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Page 1: Quality - csp.org.uk · Purpose of the Quality Assurance Standards These Quality Assurance (QA) Standards have been developed by the Chartered Society of Physiotherapy (CSP) for its

Quality Assurance Standards for physiotherapy service delivery xx

AssuranceQuality

Standardsfor physiotherapy service delivery

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2 Code of Members’ Professional Values and Behaviours

Contents

Foreword 3

Introduction 4

TheQualityAssuranceStandards 7 Section1Autonomyandaccountability 7 Section2Deliveringasafeandeffectiveservice 9 Section3Learninganddevelopment 13 Section4Workinginpartnership 15 Section5Consent 17 Section6Recordkeepingandinformationgovernance 19 Section7Communication 21 Section8Physiotherapymanagementandtreatment 23 Section9Evaluationofclinicalcareandservices 27 Section10Promoting,marketingandadvertisingphysiotherapyservicesandproducts 29

Glossary 30

References 33

Annexxes 34 Annex1Steeringgroup 34 Annex2Relatedresources 35

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Chartered Society of Physiotherapy 3

Foreword

AstheChairofCouncil,IampleasedtointroducetheSociety’snewQualityAssurance(QA)Standardsforphysiotherapyservicedelivery.ThesereplacetheoriginalCoreandServiceStandardsdevelopedin2000andupdatedin2005.TheQAStandardsprovideanintegratedandperson-centredapproachtopracticeandservicedeliverywhichreflectsthecomplexityofservicedeliveryandphysiotherapypractice.Theyareintendedtosupportmembersinmeetingtheirlegal,ethicalandregulatoryrequirements.

TheseQAStandardshavebeendevelopedinresponsetoMemberfeedbackthattheCSPStandardscontinuetoberelevanttomember’sworkinglivesandintegraltodeliveringandassuringthehighqualityofphysiotherapyservices.TheprojecttodeveloptheminvolvedextensiveconsultationwithCSPmembersthroughouttheUKworkinginarangeoforganisationsandrolesandwasoverseenbyasteeringgrouprepresentingmembers.

TheQAStandardsprovidestatementsofexpectedlevelsforservicedeliverywhichmembers,throughconsultation,agreearesetatalevelwhichisreasonableandachievablebyaCSPmember,orphysiotherapyserviceintheUK.Theyapplyregardlessofanindividual’srole,gradeorexperienceandapplytoindividualmembers,physiotherapyteamsdeliveringservicesandthose,includingmanagersoremployerswhosebackgroundmaynotbephysiotherapy,witharesponsibilityforoverseeingservicedelivery.TheQAstandardsareatoolformemberstousecollectivelyorasindividualsaspartofaqualityassuranceprocess.Theywillalsobeusefulforserviceusersandthosepurchasingservices.TheQAstandardsresourceincludesaQAtoolwhichenablesthecomparisonofactualserviceswiththesestandards.

DrHelenaJohnsonEdDMEdPgDHEBScHonsMCSPFHEAChair of CSP Council

August2012

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4 Code of Members’ Professional Values and Behaviours

Introduction

PurposeoftheQualityAssuranceStandardsTheseQualityAssurance(QA)StandardshavebeendevelopedbytheCharteredSocietyofPhysiotherapy(CSP)foritsmembers;qualifiedmembers,associatesandstudents.

TheQAStandardstogetherwiththeQualityAssurance(QA)AuditToolhavebeendevelopedto:• promoteandassurequalityinclinicalpracticeandservicedelivery• supportCSPmembersinassuringanddemonstratingthestandardofphysiotherapycareandservices• supportCSPmembersindeliveringsafeandeffectivephysiotherapyservices• provideamarkerforCSPmembersandthosewhopurchaseorusephysiotherapyservicesonwhichtoassess

thestandardofalocalphysiotherapyserviceorcare• supportCSPmembersinmeetingtheexpectationsoftheSocietyasarticulatedintheCode of Professional

Values and Behaviour(1)

• SupportqualifiedMembersinmeetingtherequirementsoftheHealthandCareProfessionsCouncilassetoutintheStandards of Proficiency – Physiotherapists (2)andStandards of Conduct, Performance and Ethics.(3)

DevelopmentoftheQualityAssuranceStandardsPhysiotherapyisahealthcareprofessionthatworkswithpeopletoidentifyandmaximisetheirabilitytomoveandfunction.Functionalmovementisakeypartofwhatitmeanstobehealthy.Thismeansthatphysiotherapyplaysakeyroleinenablingpeopletoimprovetheirhealth,wellbeingandqualityoflife.(4)

TheCSPhastheresponsibilityforleadingthephysiotherapyprofessionintheUK.Itprovidesarangeofresourcesforitsmembersandothersinterestedinthepractiseofphysiotherapy.Itisanticipatedthatawiderangeofindividualsandorganisationswillusetheseresourcestoinformtheirknowledgeofphysiotherapyandthephysiotherapyprofession.

TheseQAStandardsbuildonandreplacetheformerCSPCoreStandards(5)andServiceStandards(6)producedin2000andtheCoreStandardsofPhysiotherapyPracticeupdatedin2005.(7)TheQAStandardshavebeendevelopedinconsultationwithCSPmembersworkinginarangeoforganisationsandrolesandinresponsetomemberfeedbackthattheCSPStandardshaveremainedatoolwhichisusedandvaluedbythem.Thekeychanges,seeninthisdocument,hasbeentodevelopasingleresourcewhichintegratesandbuildsontheCoreandServiceStandards,appliestoallCSPmembersandplacesgreateremphasisontheirroleinpromotingandassuringqualityclinicalpracticeandservicedelivery.InresponsetofeedbackarangeofformatsareavailabletoenablememberstoaccesstheQAStandardsinthedepthrequiredatanygiventime.

InterpretationoftheQualityAssuranceStandardsTheQAStandardsaresetatalevelwhich,membersthroughconsultationagree,isreasonableandachievablebyaCSPmemberorphysiotherapyserviceintheUK.TheQAStandardsapplytoindividualmembers,physiotherapyteamsdeliveringservicesandthose,includingmanagersoremployerswhosebackgroundmaynotbephysiotherapy,witharesponsibilityforoverseeingphysiotherapyservicedelivery.TheQAStandardshavebeendevelopedtoreflectthecomplexityofservicedeliveryandphysiotherapypractice.Assuch,althoughaccessingasectionoftheresourcemayberelevantattimes,eachsectionshouldbeconsideredaspartofawhole.

TheQAStandardsapplyregardlessofanindividual’srole,gradeorexperience.Theirinterpretationwillvaryfordifferentmembergroupsorlevelsofpracticeandnotallofthestandardswillbeapplicableinallsituationsoratalltimesofanindividual’scareer.CSPmembersshouldcriticallyreflectontheirroleandindividualscopeandthecontextoftheirpracticeandtheservicewithinwhichitisdeliveredtodeterminewhenstandardsdonotapply.

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Chartered Society of Physiotherapy 5

TheQAStandardsareorganisedinto10sections.Withineachsectionareanumberofstandards.TheseQAstandardsprovideclearstatementsonexpectedfeaturesofphysiotherapyservicedeliveryprovidedbymembersofthephysiotherapyprofession.Eachofthestandardshasanumberofmeasurablecriteriarelatingtothemwhichpresentthecomponentsofhowastandardmaybemet.Theseareprovidedforqualityassurancepurposes.Thesecriteriaarenotexhaustiveanditislikelythattheremaybeotherwaysinwhichtodemonstratethatastandardhasbeenmetandtheseshouldbeagreedlocally.

Aqualityassuranceaudittool(QAtool)hasbeendevelopedtofacilitatethecomparisonofactualservicedeliverywiththecriteriaintheQAstandards.Therearelinksthroughoutthestandardstothistool.

TerminologyTheterm‘organisation’hasbeenusedthroughouttheQAStandardstorefertothecontextwithinwhichthephysiotherapyserviceisdelivered,e.g.asinglehandedindependentpractitionerdeliveringaservice,oraservicewithinalargeorganisation.

Thetermserviceuserhasbeenusedtoincludeallthoseinreceiptofphysiotherapyincludingpatients,clients,carersandothers.

Theterm‘intervention’hasbeenusedtoincludeallaspectsofservicedelivery,clinicalcareandphysiotherapymanagement.

ResponsibilityforimplementationCSPmembersareresponsiblefortheimplementationandauditoftheseQAStandards.Thereisnointentiontomonitortheimplementationofthemastheyareatoolformemberstouseeithercollectivelyorasindividualsaspartofaqualityassuranceprocess.Individualsandservicesareadvisedtoidentifylocallywhereresponsibilityforensuringtheactualimplementationofaspecificstandardandcriterialies.

ItislikelythattheQAStandardswillbeusedatalocallevelforreferenceandsupportinorganisationalgovernancesystemsandusednationallyforreference,incasesheardbytheHealthandCareProfessionsCouncil(HCPC).Whereappropriate,inafitnesstopracticecasetheregulatorlooksforevidenceofwhatisareasonablestandardofpracticeandwhattheaverageprofessionalwoulddo.TheQAStandards,alongwithotherdocumentsproducedbytheCSP,inparticulartheCode(1),thePhysiotherapyFramework(4)andtheLearning&DevelopmentPrinciples(8),mayalsobeusedtoformpartofthisprofessionalframework.

Participationinauditshouldbepartofamember’scontinuingprofessionaldevelopment(CPD)anduseoftheQAtoolsupportsCSPmembers’activityinthisway.ThelinktotheePortfolio(9)providestheindividualmemberwithatoolforrecordingparticipationinthequalityassuranceprocess.TheePortfolioprofiletoolallowsmemberstoaddevidencetodemonstratehowtheyfulfilthecriteriaineachstandardandthereforebecomesalogofdevelopmentofpracticeandservicedelivery.

QualityAssuranceaudittool(10)

TheQAaudittoolhasbeendevelopedtofacilitatethecomparisonofphysiotherapyservicedeliverywiththatpresentedintheQAstandards.TheQA,throughtheQAaudittool,enabletheauditofthestandardsineithertheirentiretyorinsectionsifrequired.TheQAaudittoolusesthecriteriabeneaththestandardtoidentifywhethertheactualstandardhasbeenmet.Themajorityofthecriteriaaremeasurableandinformationcanbegatheredfromrecordsorpolicies,ormaybeobservedorassessed.However,therearesomecriteriawhichmayrequirereflectionbythephysiotherapistorphysiotherapyteammemberthrough,forexample,peerreviewor

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6 Code of Members’ Professional Values and Behaviours

gatheringserviceusers’experiencestodemonstratethatthecriteriahavebeenmet.

