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Document Title:

HAAD Standard for Scope of Practice for Traditional Complementaryand Alternative Medicine (TCAM) Practitioners

Document Ref. Number: TCAM/HFL/1.0 Version 1.0

Approval Date: 23/03/14 Effective Date: 23/03/14

Last Reviewed: October 2012 Next Review: December 2016

Revision History Version 0.9 Published 2012

Document Owner: Health Regulation Division

Applies to: HAAD Licensed Healthcare Providers in the Emirate of Abu Dhabi

Classification:

Public

1. Purpose 1.1. This Standard defines the permitted professions as per HAAD Personal Qualification

Requirements for those practitioners wishing to practise Traditional, Complementary andAlternative Medicine (TCAM) in the Emirate of Abu Dhabi and describes the servicespecifications for healthcare facilities wishing to provide TCAM services. It aims to ensurethat safe and quality TCAM practices are provided to members of the Abu Dhabicommunity.

2.

Scope

2.1. This Standard applies to applicants eligible to apply for HAAD licence to practise TCAMprofessions and healthcare providers wishing to engage the services of thesepractitioners in the emirate of Abu Dhabi.

3.

Definitions

3.1 HAAD recognises the W.H.O definition for Traditional Medicine which for the purposes ofthis Standard is inclusive of the terms “Traditional”, “Complementary” and “Alternative” usedcollectively by HAAD to refer to a broad set of healthcare practices that are part of the UAEtraditional medicine practices and those that are not part of the UAE’s own traditional practices and are not integrated into the dominant healthcare system, but which have beensupported by evidence deemed by HAAD to be of acceptable quality and safety.

3.2 Acupuncture: A procedure used in or adapted from Chinese medical practice in whichspecific body areas are pierced with fine needles for therapeutic purposes or to relieve pain orproduce regional anesthesia;3.3 Chiropractic: A system of therapy in which disease is considered the result of abnormalfunction of the nervous system. The method of treatment usually involves manipulation of thespinal column and other body structures;



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3.4 Homeopathy: A system for treating disease based on the administration of minute doses ofa drug that in massive amounts produces symptoms in healthy individuals similar to those ofthe disease itself;3.5 TCM (Traditional Chinese Medicine): Chinese-based alternative therapies, includingacupuncture, certain forms of massage, and some herbal remedies;3.6 Ayuverda (Traditional Indian Medicine): The ancient Hindu science of health and medicine

and includes prevention and treatment of diseases through consultation, prescriptions,lifestyle interventions, detoxification therapies, breathing exercises and meditation;3.7 Naturopathy: A system of therapy that relies on natural remedies, such as sunlightsupplemented with diet and massage, to treat illness;3.8 Osteopathy: A system of medicine based on the theory that disturbances in themusculoskeletal system affect other bodily parts, causing many disorders that can becorrected by various manipulative techniques in conjunction with conventional medical,surgical, pharmacological, and other therapeutic procedures;3.9 Unani: A system that is based around the concepts of the four humours: Phlegm(Balgham), Blood (Dam), Yellow bile (Safra) and Black bile (Saudā') including but not limited todiet therapy, nutritional therapy, life style modification, stress management, cupping,diaphoresis, massage, purging, emesis and exercise;

3.10 Hijama: is the name in Arab traditional medicine for wet cupping, where blood isdrawn by vacuum from a small skin incision for therapeutic purposes; and

4. TCAM Professions

4.1. All professionals wishing to engage in providing healthcare services, including TCAMservices, must be licensed by HAAD. Appendices 1, 2, 3 and 4 set out the requirementsfor the TCAM providers and professionals covered by this Standard.

4.2. TCAM professions covered by this Standard include:4.2.1. Acupuncture Practitioner;4.2.2. Chiropractic Practitioner;4.2.3. Homeopathy Practitioner;4.2.4. Traditional Chinese Medicine (TCM) Practitioner;4.2.5.

Ayurveda Practitioner (Traditional Indian Medicine);4.2.6. Naturopathy Practitioner;4.2.7. Osteopathy Practitioner;4.2.8. Unani Medicine Practitioner;4.2.9. Hijama Practitioner;4.2.10. Hijama Therapist.

5. General Duties for HAAD Licensed TCAM Practitioners and their employing healthcare

providers

5.1. As per the HAAD PQR requirements, each HAAD Licensed TCAM professional must:5.1.1. comply with the HAAD licensure and examination and continuing professional

development and medical education requirements;5.1.2. have medical and professional liability insurance;5.1.3. only use the professional title granted by the HAAD Professional Licensing

Committee;5.1.4. limit his/her services and practices to the respective HAAD approved TCAM scope

of practice pertaining to his/her profession and licence as defined in this HAADStandard;

5.1.5. comply with any restrictions imposed under his/her licence;



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5.1.6. comply with Appendices 1, 2, 3 and 4 to this Standard on the Requirements forTraditional Complementary and Alternative Medicine (TCAM) Facility types and sub-types and requirement for HAAD licensed healthcare professionals;

5.1.7. comply with HAAD policies and standards on patient informed consent, managingpatient medical records, including developing effective recording systems,maintaining patient records; maintaining confidentiality, privacy and security of

patient information; educating patients on services provided and satisfying therequirements of patients’ rights and responsibilities charter; 5.1.8. abide by the HAAD Code of Practice for TCAM professionals (Appendices 1 and 2);5.1.9. not prescribe any prescription-only-medicines to patients, unless authorized to do

so under the HAAD issued licence to practise the profession;5.1.10. when recommending or prescribing general sale or over the counter

complementary medical products, only do so from the HAAD Approved Products List;5.1.11. not alter and/or change a patient’s treatment protocol or prescription issued by a

