PhysioPhilosophy COVID-19 Policies and Procedures

01/06/20 

Review date: ongoing during the COVID-19 pandemic and subject to change according to PHE guidelines.

Purpose

  1.  On 10thMay 2020, following the Prime Minister’s statement, we moved into the second phase of COVID-19 pandemic response, and communication from NHS England chiefs signalling a re-opening of some non-COVID healthcare pathways.
  2. Provision of a timely and effective Physiotherapy Service is so important in recovery from illness and injury and PhysioPhilosophy is committed in providing a safe environment for all staff, patients and the wider community to achieve this, and whilst we have entered the next phase of the pandemic response, this does not signal a return to the usual ways of working.
  3. PhysioPhilosophy will follow the government guidance and work within within the legal, regulatory and professional frameworks that guide us in the safe practise and safe management of our patients, your families and the wider public.
  4. Please read Covid-19 Policy

Our PhysioPhilosophy Responsibilities – Risk Assessments and Client and Staff Safety

  1. At PhysioPhilosophy we have taken all reasonable steps to maintain the safety and wellbeing of our patients, staff and the wider pubic, in addition to protecting our reputation as a professional health care facility.
  2. We have conducted a full risk assessment of our clinic environment, in line with the Health and Safety Executive and the Government advice on working safely, and put measures in place to mitigate risk.
  3. We are following the Public Health England and CSP guidance on PPE, (provision and usage), and hand washing for staff and patients, with policies in place that govern its use.
  4. We understand, and will promote the requirement for the ‘Virtual First’ approach for our patients; using digital solutions to provide care and limit face to face contact. We have Procedures in place for this.
  5. For every patient, an initial Telehealth  (video) triage consultation will take place to include: Covid-19 screening, clinical triage and a risk-assessment. We will the weigh up variety of factors in order to make a shared, balanced and reasoned decision on how to proceed, whether it be via a virtual or a face to face clinic consultation. A new risk assessment must be done for every new patient consultation and every follow up; being documented in the patients clinical record.
  6. Should a face to face consultation be deemed necessary, the patient will be made aware of the risks associated with this including the risks of infection transmission, and they must give documented consent.

The PhysioPhilosophy Clinic Environment and Cleaning

  1. There will only be one Physiotherapist in the clinic at all times.
  2. The clinic room and the gym area are large enough to allow the 2-meter socially distance rule to be maintained for subjective assessments, most of the objective assessments and 1:1 Pilates sessions.
  3. Where the patient may require some ‘hands on’ testing or treatment, the time allocation for this will be < 15 minutes.
  4. The patient will be advised to come to the clinic for their allocated appointment time and no earlier, although the clinic will always have a one in and one out policy.
  5. The clinic door will be left open – to avoid touching of the handles and due to the fact that the windows do not open. Privacy will be maintained as there are no other patients or staff will be in the clinic at any one time.
  6. Should a patient require a chaperone (< 18 yrs. or an interpreter), this will be separately risk assessed and mitigated against.
  7. Patients will be informed prior to their appointment that the toilet is advised not to be utilised and to go prior to their appointment. Should the toilet be used, it will be throughout cleaned during the clinic cleaning break.
  8. Hand hygiene will be performed immediately by the physiotherapist before and after each episode of patient care and after cleaning the clinic room.
  9. The patient will be asked to clean their hands with alcohol-based gel before entering the clinic.
  10. The clinic will be cleaned between each patient allowing 15 minutes between each patients for this and a thorough deep clean a minimum of twice a week.
  11. Pillow covers are disposable and changed for each patient.
  12. Payment will be made prior to the appointment using BACS or with the contactless system.

Please read the Infection Control Cleaning Policy and Procedure including Staff Uniform and Waste Management for greater detail, Infection Control and Cleaning Policy


Personal Protective Equipment (PPE)

  1. There will be appropriate signage in the clinic on the Best Practise for Hand Washing and Hand Rubbing.
  2. Patients MUST wear a face mask for the entire time of their appointment as per the government recommendations. PhysioPhilosophy will supply the face mask, if they don’t have their own. This will be explained prior to the appointment to avoid unnecessary stress or anxiety placed on them at the time of the appointment.
  3. The following PPE will be worn by the physiotherapist in the clinic:
    • Non-latex gloves (single use)
    • Apron (single use)
    • IIR Facemask (sessional use)
    • Eye protection goggles (if required)
  4. All PPE will be disposed of in line with guidance, using double bagging, leaving for 72 hours before        placing in the main disposal unit.
  5. Posters demonstrating the appropriate donning and doffing of the PPE will be in the clinic room and it is the responsibility of the Physiotherapist to ensure that this is complied with according to IPC legislations.
  6. Patients will be informed prior to their appointment that the physiotherapist will be wearing PPE and the reasons behind this.

Please read the Use of  Personal Protective Equipment (PPE) and Hand Washing Policy and Procedure for greater detail, PPE and Hygiene Policy and Procedure


Procedures of Client Bookings – “Virtual First”

  1. A ‘virtual first’ approach with remote consultations must remain standard practice during this period and we will only be seeing patients who we decide require face to face consultations rather than continuing with virtual consultations. This is in line with the recommendations from our regulatory bodies: The Chartered Society of Physiotherapy https://www.csp.org.uk/news/coronavirus/clinical-guidance/face-face-or-remote-consultations/guidance-england
  2. A flowchart demonstrating PhysioPhilsophy’s current working practise is provided in the link attached and is available for all prospective patients for their information. The process is:
    • An initial telephone triage consultation including questions to screen for Covid-19 symptoms and a clinical triage with relevant signposting via emergency / urgent pathways to acute NHS services if a serious pathology is suspected.
    • This is followed by a virtual consultation for patient assessment, intervention, guidance on self- management or for progression of their rehabilitation.
    • Where a virtual consultation is deemed not appropriate, and it is agreed that the patient needs to come into the clinic, a full risk assessment will be completed with justification that the benefits of seeing the patient are greater than the risks of infection transmission.
    • If the patient is deemed high risk, they will not be eligible for face to face consultation at this point.
    • It is imperative that the physiotherapist explains the risks for coming into the clinic and ensures the patient understands these risks. This is agreed between both the physiotherapist and the patient, with all discussions documented.
    • A consent form will be emailed and must be completed prior to the appointment.
    • The Covid-19 screening questionnaire and the risk assessment will be completed every time the patients comes in as a follow up, until discharge.

At PhysioPhilosophy, we feel that the stringent policies and procedures we have in place makes the risk to our staff and patients contracting Covid-19 very low.


Please see the following documents:

a) Covid-19 Current Working Practise Flowchart Current working practice

b) Covid-19 Telephone Triage and Screening questionnaire (for physiotherapists) Triage Telephone

c) Covid-19 Face to face consent for Consent for Face to Face Treatment