TheQAaudittoolcomprisesthreeelementswhichenablethetriangulationofinformation;• adatacollectiontooltogatherinformationfromtheserviceuserorphysiotherapyrecordsandorganisational

policies• astructureforgatheringserviceuser’sexperiences• atoolforpeerreview

UseoftheQAStandardsasaframeworkforqualityassurancewillprovideonemethodthroughwhichactionscanbeidentifiedforserviceimprovementandwillsupportmembersincomplyingwiththelegal,moralandethicalobligationsplacedonthemwhenpractisingphysiotherapyintheUK.UseoftheQAaudittoolwillprovideevidencethatphysiotherapyservicedeliveryisofastandardquality;andwillprovideusefulinformationaspartofacyclicalqualityassuranceprocess.Thisinformationmaybeshared,bothwithintheserviceaspartofthequalityimprovementcycleandwiththoseoutsidetheservicetoassurethequalityofaservicebeingdelivered.Wheretheprocessidentifiesvariationsfromthestandard,thephysiotherapistorphysiotherapyteammemberisresponsibleforcommunicatingthisinformationtotheresponsibleperson(s).

AttimestheorganisationalpolicymayconflictwiththeQAStandardsandpreventastandardbeingmet.InanalysingtheresultsoftheQAprocessthesediscrepanciesshouldbeidentifiedactiontakentoexplorethisfurther.Inthissituationtheindividualmemberandtheorganisationareadvisedtoconsiderlegalresponsibilities,organisationalresponsibilitiesHCPCrequirements,andresponsibilitiestoserviceusers.

TheannexonrelatedresourcesincludesarangeofresourcestosupporttheunderstandingandimplementationoftheseQAstandards.

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QualityAssuranceStandards1.1 Membersworkwithinthescopeofpracticeoftheprofession andtheirindividualscopeofpractice1.2 Membersdemonstratethebehaviours,skillsandknowledgetofulfil theresponsibilitiesoftheirrole1.3 Membersfulfiltheirdutyofcaretoserviceusers1.4 Membersdemonstrateprofessionalismatalltimes

IntroductionMaintainingautonomyandaccountabilitytotheserviceuser,thepatient,theprofessionandthepublicrequireseachCSPmembertobeawareofthemanyenvironmentalfactorsunderpinningthese:suchastheneedtopracticewithinthelegalobligationsofthecountryandtheorganisationinwhichtheywork.

Asanautonomousprofession,physiotherapistscanacceptreferralsforassessmentfromarangeofsources:fromanindividualthemselves(self-referral)orfromotherpeopleinvolvedwiththatindividual.Professionalautonomymeansthatamembermakesdecisionsandactsindependentlywithinaprofessionalcontextandisresponsibleandaccountableforthesedecisionsandactions.Akeyelementofprofessionalautonomyisunderstandingandworkingwithinthelimitsofpersonalcompetenceandscopeofpractice.

Neitherphysiotherapystudentsnorsupportworkersholdprofessionalautonomy.Bothgroupsofmembersundertakephysiotherapy-relatedactivitywithappropriateformsofsupervision.Physiotherapystudentsarepreparedthroughtheirqualifyingeducationtoassumetheresponsibilitiesofprofessionalautonomyonqualification.Whilenotautonomouspractitioners,physiotherapysupportworkerstakeresponsibilityforundertakingthetasksdelegatedtothemindeliveringaphysiotherapyservice.

Astheprofessionalbodyforphysiotherapy,theCSPdefinesscopeofpracticeforphysiotherapyintheUK.Scopeofpracticerelatesstronglytocompetenceandprofessionalism.Theconceptrecognisestheprofession’sscopeofpracticeisevolving,andneedstoevolve,inlinewithchangingpatientandpopulationneeds,developmentsintheevidencebase,changesinservicedesignanddeliveryandchangingopportunitiesforprofessionalandcareerdevelopment.IndividualmembershavearesponsibilitytobeawareofhowtheirpracticemaychallengetheboundariesofthescopeofpracticeofUKphysiotherapyandtotakeappropriateaction.Individualmembersalsohavearesponsibilitytolimittheiractivitytothoseareasinwhichtheyhaveestablishedandmaintainedtheircompetence.

Professionalismdefineswhatisexpectedofaprofessional,andwhatitmeanstobeaprofessional.Broadly,itcanbesummarisedas;amotivationtodeliveraservicetoothers,adherencetoamoralandethicalcodeofpractice,strivingforexcellence,maintaininganawarenessoflimitationsandscopeofpracticeandacommitmenttoempoweringothers(ratherthanseekingtoprotectprofessionalknowledgeandskills).

1.1 Membersworkwithinthescopeofpracticeoftheprofessionandtheir individualscopeofpracticeCriteria1.1.1 Membersdemonstrateanunderstandingoftheirpersonalscopeofpracticeandthescopeofthe

profession1.1.2 Memberspractisewithintheirindividualscopeofpractice1.1.3 Membersidentifytheirlearningneedsandputinplacelearningopportunitieswhichconsidertheneeds

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8 Code of Members’ Professional Values and Behaviours

oftheserviceandserviceusers1.1.4 Membersareinsuredfortheactivitiesthattheyundertake

1.2 Membersdemonstratethebehaviours,skillsandknowledgetofulfilthe responsibilitiesoftheirroleCriteria1.2.1 Membersreflectontheirroleandevaluatetheirlearningneeds1.2.2 Membersidentifyareasoflearningrequiredtodevelopandmaintaincompetenceintheirrole1.2.3 Thereisapolicywhichincludes:

a. checkingphysiotherapistsareregisteredwiththeHCPConinitialemploymentandannually b. checkingphysiotherapyteammembershaveundergonerelevantdisclosures c. assessingthesuitabilityofnewphysiotherapyteammembersusingtherelevantperson

specificationandjobdescription d. holdingpersonnelfileswhichincludeaCVwhereapplicable,references,recordsofappraisal,

andevidenceofengagementinCPD e. anappraisalsystemtoevaluatelearningneeds

1.2.4 Asignature,jobtitleandworkareaisrecordedinthesignaturebookforallphysiotherapyteammembersandretainedinlinewithrecordkeepinglegislation

1.3 MembersfulfiltheirdutyofcaretoserviceusersCriteria1.3.1 Membersdemonstrateanunderstandingoftheirdutyofcareresponsibility,includinghowthisrelatesto

organisational,regulatoryandprofessionalstandards1.3.2 Memberstakeresponsibilityforfulfillingtheirdutyofcaretotheserviceusers1.3.3 Memberstakeresponsibilityforidentifyingwherefactors,includingimplementationoforganisational

decisionsandstructures,havetheeffectofcompromisingtheirdutyofcaretoindividualserviceusers1.3.4 ThereisapolicyinplacetoensurethatCSPmembersaresupportedinidentifyingandaddressing

factorsthatmaycompromisetheirfulfilmentoftheirdutyofcaretoserviceusers

1.4 MembersdemonstrateprofessionalismatalltimesCriteria1.4.1 Membersdemonstratepracticethatisethicalandinaccordancewithrelevantorganisational,legaland

regulatoryrequirements1.4.2 Membersbehaveinsuchawaythattheirmanner,attitudesandactionsinstilconfidenceinthe

profession1.4.2 Thereisapolicyinplacewhichincludes: a. anappearancepolicy b. dutytoreport c. theuseofsocialmedia d. physiotherapyteammembersworkingexcessivehours e. physiotherapyteammembersworkinginrolesoutsideofphysiotherapy

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QualityAssuranceStandards2.1 Thereisaplannedorientationandinductionprogrammeformembersworkinginnewroles2.2 Physiotherapystaffingandskillmixissufficienttosupporttheservicesbeingprovided2.3 Physiotherapyservicesaredeliveredinasafeenvironment2.4 Thereisasystematic,proactiveandresponsiveapproachtoriskmanagementthatfollowsthe

organisation’soverallstrategy2.5 Allmedicaldevicesaresafeandfitforpurpose,ensuringserviceuser,carerandphysiotherapy

teamsafety2.6 Therisksofloneworkingareminimised

IntroductionDeliveringasafeandeffectiveservicerequiresarangeofactivitiestoassurethesafetyofserviceusersandthosewhoworkwithinitandtheeffectivenessoftheservicedelivered.Acomprehensiverangeofpoliciesandproceduresarerequiredtounderpinthisservicedelivery.Therequirementsandemphasisonspecificaspectsofthiswillvaryaccordingtotheorganisation,servicedelivered,serviceusersandthecontextofcare.TheCSPprovidesabroadrangeofresourcestosupportmembersintheseareas.

2.1 Thereisaplannedorientationandinductionprogrammeformembers workinginnewroles.Criteria2.1.1 Thereisanaccessibleandplannedorientationandinductionprogrammeforallmembersworkingin

newenvironments,e.g.returners,newstartersandmembersgoingtonewsitesetc2.1.2 Membersattendtheinductionprogrammeandidentifywherecomponentsofitareomitted2.1.3 Membersprovidefeedbackontheinductionprogrammetoensureitscontinuedrelevance2.1.4 Thereisapolicyinplacefortheinductionprogrammewhichincludes: a. contentandstructureoftheprogramme b. anamedpersonresponsibleforplanningandforimplementation c. anamedpersonresponsibleforevaluationandreviewtoensuretheprogrammecontinues

tofulfilitsintendedpurpose d. completionoftheprogrammewithinlocallyagreedtime-scales e. issueoftheprogrammetoeachnewmemberofthephysiotherapyteam2.1.5 Mandatorytrainingiscompletedwithinagreedtimescales2.1.6 Membersreceivetrainingin: a. fireprocedures b. lifesupport c. movingandhandling d. dealingwithviolenceandaggression e. controlandpreventionofinfection f. confidentiality g. informationgovernance h. safeguardingchildren i. safeguardingvulnerableadults j. familiarisationwithrecordkeepingsystems(egstorageofpaperrecordsorelectronicaccess) k. anapproachtorecordkeepingwithintheteam(style/useofacronymsandshortformsetc)

2 Delivering a safe and effective service

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2.2 PhysiotherapystaffingandskillmixissufficienttosupporttheservicesbeingprovidedCriteria2.2.1 Thereisapolicywhichincludes; a. anappropriaterecruitmentandselectionprocedure b. staffingcommensuratewithdeliveringasafeandeffectiveservicewhichmakesbestuseof

existingresourcesintermsof: • grade • skillmix • experience • staffnumbers c. managing: • situationswherestaffinglevelsfallbelowlocallyagreedminimumlevels • theregularreviewofstaffinglevels • theregularreviewofskillmix d. prioritisationofworkloadifdemandexceedsstaffinglevels • flexibilityinbothserviceprovisionandtheneedsofCSPmembers • asystemtoensureallphysiotherapyteammembershaveskillsandexperienceinthe

areasinwhichtheyarerequiredtowork • arrangementsforidentifyingandaddressinglearningneedsarisingfromchanging

servicerequirements • arrangementsforthedelegationofactivitieswithinteams • arrangementsforclinicalleadership • arrangementsfortheclinicalleadershipofservices • aproceduretorecogniseandcorrectpoorperformance

