Here are some of the most commonly-asked questions raised with full answers on a variety of topics. Click on the area that covers your query.

Practice information

Will a physiotherapist charge me for photocopying my patient record notes?

If a signed request is made in writing by a patient for a copy of their medical records to be sent to them (or more commonly to a solicitor or nominated intermediary) they must supplied within 40 days.

It is common for practitioners to request payment before sending copies.

There is no guidance as to what or how to charge for the copying of records other than the general advice to charge only what can be justified in terms of time and cost and that this must not exceed 50.

The law states that if there has been an amendment to the patients records within 40 days of the request, the patient has the right to view the record without charge.

For how long should a physiotherapist retain their records of patient consultations and treatments?

Records must be retained in accordance with existing policies and current legislation.

a) Records must be retained for a minimum of 8 years after the conclusion of treatment.

b) Obstetric records must be held for 25 years.

c) Records relating to children and young people must be kept until the patients 25th birthday, or 8 years after the last entry if longer.

d) Patient records must be stored securely at all times.

e) Computerised physiotherapy records must be registered under the Data Protection Act 1984.

f) Records can only be released with the patients permission.

g) A patient or carer must be made aware that the patients records may be accessed in accordance with health authority policy.

h) A procedure must be in place for patients to access their post November 1991 records.

Does a Physiotherapist need a police check to treat a child?

As long as the person accompanying the child for treatment is the parent/guardian or has a note from the parent/guardian giving the person accompanying the child parental authority to do so, the physiotherapist does not need a police check.

Are Physiotherapists able to issue sickness certificates?

The simple answer is yes.

They can be given to patients to offer to employers or the Department of Social Security

Their acceptance is discretionary, though little difficulty has been reported since they were introduced

They should only be used for conditions for which the physiotherapist is taking clinical responsibility (e.g. back pain, other joint problems or the after effects of a stroke)

A fixed date of expiry must be given the certificate cannot be open ended

The diagnosis must be clearly stated.

Is there a set hourly rate for seeing patients on a private basis?

Each private physiotherapist sets their own scale of charges. We are unable to supply information regarding charging rates due to the Competition Act except in certain circumstances and then only to Members of the Organisation. The best way to find out the charges is to contact local practitioners. These can be found through the Find a Physio service on this website.

What are the differences between Physiotherapy and Osteopathy/Chiropractice?

In the main Osteopaths and Chiropractors are involved with musculo-skeletal work and tend predominantly to use their manipulative skills. Physiotherapists deal with the rehabilitation of any condition, including neurological problems, womens health, burns, intensive care etc. by physical means. As a result, the training of physiotherapists is broader and more diverse to reflect this.

Why doesn’t Physio First campaign for higher fees?

A question that Physio First has been wrestling with for years and which our new strategy takes into account.

It is firstly a question of “who Physio First are” i.e. essentially we are a membership trade association that is run by volunteers who step up from among us and who give up their time and energy for us.

Each volunteer runs his or her own practice but also contributes masses of their own time and energy to doing the best they can for our colleague members, supported of course by our General Secretary and our office team.

In terms of meetings that we have with Bupa, AXA PPP or Nuffield or indeed any private medical insurer or commercial intermediary, these are really quite tricky in that in communicating with them we have to balance informing them of the problems that we as private practitioners face with the reality of their and our marketplace.

Reporting a problem to a private medical insurer or commercial intermediary such as:

Our members do not like the rates that you are offering

we know will lead to the response:

“So what are you suggesting – that we offer your members more than our position in the marketplace requires us to do? You should know that if we were to offer more:

–       We want a marketplace benefit from Physio First members in return

–       A benefit that will save us money or make us money or really help us to improve our brand

–       Unless we get that we would become uncompetitive ourselves!”

So to avoid being regarded as amateurs in a professional business “marketplace” space, Physio First representatives can allude to our member dissatisfaction but cannot yet address their legitimate question as to what Physio First members can do for them in terms of helping them to make money, save money or improve their brand – but we have a plan!

If we are too hostile i.e. telling them how we as private practitioners really detest the way that they do business and that private practitioners would be encouraged to criticise them openly e.g. by implication to their customers (i.e. our patients):

  • At best they will simply refuse to meet us any more
  • At worst remind us that if we were to encourage criticism of them then they would be “asking their lawyers to intervene!”

So again, not really a productive option as without these meetings and an open communication channel with them, we would get no advanced marketplace information that we can publish that helps us all.

So overall, the very best that we can hope to obtain from meeting them (which we do) is to try to persuade them to tell us about what they are intending to do in the future so that we can give everyone a “heads-up” on what to expect and thus enable us as members to factor any marketplace changes that we learn about into our own individual plans.

