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As part of its statutory commitment to developing the profession, the GCC has created a series of Code-compliant guidance documents and toolkits. 

These provide registrants with advice on several important professional requirements, particularly in areas which have led to past Fitness to Practise complaints and investigations.


GCC Guidance provides registrants with GCC Code-based policy and best practices in various subject areas.

GCC Toolkits are 'how-to' guides that provide top-line helpful advice and guidance on a particular subject.

For some subjects, such as advertising, guidance and a toolkit have been created.

Joint Statements are developed with other health and social care regulators and cover multi-discipline subjects.


Guidance

Candour Guidance (April 2016)


Joint Statement

Duty of Candour (2014)

Our Duty of Candour joint statement explains the expectation that all health and social care professionals should act openly and honestly with their patients in the event things go wrong (a duty of candour). Duty of candour is an implied requirement of the GCC Code

Joint Statement

Conflicts of Interest Guidance (May 2017)


The Conflicts of Interest joint statement sets out the expectations of how healthcare professionals should act in relation to avoiding, declaring and managing actual or potential conflicts of interest across all health and social care settings. It supports the GCC Code.

This joint statement has been agreed by all nine regulators overseen by the Professional Standards Authority.


You may also wish to review this illustrative scenario of a conflict of interest and how it might be managed.

Other illustrative scenarios from different regulators:

General Osteopathic Council: Making referrals to a colleague

General Medical Council: Disclosure

General Medical Council/General Pharmaceutical Council/Pharmaceutical Society of Northern Ireland: Prescription direction

Health and Care Professions Council: NHS and private treatment

In this section, you will find:

  • GCC Guidance on diagnostic imaging
  • Additional Resources
    • IRR17: Ionising Radiation Regulations 2017
    • IR (ME)R: Ionising Radiation (Medical Exposure) Regulations 2017 
    • NICE guidelines for imaging spines
    • Further information and guidance
  • Background Information on GCC diagnostic imaging guidance

GCC Guidance

Diagnostic Imaging Guidance (March 2022)


Additional Resources

Radiographic imaging (X-ray) is part of the suite of diagnostic procedures used by chiropractors, either in a chiropractic clinic or through referral.

Employers must have in place and make available referral guidelines. This will be the evidence base for making a referral.

Chiropractors undertaking their own radiography must ensure that they comply with the Ionising Radiation Regulations 2017 and the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R 2017 or (IR(ME)R NI 2018) (see below). 

Radiographs should only be obtained if there is sufficient clinical justification in an evidence based context. A practitioner or operator must not carry out any radiographic exposure or any practical aspect without having been adequately trained (regulation 17), and the exposure must be justified by the practitioner as showing a sufficient net benefit (regulation 11).

IRR17 

On 1 January 2018, Ionising Radiation Regulations 2017 (IRR17) came into force and replaced Regulations IRR99.  These regulations were created to ensure the safety of employees and the public, and are separate to the regulations concerned with the safety of patients (IR(ME)R 2017) (see below).

In order to ensure compliance with IRR17, the Health and Safety Executive (HSE) have begun a rolling program of inspections. The GCC was informed that the chiropractic profession would be subject to these inspections. This is not in response to any incident or designed to target the profession for any reason. All professions subject to the new regulations may be inspected to ensure that their procedures are safe and compliant. It is important to note that all practices with X-Ray facilities are subject to inspection. As such, all practitioners need to work within a robust governance framework and have a means by which to evidence how each of the requirements of the regulations are being met. Radiation Protection Advisers (RPAs) can advise on this.

In October 2018, a statement was issued by the GCC, chiropractic professional associations and Royal College of Chiropractors regarding the planned inspections of chiropractors with X Ray facilities. The HSE subsequently published a report based on their inspections, followed by the professional associations providing guidance to registrants.

IR(ME)R 

The Ionising Radiation (Medical Exposure) Regulations 2017 replace the 2000 regulations, including amendments made in 2006 and 2011. For Northern Ireland, Ionising Radiation (Medical Exposure) Regulations (Northern Ireland) 2018, is applicable.

The regulations provide a framework for the safe use of ionising radiation when using medical radiological equipment for medical and non-medical imaging. They aim to ensure patients are protected from the risk of harm when being exposed to ionising radiation. 

The regualtions set out the responsibilities of duty holders (the employer, referrer, IR(ME)R practitioner and operator) for radiation protection and the basic safety standards that duty holders must meet. Responsibilities include:

  • minimising unintended, excessive or incorrect medical exposures
  • justifying each exposure to ensure the benefits outweigh the risks
  • optimising diagnostic doses to keep them “as low as reasonably practicable” for their intended use.

It is important to note that all practices with X-Ray facilities are subject to inspection. The regulations apply to both the independent sector and the public sector (NHS).

Both sets of regulations are enforced through various organisations within each of the four home nations. These are known within the regulations as the ‘appropriate authorities:

NICE guidelines for imaging spines

Further information and guidance

HSE Working with ionising radiation. Ionising Radiations Regulations 2017 - approved Code of Practice and guidance

DHSC Ionising Radiation (Medical Exposure) Regulations 2017 guidance

Royal College of Radiologists iRefer

IR(ME)R: Implications for clinical practice in diagnostic imaging, interventional radiology and diagnostic nuclear medicine 

Trans equality guidance for the radiography workforce


Background Information on GCC diagnostic imaging guidance

In 2021, an Expert Group was appointed with representatives from the field of radiology and radiography, and from within and outside of the chiropractic profession. 