2.3 PhysiotherapyservicesaredeliveredinasafeenvironmentCriteria2.3.1 Thephysiotherapyserviceactsonhealthandsafetyguidance2.3.2 Thephysiotherapyservice(wherepartofalargerorganisation)isconsidered,andifappropriate

included,inthewiderorganisationalplansforemergencyincidentswhichcouldaffectprovisionofnormalservices

2.3.3 Physiotherapyservicescomplywithpolicyon; a. safeguardingchildren b. safeguardingvulnerableadults c. nationalchildprotectionguidance2.3.4 Serviceusersreceivingphysiotherapyaremadeawareofhowtosummonassistance2.3.5 Therearesystemsinplacetoidentify,reportandlearnfromserviceusersafetyincidentsandother

notifiableincidents,usingappropriatelocaland/ornationalgovernancesystemsandtodemonstrateresultingimprovementsinpractice

2.3.6 Thereisahealthandsafetypolicywhichincludesprocedurestomanage; a. fire b. wastedisposal d. disposalofmedicalwaste e. resuscitation f. firstaid g. controlandpreventionofinfection h. disposalofsharps i. loneworking j. chaperoningarrangements

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Quality Assurance Standards for physiotherapy service delivery 11

k. interpreters l. workingoutsidenormalhours m. controlofsubstanceshazardoustohealth n. safemovingandhandlingofloads o. reportingofindustrialdiseasesanddangerousoccurrences p. plannedmaintenance q. rehabilitatione.g.practisingstairspolicy r. thesummoningofurgentassistancewhenrequired2.3.7 Therearepoliciesinplaceforthemaintenanceof: a. temperature b. humidity c. lighting d. ventilation

2.4 Thereisasystematic,proactiveandresponsiveapproachtoriskmanagement thatfollowstheorganisation’soverallstrategyCriteria2.4.1 Careistakentominimiseriskstophysiotherapyteammembersandserviceusers2.4.2 Regularhealthandsafetyauditsareundertakeninaccordancewithlocallydefinedtime-scales2.4.3 Noticesofhazardstoserviceuserareprominentlydisplayedinareasofknownrisk2.4.4 Therearepoliciesforriskmanagementwhichinclude: a. clearlydefinedproceduresforthemanagementofrisks b. traininginundertakingriskassessmentswhichincludeidentificationandeffectivemanagement

ofrisks c. theindicationsforadocumentedriskassessment d. indicationsforariskassessmentcarriedoutforeveryserviceuser,priortoeachprocedure

ortreatment e. indicationsforariskassessmentcarriedoutforeveryactivityinvolvingaphysiotherapy

teammember f. theanalysisoffindingsfromriskassessmentstomakerecommendationsforchanged

workpractices. g. actiontakenontheresultsofariskassessment,tominimiseanyhazardsidentified

2.5 Allmedicaldevicesaresafeandfitforpurpose,ensuringserviceuser, carerandphysiotherapyteamsafetyCriteria2.5.1 Thereisaprocessinplacefor; a. registrationtoreceivebyemailpatientsafetyandMRHA(MedicinesandHealthcare

productsRegulatoryAgency)alerts b. cascadinginformationon‘PatientSafetyAlert’notices c. foractinguponPatientSafetyAlertsandothercommunicationsthatrelatetothesafe

provisionofphysiotherapy d. ensuringthatactionistakenonnewguidanceaboutmedicaldevicessafetyandon

‘PatientSafetyAlert’noticesissuedontreatments/interventionsthataffectpractice2.5.2 Therearepoliciesinplacewhichinclude; a. theuseofmedicaldevicesaccordingtomanufacturer’sinstructions b. regularservicingofmedicaldevices,wherebyservicingisundertakenandactiontaken

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whenindicated c. visualandphysicalsafetychecksofmedicaldevicespriortouseorissuetoserviceusers d. theidentification,reportingandrecordingofactiontakenregardingfaultsofmedicaldevices e. cleaningofmedicaldevicesaccordingtomanufacturer’sinstructionsandpoliciesforcontrol

andpreventionofinfection f. removaloffaultymedicaldevices g. evaluationofnewmedicaldevicesinthecontextofaclinicaltrialtomeettherequirements

ofresearchgovernance h. safeequipmentforthecareofbariatricserviceusers(toincludevisiblemaximumweight

offurnituree.g.,treatmentcouches,waitingroomchairs,departmenttoiletsandupstairsflooring) i. weighingandrecordingoftheweightofserviceuserswhereindicated2.5.3 Therearepolicesinplacewhichensure; a. trainingisprovidedinissuingandmaintainingmedicaldevices b. atrainingrecordiskept c. arecordiskeptofmedicaldevicesand/orproductsloanedtoserviceusers d. arecordiskeptofmedicaldevicesand/orproductspurchasedbytheserviceuser e. wheremedicaldevicesand/orproductsareloanedorsoldtoserviceusersinstructionson

thesafeuseareprovided

Standard2.6TherisksofloneworkingareminimisedCriteria2.6.1 Therearepoliciesinplaceforloneworkingwhichinclude: a. membersworkingalone b. communicationlinksbetweenmembersworkingaloneandtheirbase c. theuseofpersonalalarms d. homevisiting e. homevisitingwhereaknownriskexists f. theindicationsforanduseofchaperones.

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QualityAssuranceStandards3.1 Membersactivelyengagewithandreflectonthecontinuingprofessionaldevelopment(CPD)

processtomaintainanddeveloptheircompetencetopractise3.2 MembersofferqualityCPDopportunitiesthathelpotherslearnanddevelop3.3 Membersactivelyengagewithsupportingstudents’practiceeducationandthedevelopmentof

theirprofessionalsocialisation3.4 Therearerecognisedstructures,processesandresourcesinplacethatsupportlearningand

developmentintheworkplaceandenablememberstomeettherequirementsoftheirroleandmeetprofessionalandregulatoryCPDrequirements

IntroductionLearninganddevelopmentisintegraltophysiotherapypractice.TheCSPexpectsitsmemberstoactivelyengagewiththetwofacesoflearninganddevelopment;aslearnersthroughtheprocessofcontinuingprofessionaldevelopment(CPD),andasfacilitatorsofothers’learninganddevelopment.

ActiveengagementwithCPDensuresthatCSPmemberscanmaintainanddeveloptheircompetencetopracticeandcontinuetoworkwithinanevolvingscopeofpractice.CPDisthereforeaprofessionalandregulatoryrequirement.ByenablingmemberstoactivelyengagewithCPDopportunitiesappropriatetotheirindividuallearningneeds,organisationscanensurethatthephysiotherapyworkforceisabletoprovideperson-centred,ethicalandeffectiveservicesthatreflect(andshape)developmentsinresearchandpractice.Italsomeansthatthebehaviours,knowledgeandskillsofthephysiotherapyworkforcearedeployedsafelyandeffectivelybyensuringthatphysiotherapyteammemberscantakeresponsibilityfordelegationoftasks.SupportforCSPmembers’CPDthereforeenablesemployerstoaddressgovernanceissuesbyassuringthatthephysiotherapyworkforcefulfillingprofessionalandregulatoryrequirementsforpractice.

TheCSP’soutcomes-basedapproachtoCPDmeansthatmembersareexpectedtodemonstratehowtheirlearningthroughCPDsupportsthedevelopmentofpractice.Thisoutcomes-basedapproachalsorecognisesthatlearningcanoccurthroughawiderangeofactivities(bothformalandinformal)andinavarietyofspaces(e.g.workplace,classroomoronline),andencouragestheintegrationoflearningandpractice.

Thebehaviours,knowledgeandskillsrequiredtoengageinCPDarethesameasthoserequiredtohelpotherslearnanddevelop.Bothprocessesareaboutlearning:CPDisaboutbeingalearner,whilehelpingotherslearnanddevelopisaboutbeingateacher,orfacilitatoroflearning(e.g.byofferingmentorship/preceptorship,practicelearningorsupervisedpracticeopportunities).TheprocessofhelpingotherslearnanddevelopcanofferavaluableCPDopportunitythatsupportsthedevelopmentofindividuals,theserviceandphysiotherapypractice.

3.1 Membersactivelyengagewithandreflectonthecontinuingprofessional development(CPD)processtomaintainanddeveloptheircompetencetopractiseCriteria 3.1.1 Membersassesstheirlearninganddevelopmentneedsandpreferences3.1.2 Membersdevelopandengageinapersonalisedplantomeettheirlearninganddevelopmentneeds3.1.3 Memberscriticallyevaluatetheirlearningintermsofhowitrelatestotheircurrent/futurepractice3.1.4 Membersrecordandevidencetheoutcomesofthelearningprocess

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3.2 MembersofferqualityCPDopportunitiesthathelpotherslearnanddevelopCriteria 3.2.1 Membersworkwithlearner(s)toestablishlearningoutcomesforanyCPDopportunityprovided3.2.2 Membersdesignanddelivermaterials/experiencesthatfacilitateanindividual’slearningand

development3.2.3 MembersevaluatetheeffectivenessoftheCPDopportunityprovided3.2.4 Memberscriticallyreflectonthelearninganddevelopmentprocess

3.3 Membersactivelyengagewithsupportingstudents’practiceeducationandthe developmentoftheirprofessionalsocialisationCriteria3.3.1 Membersworkcollaborativelywithcolleagues,otherhealthprofessionsandHigherEducation

Institutions(HEIs)toplanandprovidemechanisms,resourcesandactivitiestofacilitatestudents’learningasanintegralpartofservicedevelopmentanddelivery

3.3.2 Membersactivelyengagewith,andreflectontheCPDopportunitiesavailabletothemthatexisttodeveloptheirabilitytosupportstudents’learninganddevelopment

3.3.3 Membersstrivetoprovideopportunitiesforstudentstolearnanddevelopincludingby: a. ensuringthatmultidisciplinaryworkingpromotesunderstandingoftherolesandthevalueof

otherprofessionsinvolvedindeliveringhighqualityhealthcare b. workingcollaborativelywithothercolleaguestoensureappropriatemodelsofsupervision c. criticallyevaluatingtheirownlearninganddevelopmentneedsandpreferencesaswell

astheirstudents,inordertoadapttheirteachingstylesappropriately d. sharingtheirownlearningappropriatelywithothercolleaguesinvolvedinsupportingstudents,

andwiththestudentsthemselves3.3.4 Membersensureconsistencyandtransparencyintheassessmentofstudentlearning

3.4 Therearerecognisedstructures,processesandresourcesinplacethatsupport learninganddevelopmentintheworkplaceandenableindividualstomeetthe requirementsoftheirroleandmeetprofessionalandregulatoryCPDrequirementsCriteria 3.4.1 Thedevelopmentneedsoftheserviceareevaluatedonanannualbasisandusedtoinformthelearning

anddevelopmentneedsofphysiotherapyteammembers3.4.2 Therearepoliciesinplacetoensure; a. thatCPDpoliciesandprocessesareinclusiveandequitable,andimplementedinwaysthat

accommodateallmembers’learninganddevelopmentneeds b. Membershaveprotectedpersonallearningtimeofatleast½day/monthforinformalCPD

activitiesinadditiontostudyleavearrangementsforformalCPDandmandatorytraining c. Membershaveaccesstoadvice,guidance,andavarietyoflearninganddevelopmentresources

thatenabletheindividualtoimplementtheirCPDplan.

