A patient is threatening to sue me; what should I do?

Depending on the nature of the complaint, the following steps should be taken. 

- where the patient has complained to you directly either in person, or by correspondence, you should contact the CSP industrial relations deparment who will be able to guide you through dealing with this level of complaint.

- where you feel that your patient is likely to prosecute, i.e. you receive a letter from their solicitor, you should contact the CSP professional affairs department for further advice.


Insurance covering professional indemnity has been extended to include lecturing, although this only appliies to special interest groups (SIGs), i.e. if the CSP member is also a member of a SIG and is sued regarding any poor advice given during a lecture or presentation, then they are insured.


[February 2009]

Am I able to offer Pilates instruction to individuals or groups?

Pilates is considered to be within your scope of practice and is referred to as exercise therapy. To teach it at all, in any size of group, you have to be satisfied that you have the requisite training and competence to teach. In other words it is a professional rule one issue.

[February 2009]

Does it matter how the patient gives consent?

No. Consent may be :



Implied by acquiescence by a person who understands what will be undertaken.

Acquiescence when a patient does not know what the intervention entails or is unaware that he or she can refuse, is not consent

It may be:

An active request by a patient for a particular treatment. Where patients access clinics directly, it should not be assumed that their presence at the clinic implies consent to a particular treatment. The therapist should ensure that they have the information they need before proceeding with an examination or treatment.

Passive acceptance of a health professionals advice

[February 2009]

How can I extend the scope of my practice to include injection therapy?

Injection therapy is covered by your professional Indemnity Insurance.

Courses in injection therapy are run by the Society of Musculoskeletal Medicine (SOMM). 

For more information visit their website: http://www.sommcourses.org/ 

The Association of Physiotherapists in Orthopaedic Medicine (ACPOM) also run courses and their website can be found at http://www.acpomit.co.uk//

[February 2009]

How important are the HCPC revised Standards of Conduct?

The HCPC revised Standards of Conduct are a must read

You should have received a booklet from the HCPC Standards of Conduct, Performance and Ethics these are equivalent to the CSP Rules of Professional Conduct or in some ways, more important, because if you breach these you could be removed from the HCPC register, ending your entitlement to call yourself a physiotherapist.

This booklet represents the revised and updated HCPC Standards and replaces those that appear in your members' manual.

As per the forward to this publication, these are the standards against which you will be judged and, at HPC conduct hearings, it is heartrending to note the number of individuals who, when asked by the prosecuting barrister if they have ever read them, say no. Please therefore regard it as mandatory to read and inwardly digest this booklet.

On a wider note, one of the concerns that Physio First has had as an organisation was that the old Standard 15 (now the new Standard 14) was not as robust as the CSP Professional Rule 7, when dealing with the issue of whether a physio (or any other allied health professional) could receive a commission for referring patients to services or products.

The new Standard 14; "you must behave with honesty and integrity and make sure that your behaviour does not damage the publics confidence in your or your profession" could be construed similarly to that of the CSP Rule 7.

Whilst on the face of it one might feel that restricting private practitioners from receiving a commission for the onward referral of a patient to be unnecessarily restrictive, the reality is that rules that help prevent the commercial excesses that a commission for a referral can produce are to be welcomed, as the alternative only serves to undermine the profession in the mid to long term just ask solicitors about the problems that their profession got into when a similar rule was not policed by the Law Society, which lead to the rise of Claims Direct, and claims farmers in general!

[August 2012]

How might Rule 7 of the CSP rules of professional conduct affect me?

Having considered the problem of increasing overtures to members to advertise services within their practice in the context of Rule 7 of the CSP Rules of Professional Conduct, our executive & main committee have produced a policy statement and standard response. This position is being communicated to the CSP with a request that some or all of it be included in the notes to Rule 7 in the next published edition of the Rules.

Essentially the problem is that there are increasing solicitations from solicitors, advertising agencies and intermediaries to members, who ask them to do a number of things based upon the fact that accident victims are likely to attend for treatment and are therefore a good vehicle for advertising their services.