HAAD licensed physician or specialist; when a patient’s health improves as a result ofTCAM treatment, the TCAM practitioner must not change, alter and/or stop thetreating physician’s prescribed medication or it dosages;

5.1.12. not treat communicable diseases. TCAM practitioners must be aware of and

comply with the notifiable communicable diseases and the HAAD requirement tonotify as per the HAAD Standards for Reporting Public Health Statistics;

5.1.13. take appropriate actions and precautions to ensure infection control and act inaccordance with HAAD Policies and standards for infection control (HAAD EHSMSStandards);

5.1.14. not sell or dispense any prescribed medication or advertise medical products orpreparations from their own practice clinic unless permitted to do so by the HAAD;

5.1.15. following examination of, and where the TCAM practitioner suspects diseasecondition from the patient’s history, signs and symptoms, then he/she must advisethe patient to consult a HAAD licensed physician;

5.2. Each healthcare provider employing or engaging the services of a HAAD licensed TCAMpractitioner must ensure that:

5.2.1.

TCAM practitioners employed by them comply with the general duties detailed inthis Standard (paragraphs under 5), and that they grant and manage privileges oftheir TCAM practitioners in accordance with the HAAD Standard for ClinicalPrivileging Framework;

5.2.2. they provide medical and professional liability insurance to all TCAM practitionersemployed at their facilities;

5.2.3. they manage and report on adverse events in accordance with the requirementsof the HAAD Standard for Adverse Events Management and Reporting in the emirateof Abu Dhabi;

5.2.4. they comply with HAAD audits, and cooperate with the HAAD authorisedinspectors and auditors; and

5.3.

TCAM Providers must comply with all HAAD licensing requirements, as they apply to theirrespective practice.

6. Enforcement and Sanctions

6.1 TCAM providers must comply with the terms and requirements of this Standard, theHAAD Standard Provider Contract and the HAAD Data Standards and Procedures. HAAD mayimpose sanctions in relation to any breach of requirements under this standard in accordancewith the Complaints, Investigations, Regulatory Action and Sanctions Policy, Chapter IX,Healthcare Regulator Policy Manual Version 1.0.



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7. TCAM Scopes of Practice

7.1. Scope of Practice for Acupuncture Practitioner

7.1.1. Acupuncture treatment involves the insertion of fine, sterile needles into specificsites (acupuncture points) along the body's meridians to clear energy blockages andencourage the normal flow of qi through the individual.

7.1.2. The Practice of Acupuncture may include activities that involve: 7.1.2.1. Physical examination,7.1.2.2. History taking,7.1.2.3. Inspection and tongue diagnosis,7.1.2.4. Palpation and pulse taking,7.1.2.5. Auscultation and olfaction,7.1.2.6. The stimulation of points, areas of the body or substances in the body

using qi, needles with or without electrical stimulation(using clean needle technique), moxibustion, heat and cold, colour, light, lasers,

or suction (cupping - dry or wet);7.1.2.7. Therapeutic exercises, qi exercises, breathing techniques, and meditation;7.1.2.8. Musculoskeletal manipulation consistent with their training (Tui Na); 7.1.2.9. Differentiation of syndromes according to eight principles, the theory of

visceral manifestations (zang-fu), the theory of qi and blood, and theory ofmeridians and collateral vessels;

7.1.2.10. Evaluation of the sensitivity of patient to the acupuncture treatment andthe probable reaction and response of the patient to administration of thetreatment.

8. Scope of Practice for Chiropractic Practitioner

8.1 Chiropractic treatment involves diagnosis and treatment of disorders of the neuro -

musculoskeletal system and the effect of these disorders on general health. There isan emphasis on manual techniques, including joint adjustment and /ormanipulation, with a particular focus on subluxation

8.2 The Practice of Chiropractic includes activities that involve:8.2.1. Physical examination and history taking;8.2.2. Requesting clinical laboratory tests and physiological function tests;8.2.3. Requesting diagnostic imaging tests, consistent with their licence;8.2.4. Treatment interventions designed to correct neurological, skeletal, or soft tissue

dysfunction by employing particular chiropractic adjustments and/ormanipulations (with particular attention to the spine, skull and pelvis) andapplying hot or cold hydrotherapy; trigger point therapy; electrotherapy;

8.2.5. Dietary and nutritional counselling; therapeutic exercise.

9. Scope of Practice for Homeopathy Practitioner:

9.1 Homeopathy involves diagnosis and treatment by using substances capable of causing thesame symptoms, syndromes and conditions when administered to healthy people. Thebasic principles of treatment are: law of similarity, direction of cure, principle of singleremedy, the theory of minimum diluted dose and the therapy of chronic diseases.

9.2 The Practice of Homeopathy may include activities that involve:



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9.2.1. Physical examination and requested laboratory examinations consistent with theireducation and training, for diagnostic purposes, including clinical laboratory testsand physiological function tests;

9.2.2. Request diagnostic imaging studies consistent with their licence;9.2.3. Administer, order or prescribe homeopathic medicines (pharmaceutical dosage

form) and Over- the -counter medicines registered with HAAD approved products

list;9.2.4. Provide nutritional, dietary and preventive medicine advice;9.2.5. Education regarding physical, emotional and spiritual balance as it relates to

Homeopathic Medicine.

10. Scope of Practice for TCM (Traditional Chinese Medicine) Practitioner

10.1Traditional Chinese Medicine involves unique theories and methods for healthenhancement and treatment. There are many modalities included in traditionalChinese medicine, such as Chinese herbal medicine, acupuncture and moxibustion.

