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Practising during Covid-19

In the months ahead, the profession will continue to face significant challenges, not least how to re-establish and continue to provide care in a variety of trying and different settings. 

As health care professionals, chiropractors are responsible for ensuring that during this process patient and public safety remain paramount. For safe chiropractic treatment to take place thorough and regular risk assessments should be undertaken by each professional to minimise the spread of the virus and the risk of contamination.

The GCC issued a number of statements and advice since March 2020 to registrants on Government policies and guidance on treatment in relation to Covid-19. 

As chiropractors’ business/premises remain open we continue to emphasise the importance of putting patients’ health and safety first and having regard to the Code and the various guidance. Please check our dedicated Covid-19 news webpage regularly. 

It is our expectation that a registrant should only provide treatment if, in their professional opinion, it is safe to do so for the patients, the registrant and any staff and after conducting comprehensive and regular risk assessments.

Covid-19 complaints

We have seen an increase in Covid-19 complaints to FtP. You should have a complaints process that is transparent and easily accessible for your patients. Now might be a good time to make sure it is more visible so that patients can be encouraged to talk to you about any concerns before the GCC is engaged. External advice and guidance on good complaint handling may be available from Professional Associations and the Royal College of Chiropractors. More information can be found in the Covid-19-related complaints below. 

This new guidance has been issued jointly by the Department of Health and Social Care (DHSC), Public Health Wales (PHW), Public Health Agency (PHA) Northern Ireland, Health Protection Scotland (HPS)/National Services Scotland, Public Health England (PHE) and NHS England and is classified as official guidance. As such it is our expectation that registrants review the guidance carefully and implement any necessary changes. We expect that registrants will already be adhering to the infection prevention and control measures previous set out. 

We draw particular attention to the categories of risk and applicable requirements in relation to PPE (The high-risk pathway is not applicable to care provided by chiropractors).

The relevant care pathway for some chiropractic patients may be LOW risk: Any care facility where: 

a) triaged/clinically assessed individuals with no symptoms or known recent COVID-19 contact who have isolated/shielded AND have a negative SARS-CoV-2 (COVID-19) test within 72 hours of treatment and, for planned admissions, have self-isolated from the test date 

OR 

b) individuals who have recovered from COVID-19 and have had at least 3 consecutive days without fever or respiratory symptoms and a negative COVID-19 test. The PPE requirements are set out in Section 7.2 – as follows: 

The relevant care pathway for most chiropractic patients is likely to be MEDIUM risk: Any care facility where: 

a) triaged/clinically assessed individuals are asymptomatic and are waiting for a SARS-CoV-2 (COVID-19) test result with no known recent COVID-19 contact 

OR 

b) testing is not required or feasible on asymptomatic individuals and infectious status is unknown. The PPE requirements are set out in Section 9.2 – as follows:

For the medium risk pathway, which we expect will apply to most patients receiving direct care, a visor must be worn. 

Registrants are expected to consider this new guidance in their risk assessments of treating patients.

Please note: We are advised by the authors the sample triage tool at Appendix 1 is indicative, and that the main text within the guidance has primacy. Therefore, the prospective patient needs to have a negative SARS-CoV2 result before being able to be considered in the low-risk category. 

In our June newsletter we referred to NHS Track and Trace.  We now need to remind you of the importance of undertaking a full assessment of risks in undertaking any treatment. If you are undertaking treatment you must follow the guidance on PPE.   

If you are contacted by the Track and Trace service, having seen a patient who subsequently tests positive, Public Health England has clarified what you have to do i.e. self-isolate for 14 days if you weren’t wearing appropriate PPE and not rely on a test.

Appropriate PPE where the patient is not currently a confirmed or possible case is recommended as mask, apron and gloves - with no breaches of the PPE during the appointment. Visors only need to be used based on a risk assessment regarding the risk of contamination with body fluids/splashes.