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Quality Assurance Standards for physiotherapy service delivery 15

QualityAssuranceStandards4.1 Servicesaredesigned,plannedanddeliveredwiththeaimofpromotingandimprovingthe

healthofindividualsandthelocalpopulationanddecreasinghealthinequalities4.2 Serviceusersarerespectedasindividualsandplacedatthecentreofserviceplanningand

physiotherapymanagement4.3 Informationisprovidedtoenableserviceuserstoparticipatefullyintheircare

IntroductionToensureeffectiveandefficientservices,atanindividualorservicelevel,physiotherapycaremustbedeliveredinpartnershipwiththeserviceuser(s).

Person-centredpracticeisanapproachtohealthcarewithinwhichthegoals,expectations,preferences,capacityandneedsofserviceusersformthefocusofallactivity.Indeliveringtheserviceconsiderationneedstobegiventorespectingandpromotingdiversity,thatistheprocessofrecognising,respectingandvaluingpeople’sdifferences(e.g.age,disability,gender,race,religionandbelief,sexuality)andincludingthisinthedecisionmakingprocess.

Person-centredpracticeincludesacknowledgingandunderstandingthat,attimes,theviewofanindividualmayconflictwiththeviewofamember,theprofessionortheorganisationwithinwhichaserviceisbeingdelivered.Considerationshouldalsobegiventotheserviceuserasanindividualandthedegreeofinvolvementtheywouldliketohaveinplanningtheircareandservicesasthiswillvaryaccordingtoindividuals.

4.1 Servicesaredesigned,plannedanddeliveredwiththeaimofpromotingand improvingthehealthofindividualsandthelocalpopulationanddecreasing healthinequalitiesCriteria4.1.1 Serviceusersandcarersareinvolvedintheplanning,developmentanddeliveryofservices4.1.2 Servicedevelopmentanddeliveryisinformedbylocaldemographic/epidemiologicaldata4.1.3 Processesareinplacetoexploretheeffectofrationingandothermeasuresonthesufficiencyand

qualityofcarereceivedbyserviceusers4.1.4 Thereisasysteminplaceforobtainingfeedbackfromserviceusersaboutexistingservices4.1.5 Thereisevidenceofactiontakenasaresultofserviceusers’feedbackandexperiences

4.2 Serviceusersarerespectedasindividualsandplacedatthecentreof serviceplanningandphysiotherapymanagementCriteria4.2.1 Serviceusersareinvolvedinserviceplanningandserviceevaluationthroughserviceuserexperience

surveys,focusgroupsandongoingserviceuserfeedback4.2.2 Serviceusersareinformedofthecontactnameofthephysiotherapistresponsiblefortheirepisodeof

carewhereappropriate4.2.3 Theserviceuser’sprivacyanddignityisrespected4.2.4 Theserviceuserisofferedachaperonewhereappropriate4.2.5 Members; a. demonstratecareandcompassionintheirinteractionwithserviceusers. b. arecourteousandconsiderate c. addresstheserviceuserbythenameoftheirchoice

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d. considertheserviceuser’slifestyle,culturalbeliefsandpractices e. respectandrespondappropriatelytoanindividual’slifestyle,personalandculturalbeliefs andpractices

4.3 InformationisprovidedtoenableserviceuserstoparticipatefullyintheircareCriteria4.3.1 Appropriateinformationisavailabletoserviceuserson: a. therangeofservicesandoptionsofinterventionavailable b. arrangementsforthefirstcontactwiththephysiotherapist c. accesstoservices d. costsofcarewhereappropriate e. transportandaccess f. didnotattend/cancellationpolicies g. accesstomedicalrecords h. accesstophysiotherapyrecords i. hazardsrelatedtoclinicalcare j. dischargeplanning k. howtoprovidefeedbackonthephysiotherapyservice l. howtomakeacomplaint

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Quality Assurance Standards for physiotherapy service delivery 17

QualityAssuranceStandards5.1 Membersobtainanddocumenttheserviceuser’sinformedconsentbefore

anyadvice,assessment,examination,intervention,treatmentorprocedure5.2 Wherewrittenconsentisobtainedacopyoftheconsentrecordisincludedinthe

serviceuser’srecords5.3 Whereaserviceuserlackscapacitytoconsentforthemselvestheappropriateprocess

isinplacetoallowa‘bestinterestsdecision’tobemadeundertherelevantMentalHealthorIn/CapacityActs(11-15)

IntroductionConsentisthevoluntaryagreementgivenbyapersontoallowsomethingtohappentothemand/ortoallowtheirparticipationinsomething.Itisafundamentalrightthateveryadultwithcapacityhastheabsoluterighttodeterminewhathappenstotheirownbodyandthisrightisprotectedinlaw.Physiotherapistsshouldensurethatserviceusershavethecapacitytoconsent,giveconsentvoluntarilywithoutcoercion,andhavesufficientinformationonwhichtomakethisdecision.Consentshouldbereaffirmedthroughouttherapeuticinteractionwheretherearesignificantchangestotheserviceuser’streatmentplanorconditionortheserviceuserreportsnewinformation.

Consentmaybewrittenororalandthelawdoesnotrequirewrittenconsentforphysiotherapytreatment.However,itisrecommendedthatwrittenconsentisobtainedforanyinterventionthatisinvasivee.g.acupunctureorinjectiontherapy.

5.1 Membersobtainanddocumenttheserviceuser’sinformedconsentbeforeany advice,assessment,examination,intervention,treatmentorprocedureCriteria5.1.1 Theserviceuser’sconsentisobtainedanddocumentedbeforegivingadviceorbeginningan

assessment,examination,intervention,treatmentorprocedure5.1.2 Theconsentprocessincludes: a. considerationoftheserviceuser’sage,capacitytoconsent,emotionalstateandcognitiveability, b. discussionoftreatmentoptions,includingsignificantbenefits,riskssideeffectsandalternativesto

proposedintervention c. opportunityfortheserviceusertoaskquestions d. establishingtheserviceuser’sconsentorotherwisetosharinginformationtoothersdirectly

involvedintheircare e. informingtheserviceuseroftheirrighttodeclinephysiotherapyatanystage f. specificrecordinginthenoteswhenaserviceuserdeclinesphysiotherapy,includinganoteasto

theserviceuser’srationaleforthedecisionifknown g. informingtheserviceuserthattheirphysiotherapymaybeobservedordeliveredbyanother

healthcareprofessional/student h. givingtheserviceusertheopportunitytodeclineobservationoftheirphysiotherapytreatmentby

anotherhealthcareprofessionalconfidentially i. provisionofwritteninformation,wherepossible,toassistintheconsentprocess5.1.3 Wherewritteninformation/leafletsareusedthisisdocumentedinthenotes5.1.4 Versionsofwritteninformation/leafletsarestoredinlinewithlegislationfortheretentionofmedical

records5.1.5 Therearepoliciesfortheconsentprocesswhichinclude;

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a. inductionandtrainingingainingconsent b. indicationsofappropriatesituationsforthedelegationofthegainingofconsent c. membersundertakethedelegatedtaskofgainingserviceuser’sconsentonlywhenitis

appropriatetodoso d. thoseinterventionsrequiringwrittenconsentforms e. situationswheretheserviceuserdeclinestreatmentbyastudentorsupportworker f. safeguardingchildren g. safeguardingvulnerableadults h. situationswhereaformalassessmentofcapacitymayneedtobemadebyanappropriate

practitioner

5.2 Wherewrittenconsentisobtained,acopyoftheconsentrecordisincludedintheserviceuser’srecords

Criteria5.2.1 Apolicyisinplacedetailingthosephysiotherapyprocedureswherewrittenconsentistobeobtained5.2.2 Wherewrittenconsentisgained,acopyisretainedintheserviceuser’srecordsandacopyisgivento

theserviceuser

5.3 Whereaserviceuserlackscapacitytoconsentforthemselvestheappropriate processisinplacetoallowa‘bestinterestsdecision’tobemadeunderthe relevantMentalHealthIn/CapacityActs(11-15)

Criteria5.3.1 Therearepolicesinplaceforidentifyingwhenaserviceusermaylackthecapacitytogiveconsentfor

treatmentthemselves5.3.2 QualifiedmembersareawareoftheprocessforinvokingtherelevantMentalHealthorIn/Capacity

Act(11-15)whereaserviceuserlacksthecapacitytogiveconsentforthemselves5.3.3 Whereconsentisgainedbytheserviceuser’sadvocateundertherelevantMentalHealthorIn/Capacity

legislation,arecordisretainedintheserviceuser’srecords5.3.4 WhereavalidLastingPowerofAttorney(LPOA)isinplaceitsdirectionsarefollowed5.3.5 Wherethereisavalidadvanceddirectiveitsdirectionsarefollowed

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Quality Assurance Standards for physiotherapy service delivery 19

QualityAssuranceStandards6.1 Everyserviceuserwhoreceivesphysiotherapyhasanappropriaterecord6.2 Recordsarestoredwhilecurrentanddisposedofaccordingtolegalrequirements6.3 Datacapturesystemsaredesignedandmaintainedtoprovideeffectiveandsecuretransferofpatient

identifiableinformation6.4 Thereisevidencethatregularauditsofrecordkeepingareplanned,undertakenandactiontakenas|a

result

IntroductionCSPmembershaveaprofessionalandlegalobligationtokeepanaccuraterecordoftheirinteractionwithserviceusersinwhateversystemorformat(paperorelectronic)theorganisationspecifies.

A‘healthrecord’isanyrecordwhich:• consistsofinformationrelatingtothephysicalormentalhealthconditionofanindividual,and• hasbeenmadebyoronbehalfofahealthprofessionalinconnectionwiththecareofthatindividual.

Arecordcanbeinpaperorelectronicformat,oramixtureofboth,andincludesalltheinformationrelatingtothehealthstatusandmanagementoftheindividualserviceuser.Therearevarioustypesofrecordsinpractice:forexample,summary/fullrecord;sharedrecord;uni-professionalrecord;andserviceuserrecord.

Therecordmaycontaininformationaboutthecurrentepisodeofcareonly,ormaybeacompilationofeveryepisodeofcareforthatindividualinagiventime-frame.Dependingontheneedsoftheserviceuser,andthecaresetting(s)involved,therecordmaybemaintainedbyanindividualhealthcareprofessionaloragroupofdifferentprofessionalsacrossthecarepathway.

Membersinvolvedinrecording,accessing,andstoringhealthrecordsmustbeawareofthelegalcontextwithinwhichtheywork,andcomplywithregulatory,national,professionalbodyandlocalemployerguidanceonrecordkeeping.

