COVID-19: Frequently Asked Questions

The FAQ’s below is in line with current Government advice, NHS guidance and in alignment with other professional bodies for healthcare professionals operating in private practice, such as the Chartered Society of Physiotherapists. Guidance is correct at the time of publication, is changing rapidly, and we recommended that you check back regularly.


Your questions:

 

What is the Coronavirus (COVID-19) Restrictions Regulations Act?

We have been advised that there is a communication circulating with a certain interpretation of the COVID-19 Restrictions Regulation Act.

We would like to clarify that the Public Health Statutory Instrument linked to the Coronavirus (COVID-19) Restrictions Regulations Act, states which business must close under the current restrictions and which businesses may remain open, in the context of travel to and from those businesses and NOT how businesses operate during the lockdown period.

The guidance of how clinics operate during the lockdown period is informed by advice from Public Health England and remains, and as advised below.

Under no circumstances does this legislation provide a basis to operate your clinics as normal during the lockdown period.

Updated: 27 March 2020

 

What support will I get if I am self-employed?

On 26 March 2020, the Chancellor announced a package of financial support for the self-employed; full details of the scheme won’t be available for a few days, but below is an overview:

Who is eligible?

  • The scheme will be available to self-employed people who have an average trading profit of £50,000 or less in the years 2016-17, 2017-18, 2018-19 – during that period more than half of the person’s income must be from self-employment.
  • The self-employed scheme is only open to those who have already registered with HMRC as being self-employed. HMRC will identify the eligible people and contact them directly with details of how to apply. Please do not contact HMRC directly as they are unable to provide any information about your eligibility at this stage.

What will the scheme cover?

  • The scheme will cover 3 month’s pay for the period March 2020 to May 2020 and will be paid in a single instalment covering those 3 months. Payment will be made at the beginning of June 2020, or sooner if systems can be developed in time.
  • You will receive 80% of your average monthly profits up to a maximum of £2,500 per month. The payment will be a taxable grant which means that it must be included in your tax return for 2020-21.
  • If you have not completed your tax return for 2018-19, you have 4 weeks from now to submit the return. Note the deadline for these returns was 31 January 2020.
  • If you have not completed 3 years of trading, then HMRC will use the information that’s available to calculate the average monthly profits.

Can I still work?

You can claim this grant and still stay in business, earn an income and the usual activities that you would do to support your business e.g. marketing. You can also undertake courses including – CPD – during this time.

Who is not eligible under the Scheme?

  • The scheme will not support those who have started trading since April 2019. If you have only recently started your clinic, then you will have to claim Universal Credit for the self-employed from DWP.
  • If you have an average trading profit of more than £50,000 over the designated 3 year period, you are not covered by this scheme, but can apply for a Coronavirus Business Interruption Loan – guidance published on 25 March 2020.

If you need cash flow between now and June 2020 to pay your bills and keep your clinic going, then consider applying for a Coronavirus Business Interruption Loan or alternative forms of finance. Please refer to the relevant sections in the guidance published on 25 March 2020 for information on these loans and other action that you can take. You may also wish to claim Universal Credit.

As further guidance is issued in the coming days, we will update this information. You can also visit HMRC’s COVID-19 Self-Employed Support Scheme.

Updated: 27 March 2020

 

What financial support is there if I am an owner-managed company?

If you are a director of an incorporated company and pay yourself a mix of salary and dividends, you are not covered by the scheme for self-employed people. You will fall under the Coronavirus Job Retention Scheme.

Updated: 27 March 2020

 

What other financial support is being given by the Government?

We have published two guides on the current support available to osteopaths and recommend you review these relevant to your circumstances. Useful links for relevant Government information can also be found here:

Updated: 27 March 2020

 

Should I close my practice?

If you choose to stay open, you should only be conducting remote consultations during the lockdown period unless for urgent and emergency cases – see the iO’s COVID-19 FAQ’s and guidance on these exceptional circumstances.

You should not under any circumstances be in contact with anyone from vulnerable or high-risk groups.