We appreciate that this slightly conflicts with advice in table 4 of IPC guidance, and this inconsistency is being raised nationally.

Also, please note that guidance is likely to change over time, so we advise regularly checking the gov.uk website for relevant updates on the novel-coronavirus and infection prevention and control.

Registrants are facing some fundamental challenges. GCC requirements of registrants in relation to CPD may feel like a low priority right now. As the situation evolves priorities will also evolve. We appreciate the challenges that self-isolation could present for CPD planning, at least in the short term, and the disappointment and difficulties caused by learning events and conferences being postponed or cancelled. We understand that, in some cases, the organisers of cancelled events are working to make the learning resources available online instead.

However, our CPD scheme already allows for many different types of learning and development, not just attending physical events. While going to conferences and other events may not be possible for many for the time being, there is a wide variety of CPD that you can still access, including webinars, online learning, and reading relevant journals.

In the meantime, we will continue to monitor the situation closely and update you as appropriate.

https://www.gcc-uk.org/concerns-about-a-chiropractor/make-a-complaint/complain-about-a-registered-chiropractorAll chiropractors practising in the UK must have indemnity arrangements in place to cover them for any claims made against them.
 
We appreciate that insurance premiums are a significant challenge in the current circumstances being faced. We understand that some schemes operated by some insurers and associations have introduced flexible arrangements allowing payments to be made later in the year whilst cover remains in place. This is acceptable and meets the GCC requirements.
 
If an insurance policy is subject to renewal, that policy must be renewed, or a suitable alternative put in place. The GCC do not recognise ‘deferral’ on the basis that treatment is not currently taking place due to measures relating to COVID-19.
 
We emphasise that allowing indemnity arrangements to lapse is a serious matter. It is vital that cover is maintained for past, present and future events. This provides protection for patients and registrants alike.
 
In any event, our rules on indemnity allow the Registrar to either refer such a matter to the Investigating Committee, or to remove a registrant from the register.
 
More details on indemnity can be found here

We take patient concerns related to the ongoing Covid-19 outbreak very seriously and devote time to investigate every individual case with attention and the required expertise.

The Covid-19 pandemic continues to be incredibly challenging for patients and chiropractors alike. 

In the exceptional circumstances of Covid-19 all registrants should comply with the current guidance on safety, infection control and appropriate use of Personal Protective Equipment (PPE) and ensure appropriate and thorough risk assessments are conducted for any treatment provided.

It is the GCC’s expectation that a registrant should only provide treatment if, in their professional opinion, it is safe to do so for the patients, the registrant and any staff.

If you want to make a complaint relating to Covid-19 around PPE or infection control and safety, please speak with the chiropractor first before making a complaint to us. We would always encourage complaints to be raised directly with the professional concerned, so they have an opportunity to rectify your concerns. This may also result in a quicker resolution for you. If a complaint raised directly with a chiropractor is not acted upon, please do let us know.  

The GCC will commence an investigation into a registrant’s fitness to practise in relation to Covid-19 only if it is clearly shown that a registrant has not acted in accordance with the current guidance.

We have published a number of updates on Covid-19 on our dedicated corona virus news page.

You can read the full advice for patients and members of the public wishing to see a chiropractor here.

Our investigation team is available to speak to anyone concerned about the treatment you have received during the pandemic or at any other time - email investigation@gcc-uk.org.  

However, if you wish to make a formal fitness to practise complaint, please do so by completing our online form.

Why see a registered Chiropractor?

Find out why you should see a registered chiropractor

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Seeing a Chiropractor for the first time

We cannot help you choose which chiropractor to see, but our list of the most commonly asked questions may be helpful if you are seeking chiropractic treatment

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The Code

The Code clearly outlines the standards of performance, conduct and ethics that are expected of chiropractors in the UK. Chiropractors must meet these standards in order to join and remain on our register.

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Guidance

Our guidance is published separately from the Code but should be read alongside it.

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Education Standards

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