Requests from anyone to an MCSP to refer a patient for a commission (often as much as £150 per patient) is easily dealt with as it would be a clear breach of Rule 7. A request to carry an advertisement for a solicitor or legal service for example, is more problematic.

The potential Rule 7 problem arises if the MCSP refers the patient to the advertisement or the firm or company advertised there. Such reference could constitute a clear breach of Rule 7.

The danger for breaching Rule 7 becomes even more pronounced if the patient asks the MCSP what they think of the firm or company who are advertising in their practice.

By way of illustration, if the response is "frankly I have no idea they just advertise here", then there is unlikely to be a problem.

If however the response is an endorsement of the advertiser, a response that could range from "they offer a superb service in that they have a good reputation and act for many clients like you" to "they acted for me in my accident and they were great" then this would be a probable breach. In the former response how can an MCSP make a judgement about the quality of the advertiser and even in the latter case, an MCSP may have personal experience of an individual doing a good job for them, but they are in no position to endorse the whole firm of company.

Even more compelling is the fact that such an endorsement or promotion of the service to a patient arguably always exploits the professional relationship with a patient.

September 2009

How to take advice about professional issues?

The most intelligent way of taking professional advice, especially when you are not paying for it by the hour (in which case you can request advice to your question in writing) is a matter of attention to detail and appropriate communication.

In most cases advice will be provided over the telephone rather than by email, as it is very difficult for the advisor to understand enough detail from a written version by the enquirer unless the enquirer is prepared to spend a lot of time on the detail and, even here, the advisor will still have questions that need to be asked before they can advise.

So on the basis that the professional advice sought is over the telephone, which is for example how one would seek professional advice from the Enquiry Handling Unit at the CSP; there are several short steps that one should take.

Steps to taking Professional Advice

  1. Before making the call write down all of the questions that you want to cover as it is easy to forget during the discussion itself.
  2. Make sure you have any details that you want to refer to during the conversation to hand e.g. a letter.
  3. Make sure that you have pen and paper to hand to make notes during the call itself
  4. Always ask for the name of the advisor. 
    Note: Some advisors will be reluctant to give their names for reasons that may be as diverse as it is company policy to I do not see why I should, but it is essential to get this. Often how you ask for it produces better results i.e. if you are dictatorial and strident in demanding it, the advisor will be defensive and potentially non compliant if you are open, reasonable and friendly, they will be happier to. But do get it.
  5. Note the start time and end time as well as the date upon which the telephone call took place and the same details if more than one telephone discussion takes place on the same topic.
    Note: Keep your hand written note duly signed and dated in a file for future reference
  6. Before ending the call summarise the advice that you have received so that you and the advisor are in agreement
    Note: Every advisor will stipulate caveats to their advice (e.g. this approach may or may not work it still remains a matter of your clinical judgement you may find out more information that would change this advice) as this is the nature of advice if it did not it would be telling you what to do, which is not their job.
  7. Write the following letter to them after the call:

Dear (insert name)

I am just writing to thank you for the advice that you gave me during our telephone discussion on the [insert date].

In short, the question(s) that I had was:

  • [Insert question(s)]

The background to this question(s) was:

  • [Insert background]

The advice that you gave me was:

  • [Insert advice received to include the caveats referred to in step 6 above]

The steps that I took based upon this advice were:

  • [This detail is optional, but can be helpful for the reasons stated in the conclusion below]

If I have misunderstood any aspect of this, then please do not hesitate to contact me. I can be contacted on the following telephone numbers (mobile) (land line) and or by email at

Kind regards

Yours sincerely

[Insert name]


In taking advice in this way you will end up with a letter that can be used to defend yourself if you are criticised for taking the action that you did.

Criticism can come in the forms of:

  • A complaint to the CSP
  • A complaint to the HCPC
  • A threat of or actual legal action

In any of these situations, a letter recording the details of the advice you took can be a fantastic tool in your armoury when having to defend yourself.