CSPmembersmustbeawareof,andadheretotherelevantinformation1orgovernanceframeworkwhendealingwithserviceuseridentifiableinformation.Auditservesasalearningprocessratherthanmerelyacompliancetool,andorganisationsshouldplananddeliverauditaspartofaplannedauditcyclethroughwhichindividualsandteamsarehelpedtolearnfrommistakes,etc.

6.1 EveryserviceuserwhoreceivesphysiotherapyhasanappropriaterecordCriteria6.1.1 Records; a. arestartedatthetimeoftheinitialcontact b. writtenimmediatelyafterthecontactwiththeserviceuserorbeforetheendofthatworkingday c. includeareferenceineachentrytothedateandtimeoftreatmentoradvice d. includeareferencetothedateandtimethattheentryintotherecordwasmade e. arelegible,factual,consistentandaccuratesuchthatserviceusersandotherhealthprofessionals

canunderstandthecontent f. areattributabletotheindividualcompletingthem g. provideevidenceofthecareplanned,thedecisionsmade,thecaredeliveredandtheinformationshared h. identifyproblemsthathavearisenandtheactiontakentorectifythem i. provideevidenceofactionsagreedwiththeserviceuser(includingconsenttotreatmentand/orconsentto

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discloseinformation) j. arewritten,whereverappropriate,withtheinvolvementoftheserviceuser k. usestandardcodingtechniquesandprotocolsforelectronicrecordswhereappropriate6.1.2 Recordscomplywithpolicieswhichinclude: a. alocallyagreedshortformsglossary b. disclosureofinformation c. serviceuseraccesstorecords,includingchargesforviewingorreceivingacopyofahealthrecord

6.2 RecordsarestoredwhilecurrentanddisposedofaccordingtolegalrequirementsCriteria6.2.1 Therearepoliciesfor: a. theretentionofrecords b. thesecurestorageofrecordswhilecurrentsothattheycanbeeasilyretrieved c. thesecurestorageofrecordsoncetheyarenolongercurrent d. thedisposalofrecordsinaccordancewithstatutoryrequirements e. identificationofwhohasstorageandaccessrightsovertherecord f. accesstorecordsbyserviceusersandothers.6.2.2 Recordsarekeptinaccordancewithrelevantlegalandregulatoryrequirements6.2.3 Thelocalpolicyisfollowedwhentheserviceuserasksfortherecord.6.2.4 Thereis: a. asignaturebooktoensurephysiotherapyteammemberscanberecognisedandtracedbytheir

signature,jobtitleandworkareaorotheridentifiableinformation b. informationavailabletoensurethattheserviceuserisawareoftheirrighttoaccesstheirrecords c. aglossaryofshortformsdescribingtheallowableabbreviationsandtheirmeaning d. aprocessfordestroyingserviceuserrecordsinasecuremannerafterthe(lapseofthe)requiredtime

6.3 Datacapturesystemsaredesignedandmaintainedtoprovideeffectiveandsecure transferofpatientidentifiableinformationCriteria6.3.1 ThereisapolicyforIT(InformationTechnology)anddatasecuritywhichisupdatedannually.6.3.2 Systemsareconfiguredtomeetinformationgovernancestandardsaroundmaintainingthesecurityand

confidentialityofserviceuseridentifiabledata,includingencryptionofemailsanduseofmobile/portabledevice.6.3.3 MembersaremadeawareoftheirresponsibilitiesundertheDataProtectionAct(1998).(16)

6.3.4 Memberscomplywithlocalhealthinformatics/ITsecuritypolicies

6.4 Thereisevidencethatregularauditsofrecordkeepingareplanned,undertaken andactiontakenasaresultCriteria6.4.1 Membersareclearofthestandardsinplaceforgoverningtheirrecordkeepingpractice6.4.2 Auditofrecordkeepingisplannedandundertakenannuallytomonitorcompliancewithrelevant legislationandensurebestpracticeguidanceisbeingupheld6.4.3 Thereisevidencethattheresultsofauditaredisseminatedandrecommendationsmadeforaction6.4.4 Thereisevidencethatactionistakenasaresultoftheoutcomesofaudit

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QualityAssuranceStandards7.1 Mechanismsexisttoensureeffectivecommunicationwithinandoutsidethephysiotherapyservice7.2 Memberscommunicateeffectivelywithserviceuserstoensureeffectiveandefficientservices7.3 Memberscommunicateeffectivelywithotherhealthprofessionalsandrelevantoutsideagenciesto

ensureeffectiveandefficientservices7.4 Memberstreatallinformationinthestrictestconfidence

IntroductionCommunicationistheinteractiveprocessofconstructingandsharinginformation,ideasandmeaningthroughtheuseofacommonsystemofsymbols,signsandbehaviours.Itincludesthesharingofinformation,adviceandideaswitharangeofpeople,usingavarietyofmedia(includingspoken,non-verbal,writtenande-based)andmodifyingthistomeetserviceuser’spreferencesandneeds

Effectivecommunicationrequiresconsiderationofthecontextandnatureoftheinformationtobecommunicatedandengagementwithtechnology,particularlytheeffectiveandefficientuseofInformationandCommunicationTechnology

WheretheserviceuserdoesnothavecapacityreferenceshouldbemadetoSection5Consent.

7.1 Mechanismsexisttoensureeffectivecommunicationwithinandoutside thephysiotherapyserviceCriteria7.1.1 Theorganisationhas a. anorganisationalchartavailable b. locallyagreedsystemsforreferral c. locallyagreedprocessesfortheprovisionofinformationformultidisciplinaryassessments,planned

transfersanddischarges d. policieswhichgoverntheuseofelectroniccommunicationtoensureitisappropriate,secureand

confidential e. policiesfortheuseofsocialmediaprofessionally,sociallyandresponsibly

7.2 Memberscommunicateeffectivelywithserviceuserstoensureeffective andefficientservicesCriteria 7.2.1 Memberscommunicateopenlyandhonestlywithserviceusersandconsiderthewishesofthosewhodonotwant

themselvesorother’se.g.arelativetoknowthediagnosis7.2.2 Membersassesstherecipient’sunderstandingoftheinformationgiven7.2.3 Membersuseactivelisteningskills,providingopportunitiesfortheserviceusertocommunicateeffectively7.2.4 Theserviceuserisawareoftheroleofanyothermemberofthephysiotherapyteam,alliedhealth

professional,orsocialservicesstaffinvolvedintheircare7.2.5 Allcommunication,writtenandoral,isclear,unambiguousandmodified,whereappropriate,tomeettheneedsof

theserviceuser7.2.6 Methodsofcommunicationaremodifiedtomeettheneedsoftheserviceusere.g.wherethereisalanguage

barrieraninterpreterisused7.2.7 Informationisavailableoncondition-specificsupportgroupsandnetworks7.2.8 Wherewritteninformationisprovidedtoserviceusers;

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a. acopyorreferenceiskeptintheserviceuser’srecord b. allinformationprovidedidentifiestheauthor,productiondateandreviewdate c. supersededversionsofinformationdocumentsforserviceusersareretainedforthesame

lengthoftimeashealthrecords

7.3 Memberscommunicateeffectivelywithotherhealthprofessionalsandrelevant outsideagenciestoensureeffectiveandefficientservicesCriteria7.3.1 Thereareorganisationalpoliciesinplaceforthe; a. referralandtransferofcare b. useofelectroniccommunicationtoensureappropriateinformationisconveyedandthatsuch

communicationsaresecureandconfidential c. delegationoftreatmenttooutsideagencies d. useofmulti-professionalrecordkeepingandserviceuser-heldrecords7.3.2 Members; a. areawareoflinesofcommunicationwithinandoutsidetheorganisation b. informothersoftheirownspecificrole c. areinvolvedinregularteammeetings/briefings d. arerepresentedatorganisation-widemeetingswheretheseexist e. areinvolvedinseniormanagementpolicymakingandthebusinessplanningprocess f. areawareoftherolesofmembersofthemultidisciplinaryteam g. provideinformationformultidisciplinaryassessments,plannedtransfersanddischarges h. ensurethattheinformationsuppliedtootherprofessionalsisdirectlyrelevanttotheirrole

withtheserviceuser i. communicatewithotherhealthprofessionalsandagenciesinvolvedintheserviceuser’scare j. communicaterelevantinformationclearlyandpromptly k. agreecommongoalswiththeserviceuser,multidisciplinaryteamandwidercarersandfamily l. whendelegatingatask,ensurethatthelineofresponsibilityisunderstoodandclear m. ensurethatwhereataskhasbeendelegated,theoutcomeisclearlycommunicated

7.4 MemberstreatallinformationinthestrictestconfidenceCriteria7.4.1 Membersensurethat; a. thereisprivacywhendiscussingpersonaldetailse.g.communicationofasensitivenature b. serviceuseridentifiableinformationistransmittedsecurely c. serviceuser’sinformationisonlyreleasedtosources,otherthanthoseimmediatelyinvolvedinthe

planforintervention,withpermissionorwhenthereisasignedconsentformtoallowthisprocess d. thewrittenconsentofserviceusersisobtainedbeforeusingidentifiableclinicalinformation

(photographs,videosetc)forpurposesotherthanthetreatmentofthepatient e. whereconfidentialitycannotbeguaranteed,theserviceuserisinformedofthisfactandgiven

theoptiontodeclinegivinginformation f. whenitisofbenefittotheserviceuserandindiscussionwiththeserviceuser,otherhealthcare

workersmaybegivenaccesstothephysiotherapyrecord g. consentissoughtfromtheserviceuserbeforediscussingconfidentialdetailswithcarers,friendsorrelatives7.4.2 Therearepoliciesinplace,whicharefollowedto; a. ensuretheconfidentialityofserviceuseridentifiabledataheld,ortransmitted,inelectronicformats b. ensuretheconfidentialityofserviceuseridentifiabledataseenbymembersbutintendedforother

professionalteammembers

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QualityAssuranceStandards8.1 Thereisfairandequitableaccesstophysiotherapyservicesaccordingtoneed8.2 Thereisasystemtoensurethatphysiotherapycareisbasedonthebestavailableevidenceof

effectiveness8.3 Appropriateinformationrelatingtotheserviceuserandthepresentingproblemiscollected8.4 Analysisisundertakenfollowinginformationgatheringandassessmentinordertoformulatea

treatmentplan,basedonthebestavailableevidence8.5 Appropriatetreatmentoptionsareidentifiedbasedonthebestavailableevidence,inorderto

delivereffectivecare8.6 Theplanforinterventionisconstantlyevaluatedtoensurethatitiseffectiveandrelevantto

theserviceuser’schangingcircumstancesandhealthstatus8.7 Oncompletionofthetreatmentplan,arrangementsaremadefordischargeortransferofcare

IntroductionDeliveringeffectiveclinicalcareisaprocessundertakeninpartnershipwiththeserviceusertoensurethetreatmentplanisindividualisedtomeettheindividual’sgoals.Thisincludesthesystematiccollectionofinformationfromawidevarietyofsourcesrelevanttothedecisionmakingsituation;theprocessingandanalysisoftheinformationcollected;ananalysisoftheinterventionandreflectionoftheeffectivenessofit;discussionwiththeserviceusertoidentifythemostacceptablemanagementplanandcriticalevaluationoftheplananditsoutcomesduringimplementation.