  • Dr Julian Chakraverty MBChB: Consultant Musculoskeletal and Sports Radiologist, University Hospitals Bristol and Weston NHS Foundation Trust, British Society of Skeletal Radiologists
  • Maria Murray: UK Radiation Protection Lead and Professional Officer for Scotland, Society and College of Radiographers
  • Mark Gurden FRCC: President of the Royal College of Chiropractors. Registrant
  • Inger Roug DC, DACBR, Pg. cert (Medical Ultrasound) FRCC, FHEA: AECC University College, Bournemouth. Registrant
  • Laura Finucane: Consultant Physiotherapist FMACP FCSP, Sussex MSK Partnership
  • Matthew Rogers: Bsc (Hons) Ost, MInstLM, MICB, Head of Policy at the Institute of Osteopathy
  • Phil Yalden, Member of the General Chiropractic Council. Registrant.

At its meeting in spring 2021, the Expert Group was presented with a discussion paper on diagnostic imaging. This paper set out the:

  • current arrangements of diagnostic imaging within healthcare, both generally and within chiropractic
  • statutory and regulatory considerations in X-ray
  • current guidance and expectations of practitioners 
  • risks of imaging
  • extant guidance and protocols in relation to chiropractic.  

The Expert Group considered the discussion paper helpful and agreed that Guidance should be created that addressed the centrality of diagnostic decision-making, including the use of imaging.

It also agreed that a briefer background document should be developed which sets out options as to how the regulator can incentivise good practice, emphasising that standards and guidance are a principal focus for the regulator with clinical decision-making a matter for the professional. Equally, the regulator can and must affect its public protection duties.

The Expert Group agreed to a staged approach, with the GCC setting out certain expectations, including:

  • the clinician exercising professional judgment based on evidence and referencing extant guidance, such as i-Refer
  • answering ‘will imaging influence the care of the patient?'
  • what type of imaging is appropriate? 
  • weighing up the risk/benefit equation in relation to ionising radiation
  • all of the above being subject to discussions with the patient, gaining informed consent and with the clinician’s decision-making process recorded.

In summer 2021, the Expert Group considered and agreed the background document and draft guidance, and recommended it for consideration by Council at its meeting in September 2021. 

Council agreed that the supporting documentation and draft guidance published, subject to consultation. Following the consultation, where over 200 submissions were received, the guidance was revised and re-presented to Council for approval its December 2021.

The following documents were created for the Expert Group:

Government Guidance

FMG mandatory reporting in healthcare 


A mandatory duty to report female genital mutilation (FGM) cases to the police came into effect in England and Wales on 31 October 2015. It applies to all registered healthcare professionals, including chiropractors. 

All chiropractors should familiarise themselves with the government’s guidance and resources. Under the legislation, failure to comply with the duty may result in a Fitness to Practise investigation.

The duty applies:

  • where a chiropractor, in the course of their work, is informed directly by a girl that an act of FGM has been carried out on her
  • where a chiropractor observes physical signs which appear to show an act of FGM has been carried out and has no reason to believe that the act was necessary for the girl’s physical or mental health or for purposes connected with labour or birth
  • to girls who are under 18 at the time that FGM is observed or disclosed. It does not apply if the health professional only suspects that FGM may have been carried out.

While the duty is limited to the specific circumstances described above, chiropractors should consider their wider safeguarding responsibilities in line with the standards outlined in the GCC Code.


Scotland and Northern Ireland

Although the duty does not apply to Scotland and Northern Ireland, chiropractors should still follow local safeguarding procedures.

Scottish legislation is outlined here.

Information for those based in Northern Ireland is available here.

Toolkit

Mental Health Toolkit (June 2021)

 


Valuing good mental health

46.4% of all adults will experience mental health issues during their lifetime. (National Council of Mental Wellbeing)

Good mental health can help you to cope better with daily life, especially during these unusual times. Indeed, many organisations, such as the Mental Health Foundation, have long advocated that good mental health is as important to a person’s wellbeing as their physical condition. 

Within the workplace, we (employers, employees and colleagues) have a responsibility to create a culture in which people can openly speak about mental health concerns without fear or discrimination. By doing so, we can better provide support for all and begin to dismantle the long-associated stigma surrounding mental health.

To help registrants, or any other visitor to our website, the General Chiropractic Council has created this Mental Health Resource Pack, providing information, helpful tips and signposting to additional resources.

Good mental health.

Joint Statement

Reflective Practice


The Reflective Practice joint statement has been agreed by all nine regulators overseen by the Professional Standards Authority.

There are many benefits to becoming a reflective practitioner. This statement sets out our common expectations for health and social care professionals.

Being a reflective practitioner benefits people using health and social care services by:

  • Supporting individual professionals in multi-disciplinary team work
  • Fostering improvements in practice and services
  • Assuring the public that health and social care professionals are continuously learning and seeking to improve.

As well as expecting the people we regulate to be reflective practitioners, we also have a duty to consider our own actions, and their effect. We are committed to improving how we provide assurance and protection to the public. We do this continuously in our work, through evaluation, to reflect and make changes in what we do and how we work.

This statement reflects the principles set out in each regulator’s individual code of practice, professional standards or guidance on reflective practice.

The Code

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

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Career Pathways

Discover more about other career options open to chiropractors in addition to clinical practice.

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I’m Registered logo

Exclusive to GCC Registrants, the I'm Registered brand assures your patients of your training and abilities, setting you apart from non-regulated practitioners.

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Quality Standards and Guidelines

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Use of ‘Chiropractic’ in a Company Name

Information on how to apply for a Companies House Letter of Authorisation from the GCC.

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Your registration number and the title of Doctor

Guidance on using your GCC registration and the Doctor title.

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Complaints

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