This approach is one that many professionals use in that:

  • It avoids the need to try to persuade the advisor to put their advice in writing as most will not as they do not have the time and do not want to for obvious reasons.
  • It gives the advisor the opportunity to review your interpretation of the advice given and correct it if necessary.
  • It gives substantial reasons for justifying action that you have taken if you are subsequently criticised for doing so.

Should you need any more specific guidance please contact the Physio First General Secretary, Paul Donnelly on 01202 417627.

[August 2012]

What are the principles of confidentiality?

An essential feature of the relationship between patients and therapists is the need for patients to be fully informed of the uses to which information about them may be put.

Health professionals have ethical duties of confidence and the duty of confidence is long established in common law.

Patient information applies to ALL personal health and non-health information gained from the patient or relatives/other professionals/other sources.

Patients have a right to expect that you will not disclose any personal information that you may learn during the course of your professional duties, unless they give permission. Without assurances about confidentiality, patients may be reluctant to give physiotherapists information they need in order to provide good care.

For these reasons:

When you are responsible for confidential information you must make sure that the information is effectively protected against improper disclosure when it is disposed of, stored, transmitted or received;

When patients give consent to disclosure they understand what will be disclosed, the reasons for the disclosure and the likely consequences;

You must make sure that patients are informed whenever information about them is likely to be disclosed to others involved in their healthcare, and that they have the opportunity to withhold permission;

You must respect requests by patients that information should not be disclosed to third parties, save in exceptional circumstances (for example, where the health or safety of others would otherwise be at serious risk);

If you disclose confidential information you should release only as much information as is necessary for the purpose;

You must make sure that health workers to whom you disclose information understand that it is given to them in confidence that they must respect.

If you decide to disclose confidential information, you must be prepared to explain and justify your decision

[February 2009]

What are the regulations governing the use of acupuncture in Scotland?

The following regulations for Scotland came into force on 1st February 2006 and cover all forms of skin piercing and tattooing.

a) Separate rooms must be provided for a waiting area and the carrying out of the procedure.

b) The waiting area must display signs advising that no acupuncture will be carried on:

(i) any person under the influence of alcohol or drugs

(ii) any child under the age of 16 unless accompanied by a person with parental rights and responsibilities who has given their permission in writing.

c) The room used for the acupuncture must have:

(i) a sink with hot and cold running water which uses non-hand operated taps.

(ii) a paper towel holder containing paper towels

(iii) a soap dispenser containing soap

(iv) a washable bench or chair with disposable paper sheet

(v) a waste bucket with pedal operated lid

(vi) a dispenser containing alcohol solution

(vii) a sharps container for storage of needles after use

(viii) a first aid kit

d) The premises must be well ventilated and illuminated

e) Only sterile, single use, disposable needles may be used

f) The operator must wear disposable vinyl or latex gloves which must be changed for each patient.

[February 2009]

What constitutes a "Duty of Care"?

RULE 2 of the Rules of Professional Conduct of the Chartered Society relates to Relationships with Patients. It states: Chartered physiotherapists shall respect and uphold the rights, dignity and individual sensibilities of every patient

These rights encompass: The right to have the individuals lifestyle, cultural beliefs and practices respected; The right to privacy and dignity; The right to be treated by a competent clinician; The right to comprehensive and effective communication; The right to consent to all aspects and stages of the treatment episode; The right to confidentiality; The right to a true record of treatment interventions kept in accordance with existing policies and current legislation; The right to access their clinical record in accordance with existing policies and current legislation; The right to be treated in a safe environment with safe equipment.


The definition of duty of care is how it is judged against:

  • The patient's expectations;
  • The effectiveness of the intervention in relationship to the problem ( including the evidence base for the choice and use of the intervention;
  • The Rules of Professional Conduct of the CSP
  • The Standards of Physiotherapy Practice (Core and Service Standards of the CSP).
  • The Health and Care Professions Councils Standards of Proficiency;
  • Local requirements e.g. legal report guidelines;
  • The laws of the land.

[February 2009]

What is competence?