When meeting Bupa, AXA PPP, Nuffield, Simply Health or indeed any of them, our Physio First representatives really try to walk the line of raising legitimate complaints and in seeking information from them and (occasionally) seeing what we can do “with them” that would benefit us as members or ward off a threat (e.g. the Physio First DBS enhanced checks that as Physio First we set up to satisfy Bupa’s new demand that all private practitioners have to prove they are not a danger to children or vulnerable adults).

So why not just advise us all to simply band together and say “no”?

Essentially in order to “offer a united front”, Physio First as an organisation of like-minded members (like-minded in that we are passionate about what we do and we are self-employed and in business) we have to become really organised. 

To try to present a united front as groups of individual members or as individual businesses e.g. for Physio First to suggest that all members tell Aviva, Bupa, Nuffield or AXA PPP or anyone, that “we will not treat their patients for less than £x per session”, would be to put ourselves in breach of the law and also very likely to shoot ourselves in the foot.

The legal danger is that we would leave ourselves open to being sued by the Office of Fair Trading or indeed any of the private medical insurers or commercial intermediaries directly for trying to adversely affect competition – a subject that we have taken legal advice upon and written tomes about. The OFT makes the point on its website that:

 

“In addition to our own research and market intelligence, the OFT relies on complaints to help us in enforcing competition law. If you suspect that a competitor, supplier, customer or any other business is infringing the law, you may contact us with your concerns”.

The likely outcome of shooting ourselves in the foot outcome comes from the fact that not everyone would agree to unite.

In a free competitive marketplace some of us would regard any attempt by a group of members to band together (to effectively go on strike) to try to protect or improve fees as a major marketplace opportunity to nip in and take the business. Of course we would expect such action to be much more common among non-Physio First member businesses but we were informed of instances of members doing precisely this during the Bupa Blind Tender process in 2009.

All this tells us is that to expect such unity (even if it were legal) in a society that is set up to value competition would be naïve and it would damage to our marketplace credibility.

Bupa, AXA PPP, Aviva, Nuffield or any company we approached where we allow ourselves to say that “our members do not like your fees” would, even if they did not say it to our face, regard us as amateurs and irrelevant and most likely simply ignore us – and rightly so. If we were them would think the same!

Where the new Physio First strategy takes us, is on a continued journey towards marketplace credibility i.e. an expressed understanding that “if” as Physio First we are going to have an impact on the marketplace, we are going to have to create something that marketplace players value!

Please read the article about our Goal 9 in our May 2014 edition of Update for details.

Some of us will remember Physio First projects and initiatives such as:

  • Physio First Clinic Accreditation Scheme i.e. our attempt to provide a quality assurance scheme
  • The Physio First “RehabFirst Scheme” i.e. our attempt to become a commercial intermediary
  • Change of name from OCPPP to Physio First i.e. to create a name that meant something to the public
  • The development of a whole suite of Physio First business courses i.e. to help members develop business skills to meet the changing healthcare marketplace
  • Physio First FAQs on business questions i.e. to answer questions that members frequently ask that can be reviewed quickly and easily and a whole host of other projects and initiatives.

All of these initiatives have helped to improve our business knowledge and skills which have culminated in our Executive’s ability to create our new strategy in 2013 which we are now deploying.

Our past Chairman Sandy Lewis provides lots of details of our new strategy via video and articles on our website.

Our new strategy was born out of a decade of getting ourselves (Physio First) organised along commercial lines – i.e. addressing the 5-key business skills that are needed to take an organisation into what is called “advanced development” i.e.

  1. Positioning – Understanding what is Physio First’s unique position in the marketplace
  2. Advance management tools – Obtaining the best business tools that we can afford e.g.
    • The development of our business training courses which have been attended by our Executive members as well
      The import of our Membership Relationship Management Software
      Professional Performance Management Training for our Office Team 
    • Succession planning – Hard material plans and systems in place to safe guard continuity for every Physio First post to ensure someone becomes the resource to carry on with our journey
  3. Becoming functional – Simply put, becoming as fit for purpose as we can be given our available resources. This has been especially important given that most of our resources are our volunteer member time and energy. We have done this through being really focussed in what we do. We plan everything, we manage our capacity, we have a written down culture (i.e. agreed behaviour), each post has a job profile and our executive are peer reviewed by our Chairman and our office team appraised by our office team manager
  4. Understanding our distribution – “Distribution” simply means being really clear about how we recruit new members and as per our positioning report (details to be sent to all members later in 2014) we understand completely that we, as Physio First, obtain the vast number of our new members from recommendations from existing members – from us!

Of course we still have to improve each of these five skills but having developed them so far we now have our reason for existing and 9 goal five year plan. So it is now worth turning to goal 9 as this is where we think the solution to the question lies i.e. the question “how do we as Physio First have an impact upon the marketplace?