10.2 The Practice of Traditional Chinese Medicine may include activities that involve:10.2.1. Physical examination and requested laboratory examinations consistent with their

education and training, for diagnostic purposes, including, clinical laboratory tests,

and physiological function tests;10.2.2. Refer to HAAD Licensed physician appropriately qualified and privileged to assess

patients and order diagnostic imaging as required;10.2.3. Administer, order or prescribe or perform the following:

10.2.3.1. stimulation of points, areas of the body or substances in the body usingqi, needles with or without electrical stimulation (using clean needletechnique), moxibustion, heat and cold, colour, light, lasers, or suction(cupping –“wet” or “dry”);

10.2.3.2. Therapeutic exercises, qi exercises, breathing techniques, and meditation;10.2.3.3. Nutritional, dietary and preventive medicine advice in terms of Traditional

Chinese medicine;10.2.3.4. Education regarding physical, emotional and spiritual balance as it relates

to Traditional Chinese Medicine;10.2.3.5. Prescription of herbal medicines (pharmaceutical dosage form) and Over

the Counter medicines included in the HAAD approved list of products; and10.2.3.6. Musculoskeletal manipulation consistent with Traditional Chinese

Medicine training (Tui Na).

7.1.3. 11. Scope of Practice for Ayurveda (Traditional Indian Medicine) Practitioner: 11.1 Ayurveda (Traditional Indian Medicine) involves prevention and treatment of illness

through lifestyle interventions, detoxification and natural therapies;11.2 The Practice of Traditional Indian Medicine may include activities that involve:

11.2.1. Physical examination and requested laboratory examinations consistent withtheir education and licence, for diagnostic purposes, including clinical

laboratory tests, and physiological function tests;11.2.2. Refer to HAAD Licensed physician appropriately qualified and privileged to

assess patients and order diagnostic imaging as required;11.2.3. Administer, order, prescribe or perform the following:

11.2.3.1 Prescription of herbal medicines (pharmaceutical dosage form) andOver the Counter medicines from the HAAD approved products list;

11.2.3.2 Therapeutic yoga exercises, detoxification therapies, breathingexercises, and meditation;



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11.2.3.3 Nutritional, dietary and preventive medicine advice in terms ofTraditional Indian medicine;

11.2.3.4 Education regarding physical, emotional and spiritual balance as itrelates to Traditional Indian Medicine;

11.2.4.6 Musculoskeletal manipulation and /or therapeutic massage consistentwith training.

12. Scope of Practice for Naturopathy Practitioner:12.1 Naturopathy involves the prevention, treatment and the promotion of optimal healththrough the use of therapeutic methods and modalities which encourage the self-healing process, the vis medicatrix naturae;

12.2. The Practice of Naturopathy includes:12.2.1. Physical examination and requested laboratory examinations consistent with

their education and licence, for diagnostic purposes, including, clinicallaboratory tests, and physiological function tests;

12.2.2. Refer to HAAD Licensed physician appropriately qualified and privileged toassess patients and order diagnostic imaging as required;

12.2.3. Administer, order, prescribe or perform the following:

12.2.3.1 Nutritional, dietary and preventive medicine advice in terms of

Naturopathy;

12.2.3.2 Recommendation of food, extracts of food, nutraceuticals, vitamins,

amino acids, minerals, enzymes, botanicals and their extracts, botanical

medicines and dietary supplements;

12.2.3.3. Hot or cold hydrotherapy; naturopathic physical medicine;

naturopathic osseous manipulation, electromagnetic energy; colon

hydrotherapy; and therapeutic exercise;

12.2.3.4 Education regarding physical, emotional and spiritual balance, as it

relates to Naturopathic medicine.

13. Scope of Practice for Osteopathy Practitioner:

13.1. Osteopathy involves an approach to healthcare that emphasizes the role of themusculoskeletal system in health and disease. Osteopathy recognizes the importance ofthe link between the structure of the human body and the way it functions and thepractice focus on the body’s skeleton and joint function along with the underlyingmuscles, soft tissue and internal organs.13.2. The Practice of Osteopathy may include activities that involve:

13.2.1. Physical examination, requesting laboratory examinations clinicallaboratory tests, and physiological function tests;13.2.2. Request diagnostic imaging studies consistent with their licence;13.2.3. Order, prescribe or perform the following:13.2.4. Cranial Osteopathy; electro-therapy; therapeutic exercises; osteopathictechniques including direct techniques such as high velocity low amplitude thrust,articulatory, general osteopathic technique, and muscle energy; indirecttechniques including functional techniques, counter strain; balancing techniquesincluding balanced ligamentous tension, and ligamentous articulatory strain;combined techniques including myofascial/fascial release, Still technique,osteopathy in the cranial field, involuntary mechanism, and visceral techniques;reflex based techniques such as Chapman’s reflexes, trigger points,neuromuscular techniques (NMT); and fluid based techniques such as lymphaticpump techniques; and



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13.2.5 Health education and health counselling.14. Scope of Practice for Unani Medicine Practitioner:

14.1. Unani Medicine encompasses a range of practices: herbal medicine, diet therapy,nutritional therapy, life style modification, stress management, cupping, diaphoresis, massage,purging, emesis and exercise;

14.2. The Practice of Unani may include activities that involve:

14.2.1. Physical examination and request laboratory examinations consistent withtheir education and licence, for diagnostic purposes, including clinical laboratorytests, and physiological function tests;14.2.2. Administer, order, prescribe or perform the following:

14.2.2.1. Nutritional, dietary and preventive medicine advice in terms ofUnani medicine;14.2.2.2. Education regarding physical, emotional and spiritual balance, as itrelates to Unani medicine;14.2.2.3. Herbal medicine, diet therapy, nutritional therapy, life stylemodification;14.2.2.4. Management, cupping, diaphoresis, diuresis, Turkish bath,therapeutic massage;

14.2.2.5. Purging, emesis and exercise.

15. Scope of Practice for Hijama Practitioner and Hijama Therapist:

15.1 Hijama is the name in Arab traditional medicine for wet cupping, where blood isdrawn by vacuum from a small skin incision for therapeutic purposes. It may involve theapplication of suction cups to the skin to draw out stagnant, congested blood, as well asother stagnant or morbid humors. Usually, the cups are made of glass, but they can alsobe made of bamboo, bone, horn or metal;15.2. The Practice may include activities that involve:

15.2.1 Physical examination, proficiency in making a simple but competentexamination of patient leading to a reasonable assessment of the severity ofsymptoms and signs;

15.2.2 the preparation/stimulation of points, areas of the body or substances inthe body using cups; (“dry” or “wet”); and

15.3 Education regarding physical, emotional and spiritual balance, as it relates toHijama Practice.

16. Use of Medical devices

16.1 All medical Devices used must be approved for use in Abu Dhabi, and must be usedonly by the licensed practitioner, who must have the appropriate training, and must usethe device in accordance with its intended purpose, the manufacturer’s recommendations and in accordance with good industry hygiene and infection controlpractices;16.2 When using medical devices, the licensed practitioner must not compromise the

clinical condition or the safety of patients, or the safety and health of users or, when

present, other persons. The practitioner must assess any risks which may be associated

with their use, and ensure that such risk is considered minimal or acceptable when

weighed against the benefits to the patient and can be managed in a manner that

protects their health and safety;

16.3 All medical devices must be registered according to Ministry of Health requirements

in compliance with Federal Law no. 4, “UAE Medical Devices Registration Guidelines”



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based upon existing UAE Federal Law 4 (1983), [and included on the HAAD approved list

of products].



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Appendix 1 - HAAD standards on credentialing requirements for approved list of TCAM specialties

1.

Acupuncture

Practitioner Eligibility CriteriaIn determining the eligibility of an applicant for licensing with Health Authority - AbuDhabi (HAAD) as Acupuncture Practitioner, the applicant must comply with all the

following requirements:a) A professional degree of Acupuncture: Bachelor of Medicine (Acupuncture)with minimum 5 years full time duration including internship.

b) Current license/registration to practice in home country or country of lastemployment.

c) Experience: Not less than 2 years after internship.

ORa) A Licentiate from an accredited Acupuncture program of minimum two

years full time or the part time equivalent with not less than 2500teaching hours / Certification from National Certification Commission forAcupuncture and Oriental Medicine (NCCAOM).

b) Current license/ Registration to practice in home country or country of lastemployment


Physician privileged to practice Acupuncturea) Certification from an Accredited Acupuncture training program of not less

than 200 hours/one year.b) Current license/ Registration to practice in home country or country of last

employment.c) Holding a valid HAAD license to practice as a physician.

2. Chiropractic

Practitioner Eligibility criteriaIn determining the eligibility of an applicant for licensing with Health Authority - AbuDhabi (HAAD) as Chiropractic Practitioner, the applicant must comply with all thefollowing requirements:

a) A professional degree of Chiropractic – Doctor of Chiropractic (D.C),

honours degree or undergraduate, masters or equivalent of not less than 4

years full time duration with minimum 4200 student/teacher contact

hours.

b) Current license/registration to practice in home country or country of last

employment.

c)

Experience: Not less than 2 years after internship.

Physician privileged to practice Chiropractica) Accredited Chiropractic training program of not less than 1800 hours over a

two or three years full – time or part –time program including not less than1000 hours of supervised clinical experience.

b) Current license/ Registration to practice in home country or country of lastemployment.

c) Holding a valid HAAD license to practice as a physician.



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3. Homeopathy

Practitioner eligibility criteriaIn determining the eligibility of an applicant for licensing with Health Authority - AbuDhabi (HAAD) as Homeopathic Practitioner, the applicant must comply with all thefollowing requirements:

a)

Professional Degree of Homeopathy (BHMS- Bachelor in HomeopathicMedicine and surgery)/ licentiate from an accredited Homeopathic program ofnot less than 5 years (including internship).



OR

a) To have certified from an accredited Homeopathy program of not less than 3years full time program.

b) Current license/ Registration to practice in home country or country of last

employment.c) Experience: Not less than 4 years after completion of the course.

Physician privileged to practice Homeopathy

a) Successful completion of an accredited Homeopathic program of not less than1 year full time duration.



4. Osteopathy

Practitioner eligibility criteriaIn determining the eligibility of an applicant for licensing with Health Authority - Abu

Dhabi (HAAD) as Osteopathy Practitioner, the applicant must comply with all the following

requirements:

a) Professional Degree of Osteopathy:– Diploma of Osteopathy (D.O) / -Bachelorof Osteopathic Medicine (B.Ost Med.)/ BSc Hons. Osteopathy or equivalent ofnot less than 4 years full time duration comprising not less than 1000 hours ofsupervised clinical training (internship).



Physician privileged to practice Osteopathya) Successful completion of an accredited Osteopathy program of not less than

one year full time or part time equivalent of not less than 1000 hoursincluding supervised clinical training.





