Covid-19 measures for face to face appointments

 

 

This is to explain the measures I am taking for face to face appointments. Face to face sessions can only be considered where there is an identified mental or physical health condition or injury that is causing you pain or having an adverse impact on your mobility or quality of life.

 

My registration body (the CNHC) has provided clarification and reassurance that I am able to continue to offer face to face appointments in all Tiers and during National Lockdown (provided we discuss risk to yourself and others and the purpose of face to face sessions). Please see below for their official message.

 

Here is the message from the CNHC (Complementary and Natural Healthcare Council):

 

"Under the legal advice we obtained during the November 2020 national lockdown in England, CNHC Registrants in England meet the definition of  “other…health services, including services relating to mental health” contained in Section 17(o), Schedule 3A of The Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020. The amended legislation on which Parliament voted today made no changes to that section of the Regulations.

This means, as a CNHC Registrant, you can continue to practise in England during the current restrictions if you meet the criteria set out below.

 

In order to stay within the remit of providing “other…health services, including services relating to mental health”:

  • You must only provide the therapies you are registered for, on a one-to-one basis to clients, for an identified mental or physical health condition or injury that is causing them pain or having an adverse impact on their mobility or their quality of life.

  • You must be able to evidence that your therapeutic intervention is supporting your client with their condition. You can do this by recording their health condition and giving a clear rationale in your client’s care record for the treatment that you are providing,

  • You cannot provide treatment to a client in their own home unless you have received a direct referral from a statutory regulated health professional.

  • If your practice is based in your own home you can continue to work from there as long as it is COVID-secure."

 

The following is based on the Complementary and Natural Healthcare Council (CNHC) COVID-19 guidance for Registrants: Preparing to return to work, 29 May 2020 and updated in accordance with the latest advice.

 

1. Insurance

 

My insurance company (Wellbeing Insurance) have confirmed in writing that I am insured to do face to face sessions.

 

They will continue to insure me for remote appointments.

2. Assessing the risk of reopening

 

I have carried out a risk assessment of my premises and my ways of working. Please ask if you would like further details.

 

Some of the material changes I have made include:

  • Professional cleaning twice per day

  • Removing all soft furnishings from the client area (fabric chairs, curtains, rug, cushions)

  • Installing a plastic screen to divide client and therapist areas

  • Providing comfortable plastic chairs that can be cleaned between appointments

  • Providing hand sanitizer

  • Providing single use tissues and a no-touch bin

  • Professional cleaning of the bathroom

  • Washing all towels and cleaning cloths at 60 degrees

 

I have read and carried out the recommendations in the Government document which was written to help people safely return to work: https://www.hse.gov.uk/news/assets/docs/working-safely-guide.pdf

 

 

3. Assessing your risk of attending in person

You will be asked some questions to help understand the risk of you attending in person.

If you are considered high risk you will be not be invited to attend in person.

If you are at a moderate risk and you have the capacity to make your own decisions, you will be asked if you want to attend in person.

 

People considered high risk include those who:

  • have had an organ transplant;

  • are having chemotherapy or antibody treatment for cancer, including immunotherapy;

  • are having an intense course of radiotherapy (radical radiotherapy) for lung cancer;

  • are having targeted cancer treatments that can affect the immune system;

  • have blood or bone marrow cancer (such as leukemia, lymphoma or myeloma);

  • have had a bone marrow or stem cell transplant in the past six months or are still taking immunosuppressant medicine.

  • have been told by a doctor that they have a severe lung condition such as cystic fibrosis, severe asthma, or severe Chronic Obstructive Pulmonary Disease (COPD);

  • have a condition that means they have a very high risk of getting infections such as Severe Combined Immunodeficiency (SCID) or sickle cell;

  • are taking medicine that makes them much more likely to get infections (such as high doses of steroids);

  • have a serious heart condition and are pregnant.

 

People are considered moderate risk include those who:

  • are 70 or older;

  • are pregnant;

  • have a lung condition that's not severe (such as asthma, COPD, emphysema or bronchitis);

  • have heart disease (such as heart failure);

  • have diabetes;

  • have chronic kidney disease;

  • have liver disease (such as hepatitis);

  • have a condition affecting the brain or nerves (such as Parkinson's disease, motor neurone disease, multiple sclerosis or cerebral palsy);

  • have a condition that means they have a high risk of getting infections;

  • are taking medicine that can affect the immune system (such as low doses of steroids);

  • are very obese (a BMI of 40 or above).

4. If you have symptoms

 

If you have any symptoms of Covid-19, please do not attend your appointment in person.

 

Check here to read the latest information on Covid-19 symptoms and how to arrange for a test.

 

If you feel well enough you can request a video or telephone appointment.

 

If you do not feel well enough you can cancel, there is no charge for Covid related cancellations (see 11 below)

 

5. Temperature checks

 

When you arrive I will use a no-touch thermometer to take your temperature.

