COVID-19 Standard of Practice Guidelines
The aim of these guidelines is to ensure that PhysioCare Holistics is as safe as possible for patients and staff, and to help stop the spread of the coronavirus.
These standards have been produced in line with the Government, Public Health England (PHE), The Department of Health (DoH), The Chartered Society of physiotherapy (CSP), The Health and Care Professions Council (HCPC) and the International Federation of Professional Aromatherapists (IFPA).
Following recent Government guidance PhysioCare Holistics is now able to offer face to face consultations where clinically appropriate and necessary.
The following types of appointments may now be booked:
Virtual (video) appointment using a secure password protected link
Essential Home visit – subject to a “virtual triage” and risk assessment
Clinic appointment at Brighter Spaces in Wilmslow – subject to a “virtual triage” and risk assessment
Appointments can only be booked over the phone or by email.
Screening and Consent
The initial triage and screening will be done remotely, either over the telephone or via a video call.
This MUST take place before any face-to-face appointment takes place.
Patients will have the opportunity to discuss their preference – face-to-face or virtual appointment.
The physiotherapist will use this session to consider the risks, clinical reasoning and rationale for the different appointment options.
Both the physiotherapist and patient will decide together whether a face-to-face appointment will take place, and if so the location (either the patient’s own home or at the clinic).
This process is very individual and the outcome will vary according to each patient’s specific needs. The risk assessment will be reviewed prior to every planned face-to-face contact.
Following the initial triage if a face-to-face treatment is going ahead, a specific Covid-19 essential health questionnaire, declaration and consent form will be sent via email to the patient.
This form MUST be completed before any face-to-face treatment will take place.
All patients who are offered a face-to-face appointment will be asked to declare that they have no symptoms of COVID-19, and confirm that they have not been in contact with anyone with symptoms of COVID-19 in the last 14 days.
The form also asks the patient to consent to face-to-face treatment.
In addition there is some information about the NHS Track and Trace Service. Each patient must consent to their name being shared with the NHS contact tracing service in the event of the physiotherapist developing COVID-19, prior to receiving face-to-face treatment.
If it is deemed not safe, or not essential to see a patient face-to-face the patient will be offered the option of a virtual treatment as an alternative.
A secure password protected link will be sent via email to access the appointment.
Upon arrival at every face-to-face appointment each patient will be screened again.
The patient will be screened for COVID-19 symptoms and exposure to the virus.
The patient’s temperature will be checked using a non-contact thermometer.
If the patient has any symptoms of COVID-19 or their temperature is over 37.8 treatment will be postponed.
Hands will be washed with soap and water before and after each client, and before and after preparing any client massage blends, using approved hand washing methodology for at least 20 seconds.
Patients will also be asked to wash their hands prior to treatment.
Gel sanitiser will be available both within the clinic and on home visits for use on entry and exit.
Both the physiotherapist and patient will be expected to observe good respiratory hygiene – avoid touching eyes, nose or mouth and covering coughs or sneezes with a tissue or elbow.
The physiotherapist will take their temperature each day before attending work and document this on a personal spreadsheet.
The Physiotherapist will not work if they believe they have any COVID-19 symptoms.
Social distancing according to the Government guidelines will be maintained during all “hands off” treatment.
Non treatment related physical contact will be minimised, for example opening doors for patients, not shaking hands, not sharing paper documents or pens. Digital signatures will be obtained in advance whenever possible.
A thorough clean of the clinic space and equipment will take place at the beginning and end of each working session.
Any equipment used, either in the clinic or portable equipment used in the patient’s own home will be wiped down in between each client, using soapy water and disinfecting spray.
This includes but is not limited to:
Pillows (waterproof and wipeable)
Storage box used for patient’s clothes
Card terminal (using an antibacterial screen wipe)
No alcohol wipes or bleach products will be used on the treatment bed as this results in the fabric cracking and will add to the infection risk.
Depending on the type of treatment, and according to a risk assessment either disposable single use couch roll, or a single use towelling cover will be used on the treatment bed.
Any reusable items used during a treatment session will be placed in sealable plastic bags after each client prior to laundering. All laundry will be washed at 60 degrees.
Foot operated pedal bins will be available in the clinic room for tissues, paper towels and couch roll.