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5. Traditional Chinese Medicine (TCM)

Practitioner eligibility criteriaIn determining the eligibility of an applicant for licensing with Health Authority - AbuDhabi (HAAD) as Chinese Medicine Practitioner, the applicant must comply with all thefollowing requirements:

a) Professional degree of Traditional Chinese Medicine (B.TCM - Bachelor ofTraditional Chinese Medicine) from a recognized University of minimum fiveyears full time duration including one year internship.


c) Experience: Not less than 2 years after internship.OR

a) A Licentiate from an accredited Traditional Chinese Medicine Educationprogram of three to four year years full time or equivalent of not less than totalof 2,400 hours (consisting of 1,500 hours of theory and laboratory/clinicalpractice and 900 hours of clinical practicum).

b)

Current license/ Registration to practice in home country or country of lastemployment.

c) Experience: Not less than 4 years after completion of the course.

Physician privileged to practice Traditional Chinese Medicine

a) Successful completion of an accredited training program in TCM of two tothree years full time or equivalent of not less than total of 1300 hours(Consisting of 800hours of theory and laboratory/clinical practice and 500hours of supervised clinical practicum).



6. Ayurveda (Traditional Indian Medicine)

Practitioner eligibility criteriaIn determining the eligibility of an applicant for licensing with Health Authority - AbuDhabi (HAAD) as Ayurveda Practitioner, the applicant must comply with all the followingrequirements:

a) Professional Degree of Indian medicine - Ayurveda (BAMS- Bachelor ofAyurvedic Medicine and surgery) or equivalent of not less than 5 years full timeduration including internship (comprising not less than 4500 hours ofclassroom theory and practical sessions and 1000 hours of internship training).

b) Current license/registration to practice in home country or country of last

employment.c) Experience: Not less than 2 years after internship.

OR

a) Licentiate from an accredited Ayurveda Medicine program over a three to fouryears full time / equivalent, comprising not less than 2500 hours (classroom



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theory and practical sessions) followed by 500 hours of supervised internshiptraining.



Physician privileged to practice Traditional Indian Medicine (TIM) a) Successful completion of an accredited Homeopathy program of not less thanone year full time duration.



7. Naturopathy

Practitioner eligibility criteriaIn determining the eligibility of an applicant for licensing with Health Authority - AbuDhabi (HAAD) as Naturopathy Practitioner, the applicant must comply with all thefollowing requirements:

a) Professional Degree of Naturopathy (ND - Doctor of Naturopathy / BNYS-Bachelor of Naturopathy and Yogic Sciences) or equivalent of not less than 4years full time duration including supervised clinical training.

b) Current License/registration to Practice in home country or country of lastemployment.


Physician privileged to practice Naturopathya) Completion of an accredited Naturopathy training program over a two or

three years full-time or part-time period of not less than 1000 hours, includingnot less than 400 hours of supervised clinical training.



8. Unani

Practitioner eligibility criteriaIn determining the eligibility of an applicant for licensing with Health Authority - AbuDhabi (HAAD) as Unani Practitioner, the applicant must comply with all the followingrequirements:

a) Professional Degree of Unani (BUMS- Bachelor in Unani Medicine and surgery /BEMS- Bachelor in Eastern Medicine and Surgery / Diploma Fazil ut Tibb WalJarahat) or equivalent of not less than 4 years full time duration including

supervised clinical practicum.b) Current license/registration to practice in home country or country of last

employment.c) Experience: Not less than 2 years after internship.

Physician privileged to practice Unani a) Successful completion of an accredited training program in Unani Medicine of

two years full time or part time equivalent of not less than total of 1500 hours



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(theory and practical) followed by 750 hours of supervised training in ahospital or recognized medical centre.



9 HijamaPractitioner eligibility criteriaIn determining the eligibility of an applicant for licensing with Health Authority - AbuDhabi (HAAD) as Hijama Practitioner, the applicant must comply with all the followingrequirements:

a) Hold a valid HAAD health professional license (in anymedical/paramedical/allied health specialties).

b) Submit proof of having completed a satisfactory training program offeredthrough a licensed and/or competent Hijama practitioner or therapist and/orinstitute as deemed appropriate by HAAD.

Hijama Therapist eligibility criteria (only for UAE Nationals):a) For UAE nationals who do not meet the stated educational requirements, but

have been traditionally practising Hijama, the designated HAAD panel reviewsthe candidate portfolio, and recommends the application for HAAD licensure,if the candidate meets the professional standard as defined by the panel.

b) The candidate must be able to prove that he has been traditionally practisingHijama for a period of not less than 2 years and must possess a certificationattested from court in this regard.



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Appendix 2 Governance

1. Codes of Practice

TCAM practitioners must practice TCAM services in accordance with the requirements of thisHAAD Standard, and the relevant HAAD Policies and Standards to ensure that they provide safeand quality TCAM services for their patients. It is a requirement that TCAM practitioners apply the

principles of professionalism and ethics at all times; for this purpose, this Code of Practicedescribes the professional and ethical duties for TCAM practitioners, which aims to ensure thedelivery of quality, safe and ethical standards of treatment and care.

2. Ethical Practice:

TCAM practitioner’s must: 2.1 Practice in a manner consistent with this code of practice.2.2 Advocate protecting human health, safety and rights and report on acts that violatethese rights.2.3 Maintain confidentiality and security of written, verbal and electronic information.2.4 Respect and maintain the client’s right to privacy and dignity. 2.5 Respect and demonstrate sensitivity to diverse cultural and religious beliefs.

