Policies with purpose

During Covid the CSP and Physio First worked collaboratively to develop tailored guidance to empower members to consider all the required relevant governance, applicable to their practice. This included legal and regulatory frameworks, risk assessments, infection control and consent policies. 

The CSP’s recent review into the services offered to private practitioners found that these resources had proved invaluable and there was a request for more. 

Setting up and working in private practice is a significant undertaking. Business models, finance, and legal aspects aside, you become responsible for taking on aspects of practice previously provided by the NHS or your private employer. This includes ensuring that you address aspects such as quality and safety that help sustain and improve high standards of patient care.

We fully accept this can be a somewhat daunting task. Where to start? What policies and procedures are needed? How should they be written? How often should they be reviewed? Now breathe! This need not be overly onerous or complex. Neither should this be something to be feared or a costly process whereby you 'buy in' the service. 

This article aims to unpick these issues and hopefully show you what you need to consider.

Duty of care 

All physiotherapists have a legal duty to provide a reasonable standard of care to patients and to act in ways to protect their safety. This duty of care requires the use of reasonable skill in providing treatment to patients and it is not acceptable to use any form of disclaimer, or any other method, to deflect this responsibility. The duty of care requires patients to be assessed and advised accordingly. 

In effect this is what you must be able to demonstrate:

• you have the appropriate skills to deliver a standard of care that would be accepted as proper by other physios.
• you are aware that you owe a duty to ensure the safety of relatives and other visitors to the premises such as providing seating in the waiting area.
• you have pathways in place to assure the screening, triage, prioritisation, and management of referrals.
• should you choose not to accept the referral you are able to signpost on whilst being mindful of your duties under the Equality Act.

Thus, you need to be able to demonstrate issues such as consent to treatment, health and safety within your practice and basic infection control measures. 

As a sole practitioner addressing the above may suffice. You will need to consider simply writing down what you do to manage each.

If, however, you are part of a larger team, then writing them down as a protocol or procedure is a good idea to both remind every member of your team and ensure consistency. 

What is important here is that you only create policies and procedures that you need. Downloading or acquiring a set of templates that you can print off, save as your own and feel you have ticked the governance box is not a worthwhile exercise and one that could actually be detrimental. What if a complaint is made against you and you have a suite of policies and procedures that you (or your colleagues) simply haven’t followed or reviewed? 

It is important to note that in any routine HCPC audit, policies and procedures within your business are not important or scrutinised.

What is important in this instance is that you can demonstrate that you have the ongoing education and reflective practice to support the scope of your work as a physiotherapist. 

Further, should a complaint be made against you as a physiotherapist then it is usually your clinical competence and/ or your patient notes that are questioned and having a suite of complicated, unnecessary policies may hinder rather than help you.

You must decide for yourself what is important to the running of your business, however small or large. If you feel it will help with consistency, write your own simple procedures that outline how you practice, then use these as working documents. In general, the larger the business the more you are likely to need. This will enable you to maintain quality and show things done in a consistent and standardised manner.