Pursuant to section 12 of the Act, the Council has prescribed the following qualifications for registration in the Scope of Practice - Trainee Osteopath.
All applicants must:
(1) be enrolled in the Unitec Institute of Technology Master of Osteopathy course;
and
(2) have successfully completed the following units in that course of study:
HEAL 8302 Clinical Science 1
HEAL 8303 Clinical Science 2
HEAL 8306 Clinical Practicum 1
HEAL 8308 Patient Management & Clinical Reasoning 1
HEAL 8305 Integrated Osteopathic Practice
HEAL 8307 Clinical Practicum 2
HEAL 8309 Patient Management & Clinical Reasoning 2
HEAL 8310 Professional Practice;
and
(3) have submitted the research thesis component in that course of study.
6. Visiting Osteopathic Presenter / Educator Scope of Practice
The purpose of the Visiting Osteopathic Presenter / Educator Scope of Practice is to create a mechanism to allow overseas registered osteopaths to visit New Zealand for the purpose of presenting or teaching osteopathy without requiring full registration in the General Osteopathic Scope of practice. This will restrict the activities of the osteopath to the presenting and / or educating activities described in the application. Registration will in general be for the period of time required to deliver a specific course / training event.
Council may grant registration for an extended period if the candidate’s application is supported by Unitec, another tertiary institute or the individual is otherwise eligible for registration in the General Osteopathic Scope of Practice, such as osteopaths registered in Australia.
Pursuant to section 12 of the Act, the Council has prescribed the following qualifications for registration in the Scope of Practice: Visiting Osteopathic Presenter / Educator.
All applicants must:
(1) be registered, and in good standing, with an overseas healthcare regulatory authority (where such arrangements are in place) and possess an osteopathic qualification;
and
(2) be able to provide evidence of achievements in research / scholarship or teaching either by publication or educational attainments deemed by Council to be relevant to the osteopathic scopes of practice;
and
(3) submit an outline of the course / teaching activity they aim to deliver in New Zealand.
Dated at Wellington this 31st day of January 2013.
ANDREW CHARNOCK, Registrar, Osteopathic Council.