2.6 limit his/her services and practices to the respective HAAD approved TCAM scope ofpractice pertaining to his/her profession and license as defined in this HAAD Standard;2.7 provide comprehensive and accurate information to the patient about the treatmentallowing the patient to make an educated choice of treatment;2.8 Make a valid assessment of the patient’s condition based on health history, physicalexamination, laboratory and other diagnostic tests.2.9 Communicate clearly and compassionately with the patient (or patient advocate ontheir current state of health and wellbeing offering appropriate treatmentrecommendation and advice;2.10 Consult other healthcare professionals when their expertise is required.2.11 Respond promptly and constructively to concerns, criticisms and complaints.2.12 undertake regular self-assessment and review of own practice based on establishedcriteria through reflection, peer review, critical examination and evaluation;2.13 Identify the need for updated knowledge base and skills for practice;2.14 Actively seek new knowledge and skills to ensure ongoing professional developmentand competency to practice;2.15 Participate and maintain record of learning and professional development activitiesattended.2.16 TCAM practitioners licensed by HAAD and following the guidance in this code areable to practice their profession safely, competently and ethically. This should be inaccordance with to the HAAD standard for complaints management and SOPs.

3. Good Communication:

3.1 TCAM practitioners must communicate effectively with their patients by:3.1.1 Listening to patients and responding to their concerns and preferences.3.1.2 Clearly communicating information required by the patient concerning theirwellbeing or treatment.3.1.3 Regularly update the patient with the progress of their treatment and care.

3.2 Clarity of contract: 3.2.1 To ensure that the patient is always able to make informed choices TCAMpractitioners must give full and clear information about their service before



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commencing treatment. This shall include information about the nature of thetreatment, expenses, availability for advice, confidentiality and security of records.

3.3 Informed Consent; All practitioners must:3.3.1 Comply with the HAAD Policy on Consent.3.3.2 Communicate clearly with the patient information about the recommended

treatment, its benefits and alternative treatments.

4. Records and record keeping: 4.1 All patient records must be maintained in accordance with HAAD standards managingpatient medical records, including developing effective record systems. Case notes mustbe clear, accurate, legible and current. They must contain all the relevant informationrelating to the progress of the case, for example, treatment given, whether the patienthas improved, maintained or deteriorated in their condition since they were last seen.4.2 Basic requirements of case notes are as follows:

4.2.1Name, address, telephone number, date of birth, essential details of medicalhistory, dates and details of treatment given. 4.2.2 A record of medication, of any kind, taken by the patient, including thenames and address of the prescriber if available, also any diagnosis the patient has

received from a competent medical authority. Blood pressure, pulse rate readings,other medical data such as weight loss, unusual bleeding or other informationmust be provided by the patient. 4.2.3 Advice given to the patient either through clinical or telephonicconsultation that can help improve the patient’s known condition.4.2.4 Decisions that the practitioner makes in the management of patient’s case,such as referrals, disclosure of information or request for medical tests andexaminations. 4.2.5 Patient’s record on no account is transferred to a newPractitioner/healthcare professional without the authorization of the patient.Where a patient requests the record of their treatment in writing, or asks therecord to be forwarded to another Practitioner, it is important to send the relevantinformation from the patient’s case notes as quickly as possible. The full originaldocuments should be retained in accordance with the requirements of HAADstandards, UAE Federal Law number 10/2008 concerning Medical Liability and theCabinet decision number 33/2009 concerning the implementation list of theMedical Liability .

5. Confidentiality and Disclosure:

5.1 All TCAM Practitioners must ensure patient information is kept in confidence;maintaining privacy and security of information and must be in accordance with HAADpolicies and standards on patient confidentiality and the applicable federal and emiratelaws.

6. Referrals:

6.1 TCAM practitioners must comply with HAAD Patient Referral Policy. Referrals can onlybe made with patient’s consent, unless it is related to life saving status. 6.2 Where consulting another practitioner is necessary, a TCAM practitioner must ensurethat they obtain the patient’s consent prior to doing so.6.3 Patients may be referred to another TCAM Practitioner; such referrals must berecorded at the time of recommendation of the new TCAM practitioner.



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6.4 The TCAM practitioner should not contact a medical doctor or another healthcarepractitioner unless the patients give their consent.6.5 Details of all the recommended referrals to other health care professionals must berecorded in the patient’s records at the time of referral.6.6 The referring TCAM practitioner must ensure continuity of patient care when referredto another practitioner by providing the necessary history of the case to the referred

practitioner.

7. Professional Practice and obligations

7.1 Practitioners must practice their work with due diligence. (Due diligence is the level ofjudgment, care, prudence, determination and activity that a person would reasonably beexpected to do under particular circumstances).They must always limit their practice totheir area of expertise and within the HAAD defined scope of practice and must ensurethat treatment is not to be influenced by a client’s gender, ethnicity, culture, beliefs,sexuality, life style, age, social status or language difficulty.

8. Competence and Continuing Professional Development

8.1 Practitioners must regularly evaluate and monitor their clinical skills and actively

extend their knowledge base and their own personal development through continuingprofessional development.

9. Notifiable diseases:

9.1 TCAM practitioners should be aware of those diseases which are notifiable under thelaw and should take appropriate action. This should also be in accordance with HAAD Vitalstatistics Standard.

10. Inappropriate use of patient related material:

10.1 TCAM practitioners must avoid recording on film, video or through digitaltechniques, any material or imagery concerning a patient which might be regarded asexplicit, indecent or pornographic.

10.2 Practitioners may use film, tape recording or digital imagery of material concerninga patient with the patient’s clear, informed, written consent to the precise use of thematerial.