Competence is enshrined in Rule 1 of the Rules of Professional Conduct of the CSP which states:

RULE 1 - SCOPE OF PRACTICE Chartered physiotherapists shall only practice to the extent that they have established, maintained and developed their ability to work safely and competently and shall ensure that they have appropriate professional liability cover for that practice.

Competence is defined as:

Appropriate updating in line with developments in professional practice and thinking, research findings, educational changes, technological advances, changing priorities inpatient care, contextual change and legislative change.

Ensuring minimum levels of knowledge and skills to practise safely and benefit patients.

[February 2009]

What is confidential patient information?

Confidential information includes all information gained during the course of a treatment episode. A duty of confidence arises when one person discloses information to another (e.g. patient to clinician) in circumstances where it is reasonable to expect that the information will be held in confidence.

It is:-

  • a legal obligation that is derived from case law;
  • a requirement established within professional codes of conduct; and
  • must be included within employment contracts as a specific requirement linked to disciplinary procedures.

Patients entrust us with, or allow us to gather, sensitive information relating to their health and other matters as part of their seeking treatment. They do so in confidence and they have the legitimate expectation that anyone who has access to that information will respect their privacy and act appropriately. In some circumstances patients may lack the competence to extend this trust, or may be unconscious, but this does not diminish the duty of confidence. It is essential, if the legal requirements are to be met and the trust of patients is to be retained, that the private practice provides, and is seen to provide, a confidential service.

[February 2009]

What is the Data Protection Act?

The Data Protection Act sets out the rules for processing personal information and applies to paper records as well as those held on computers.

It imposes obligations on those who use patient information, and grants certain rights to patients for whom the record relates.

Patients also have rights of access protected by this act.

The key messages are:

  • It applies to all media, not just computer generated records, i.e. paper records
  • It increases the rights of the data subject
  • Implementation compliance of the Act is phased

It places statutory restrictions on the use of personal information, including health information. 
The aims of the Act lie in the eight Data Protection principles, and are that information is:

  1. Processed fairly and lawfully
  2. Obtained and processed for specific purposes
  3. Adequate, relevant, not excessive
  4. Accurate, up to date
  5. Held for no longer than necessary
  6. Processed in accordance with the rights of data subjects
  7. Kept secure
  8. Transferred outside European Economic Area only is adequate safeguards exist.

This is explained in more detail at:


[September 2012]

What is valid consent?

Consent is a patients agreement for a health professional to provide care. Patients may indicate consent non-verbally (for example by presenting their arm for their pulse to be taken), orally, or in writing.

[February 2009]


There are 3 essential requirements to valid consent:

1. The patient must be competent to take the particular decision;

2. They must have received sufficient information to take it; and

3. They must be consenting voluntarily, i.e., not be acting under duress.

If any requirement is not met, consent is negated and the intervention will be unlawful.

[February 2009]

What might affect competition with Physio First members in the future?

In some ways it is surprising that big business has not taken a firmer hold on the physiotherapy market, given the relative stagnation of the private medical insurance sector and the growing popularity of physiotherapy and self-payers.

The threat of a move by big business into the private physiotherapy market is, however, one that should not be ignored by our members.

Of course, competition from big business already exists in the form of physiotherapy departments in private hospitals, but judging from the information received by our members in their research for events such as negotiations with Bupa and their preferred provider contracts, they do not really compete on price as, in the main, they are much more expensive than independent practitioners.

Competition also exists in the form of some high street outlets that offer physiotherapy, but most of these provide a range of other out patient services of which physiotherapy is only one and on a national basis there are not many of them.

The threat that needs to be emphasised, however, is the one that will deliver high street private practices that are run by big business (rather than by Chartered physiotherapists), but which are designed to compete directly with independent practices, i.e. one with outlets in many high street locations, where there is a large (or even national) advertising campaign to promote them and where they will compete with Physio First members on fees.

Every sector, whether or not that of professional services, must acknowledge that our society encourages competition. The view is that, without it, the consumer will be abused.