 

Your temperature will be recorded in your confidential notes.

 

If your temperature is 37.8C or above you will not be admitted for your appointment. Please return home, follow Government advice to self-isolate and arrange for a Covid-19 test.

If you test positive you will be required to continue to self-isolate.

If you test negative you can return to face to face appointments.

 

A temperature below 37.8C should not be taken as an indication you do not have Covid-19.

 

 

6. Social distancing

The UK Government has made it clear that social distancing of 2 metres (or 1 metre plus) will continue for the foreseeable future.

 

You will be required to maintain social distancing if attending an appointment face to face. This will involve staying 2 metres or 1 metre plus away from me wherever possible.

 

Where this is not possible, you will be asked to take additional steps such as wearing a face covering.

 

Please attend on your own. If this is not possible or you do not feel comfortable with this, let me know in advance and we can discuss it.

7. Reducing risk where social distancing may not be possible

Where social distancing may be more difficult you will be asked to take additional measures.

  • Wearing a face covering when you arrive and when in communal areas.

  • Washing your hands and using hand sanitizer – see hygiene (8)

8. Hygiene

 

To reduce the risk of infection you will be asked to avoid touching items in the building wherever possible.

 

You are requested to

  • Not shake hands, hug or make physical contact with me.

  • Leave any non-essential belongings in the car or at home.

  • Wash your hands with soap and water on arrival if you have travelled by public transport.

  • Sanitize your hands with hand sanitizer (min 70% alcohol) upon arrival, however you have travelled to the appointment. Hand sanitizer is available for you in the entrance and in the therapy room.

  • Bring your own pen and notebook. Pens will not be provided.

  • Bring your own water / tea. Refreshments will not be provided.

  • Hang your coat / bag in the therapy room.

  • Sit on the specified side of the screen so that face coverings can be taken off during the session.

  • Sanitize your hands whenever you touch your face covering, including to put it on or take it off.

  • Remain on your side of the screen throughout the session.

  • Sanitize your hands at the end of the appointment.

  • Ensure good respiratory hygiene ‘catch it, bin it, kill it’ approach to sneezing and coughs – catch them in a tissue, throw it in the bin straight away, wash or sanitize your hands.

 

9. Additional cleaning

There will be additional cleaning to do in between each session. You will be asked to support this by:

  • Waiting outside the building until your appointment time.

  • You can text me or buzz the buzzer if you’re early and I may be able to let you in the sit in the waiting room.

  • Leaving promptly at the end of the session to allow sufficient time for cleaning. You may sit in the waiting area if there is space to socially distance and you are welcome to use the bathroom.

  • Accommodating a longer gap between appointments (30 minutes) which may mean you are asked to move your usual time.

 

Surfaces which are regularly touched will be disinfected in between each appointment. Depending on contact, this may include:

  • Client chair

  • Door handles

  • Light switch

  • Card machine

  • Equipment

  • Screen

 

 

10. Payments

Pay online wherever possible (PayPal/BACS) instead of using the card machine. If you do need to use it, it will be sanitized before and after use. Cash is not currently accepted.

11. Cancellation due to Covid-19

If you need to cancel your appointment because you have symptoms, a member of your household has symptoms or you need to self-isolate, there will be no cancellation charge. You can opt for an online or telephone appointment instead.

 

Cancellation charges for any non-Covid related reasons will be reinstated from 1st October 2020 (50% fee due for 48 hours notice, 100% fee due for 24 hours notice.)

 

12. When face to face appointments will not go ahead

Face to face appointments may be changed or cancelled any time up to the appointment time in the following circumstances:

  • I or any member of my household has any COVID-19 symptoms.

  • I am required to self-isolate or quarantine.

  • a client (you) has COVID-19 symptoms.

  • I am informed that a client has attended my premises and has tested positive for COVID-19

  • a client is self-isolating or in quarantine.

  • a member of a client’s household or anyone the client has been in contact with in the last 14 days has COVID-19 symptoms.

  • a client is in the high risk group

 

13. Test and trace

Your details will be held for ‘test and trace’ in accordance with GDPR guidelines. You will be contacted if you need to self-isolate. This is unlikely as these guidelines aim to ensure we are not ‘close contacts’.

References and further information

How to wear a face covering

https://www.gov.uk/government/publications/face-coverings-when-to-wear-one-and-how-to-make-your-own/face-coverings-when-to-wear-one-and-how-to-make-your-own#how-to-wear-a-face-covering

How to wash your hands

https://www.nhs.uk/live-well/healthy-body/best-way-to-wash-your-hands/

 

People at higher risk for Covid-19

https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/whos-at-higher-risk-from-coronavirus/

 

Working safely during Covid-19

https://www.gov.uk/guidance/working-safely-during-coronavirus-covid-19/