Making difficult decisions

Difficult decisions facing you may range from the extent to which you feel able to fully support patients in a clinical area that is new to you, whether to see an outpatient face-to-face, or how to manage a long waiting list of patients whose rehabilitation has been delayed. All these decisions cause anxiety as the weight of wanting to do the right thing by patients and colleagues is balanced by what can reasonably be expected of you in your role. 

As professional advisers we have identified guidance to help you through this. We want to reassure you about your responsibilities during a time that continues to be demanding, set your mind at rest regarding your decisions, and remind those who are employed that no matter how difficult circumstances are, your employer has obligations to protect and support you.    

What are your responsibilities?

All healthcare workers have a legal duty to provide a reasonable standard of care to their patients. 

This is known as your duty of care. The ‘reasonable standard of care’ means a level of care that is accepted as conventional and usual practice by a recognised body of peers i.e. another group of physiotherapists. 

You are not expected to provide optimal or outstanding care regardless of your desire to do this. We have recently updated our duty of care webpages which include some useful frequently asked questions on this issue.   

You must escalate and report concerns and issues regarding patient and staff safety to managers. You should also report situations and concerns of clinical incidents or near misses through local systems. 

If you are a registered physiotherapist, you have a regulatory responsibility imposed by the Health and Care Professions Council (HCPC) to work within the limits of your knowledge and skills and to raise issues and concerns about patient safety. Standards two and seven of the Standards of Performance Conduct and Ethics outline these responsibilities and we recommend you familiarise yourself with them. This includes raising concerns about the level of training and supervision provided for a role into which you have been re-deployed. 

How have the HCPC responded to the pandemic?

The HCPC have adapted the way they regulate to reflect the pressures of the pandemic and support staff working across usual service and professional boundaries. 

The HCPC understand the complexities of the current climate. They encourage registrants to do all that they reasonably can and advise you to keep clear records of any decisions you make.

Should any concerns be raised about your practice, the HCPC will take account of:

• The circumstances and context you were working in.
• The approach you took to decision-making.
• Relevant resources, guidelines and protocols in place at the time.

What are you employer’s responsibilities? 

Your employer has a legal and regulatory duty under the Health and Social Care Act 2012 and CQC regulation 18 to ensure that sufficient numbers of suitably qualified, competent, skilled and experienced staff are available to meet the needs of service users at all times. Your employer also has a responsibility to ensure that staff receive the support, training and supervision necessary to carry out their role and responsibilities. This extends to ensuring you are competent in any of the tasks, activities and responsibilities you are being asked to provide. 

Should you have any workplace concerns you should also inform your CSP Steward and/or health and safety rep and seek their support. 

We are here to support you

We recognise that despite lockdown restrictions easing, the pressure on our members continues. The CSP has many resources to support your decision-making so please keep referring to our website. 

You could also tap in to the collective experience and expertise of your fellow members through iCSP. 

Our Professional Advice Service and our Employment Relations and Trade Union can be contacted via the enquiries team on 020 7306 6666; email: enquiries@csp.org.uk;