An illustration of this threat is that of high street opticians. In the early 1990s many opticians ran small businesses with their main competition being each other or perhaps some high street chemists. Today, however, many members will be regular customers of high street names that have sprung up in almost every town and that produce high profile advertising campaigns, to include advertisements on prime time television.

One feature that may attract big business is to attempt to try to reduce overheads (and recruitment difficulties) by developing systems that allow less qualified individuals to deliver the service. Such a model could seek to attempt to compete on price/profitability by the increased use of non-Chartered physiotherapist practitioners such as the employment of physiotherapy assistants, rehabilitation assistants, sports injury therapists, etc. where a few Chartered physiotherapists are employed to supervise.

Such models already exist in the legal world, particularly in personal injury cases where case management systems and specific training vastly reduce the need to employ qualified solicitors.

The premise may be that the public will not be concerned as long as the service looks and feels satisfactory. Most patients who enter a physiotherapy clinic do so for the first time. Their expectations are often governed by whatever they receive. If they have nothing to compare it to, then they may assume that what they receive is as good as is available.

Certainly there are barriers to this model working at the moment, principally in the fact that private medical insurance companies will not reimburse treatment provided by anyone other than an HCPC registered or Chartered physiotherapist.

Certainly the private practitioners group in Australia have produced articles in their journal to advise their members about the increasing corporatisation, which for them, appears to be a growing source of actual competition.

Advise such as: the strategy of the corporate operator may be a high volume, low price service. With the savings from centralised administration, and buying power, the larger organisations are likely to have a cost advantage over their smaller counterparts. It is very difficult for smaller practices to attract the attention of larger contracts, like those that may be given out by government departments One of the primary benefits of corporate entry is that business investors will usually recognise that a good business has an element of good will resulting in practitioners being more likely to be paid for their work in building a business

In addition we have received information from our members about the speculation of some businesses in this area within the UK.

In conclusion therefore, whilst this threat is not imminent, it is something that Physio First intend to monitor closely and any information that any members have about any moves by big business into this field would be welcome. Please contact your General Secretary on minerva@physiofirst.org.uk.

[August 2012]

When is it necessary to seek patient consent?

Patient consent is required on every occasion that the physiotherapist wishes to initiate an examination or treatment or any other intervention, except in emergencies or where the law prescribes otherwise (such as where compulsory treatment is authorised by Mental Health Legislation).

[February 2009]

When should I seek written consent?

When the treatment or procedure is complex, or involves significant risks (the term risk is used throughout to refer to any adverse outcome, including those which some health professionals would describe as side-effects or complications)

When providing clinical care is not the primary purpose of the procedure

When there may be significant consequences for the patients employment, social or personal life

When the treatment is part of a project or programme of research

Completed forms should be kept with the patients notes. Any changes to a form, made after the form has been signed by the patient, should be initialled and dated by both patient and health professional.

It will not usually be necessary to document a patients consent to routine and low-risk procedures, however, if you have any reason to believe that the consent may be disputed later or if the procedure is of particular concern to the patient (for example if they have declined, or become very distressed about, similar care in the past), it would be helpful to do so.

Specific physiotherapy procedures where it may help to have written consent are:

  • Movements of force to the cervical spine,
  • Grade V manipulations
  • Acupuncture
  • Vaginal and rectal examinations
  • Naso-pharyngeal and tracheal catheter suction with competent patients
  • Exercise tolerance tests for patients with cardiac conditions.

Department of Health consent forms can be used for these interventions. www.doh.org.uk

[February 2009]

Who should seek consent from a patient prior to examination or treatment?

The physiotherapist who recommends and undertakes the intervention has responsibility for providing an explanation to the patient and ensuring that the patient is genuinely consenting to what is being done; it is they who will be held responsible in law if this is challenged later.

[February 2009]

What should I do if a complaint is made against me to the HCPC?

Do not panic! The process is straight forward and the CSP offer good support and an excellent defence service.The CSP have also published a guide to The Health and Care Professions Council (HCPC) complaints procedures against physiotherapists and how the CSP supports members throughout this process. The title is HCPC investigations: a member guide. The information is targeted at those members who have just received correspondence from the HCPC informing them that a complaint against them has been made. 