Windows will be opened to change the air in between clients.
Card payment is the preferred method of payment. An envelope will be given to any patient insisting on paying by cash, to place the payment inside. Hands will be washed after handling the envelope and the cash.
When working in the clinic setting, the clinic’s own guidelines and directives will be followed at all times.
Personal Protective Equipment (PPE)
The physiotherapist will follow up to date guidelines on the type of PPE that is necessary for every face-to-face appointment. PPE includes:
Fluid resistant face mask (sessional use)
Apron (single use)
Non latex gloves (single use)
Face visor (when within a 2 metre gap)
The physiotherapist will follow guidelines on the correct donning and doffing of PPE.
Hands will be washed with soap and water for 20 seconds after removing PPE.
Gloves will be changed before cleaning the clinic room and any equipment.
The type of PPE used during the treatment will be documented in the patient’s notes.
Waste such as disposable couch roll and paper towels will be disposed as normal in household/clinic waste.
All PPE waste will be double bagged, and left for 72 hours prior to disposing in normal waste.
There should be no known COVID-19 infected waste, as no one with the virus should be receiving treatment.
If a client informs the physiotherapist that they have possible or confirmed COVID-19 within 14 days of the appointment, then a different cleaning protocol must be followed. See UK Directive on COVID-19 decontamination. In this situation waste is treated as clinical waste.
Appointment times will be scheduled to minimise contact between clients and to allow sufficient time for enhanced cleaning to take place.
Prior to treatment any unnecessary items will be removed from the treatment space to minimise touch and cleaning time.
The physiotherapist will change into uniform on arriving at the clinic.
At the end of the working session, the physiotherapist will change out of uniform and place it in a sealed plastic bag, ready to be washed on return home.
The therapist will not be able to do this for home visit appointments. Instead the number of home visit sessions will be limited each day. Visits will be scheduled with enough time in between to allow the physiotherapist to return home to change into clean uniform prior to the next visit.
The uniform will be washed in the following way:
Separately from other household linen
In a load not more than half the machine capacity
At 60 degrees
Vehicles will be regularly cleaned using gloves and standard cleaning products followed by sanitising spray.
Frequent touch surfaces will be cleaned in between each client and sprayed with 80% alcohol sanitising spray liquid.
Hands will be sanitised in the car prior to entering a patient’s home, and then washed with soap and water before treatment.
Client considerations and adaptations to treatment
Patients should aim to arrive at the time of their appointment, not any earlier.
Face-to-face contact will be minimised as much as possible before, during and after treatments.
Contact time for each client will be individually risk assessed.
Patients will be expected to wash/sanitise their hands before and after treatment.
Patients will be asked to wear a face covering during treatments. If a patient does not have their own face covering they will be provided with a mask at the beginning of the appointment.
Patients should remove their mask after leaving the clinic, or once the physiotherapist has left the house, and dispose of it at home.
Social distancing measures must be maintained in accordance with the Government guidelines.
Prone and side lying positions will be used wherever possible.
Face and neck massage in supine will be removed from routines for the time being.
Patients will need to bring their own water bottles to appointments.
Patients will be asked to use their own pillows (at home) and may wish to use their own towels.
Patients are advised where possible to attend an appointment on their own.
Relatives/carers should only attend if this is deemed necessary e.g. for those with limited mobility.
If a relative or carer must attend, they must be screened for COVID-19 before the appointment. They will be screened again on arrival.
If a patient (or anyone else in their household) develops symptoms of COVID-19, they MUST cancel their appointment and MUST NOT attend the clinic (there will be no cancellation fee in this situation).
If the patient has COVID-19 symptoms they will need to isolate for at least 7 days.
If the patient lives with someone else who has symptoms, the patient will need to self -isolate for 14 days.
There will be an option to change the appointment to a virtual treatment if desired.
Any patient wishing to have a face-to-face appointment will be asked to consent to their name and contact details being given to the Government’s contact tracing scheme.
Details will only be passed on to contact tracing if the physiotherapist develops COVID-19.
If a patient does not consent to details being passed on, a face-to-face appointment cannot take place.
If a patient that has attended for a face-to-face appointment finds out they have COVID-19, the physiotherapists contact details can be passed to contact tracing.