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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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Chartered Society of Physiotherapy 7
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
1 Autonomy and accountability
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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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Quality Assurance Standards for physiotherapy service delivery 9
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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10 Chartered Society of Physiotherapy
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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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Quality Assurance Standards for physiotherapy service delivery 13
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
3 Learning and Development
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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;
Consent
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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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Quality Assurance Standards for physiotherapy service delivery 21
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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Quality Assurance Standards for physiotherapy service delivery 23
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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Quality Assurance Standards for physiotherapy service delivery 25
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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26 Chartered Society of Physiotherapy
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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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28 Chartered Society of Physiotherapy
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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
References
REFERENCES
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34 Chartered Society of Physiotherapy
1A
nnex
SteeringgroupChairCatherinePopeHelenBalcombeKarenDandoMargaretHastingsJonathanLarnerCabellaLoweAlunMorganLisaRobertsSheilaStringerLouiseWright
FocusGroupsThank-youforallthosewhocoordinatedthefocusgroups(namedbelow)andtothosewhocontributedtothedevelopmentoftheQAStandardsthroughattendanceatthefocusgroups.
CardiffUniversity–LizWrightSheffieldHallamUniversityWesternIslesHospital–SheilaNicholsonKeeleUniversity–JackieWaterfieldRoyalWolverhamptonHospitalsNHSTrust–SheilaStringer
Annex 1
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Quality Assurance Standards for physiotherapy service delivery 35
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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
DepartmentofHealth.Safeguardingadults:theroleofhealthservices.London:DepartmentofHealth;2011.Availablefrom:www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_124882
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
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36 Chartered Society of Physiotherapy
2A
nnex
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Quality Assurance Standards for physiotherapy service delivery 37
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Sect
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25 P
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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