It can be obtained via the CSP website www.csp.org.uk and its reference is ERUS IP40.

February 2013

Can someone tell me why I should pay >£100 for a discussion meeting about voluntarily setting up a possible group that will take away our professional autonomy with the introduction of care pathways?

Wendy’s Question - Can someone tell me why I should pay >£100 for a discussion meeting about voluntarily setting up a possible group that will take away our professional autonomy with the introduction of care pathways?


Hi Wendy

You may be asking one question about two things, so to make sure that I am hitting the right points, I will set both out – but please do come back to me if I have missed the point.


Rich Katz will be talking upon 2 separate but related things i.e.


  1. He will be our main guest speaker at our symposium on Friday 31st March (Education Day) where he will contribute to the symposium upon our investigation of the feasibility of a private physiotherapists’ cooperative i.e. a self-owned self-employed private physio business


  1. He will be a conference speaker on Saturday morning, where he will be talking about his network’s experience of care pathways


The two are separate but related. Separate in the sense that at the Friday Education Day symposium, he is unlikely to address anything to do with Care Pathways, save possibly in passing, but they have been a feature of his network. In his Saturday morning conference slot he will talk about his, and his network’s experience, of using care pathways in is 20+ years of frontline negotiations with private medical insurers.



So, back to the question, but to each specific partCan someone tell me why I should pay >£100 for a discussion meeting about voluntarily setting up a possible group that will take away our professional autonomy with the introduction of care pathways?


Why pay to attend?

Essentially, in charging for this event, our executive have had to take into account our need to try to ensure that this event self-funds and fits into the overall use of Physio First finances as we deploy our strategy and meet our goals.


This whole Goal 9 endeavour, of which our groundbreaking symposium is a part, is premised on “no guarantees” that it will work and so we have to budget responsibly to cover our costs. If it fails, it is unlikely to leave a substantial financial hole in our organisation whereas if it succeeds it will help to replenish some of Physio First’s reserve which has been invested in our pursuit of our Goals 1 to 9 and without which we could not have even contemplated this development.


Even our volunteer post holders who already contribute so much of their own time, energy and money (to include our executive committee and even members of our education subcommittee who are responsible for delivering our whole Education day), will have to pay to attend.


I hope this provides some more context to this aspect.



Back to the question … voluntarily setting up a possible group that will take away our professional autonomy with the introduction of care pathways?


The symposium’s learning outcomes are:

  • What a self-owned private physiotherapy business entity is
  • Why Physio First thinks that this is something that Physio First members should contemplate now
  • What the first one might look like
  • When the first one is likely to be established
  • Whether you should plan to become involved or not

and are absolutely not about setting up a group that will take away professional autonomy but rather about whether there is sufficient appetite among members to become involved in setting up their own self-owned business – most probably as a cooperative – through which to trade and seek to impact upon the current and future healthcare marketplace.


The reasons for considering this now are set out in our FAQs around this event: http://www.physiofirst.org.uk/asset/25523CB1-8CC2-4B7A-9AAB55CDC626036E.2AA0FD77-9DD5-43DD-977B238E1B44120D/

In overall terms however, the exploration within the symposium will be about “protecting” professional autonomy on 2 counts:


  1. From its de facto erosion by private medical insurers and commercial intermediaries who impose restraints upon the number of treatments that providers who join their networks, can provide based upon their own metrics which are really only around cost with absolutely no reference to quality.


Those private medical insurers and commercial intermediaries that are honest will agree that they have no validated ways of measuring quality of any provider (from surgeon to physio to any other healthcare professional) nor indeed of the services that they, as businesses, provide i.e. how can a customer tell which private medical insurer or intermediary is of better quality than another – they simply cannot!


  1. By enabling self-employed private physios to do it yourselves! Up until now, there has been no legitimate way of articulating how good you are – save by saying “my patients would not come back, if I were not good enough” – which is a very credible position to hold, but one that we think has an increasingly short life span – our reasons for thinking this are summarised in our lead article in our November Update i.e.


