The Prime Minister’s bulletin yesterday evening declared “a moment of national emergency” and said that “the way ahead is hard”.
The entire UK osteopathic profession has been agonising about what we should be doing – closing our practices and denying our patients’ osteopathic care or continuing to play a significant role in the healthcare of our country. As the crisis deepens, our choices are starker, but we are now able to offer more definite guidance, based on what other health professionals are telling us.
The role which osteopaths are able to play in the Coronavirus pandemic is becoming clearer. As we have already said, there has been a great deal of communication within the UK and European osteopathic profession, with related healthcare professions like physiotherapy, and with NHS England, Public Health England and Health Education England.
To close or not to close
For those osteopaths who are especially vulnerable in some way or who are at risk of passing the illness to co-habitants who are vulnerable, some form of quarantine and social distancing is the clear choice.
Evidence is emerging that the infectious period starts when the person begins to feel symptoms: pyrexia, aching, fatigue and a dry cough. (COVID-19 Infection Control 2.2 Incubation and infectious period, Public Health England).
However, for those osteopaths who are willing and well, remaining available to treat acute or urgent patients will help to reduce the burden on the NHS, GP practices and MSK services.
We recommend that if a patient is able to delay their treatment because it is not urgent or essential, then it would be better to avoid the risk of contact. Only urgent or necessary treatments should be given. This includes patients with chronic conditions, for example, severe scoliosis, where stopping treatment will lead to more intractable health problems.
A number of GP practices and physio departments have closed so that the health workers can be deployed to treat more urgent cases or substitute where staff have fallen ill. This means that there is a big gap in the health system which we, as registered osteopaths and allied health professionals, are well qualified to fill.
Today, Maurice Cheng has spoken to a number of health professionals and commissioners within the NHS who make it clear that, at this moment, it is inappropriate to declare Osteopathy closed because “they need us to stay open” and we osteopaths provide a very useful public service. We are able to reduce the pressure on acute medical services and hospital beds.
The current crisis requires that all possible sources of help are mobilised. It is also necessary that the risk to health workers (that means us) is minimised. Osteopaths who work in the NHS have clearly expressed the opinion that “we need osteopaths in the NHS”. With the currently strained workforce, this has never been more true.
For this reason, the iO is investigating access both to Protective Personal Equipment (PPE) but also access to the best possible advice on infection control and hygiene. As I write, we have the COVID-19 guidance for healthcare settings available from Public Health England, with more specific guidance in the pipeline. We are working to provide the latest clear instructions on practising safely, for both patients and osteopaths.
We also understand that the children of osteopaths are eligible to go to school as osteopaths count as essential health workers. We know of particular schools where this is the case.
Attention to infection control, triaging ahead of any engagement, and defining what is urgent and what is not, is a combination of patient choice and professional judgement. This is what other healthcare professions also working in private practice are doing. We are liaising closely with Physio First, the private branch of the Chartered Society of Physiotherapists to ensure our advice to healthcare professionals in the private sector is consistent and puts safety first.
We can’t remove the difficulty of making a decision about your own course of action. However, clarity about priorities is emerging.
We ask you not to be heroic and overrule your better judgement or “gut feeling” about what course of action you would prefer to take. You may be swayed by the pressure that your ‘significant others’ are putting on you. This is good decision making.
As mentioned yesterday, we are also in discussions with our international colleagues’ associations, including those in Europe. Each are following their own national government’s specific policies around lockdown, while still seeking methods to support their patients and local communities.
Despite the challenges of the current situation, we will continue to focus on providing advice for those of you who wish to continue to serve the public and health communities, on how best to conduct your practice safely using technology, and if in urgent and necessary cases, advice on triage and infection control, together with business continuity guidance to support you in these very difficult times.
We will continue to engage with the health and public health bodies to see how the osteopathic profession can help as part of the national crisis management plan, as I know many of you want to support our NHS services in this challenging time.
We are also lobbying the Government to extend the financial support provisions available to the self-employed, which we are hopeful will be forthcoming soon, together with the suspension of registration fees for all healthcare professionals during the restricted period.
To work within the NHS, or if you continue to provide health advice you will need to maintain your GOsC registration.
For those of you that have suspended face to face consultations, we know that you will continue to be available by telephone and email to your patients and will support your local communities through a variety of means.
The situation continues to change rapidly. The Facebook group Let’s Talk Osteopathy, now has over 1000 members, and will provide the latest, fact-checked information, and a growing support network of fellow osteopaths. Our website, which holds more detailed information is being updated daily.
Summary:
- Self-isolate according to government guidelines.
- Close your practice if you decide this is necessary.
- Explore other ways of caring for patients (online, telephone).
OR:
- Reduce practice to very necessary or urgent treatments.
- Follow infection control advice
- Offer to take up work within the NHS, which may involve temporarily suspending your private practice.
Stay safe and please stay in touch via the Let’s Talk community. The more complete a picture we have, the more useful we can be.
Susan Farwell
President, Institute of Osteopathy