Osteopathic practices are listed in the Public Health Statutory Instrument linked to the Coronavirus (COVID-19) Restrictions Regulations Act, as businesses that may remain open. They have not been instructed to close in the context of travel to and from those businesses and NOT how businesses operate during the lockdown period.

The guidance of how clinics operate during the lockdown period is informed by advice from Public Health England and remains, and as advised below.

Under no circumstances does this legislation provide a basis to operate your clinics as normal during the lockdown period

Updated: 27 March 2020

 

How can I offer my services to work in the NHS?

We have been engaging with Chief Allied Health Professions Officers, Health Education England and others since the start of the Coronavirus preparations to consider how osteopaths can support our NHS services and contribute to the national crisis management plan.

Up until this point, the NHS has been prioritising and mobilising pre-existing NHS staff and registered AHPs who have recently left the NHS to return on a temporary basis.

However, they are also looking for clinicians with transferable skills to support wherever its needed, i.e. logistics, training, bedside buddies etc. The intention is that these are paid roles allocated as mid-point Band 5 where possible (approx. £27,000).  They are not looking to fill MSK roles during this period.

Routes to support

  • If you have previously worked in the NHS and would like to re-join to help during COVID-19, click here

If you have never worked in the NHS, you will soon be able to contact your local NHS provider or hospital directly and ask to join their Locum Bank staff.

  • We are working with Health Education England to include non-HCPC registered clinicians on this database over the next few days.
  • You can search for roles in the NHS, including posts relating to COVID-19 on the NHS jobs website or alternatively you may consider becoming a NHS 111 calls handler.
  • You can also apply to volunteer your time for free.

We will continue our discussions with NHS England, Health Education England and Public Health England to determine whether osteopaths may be able to contribute in other ways.

Updated: 27 March 2020

 

How should I be operating under the current lockdown?

For the provision of health services, the current recommendation is all but emergency and urgent consultations should be undertaken remotely.

The need for essential musculoskeletal care/advice continues to minimise burden on the NHS.

If you are remaining open for remote consultations, we have provided a guide for telephone and video consultations here and provided further advice on what constitutes emergency, urgent or essential cases below. Remote consultations also provide an opportunity to reiterate the Government advice.

A telephone triage should be used to determine urgency of patient need, based on your professional judgement and the NHS guidance on what constitutes emergency, urgent and essential cases, and the action that should be taken thereafter.

Updated: 25 March 2020

 

What constitutes emergency, urgent or essential consultations?

As clinicians we all have general responsibilities in relation to Coronavirus and should act on National guidelines. We also have a responsibility that essential musculoskeletal care continues with minimal burden on the NHS.

There is a role to telephone triage patients that are presenting with new or worsening musculoskeletal (MSK) symptoms for consideration of serious pathologies, which in turn may require emergency consultation or urgent referral to secondary care.

As a reminder, you should consider serious pathology as a differential diagnosis if a person presents:

  • with escalating pain and progressively worsening symptoms that do not respond to conservative management or medication as expected
  • systemically unwell (fever, weight loss)
  • with night pain that prevents sleep due to escalating pain and/or difficulty lying flat

Emergency conditions – If you suspect the following, these should be considered an emergency and sent for immediate (same day) onward referral:

  • Cauda equina syndrome
  • Metastatic spinal cord compression
  • Spinal Infection
  • Septic Arthritis

Urgent conditions – Suspicion of the following will require onward urgent referral:

  • Primary or secondary cancers
  • Insufficiency fracture
  • Major spinal-related neurological deficit
  • Cervical spondylotic myelopathy (CSM)
  • Acute inflammatory arthritis and suspected rheumatological conditions:
    • persistent synovitis
    • a suspected new-onset autoimmune connective tissue disease (e.g. lupus, scleroderma) or vasculitis
    • Myalgia
    • Polymyalgia rheumatica (PMR)
    • Myositis
  • Suspected inflammatory spinal pain

Essential support – Current guidance is suggesting that the following require telephone consultations and self-management advice:

  • those who have had recent elective surgery
  • fractures
  • those with acute or complex needs including carers to enable self-management

This list is not exhaustive. For further details on presentation and indicators of emergency and urgent conditions, please review the Urgent and Emergency Musculoskeletal Conditions Requiring Onward Referral.