Wheretreatmentorassessmenthighlightsthataserviceusermaylackcapacity,therelevantpoliciesshouldbefollowed.

8.1 ThereisfairandequitableaccesstophysiotherapyservicesaccordingtoneedCriteria8.1.1 Thereisevidencewithintheorganisationof a. stakeholderengagementspecificallytosupporttheplanninganddesignofservices b. accessroutestophysiotherapyservicesbeingpromotedtoallreferrersandappropriateservice

usergroupsorwithinappropriateserviceuserenvironments c. transparentandethicalprotocolsgoverningwaitinglistmanagementandtheprioritisationof

serviceusers d. servicefeatureswhichsupportserviceuser’schoice;thesemayincludeforexampleappointment

timesorplaceoftreatment e. aclearlycommunicatedprocedureformanagingreferralswhichhavenotbeenseenwithina

locallyagreedtime-scale f. protocolsthatensureeffectiveandappropriatedischargearrangements

8.2 Thereisasystemtoensurethatphysiotherapycareisbasedonthebest availableevidenceofeffectivenessCriteria 8.2.1 Members; a. activelyengagewiththeevidencebasethroughcriticalappraisalofavailableevidence b. haveaccessto; • libraryandlibrarysearchfacilities • internetfacilities

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8.2.2 Therearesystemsinplace; a. fordisseminatinginformationabouteffectivepractice b. forprovidinglinkswithexternalagenciestoidentifygoodpractice c. todemonstrateimplementationofevidence-basedclinicalguidelinesandtheuseofresearch

evidence d. thatsupporttheintegrationofresearchactivitywithinday-to-daypractice e. thatenableandencouragememberstodevelopevidenceandtosharetheirresearchfindings

throughappropriatechannels

8.3 Appropriateinformationrelatingtotheserviceuserandthepresentingproblem iscollectedCriteria8.3.1 Whereappropriate,standardiseddatasetsareinusethatfacilitatebenchmarkingofdataandrespond

tonationalgoodpracticeinitiativesandrequirements8.3.2 Thereisevidencethatinformationiscollectedtoinformthephysiotherapeuticprocesswhich,where

appropriate,includes: a. theserviceuser’sdemographicdetails b. presentingcondition/problems c. historyofthepresentingconditionincludingmanagementoftheproblemtodate d. theserviceuser’sperceptionoftheirneeds e. theserviceuser’sexpectationsofintervention f. pastmedicalhistory g. currentmedication/treatment h. contra-indications/precautions/allergies/redflags i. socialandfamilyhistory/lifestyle j. documentationandevaluationofrelevantclinicalinvestigations/resultstoassistthediagnosis andmanagementprocess8.3.3 Thereiswrittenevidenceofaphysicalexaminationcarriedoutincludingmeasurabledatawhich

includes: a. observation b. useofspecificassessmenttools/techniques c. handling/palpation8.3.4 Wheretherequiredinformationismissingorunavailable,thereasonsaredocumented8.3.5 Appropriateoutcomemeasuresareidentifiedandimplementedatassessmentincluding,wherepossible

andappropriate; a. onerecommendedcondition/diseasespecificpatient(serviceuser)reportedoutcome measures(PROM) b. one disease specific performance measure (clinical outcome measure) c. onepatient(serviceuser)reportedexperiencemeasure(PREM)

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8.4 Analysisisundertakenfollowinginformationgatheringandassessmentinorder toformulateatreatmentplan,basedonthebestavailableevidenceCriteria8.4.1 Thereisconsiderationandcriticalevaluationofinformationabouteffectiveinterventionsrelatingtothe

presentingcondition8.4.2 Thereisevidenceofaclinicalreasoningprocesswithidentifiedneeds/problems,formulatedfromthe

informationgathered8.4.3 Aworkinghypothesis/diagnosisisformed,withrelevantsignsandsymptomsrecorded8.4.4 Theclinicalimpressionisdocumentedanddiscussedwiththeserviceuser8.4.5 Subjectivemarkersareagreedwiththeserviceuser8.4.6 Objectivemarkersareagreedwiththeserviceuser8.4.7 Analysisisundertakenfollowinginformationgatheringandassessmentinordertoformulateaplanfor

intervention,basedonthebestavailableevidence8.4.8 Wherethereisnointerventionindicated,thisinformationisrelayedtothereferrer,wherethereisone8.4.9 Informationrelatingtooptionsforinterventionisidentified,basedonthebestavailableevidence,in

ordertodelivereffectivecare8.4.10 Thefindingsoftheclinicalassessmentareexplainedtotheserviceuser.

8.5 Appropriatetreatmentoptionsareidentified,basedonthebestavailableevidence, inordertodelivereffectivecare.Criteria8.5.1 Clinicalreasoningisrecordedthatexplainswhyaspecificapproachhasbeenimplemented.8.5.2 Theserviceuserisenabledtomakeaninformedchoiceabouttheircare,basedonthebestavailable

evidenceoneffectiveandappropriateinterventions8.5.3 Goalsareagreedwiththeserviceuser,multidisciplinaryteamincludingoutsideagenciesandwider

carersandfamily8.5.4 Whereclinicalguidelinesorlocalprotocolsareusedthisisrecordedintherecords8.5.5 Atreatmentplanisincludedinthephysiotherapyrecord8.5.6 Allinterventionsareimplementedaccordingtothetreatmentplan8.5.7 Memberscontributetothedevelopmentofevidencebygatheringinformationthroughoutthe

treatmentofserviceusers8.5.8 Alladvice/informationgiventotheserviceuserisrecorded,signedanddated.8.5.9 Arecordismadeofmedicaldevicesloanedandissuedtotheserviceuser8.5.10 Whenitisinthebestinterestoftheserviceuserareferralismadetoanotherprofessionalandthe

reasonsdiscussedwiththeserviceuser

8.6 Theplanforinterventionisconstantlyevaluatedtoensurethatitiseffective andrelevanttotheserviceuser’schangingcircumstancesandhealthstatusCriteria8.6.1 Ateachtreatmentsessionthereisareviewof: a. thetreatmentplan b. subjectivemarkers c. objectivemarkers d. resultsofrelevantinvestigations.8.6.2 Allrelevantchanges,subjectiveandobjective,aredocumented.8.6.3 Anychangestotheintendedplanarerecordedintherecordwiththereasonsgiven8.6.4 Anychangestothetreatmentplanaredocumented

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8.6.5 Outcomeismeasuredasappropriatetoeachindicatortoassesstheeffectofintervention8.6.6 Informationderivedfromtheuseofoutcomemeasuresissharedwiththeserviceuser8.6.7 Adverseandunexpectedeffectsoccurringduringtreatmentarereportedandevaluatedusingthe

relevantmechanisms

8.7 Oncompletionofthetreatmentplan,arrangementsaremadefordischarge ortransferofcareCriteria8.7.1 Theserviceuserisinvolvedwiththearrangementsfortheirtransferofcare/dischargeandofferedcopies

oftransferordischargesummaries8.7.2 Arrangementsforthetransferofcare/dischargearerecordedintherecord8.7.3 Whenthecareofaserviceuseristransferred,informationisrelayedtothoseinvolvedintheiron-going

careinthemostappropriatemannerandformat8.7.4 Adischargesummaryissenttothereferreruponcompletionoftheepisodeofcareinkeepingwith

agreedlocalpolicies8.7.5 Whereserviceuser’sinformationistransferredthismeetstherequirementsofconsent,confidentiality

anddisclosure

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Quality Assurance Standards for physiotherapy service delivery 27

QualityAssuranceStandards9.1 Effectivequalityimprovementprocessesareinplace,whichareintegratedintoexisting

organisation-widequalityprogrammes9.2 Thereisaclinicalauditprogrammetoensurecontinuousimprovementofclinicalqualitywith

cleararrangementsforensuringthatclinicalauditmonitorstheimplementationofclinicaleffectiveness

9.3 Thereisaclearandresponsiveprocedureformakinganddealingwithcomplaints9.4 Theeffectofthephysiotherapeuticinterventionandthetreatmentplanisevaluatedtoensure

thatitiseffectiveandrelevanttothegoals

IntroductionTheprocessofdevelopingand(re)designingservicesandimprovingtheeffectiveness,efficiencyandqualityofcurrentservicesrequiresacriticalevaluationofphysiotherapyservicedelivery.Thisinvolvesacyclicalprocessofinformationgathering,analysisandaction.

Qualityimprovementprocessesarenecessarytomaintaintheeffectiveness,efficiencyandqualityofaserviceprovided,torecognisesituationswhereelementsoftheservicearecompromisedandfacilitateactiontoensureimprovementandlearningtakesplace.

9.1 Effectivequalityimprovementprocessesareinplace,whichareintegrated intoexistingorganisation-widequalityprogrammes.Criteria9.1.1 Membersidentifyandcontributetoprogressingserviceimprovements9.1.2 Thereisastrategyfortheimplementationofclinicalgovernance,whichislinkedtotheorganisation’s

overallstrategy9.1.3 Therearelocallyagreedstandardsofpracticeforcommonconditionsdevelopedbymulti-professional

groupsinordertoimplementnationalguidance9.1.4 Thephysiotherapyserviceproducesanannualclinicalgovernancereportthatcontributestothe

organisation’soverallclinicalgovernancereport9.1.5 Membersaresupportedtoidentifyandcontributetoserviceimprovementprocessesasanintegralpart

oftheprocessofserviceimprovement

9.2 Thereisaclinicalauditprogrammetoensurecontinuousimprovementof clinicalquality,withcleararrangementsforensuringthatclinicalauditmonitors\ theimplementationofclinicaleffectivenessCriteria9.2.1 Membersparticipateinaregularandsystematicprogrammeofclinicalaudit9.2.2 Membersparticipateinmulti-professionalclinicalaudit,whereitisundertaken9.2.3 Theclinicalauditprogrammetakesaccountofserviceuser,organisational,serviceandnational

priorities,9.2.4 Thedocumentedresultsandrecommendationsfromclinicalauditaremadeavailablethroughthe

clinicalgovernanceprocess9.2.5 Changesinpracticeareimplementedaspartoftheclinicalauditcycle,inordertorectifyany

deficienciesidentified

9 Evaluation of clinical care and services

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9.3 ThereisaclearandresponsiveprocedureformakinganddealingwithcomplaintsCriteria9.3.1 Allmembersunderstandtheirrolewithinthecomplaintsprocedure.9.3.2 Therearepoliciesinplacewhichensure; a. serviceusershaveaccesstoinformationabouttheservice’scomplaintsprocedure b. complaintsaremanagedwithinalocallydefinedtime-scale c. complaintsaremonitoredinordertoidentifytrendsandtoinformtheprocessofservice