11. Child protection:

TCAM practitioners must safeguard and protect the health and wellbeing of child andyoung people.11.1When communicating with a child or young person, you must:

11.1.1 Treat them with respect and listen to their views11.1.2 Answer their questions to the best of your ability.11.1.3 Provide information appropriately.

11.2 It is also advisable to undertake the physical examination of child under 18 in the

presence of a parent

12. Contact with relatives / interested parties:

12.1 If a member of the patient’s family, friend or other person connected with the patient,communicates with the TCAM practitioner; it is important to provide them with theinformation required without breach of confidentiality of patients.

13. Financial and commercial dealings:

TCAM practitioners must:



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13.1 Be transparent on fees before commencing treatment.13.2 Not exploit patient’s vulnerability or lack of medical knowledge when charg ing fortreatment or services.13.3 Not encourage patients to give, lend or bequeath, money or gifts that will directly orindirectly benefit their practice.13.4 Not pressure patients or their families to make donations to other people or

organizations.13.5 Not engage in fraudulent or abusive financial practices when billing for services.

14. Conflicts of interest:

14.1 Practitioners must act in their patient’s best interest when making referrals and whenproviding or arranging treatment or care. They must t not ask or accept any inducement,gifts or hospitality which may affect treatment or patient transfer.14.2 If you have financial or commercial interests in organizations providing health careor in pharmaceutical or other bio medical companies, these interests must not affect theway you prescribe for, treat or refer patients

15. Research:

15.1TCAM practitioners intending to undertake research must seek authorization fromHAAD prior to conducting any research. It is a breach of the law if they conduct anyresearch without HAAD authorization. If authorised by HAAD to conduct health researchand/or involving patients, they must comply with HAAD Research Policies and standardsand abide by HAAD research ethics requirements patient consent to participate inresearch and research governance.15.2 The patient’ refusal to participate in research must not influence the care of thepatient in anyway

16. Arranging cover:

16.1 The TCAM practitioner should arrange effective hand-over procedures, involvingclear communication with health care colleagues when he/she is off duty.

17. Professional boundaries: 17.1 Unprofessional conduct breaches the law and is abusive.

18. Non acceptance or Termination of professional relationship:

18.1In the incidence of the patient’s unreasonable behavior, and termination oftreatment; alternative arrangements must be made promptly for the continuing care ofthe patient, if they require it.

19. Publicity and Advertising:19.1 Only can publish promotional materials if all the information contained in thosematerials is factually and accurate advertisements must not contain misleading

information that is intended to or does in fact take advantage of the status or of thevulnerability or lack of medical knowledge of any person by placing place unfair pressureon that person to receive treatment.

20. Complaints:

20.1 TCAM practitioners licensed by HAAD and following the guidance in this code are able topractice their profession safely, competently and ethically. This should be in accordance to HAADcomplaints standard and SOPs.



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Appendix 3 - Requirements for Traditional Complementary and Alternative Medicine (TCAM)

Facility types and sub-types and required HAAD licensed healthcare professionals

Traditional Complementary and Alternative Medicine (TCAM) Facility:

A health care facility that consists of a clinic or a group of clinics (two and above), staffed by

either HAAD licensed complementary Medicine Practitioner(s), or HAAD licensed Physician(s)

privileged to practice complementary medicine. These facilities provide consultation and/or

services on HAAD approved Traditional Complementary Medicine Specialties. It does not provide

emergency services, which must be referred to a hospital.

TCAM facilities can be established independently or within a healthcare facility providing various

conventional (allopathic) medical services. It must be operated and managed by a licensed TCAM

Practitioner or a licensed Physician privileged to practice traditional complementary medicine,

when established independently.

Requested laboratory examinations consistent with the TCAM specialty education and training is

part of the TCAM practice, however no laboratory or other medical diagnostic services are

permitted within an independent TCAM facility. If the TCAM centre is part of an outpatient

healthcare facility providing conventional (allopathic) medicine, then laboratory or other medical

diagnostic services may be provided, which must meet the HAAD Standards requirement and

criteria (such as the HAAD Clinical Laboratory Standards).

Subtypes

Subtypes must have either a HAAD licensed Physician or a HAAD licensed Practitioner in their

respective discipline to qualify for the issuance by HAAD of a TCAM facility Licence. For Hijama,

staffing by Therapists alone does not qualify for a TCAM facility Licence, except in the case where

the Therapist is an UAE national.

1.

Acupuncture Centre

Acupuncture Centre provides treatment which may involve the insertion of fine, sterile needles

into specific sites (acupuncture points) along the body's meridians to clear energy blockages

and encourage the normal flow of qi through the individual. The Centre may also provide

services that involve the stimulation of points with or without electrical stimulation,

moxibustion, heat and cold, colour, light, lasers, or suction (cupping - dry or wet).

Required Professional:

Acupuncture Practitioner or Physician privileged to practise Acupuncture.

2. Chiropractic Centre

Chiropractic Centre provides consultation and treatment of disorders of the neuro -

musculoskeletal system with an emphasis on manual techniques, including joint adjustment

and /or manipulation, with a particular focus on subluxation.



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Chiropractic Practitioner or Physician privileged to practice Chiropractic.

3. Homeopathy Centre

Homeopathy Centre provides treatment by consultation and prescription for homeopathic

remedies. The Centre also provides nutritional, dietary and preventive medicine advice and

education regarding physical, emotional and spiritual balance as it relates to Homeopathy.


Homeopathy Practitioner or Physician privileged to practice Homeopathy.

