We’ve been getting a few more questions recently as to when we are going back to face to face consultations.
Just to make things clear- We are *still* seeing patients- and have done since the beginning of lock down, but on an online basis- Skype and Zoom, so physio and training are still going on.
Face to face is a different matter. The Chartered Society of Physiotherapy (CSP) had a series of online seminars over the past week involving private practice physios on the subject about returning to getting people back in the treatment rooms. I was not one of the people in the online seminar, but did get to see a re-run on Vimeo last night.
The overarching message is that all the guidance and advice is coming down from Public Health England and the HCPC, and is non-negotiable, that is interpreted by the CSP and then handed on to us. That guidance tells us that we can see patients face to face if we decide it is appropriate, and if there is a patient, legal or insurance challenge we must be able to show and document that we have taken the requisite steps to prevent infection etc.
Herein lies the rub.
Conditions we must satisfy in order to see Patients
To see a patient face to face we must initially do an online consultation including a covid screening, clinical triage, and then weigh up if the benefit of seeing that person in clinic outweighs the risk of infection.
In clinic I *have* to wear disposable gloves, a disposable apron and a fluid resistant surgical mask, the plinth needs to be covered in plastic, with a disposable paper cover- all of which needs to be thrown away after each patient, all contact areas cleaned with detergent, and then cleansed with disinfectant.
The advice is that uniform should be removed and bagged before returning home- where it should be washed at as high a temperature as possible. Considering I work from home, this could be interesting.
Aerosoling procedures (expelling water droplets/mist when forcefully breathing out) are a strict no-no – so no treadmill, nothing that causes people to breathe heavily, and strict social distancing must be maintained- but for 15 mins, I can be in closer contact to do some tests. But no longer.
The guidance has also been given that I should consider closing the toilet to patients, or if someone has to use it, then it gets deep cleaned as well prior to anyone else using it.
These are the broad brush strokes of what we have been told at this time (as of the 5th June)- so yes, technically, I can see patients face to face- but there are a lot of hoops to jump through, especially for a sole trad
er working from home, trying to minimise the amount of single use plastics.
Balancing up the risk of infection, both to my patients- but also to me and Lynne- versus seeing patients in our home- puts me in an interesting position. The key question is can I do all of the above while reasonably keeping the spread of infection to a minimum- and being able to document that fact to protect myself from legal mischief?
The right decision is often the hardest one to make, but for the time being I am not going ahead with face to face treatments in the gym or the treatment room. It simply is not viable at this point.
We are continuing to provide physio services online, and have had excellent feedback from the patients who have been diagnosed, assisted and progressed through physio and rehab in an online context.
So if you have a problem that needs looking at, drop us a line. Even if I cannot see you face to face, we can still help.