improvementandriskmanagement d. complaintsinformtheprocessofserviceimprovement

9.4 Theeffectofthephysiotherapeuticinterventionandthetreatmentplanis evaluatedtoensurethatitiseffectiveandrelevanttothegoalsCriteria9.4.1 Thereisapolicy; a. tosupportmembersinengagingwithserviceimprovementinitiatives b. fortheuseofserviceuserexperiencesurveys c. fortheuseofmeasurestoevaluateclinicaleffectiveness9.4.2 Anappropriatemeasureisusedtoevaluatetheeffectofphysiotherapeuticintervention(s); a. themeasurechosenispublished,standardised,valid,reliableandresponsive b. themeasureusedisthemostrelevanttotheserviceuser’sproblemstoevaluatethechangeinthe

serviceuser’shealthstatus c. themeasureisacceptabletotheserviceuser d. themetricisusedinanappropriatewayforthatspecificmeasure(possiblyatthestartandendof

treatmentandatappropriateintervalsincludingfollowup) e. membersensuretheyhavethenecessaryskillandexperiencetouse,administerandinterpret

themeasure f. memberstakeaccountoftheserviceuser’swelfareduringtheadministrationofthemeasure g. theresultofthemeasurementisrecorded h. informationderivedfromtheevaluationandtheuseoftheoutcomemeasureissharedwiththe

serviceuseranddocumented i. writteninstructionsinthemanufacturer’smanual,testdesigner’smanualorserviceguidelinesare

followedduringtheadministrationandscoringofthemeasureifapplicable

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Quality Assurance Standards for physiotherapy service delivery 29

QualityAssuranceStandards10.1 Informationprovidedonservicesaccuratelyreflectsthoseoffered10.2 Informationprovidedonproductsaccuratelyreflectsthoseoffered10.3 Productssoldorsuppliedtoserviceusersarenecessaryindeliveringeffectivecare10.4 Theendorsementofaproductorserviceisbasedonsoundclinicalreasoning,evidence,and

considerationofcostandquality

Introduction

CSPmembersareincreasinglyinvolvedinpromotingservicesorproductstothosewhowilluseorpurchasethem.IndoingsoatalltimestheprofessionalismoftheCSPmemberandtheneedsoftheserviceuseriscentraltothisrelationship.AttimestheCSPmembermayfeelcompromisedandfurtherguidancemaybesoughtfromtheCSPasaprofessionalbodyandtheHCPCasaregulator.

10.1 InformationprovidedonservicesaccuratelyreflectsthoseofferedCriteria10.1.1 Informationaccuratelyreflectstheservice(s)offeredandsupportsthedecisionmakingprocess10.1.2 Thepromotionofservicesisbasedonevidence10.1.3 Theuseofbenchmarkingandcomparativestatementsisbasedonfact

10.2 InformationprovidedonproductsaccuratelyreflectsthoseofferedCriteria10.1.2 Informationaccuratelyreflectstheproductsofferedandsupportsthedecisionmakingprocess10.1.2 Thepromotionofproductsisbasedonevidence10.1.3 Theuseofbenchmarkingandcomparativestatementsisbasedonfact

10.3 ProductssoldorsuppliedtoserviceusersarenecessaryindeliveringeffectivecareCriteria10.3.1 Medicaldevicesandproductssoldorsuppliedareappropriatetothepresentingconditiontosupportthe

achievementofexpectedtreatmentoutcomes10.3.2. Thecosts,totheserviceuser(orservice),ofsupplyingmedicaldevicesareconsidered10.3.3 Wherepossible,serviceusersareofferedinformationonsourcingproductsandachoiceinthegoods

recommendedandtheretailoutletforthesegoods

10.4 Theendorsementofaproductorservice,byamember,isbasedonsoundclinicalreasoning,evidence,andconsiderationofcostandquality

Criteria 10.4.1 Whenexploringtheendorsementofaproduct,membersconsider: a. theappropriatenessoftheproductorserviceinrespectofpresentingconditions b. member’sownexperienceoftheeffectivenessoftheproductorservice c. theevidencepresentedbythemanufacturerwithregardtothestatedpurposeandbenefitsof themedicaldevice d. areasonableassessmentofthequalityandcostoftheserviceorproduct

10 Promoting, marketing and advertising physiotherapy services and products

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30 Chartered Society of Physiotherapy

Accountabilitytakingresponsibilityfor,andacceptingtheconsequencesof,apersonaldecisionoractionAdvocacyactingonbehalf,andinthebestinterests,ofanindividualorgroupofindividualswiththeintentionofhavingapositiveinfluenceonadecisionoractionaffectingthatindividualorgroupAssociatememberasupportworkerwhohasjoinedtheCSPasamemberAutonomytheabilitytomakedecisionsandactindependentlyClientapersoninreceiptofaservice;wherethetermuses‘individual’or‘client’,thisshouldbeinterpretedtoincludeanyotherresponsiblepersonsuchasacarer,parentorguardian,asappropriatetocircumstances;inthecaseofanimalphysiotherapy,thetermmaybeinterpretedtomeanananimalanditsowner/carerCodeofProfessionalValuesandBehaviouror‘TheCode’TheCodesetsouttheCSP’sexpectationsofallmembers:qualifiedphysiotherapists,associatesandstudentsCompassionahumanemotioninitiatedbytheexperiencesorsufferingofothersandleadingtoadesiretoalleviatetheirsufferingCompetencethesynthesisofknowledge,skills,values,behavioursandattributesthatenablesmemberstoworksafely,effectivelyandlegallywithintheirparticularscopeofpracticeatanypointintime.ConsenttheprocessbywhichanindividualallowssomethingtooccurtothemselvesContinuingprofessionaldevelopment(CPD)awiderangeoflearningactivitiesthroughwhichmembers’abilitiesaremaintainedanddevelopedthroughouttheircareertoensurethecapacitytopractisesafely,effectivelyandlegallywithinanevolvingscopeofpractice(including,inthecaseofqualified,practisingmembers,fulfilmentoftheCPDrequirementsoftheHealthandCareProfessionsCouncil(HCPC))formerlyHealthProfessionsCouncil(HPC)CSPCharteredSocietyofPhysiotherapyCSPmemberapersonwhoisamemberoftheCSPinoneofthefollowingcategories:asaqualified(chartered)physiotherapist,physiotherapystudent,orassociate(asaphysiotherapysupportworker)CSPmembershipopentophysiotherapistswhoholdregistrationwiththeHealthandCareProfessionsCouncil(HCPC)andarethereforeeligibletopractisephysiotherapyintheUK,physiotherapystudents,andphysiotherapysupportworkers;physiotherapistswhohavebeeneligibleforandCareProfessionsregistrationbutwhohaveretired,aretakingacareerbreak,orwhoreside/workoutsidetheUKmayalsobemembers,asmayphysiotherapistswhopractiseonanimalsDelegationtheprocessthroughwhichonepersonallocatesworktoanotherpersononthebasisofdeemingthatindividualcompetenttoundertakethattask,withthedelegatedindividualthencarryingresponsibilityforundertakingthedelegatedtaskDisclosureanorganisationwillaskforadisclosuretoensurethatnecessarylegalinformationforrecruitmentandplacementdecisionscanbemadeespeciallyinpositionsinvolvingchildren&thevulnerable(i.e.ProtectionofChildren&ProtectionofVulnerableAdults).ThereareanumberofmechanismsthroughwhichthisisundertakenintheUnitedKingdom• EnglandandWales:Thecriminalrecordsbureau• NorthernIreland:AccessNIisaCriminalHistoryDisclosureServicewithintheDepartmentofJusticeIn

NorthernIreland.• Scotland:ScotlandProtectingVulnerableGroups(PVG)schemewww.disclosurescotland.co.uk/pvg/

pvg_index.htmlDignityanindividualbeingrespectedandesteemedDutyofcaretheresponsibilityheldbymemberstoensurethattheirdecisionsandactionsareintheinterestsoftheindividualsreceivingoraffectedbyphysiotherapyservicesthattheydeliverEmpowermenttheprocessofgivingsomeonepowerorauthorityoveradecisionoractionEthicsissuesofcorrectconductinformedbymoralprinciplesEvidencedifferentformsofvalidandrelevantinformationthatareusedtounderpindecision-making;andactionthatareoften,butnotexclusively,theoutcomeofresearchactivity

Glossary

GLOSSARY

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Quality Assurance Standards for physiotherapy service delivery 31

FairnessreasonablebehaviourthatismotivatedbyaconsiderationoftheneedsofothersandthedeliveryofservicesequitablyHealthandCareProfessionsCouncil(HCPC)formerlytheHealthProfessionsCouncil(HPC)thestatutoryregulatorybodyforthealliedhealthprofessions(AHPs),formedin2002(asthesuccessortotheCouncilforProfessionsSupplementarytoMedicine(CPSM))A‘healthrecord’anyrecordwhich:consistsofinformationrelatingtothephysicalormentalhealthconditionofanindividual,andhasbeenmadebyoronbehalfofahealthprofessionalinconnectionwiththecareofthatindividualIndividualapersonreceivingaservicefromaCSPmember(asapatientorclient,orasthecarerofapatientorclient),orapersonwhoisaffectedbyaCSPmember’sdeliveryofaservice;e.g.derivingfromresearch,educationormanagementactivityInformedconsentintheUKthisistakenasmeaningthatthepatient/serviceuserhasbeentoldofthe‘natureandpurposeoftheproposedtreatment,togetherwithallsignificantandmaterialrisks,benefitsandoutcomesoftheproposedtreatmentANDhasbeentoldofallthealternativeandcomparativetreatmentsthatareavailablefortheconditionbeingtreated.’Interventionatermusedtoincludeallaspectsofservicedelivery,clinicalcareandphysiotherapymanagement.LeadershipanactorinstanceofprovidingguidanceordirectionLoneworkingindividualswhoworkalone–whetheronaregularorpermanentbasisorforashortperiodoftimeeachdayMemberamemberoftheCSPMedicaldevicesaninstrument,apparatusorotherwhichisintendedforuseinthediagnosisofdiseaseortreatmentormanagementofconditions.Organisationthestructure(s)withinwhichamemberundertakeshisorherphysiotherapyactivity,withinthepublic,private,independentandthirdsectorsPerson-centredpracticeputtingthepersonatthecentreofpracticedescribesthebehaviour,knowledgeandskillsrequiredto:demonstraterespectfortheindividual;provideinformationandsupportthatenablesanindividualtomakeinformedchoices;involveindividualsinshapingthedesignanddeliveryoftheirservicePhysiotherapyservicethephysiotherapyservicedeliveredtotheserviceuserincludingadvice,assessment,examination,intervention,treatmentorprocedureatanindividual,groupororganisationallevel.Physiotherapypracticethepractical(psycho-motor)skillsusedbythephysiotherapyworkforce.Theseincludemanualtherapy,electro-physicalmodalitiesandotherphysicalapproaches.Aswithphysiotherapyknowledge,anindividual’sskill-basewillevolveaccordingtotheirexperiencesandcontextofpractice,butindividual’smustdemonstratehowtheirskillsrelatetophysiotherapyandtheirpersonalscopeofpracticePREMPatientreportedexperiencemeasureProfessionalautonomytheapplicationoftheprincipleofautonomywherebyaMembermakesdecisionsandactsindependentlywithinaprofessionalcontextandisresponsibleandaccountableforthesedecisionsandactionsProfessionalismdefineswhatisexpectedofaprofessional,andwhatitmeanstobeprofessional.Broadly,itcanbesummarisedas;Amotivationtodeliveraservicetoothers,Adherencetoamoralandethicalcodeofpractice,Strivingforexcellence,maintaininganawarenessoflimitationsandscopeofpracticeandAcommitmenttoempoweringothers(ratherthanseekingtoprotectprofessionalknowledgeandskills)PROMSPatientreportedoutcomemeasuresQualityAssurancetheprocessbywhichservicesorcarearemonitoredtoensurethatmandatorystandardsarebeingmetRecordaphysiotherapyrecordisahealthrecord.Thatisanyrecordwhich:(a)consistsofinformationrelatingtothephysicalormentalhealthorconditionofanindividual,and(b)hasbeenmadebyoronbehalfofa