The Chartered Society of Physiotherapy have produced a Flowchart for Emergency Cases and have kindly given the iO permission to publish it on our website. Download the flowchart here.

Updated: 25 March 2020

 

Should we consider providing face to face consultations?

You should only be conducting remote consultations during the lockdown period, unless the below exceptional circumstances apply, and only then once you have conducted a risk assessment based on your own personal situation (i.e. are you or a loved one in an at-risk category):

  • You have a high suspicion of risk of serious deterioration from underlying pathology and you are unable to determine this remotely.
  • The patient has urgent care needs, which if not met, will require care from General Practice, secondary care or social care agencies. This is particularly important if they are themselves a carer for someone who is vulnerable.

If you determine, based on your professional judgement and following guidance for emergency and urgent face-to-face consultations, you should follow the current COVID-19: Guidance for infection prevention and control in healthcare settings.

You should not see a patient either in your clinic or in their home if they have symptoms, have been in contact with someone with symptoms in the last 14 days or have received a letter to inform them that they are in a high-risk category.

This advice is in line with current NHS guidance and provided by the Chartered Society of Physiotherapists for healthcare professionals operating in private practice.

Updated: 25 March 2020

 

Am I insured to provide telephone and video consultations?

If you have the iO’s professional liability insurance, we can confirm that you will be insured for telephone and video consultations if you follow the guidance for recording of patient interactions as outlined in our telephone and video consultation advice guide.

If you are insured with another provider, please contact your respective broker to confirm the level of cover.

Updated: 24 March 2020

 

Do I need GOsC registration to work in the NHS or provide telephone advice?

Yes. To continue to operate as an osteopath and healthcare professional you will need to maintain your GOsC registration.

Updated: 24 March 2020

 

Are osteopaths included in the definition of key workers?

The current guidance states that if you work in a critical sector and you cannot keep your child safe at home, then your children will be prioritised for education provision. This includes those working in the front line of health and social care services.

Though osteopaths are not specifically listed, osteopaths obviously would fit into this category. The government has left it to each school to interpret this guidance themselves and make a decision on a case-by-case basis. If you need your children to be prioritised for education provision you should contact the school directly.

Updated: 20 March 2020

 

What is social distancing?

Social distancing is measures you can take to reduce social interaction between yourself and others in an effort to reduce transmission of Coronavirus (COVID-19).

These include:

  • Avoiding contact with someone who is displaying symptoms of Coronavirus.
  • Avoiding non-essential use of public transport when possible.
  • Working from home, where possible. Employers should be supportive of this.
  • Avoiding all gatherings in public spaces. This includes pubs, restaurants, leisure centres and similar venues that should be closed during this time.
  • Avoid gatherings with friends and family. Use remote technology (phone, internet and social media) to stay in touch.
  • Use telephone or online services to contact essential services such as your GP, pharmacist or other medical practitioners.

The above guidance excludes those who are residing in your home or normal place of residence. However, should you need to leave your home for an essential reason, you may only do so in pairs (two people) and should adhere strictly to the UK Government guidance.

Updated: 31 March 2020

 

What is self-isolation?

Self-isolation applies to everyone who has symptoms of Coronavirus (COVID-19), lives with someone who does, or those considered in a high-risk / vulnerable group.

Symptoms of Coronavirus include:

  • a fever of above 37.8C
  • a persistent cough and / or breathing problems

If you live alone and have symptoms of Coronavirus, you must stay at home for seven days. If someone you live with develops symptoms, your entire household will need to isolate for 14 days from the date they showed symptoms, and monitor for signs of COVID-19.

If someone else within the household becomes ill during that period (and there are no other occupants living in the household), their 7-day isolation period will start on that day.

Everyone who lives in the same house or flat as someone with symptoms should self-isolate along with them.

Self-isolation requires you to:

  1. Stay at home at all times for the necessary self-isolation period. If you have a private garden, you may use this.
  2. Do not go out to buy food, collect medicine or other household supplies – order these by phone or online, or ask someone who is not self-isolating to do this for you.
  3. Do not host visitors, such as friends and family, in your home, and vice versa.

