Allied Health Provision of Therapy in the Neonatal Units in New Zealand: A Cross-Sectional Survey

To benchmark early rehabilitative intervention by occupational therapists, physiotherapists and speech and language therapists (Neonatal Neurodevelopmental Therapists, NNTs) in Neonatal Intensive Care Units (NICU) and Special Care Baby Units (SCBU) in Aotearoa New Zealand (NZ). Benchmarking included content and amount of service provision of neurodevelopmental therapy, and respondent views on workforce priorities.

An online cross-sectional survey was conducted with clinical directors of NICU/SCBU and NNTs recruited via professional networks. The survey included multiple-choice and open-ended questions. Descriptive statistics were used to analyse quantitative responses and thematic analysis for qualitative data.

Completed surveys (n = 64) were received from 17 clinical directors (85% of all clinical directors in New Zealand) and 47 NNTs. Early rehabilitation intervention delivered by NNTs is substantially below international recommended levels in all units. Only 5/17 (29%) of units employed dedicated NNTs. Within their limited time, NNT's activity included assessment (100%), intervention (82%), parent education and support (92.3%) and staff education and support (82%). Few NNTs (36.2%) had specialist training with this population. Themes in workforce priorities were the desire for continuity of care of infants by NNTs, a preference for dedicated NNT and greater access to training.

The limited availability of NNT in NICU/SCBU is likely to compromise the amount of early rehabilitation intervention and reach to neonates and their families, particularly more vulnerable populations such as Māori and Pacific. Substantial scale up of service provision and establishment of a national network of NNT are proposed to advance training, continuity and equity of care.