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32 Chartered Society of Physiotherapy

GLOSSARY

healthprofessionalinconnectionwiththecareofthatindividual.Arecordcanbeinpaperorelectronicformat,oramixtureofboth,andincludesalltheinformationrelatingtothehealthstatusandmanagementoftheindividualserviceuser.Therecordmaycontaininformationaboutthecurrentepisodeofcareonly,ormaybeacompilationofeveryepisodeofcareforthatindividualinagiventimeframe.Therearevarioustypesofrecordsinpractice;forexample,summary/fullrecord;sharedrecord;uni-professionalrecord;andpatient-heldrecord.Dependingontheneedsofthepatient,andthecaresetting(s)involved,therecordmaybemaintainedbytheCSPmemberoragroupofdifferentprofessionalsacrossthecarepathway.ReferralwhenonehealthprofessionalasksanotherhealthprofessionaltotakeoverthecareoftheserviceuserRiskAssessmentalogicalprocessofidentifyinghazardsandputtinginplacesensiblemeasurestopreventorcontrolthemReasoningtheabilitytomakelogicalinferencesfromavailableinformationServiceuseranindividualorindividualsinreceiptofaservicefromamembertoincludepatients,clients,carersandothers.Scopeofpracticethescopeofpracticeofphysiotherapyisdefinedasanyactivityundertakenbyanindividualphysiotherapistthatmaybesituatedwithinthefourpillarsofphysiotherapypracticewheretheindividualiseducated,trainedandcompetenttoperformthatactivitySupportworkeranyoneinadirectorindirectclinicalsupportrole.TheyarenotsubjecttoprofessionalregistrationValidconsentanindividualbeinginreceiptofsufficientknowledgeofallrelevantfactsandfactorstoagreeto,orrefuse,aparticularcourseofactionValuetheimportanceorworthofsomething(anoutcome,interventionorservice)foranindividualValuesidealsthatindividualsoraprofessionfindmorallycompelling

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Quality Assurance Standards for physiotherapy service delivery 33

1. TheCharteredSocietyofPhysiotherapy.Codeofmembers’professionalvaluesandbehaviour.London:TheCharteredSocietyofPhysiotherapy;2011.

Availablefrom:www.csp.org.uk/professional-union/professionalism/csp-expectations-members/code-professional-values-behaviour

2. HealthProfessionsCouncil.Standardsofproficiency:physiotherapists.London:HealthProfessionsCouncil;2007.

Availablefrom:www.hpc-uk.org/publications/standards/index.asp?id=49 3. HealthProfessionsCouncil.Standardsofconduct,performanceandethics:yourdutiesasaregistrant.

London:HealthProfessionsCouncil;2008rev2012. Availablefrom:www.hpc-uk.org/publications/ 4. TheCharteredSocietyofPhysiotherapy.Physiotherapyframework.London:TheCharteredSocietyof

Physiotherapy;2010. Availablefrom:http://eportfolio.csp.org.uk/viewasset.aspx?oid=1341451&type=webfolio 5. TheCharteredSocietyofPhysiotherapy.Corestandards.London:TheCharteredSocietyof

Physiotherapy;2000.6. TheCharteredSocietyofPhysiotherapy.Servicestandards.London:TheCharteredSocietyof

Physiotherapy;2000.7. TheCharteredSocietyofPhysiotherapy.Corestandardsofphysiotherapypractice2005.London:The

CharteredSocietyofPhysiotherapy;2005.8. TheCharteredSocietyofPhysiotherapy.LearninganddevelopmentprinciplesforCSPaccreditationof

qualifyingprogrammesinphysiotherapy.London:TheCharteredSocietyofPhysiotherapy;2010. Availablefrom:www.csp.org.uk/documents/learning-development-principles-0 9. TheCharteredSocietyofPhysiotherapy.Qualityassurancestandards:audittool.London:TheChartered

SocietyofPhysiotherapy;2012. Availablefrom:www.csp.org.uk/publications/quality-assurance-standards-audit-tool 10. TheCharteredSocietyofPhysiotherapy.ePortfolio. Availablefrom:www.csp.org.uk/professional-union/careers-development/cpd/csp-eportfolio 11. MentalHealthAct1983:1983c.20. Availablefrom:www.legislation.gov.uk/ukpga/1983/20/contents 12. MentalCapacityAct2005:2005c.9. Availablefrom:www.legislation.gov.uk/ukpga/2005/9/contents 13. MentalHealthAct2007:2007c.12. Availablefrom:www.legislation.gov.uk/ukpga/2007/12/contents 14. AdultswithIncapacity(Scotland)Act2000:2000asp4. Availablefrom: www.legislation.gov.uk/asp/2000/4/contents 15. DraftMentalCapacity(Health,WelfareandFinance)Act..Expected2013/14. See:www.rcpsych.ac.uk/expertadvice/problems/mentalcapacityandthelaw.aspx 16. DataProtectionAct1998:1998c.29. Availablefrom:www.legislation.gov.uk/ukpga/1998/29/contents/enacted

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SteeringgroupChairCatherinePopeHelenBalcombeKarenDandoMargaretHastingsJonathanLarnerCabellaLoweAlunMorganLisaRobertsSheilaStringerLouiseWright

FocusGroupsThank-youforallthosewhocoordinatedthefocusgroups(namedbelow)andtothosewhocontributedtothedevelopmentoftheQAStandardsthroughattendanceatthefocusgroups.

CardiffUniversity–LizWrightSheffieldHallamUniversityWesternIslesHospital–SheilaNicholsonKeeleUniversity–JackieWaterfieldRoyalWolverhamptonHospitalsNHSTrust–SheilaStringer

Annex 1

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Quality Assurance Standards for physiotherapy service delivery 35

AdditionalReadingCouncilforHealthcareRegulatoryExcellence.Clearsexualboundariesbetweenhealthcareprofessionalsandpatients:informationforpatientsandcarers.London:CouncilforHealthcareRegulatoryExcellence;2009.Availablefrom:http://csplis.csp.org.uk/olibcgi?oid=58404www.professionalstandards.org.uk/library/document-detail?id=35f0ef3a-e42d-49e0-8be0-07f340d5f51b

DepartmentofHealth.Goodpracticeinconsentimplementationguide:consenttoexaminationortreatment.London:DepartmentofHealth;2001.Availablefrom:http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4005762

DepartmentofHealth,SocialServicesandPublicSafety.Referenceguidetoconsentforexamination,treatmentorcare.Belfast:DepartmentofHealth,SocialServicesandPublicSafety;2003.Availablefrom:www.dhsspsni.gov.uk/consent-referenceguide.pdf

DepartmentofHealth.Referenceguidetoconsentforexaminationortreatment.2nded.London:DepartmentofHealth;2009.Availablefrom:www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_103643

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GeneralMedicalCouncil.Consent:patientsanddoctorsmakingdecisionstogether.London:GeneralMedicalCouncil;2008.Availablefrom:www.gmc-uk.org/guidance/ethical_guidance/consent_guidance_index.asp

HealthProfessionsCouncil.Standardsofeducationandtraining.London:HealthProfessionsCouncil;2009.Availablefrom:http://csplis.csp.org.uk/olibcgi?oid=60399

HealthProfessionsCouncil.Guidanceonconductandethicsforstudents:Informationforstudentsandeducationproviders.London:HealthProfessionsCouncil;2010.Availablefrom:www.hpc-uk.org/publications/brochures/index.asp?id=219

HealthProfessionsCouncil.Professionalisminhealthcareprofessionals.London:HealthProfessionsCouncil;2011.Availablefrom:www.hpc-uk.org/publications/index.asp?id=511HealthProfessionsCouncil.Yourguidetoourstandardsforcontinuingprofessionaldevelopment:yourdutiesasaregistrant.London:HealthProfessionsCouncil;2011.Availablefrom:www.hpc-uk.org/publications/index.asp?id=101

NorthernHealthandSocialServicesBoard.Safeguardingvulnerableadults:regionaladultprotectionpolicyandproceduralguidance.BallymenaNI:NorthernHealthandSocialServicesBoard;2006.Availablefrom:www.scie-socialcareonline.org.uk/profile.asp?guid=3a79cddc-866d-4e4c-aeb1-188239f9b858

PigramJ,SimpsonR,HopkinsS,etal.Supervision,accountabilityanddelegationofactivitiestosupportworkers:aguideforregisteredpractitionersandsupportworkers.London:RoyalCollegeofNursing,TheBritishDietetic

Annex 2

2

Ann

ex

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Association,RoyalCollegeofSpeechandLanguageTherapistsandCharteredSocietyofPhysiotherapy;2006.Availablefrom:www.csp.org.uk/publications/supervision-accountability-delegation-activities-support-workers-guide-registered-pract

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CSP Headquarters14BedfordRowLondonWC1R4EDTel:020 7306 6666 Fax:020 7306 6611Email:[email protected]

CSP Northern IrelandArthurHouse41ArthurStreetBelfastBT14GBTel:028 9044 6250Fax:028 9044 7110Email:[email protected]

CSP Scotland49NorthCastleStreetEdinburghEH23BGTel:0131 226 1441Fax:0131 226 1551Email:[email protected]

CSP WalesCymdeithasSiartredigFfisiotherapi1HeolYrEglwysGadeiriolCaerdyddCF119SD

1CathedralRoadCardiffCF119SDTel:029 2038 2428/9Fax:029 2038 2428/9Email:[email protected]

ISBN 9978 1 904400 32 5

Publication date 2012 review date 2017