Why do we need this scheme?

Society and the healthcare marketplace in 2016 demand authenticity. Validated data can be turned into evidence of authenticity in so many ways.


In everyday life, we give and share data everywhere we go – from interactive fitness apps to retail reward cards and hotel loyalty discounts. In the healthcare marketplace, authenticity means being able to prove our cost effectiveness – our value for money. In our world as self-employed private practitioners, this is demonstrated by measurable quality treatment with outcomes. Please see our article, page 7, on quality and how it is becoming critical in the private healthcare marketplace.


Our reasons for believing that our healthcare marketplace “will” (not “may”) be subjected to scrutiny about quality, takes into account Physio First’s discussions with marketplace stakeholders – from private medical insurers, to commercial intermediaries, to members who are ambitious to expand – as these discussions have helped us to understand that they are all looking for objective ways of measuring and then commercialising “quality”.


The reasons these stakeholders include:


  • The 2014 Competition and Markets Authority repot on their investigation of theprivate healthcare market which concluded that “…  patients considering private healthcare did not have sufficient information available to them to make informed choices” and as a result forced the establishment of The Private Healthcare Information Network (PHIN) whose remit is to “… publish trustworthy, comprehensive data to help patients make informed decisions regarding their treatment options, and to help providers improve standards” – see link http://www.privatehealth.co.uk/industry/industry-organisations/the-private-healthcare-information-network-phin/
    • This currently only applies to private hospitals and consultants who work within them, but the direction of travel in the healthcare market is clear – we all have to be able to provide “… trustworthy, comprehensive data to help patients make informed decisions regarding their treatment options, and to help providers improve standards” – and this means standardised data collection that is validated by much more than ourselves.


  • Some marketplace stakeholders have already looked to create a “TripAdvisor” consumer type quality measure – see an example from an on-line commercial intermediary https://www.zesty.co.uk/ and click on the very short video about “How does Zesty Work?”


Obviously Physio First has been working away, with the University of Brighton and our anonymous and selfless members on our Data for Impact project that now provides enough validated and standardised data to enable our Physio First Quality Assured Practitioner scheme to be launched and which is fully described in the lead article in our November Update,  “QAP scheme launch”- http://www.physiofirst.org.uk/resource-library/novemebr-2016-now-is-the-time-not-to-miss-out-2.html – which as the article says, has “delighted and worried marketplace stakeholders in equal proportion “.


So back to care pathways?

For those of you who are Bupa providers, you have been asked year on year about your need to use care pathways. We even understand that Nuffield Fusion used to (and  perhaps still do – we would love to know) mandate the use of care pathways that they have developed for their Nuffield Physio outpatient Depts and Nuffield Fusion members, but apart from these there are very few if any Care Pathways that are regularly used in private practice.


Might care pathways be used in the future – the chances are that they might well be – but this then begs the question as to who will create them and what use will they put them to?


Currently we have detected little activity in the marketplace around Care Pathways – but rather a lot of activity around being able to demonstrate quality – but this does not mean that we can ignore them or the fact that they can be a sword as well as a shield. The question is, who will wield them?


This is why our Education subcommittee asked Rich Katz to talk about his experience with care pathways over his 20 plus years of experience i.e. giving us the benefit of his hindsight in their use in helping him to enable his network to survive and prosper in the US healthcare market where many others have not as it is a very harsh environment within which to compete!


More questions

Obviously there is an awful lot going on within Physio First just now – from the launch of our QAP scheme to our Goal 9 Symposium to our Patient On-line Booking facility (due to be launched in January). But they are all connected. 


They are all about “not standing still” and allowing other marketplace stakeholders to make the running and then merely on impact us and over which we would have very little say. These developments are about “Championing private physiotherapy” which means they are about big bold steps where we do not know the answers but without which we cannot expect to have much impact on our own marketplace.


So do continue to ask questions – and if I am involved in any of the answers – I promise to try to be “briefer” than I have been here!!!


Apologies and thanks!



Paul Donnelly

General Secretary

Physio First