4. Osteopathy Centre

Osteopathy Centre provides consultation and treatment based on principles of Osteopathic

Medicine which involves an approach to healthcare that emphasizes the role of the

musculoskeletal system in health and disease. The provided services include but not limited

Cranial Osteopathy; electro-therapy; therapeutic exercises, osteopathic techniques including

direct techniques such as high velocity low amplitude thrust, articulatory, general osteopathic

technique, and muscle energy; indirect techniques including functional techniques, counter

strain and balancing techniques.


Osteopathy Practitioner or Physician privileged to practise Osteopathy.

5. Traditional Chinese Medicine (TCM) Centre

Traditional Chinese Medicine Centre provides services for health enhancement and treatment

through consultation, prescriptions and modalities such as acupuncture, stimulation of

points, areas of the body or substances in the body using qi, needles with or without electrical

stimulation (using clean needle technique), moxibustion, heat and cold, color, light, lasers, or

suction (cupping –“wet” or “dry”) and musculoskeletal manipulation consistent with

Traditional Chinese Medicine training (Tui Na).


Chinese Medicine Practitioner or Physician privileged to practise Chinese Medicine.

6. Ayurveda Centre

Ayurveda Centre provides services aimed at prevention and treatment of diseases through

consultation, prescriptions, lifestyle interventions, detoxification therapies, breathing exercisesand meditation. The centre may also provide services related Musculoskeletal manipulation

and /or therapeutic massage consistent with the training and education.


Ayurveda Practitioner or Physician privileged to practise Ayurveda.



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7. Naturopathy Centre

Naturopathy Centre provides consultation and treatment for the prevention and treatment of

human health conditions and disease; the promotion or restoration of health; and the support

and stimulation of a patient’s inherent self-healing processes through patient education and

the use of naturopathic therapies and therapeutic substances.


Naturopathy Practitioner or Physician privileged to practise Naturopathy.

8. Unani Centre

Unani Centre provides a range of services including but not limited to diet therapy, nutritional

therapy, life style modification, stress management, cupping, diaphoresis, massage, purging,

emesis and exercise. The Centre may also provide education regarding physical, emotional

and spiritual balance, as it relates to Unani medicine.


Unani Practitioner or Physician privileged to practise Unani.

9. Hijama Centre

Hijama Centre provides services related to cupping based on principles of Traditional

Arab/Islamic Medicine, where blood is drawn by vacuum from a small skin incision for

therapeutic purposes. It may involve the application of suction cups to the skin to draw out

stagnant, congested blood, as well as other stagnant or morbid tumors. Usually, the cups are

made of glass, but they can also be made of bamboo, bone, horn or metal.

Required Professional:Hijama Practitioner or Hijama Therapist.



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Appendix 4 - HAAD TCAM Facility licensure requirements/audit check list

Standard (Desired Outcome) Criteria Criteria requirements

Management Human Resources

1.1Licence is displayed

1.2Scope of service offered within facility are displayed, withinthe licensing scope & practised.

1.3Professional Staff have a valid professional licence topractise.

1.4Scope of service defined for professional staff are withinthe professional licensing scope.

1.5 List of all current staff detailing their title, position,

qualification & signature.

1.6Staff are appropriately attired and wear ID badges

Complaint Management

2.1 Patients ‘Rights & Responsibilities are displayed in differentlocations in the facility

2.2 A designated staff is responsible for managing complaints

2.3 Complaint process is implemented

Facility Maintenance

2.1Facility's physical working space is suitable to comfortablyaccommodate equipment, staff and patients.

2.2Facility is well maintained i.e. AC, illumination, ventilation,good storage practice, hygiene and housekeeping.

Fire Safety

3.1Exit signs are clearly marked lighted & exit routes areunobstructed.

3.2Fire fighting resources including fire extinguishers (red &black), smoke detectors and fire safety posters e.g. RACEPASS signs are available and are regularly inspected

Medical Equipment Management

4.1Relevant equipment available to fulfil scope of services &connected with 3 pin plugs.

4.2

Equipment are calibrated according to manufacturer'sstandards, well maintained, regularly, serviced by aqualified biomedical technician & signed service reportsare available.



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4.3 Refrigerators are temperature monitored

4.6 Out of service equipment clearly marked and stored

Infection Control

6.1Supplies are available for cleaning of surfaces and patient

contact points on equipment.

6.2 Single use/disposable supplies are used wherever possible.

6.3 Good hand hygiene & cleaning practices are followed.

Supplies/Medications

7.1Expiry of supplies, material & medications are trackedregularly by a designated responsible staff.

7.2Medications/material available comply with facility'slicense & scope of services offered.

7.3Facility contains an emergency medication kit(s) evenlydistributed across the facility & containing the minimumrequirements to manage an emergency situation.

Clinical Practice

8.1List of services/procedures professional staff is allowed todo is displayed

8.2Professional staff practise according to international clinicalpractice guidelines.

8.2aProfessional staff demonstrate knowledge of specificrelated conditions

8.2b Professional staff recognise their limitation in clinicalcompetencies and refrain from practising beyond theirclinical competencies.

8.3Client records are kept in a secure location for privacy &confidentiality.

8.4Client records are allocated a unique identificationnumber, completed in legible handwriting, signed &stamped by professional staff.

8.5 Patients’ care is documented, dated, timed & signed.

8.5a General consents are signed for all patients on the first visit.

8.5bPatient signs consent before every procedure to beconducted. Procedure is to be explained to the patients &possible risks to be documented within the consent.

8.6 Daily register is kept of all patients consulted.



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8.7Desired outcome of patients' condition is achieved &registered

8.8Staff demonstrate knowledge and evidence ofimplementation of a defined referral process for patients toother facilities.

8.9Professional staff are certified in ACLS & demonstratecompetent knowledge on managing emergency conditions

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