Physiotherapy and Covid 19 – should we be treating patients?
Physiotherapy is a touching profession, so directions to practice physical distancing and avoid person-to-person contact during the COVID-19 pandemic don’t translate well when applied to physiotherapy treatment. As this pandemic has unfolded, direction to physiotherapists has centred around maintaining a safe practice environment through enhanced cleaning practices, increasing social distance in waiting rooms and treatment spaces, and encouraging those who are ill, both patients and physiotherapists alike, to stay home.
As a result of Public Health England and Government advice, private practice physiotherapy clinics and other physiotherapy businesses were encouraged to close at the end of March except when providing emergency and urgent services. Ashburton Physio closed a few days before lockdown as we felt that continuing was unsafe for both patients and clinicians.
As a rule, physiotherapists do not provide emergency services. Defining emergency physiotherapy care is difficult due to the many settings where physiotherapists provide services and the many different patient groups physiotherapists serve.
We know that physiotherapists provide health services that are valued by their patients. We also know that those services are important to the health and wellbeing of patients. However, at this time, the directions from Public Health England and professional bodies make it clear that the risks of in-person care, in most cases, outweigh the benefits both for patients and health-care professionals.
Until the orders change, physiotherapists may only provide in-person services in physiotherapy clinics or through home-based or mobile physiotherapy practices if their patient will suffer serious and imminent harm AND is at risk of needing to go to the emergency department or be admitted to hospital because of a lack of physiotherapy.
However, physiotherapists are required to screen potential patients to determine if the patient meets the criteria for urgent, in-person care. If a physiotherapist provides care that is not urgent, they may be found to have breached their duty of care, face fines and may face disciplinary action as well. Please do not press your Physio into seeing you, it is a really difficult criteria as it is often the case that in the patients eyes, severe pain equals urgency. Unfortunately this is not the case. Saying that, there are many ways that we can help you without seeing you face to face. Do give us a call.
Physiotherapists are also required to screen patients for signs, symptoms, and risk factors for COVID-19 before providing in-person services. To keep your physiotherapist, their family, and their other patients safe, your full cooperation in this process is appreciated.
Even if a patient is categorized as requiring urgent care, physiotherapists are asked to consider if that care can be provided using a different method of delivery (such as telerehabilitation), to only provide in-person services when an alternate delivery method is not an option, and to carefully consider the frequency of in-person treatment.
One way that your physiotherapist may be able to help you until these restrictions are lifted and it is safe for you to access in-person services again, is to provide telerehabilitation services. Telerehabilitation is the use of telephone, text messaging, video conferencing or other technologies to connect with patients and provide an assessment, education, and treatment. Telerehabilitation does not require person-to-person contact and is, therefore, something that your physiotherapist can offer to patients who do not meet the criteria for urgent, in-person services, while still doing their part to limit the spread of COVID-19.
Although these services differ from traditional, in-person care, they are still subject to the same standards and expectations for safety and quality.
We encourage you to speak with your physiotherapists about this option as you are unlikely to qualify for in-person services at this time.
Physiotherapists want to provide you with care. By nature, physiotherapists want to help our patients to get well; therefore, it is difficult to be directed to stop providing in-person care. However, in the face of an unprecedented pandemic that is resulting in illness and deaths among many of the patient groups that physiotherapists serve, this is the right thing to do.
We encourage you to follow the instructions of Public Health England and adhere to directions aimed at limiting the spread of COVID-19. We do not envisage providing any face-face treatment until early July.
Rest assured that behind the scenes we are working hard to get the clinic ready as we emerge out of the Covid 19 emergency.