When you have finished self-isolating, you still need to stay at home in line with the UK Government rules, but you can go out for essential duties only.

Updated: 31 March 2020

 

What is shielding?

Shielding refers to the protection of extremely vulnerable people – who are at very high risk of severe illness from Coronavirus (COVID-19) – by minimising their interaction with others. See the UK Government guidance on protecting people defined on medical grounds as extremely vulnerable from COVID-19.

The most vulnerable group includes, but is not limited to:

  • certain types of cancer patients
  • those who have had an organ transplant or require one
  • people with certain genetic diseases
  • those with serious respiratory conditions
  • people with a suppressed immune system
  • pregnant women who have heart disease

Approximately 1.5 million people in the UK who have serious health conditions are being contacted by the NHS and urged not to leave their home at all for at least 12 weeks.

Others living within their household should minimise all non-essential contact with these vulnerable people, and will need to observe careful social distancing at all times.

Updated: 31 March 2020

 

What if I am symptomatic of COVID-19?

If you have a new, continuous cough and/or a temperature of 37.8 degrees or higher, you should follow current government guidance on self-isolation and management. You do not need to contact 111 or be tested for Coronavirus initially – see the PHE guidance on self-isolation.

If you are not clinically better after seven days, you should use the NHS 111 services who will advise if you need to be tested for COVID-19 and give you further health advice.

Updated: 24 March 2020

 

What advice can you give on financial support during this time?

We have put together a guide with the current financial advice that we know is currently available. What will be available will be different dependent if you are self-employed or a business.

While the Government has provided an exceptional level of support to both the employed and businesses, we want to see this level of support extended to the self-employed and are lobbying the Government to put in similar measures.

Updated: 23 March 2020

 

What are the current views on wearing gloves and PPE

Current thinking is that COVID-19 is predominantly spread through cough droplets. Personal Protective Equipment (PPE) including masks, aprons, gloves and protective visors are designed to reduce droplet spread. Current guidance is to wear PPE when directly caring for those with confirmed cases of COVID-19, especially when performing procedures that generate aerosols such as intubation.

From a practical point of view, it is unlikely that most osteopaths will be performing these procedures or treating patients with a confirmed case of Coronavirus. There seems to be a lack of clear guidance on what PPE should be used, but the Royal Colleges of GPs have provided this advice

Please bear in mind the PPE stocks are urgently needed for frontline care. You may want to take this into consideration to determine if you are able to see patients categorised as urgent or emergency (see above FAQ).

If you have determine based on the NHS guidance above that in a specific emergency, urgent or essential case a face-to-face consultation is required, you firstly need to make an individual risk assessment based on your own personal situation (i.e. you or a loved one in an at-risk category).

If you decided that after a risk assessment in your professional judgement an emergency face-to-face consultation is needed and you choose to wear PPE, this should be disposed of after each patient and fresh PPE used for the next client.

Standard infection control procedures should be applied immediately after the consultation. This includes correct hand hygiene, couch hygiene, disinfecting the plinth between patients etc.

Updated: 26 March 2020

 

I’m feeling anxious and concerned. What can I do?

Feeling this way during a pandemic is completely normal. In fact, millions of people are feeling this way too. The iO will be preparing content pertaining to maintaining mental wellbeing in the coming weeks.

For now, visit NHS Every Mind Matters – a great start to keeping negative feelings in check, including mental wellbeing while staying at home, and Coronavirus anxiety tips.

Updated: 26 March 2020

 

IMPORTANT NOTE: Safety of our members and the public is of paramount importance. The iO is following the UK Government advice, NHS guidance, and guidance from other professional bodies for healthcare professionals operating in private practice on a daily basis. Any guidance provided on this page is current as of the date of publishing and such guidance may change quickly at short notice.

 

Have a question pertaining to COVID-19?

Send an email to enquiries@iOsteopathy.org and we’ll get back to you as soon as we reasonably can.

 

Back to COVID-19: Updates & Guidance



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