 

Our executive’s explanation of goal 9

Goal 9 – Investigate so that we are able to understand, explain and judge the:

  • Potential impact of cooperatives (i.e. Physio owned/controlled business entities)
  • Elements of real branding (that incorporate measured quality and competence) 

… and as said above, please read the article about our Goal 9 in our May 2014 edition of Update for details.

To view The Chartered Society of Physiotherapy's FAQ, please click here, if you are unable to view this please try logging on.

July 2016

 

Training

How can I train as a physiotherapist?

The minimum entry requirements are the same as those for all degree courses. But due to competition for places, it means that conditional offers for places are set higher than the minimum.

A variety of qualifications may be accepted:

In England and Wales school leavers are normally required to have 3 A levels at grade A-C (one should be a biological science) and a minimum of 5 GCSEs at grade A-C. These GCSEs should include maths, English language and a selection of science subjects.

In Scotland a typical student profile is 5 SCE Higher at grades AABBB taken at one sitting (minimum of 2 science subjects).

In Ireland School leavers should have an Irish Leaving Certificate with a minimum of four passes in subjects at higher level (2 at B grade and 2 at C grade).

Each course has its own individual entry requirements. Applicants should write to the course of their choice, with a large stamped address envelope, for a prospectus which will include specific details of entry requirements.

There are a number of alternatives to the above qualifications, but prospective students are advised to contact the institution they intend to apply to for their specific requirements.

These alternative qualifications are:

- BTEC National Diploma in Health Studies (Science) with distinctions/merits in all units. - Advanced GNVQ/GSVQ in Health and Social Care or Science (Additionally most institutions require a biological science A level). - HND International Baccalaureate - Certain Access Courses (contact individual institutions for the access courses they recognise) - Open University Foundation course in science

Along with academic qualifications, admissions tutors will be looking for the following skills and qualities in potential students:

Communication skills, helping and caring Sensitivity and tolerance Ability to use initiative Ability to work as a team member Reliability, honesty and trustworthiness Enthusiasm, dedication and determination

Applications are welcomed from applicants who left full time study some time ago, but they will usually need to provide evidence of recent academic study at an appropriate level such as an Open University Foundation Course in Science or equivalent.

Anyone wishing to train as a physiotherapist is advised to contact CSP (020 7306 6666) or visit their website

 

Safety

Can pacemakers be affected by machinery used by physiotherapists?

Some clinics in the interests of patient safety require information about your pacemaker before using certain treatments.

You normally need to be quite close to machines for pacemakers to be affected.

Some clinics will have harmful radiations shielded from the general public. Each machine varies in the distance considered to be within a harmful range and so the manufacturers should be contacted for this information. Generally their advice will relate to the use of a machine on someone wearing a pacemaker.

Follow any advice issued by the hospital fitting the pacemaker.

You normally need to be quite close to machines for pacemakers to be affected. Other clinics ought to have harmful radiations shielded from the general public at large. Each machine varies in the distance considered to be within a harmful range and so the manufacturers should be contacted for this information. Generally advice relates to using a machine on someone wearing a pacemaker. Advice from the hospital fitting the pacemaker should be heeded.

 

Physio First

How much does it cost to join Physio First?

Full Membership:

If you join Physio First as a Full Member the initial cost is £362.

This is made up of:

  • £94.00 for Dec - Mar 2017/2018
  • £208.00 for 2018/2019 subscription
  • £60 registration fee

Affiliated Membership:

If you fulfil the requirements of an Affiliate Member, the initial cost is £334.

This is made up of:

  • £85.00 for Dec - Mar 2017/2018
  • £189.00 for 2018/2019 subscription
  • £60 registration fee

Please note that Affiliate membership is open to physiotherapists who are employed in a private practice, the practice principal or physiotherapist manager of which is a full Physio First Member.

Journal Membership:

Journal Membership costs only £40 and Members receive copies of our Quarterly journal In Touch.

 

 

Membership (Deferred)

Deferred Service Membership is for those Physiotherapists who are looking to set up in Private Practice within the next 4 months, but require our guidance.

This costs £268

  • £208 for 2016/17 subscription +
  • £60 registration fee (Non-refundable)

 

 

 

How much private practice should I be undertaking before becoming a Physio First member?

Applicants for membership of Physio First must be operating as a self-employed physiotherapist, i.e. on Schedule D, or be employed by a limited company substantially owned by chartered physiotherapists. Where specific classes are run on a private basis these conditions must apply for the hours during which such classes are being run.

The Physio First rebrand; How and Why?

The rebrand of Physio First required much consideration to align its new image and brand 'feel' with its intent.

Physio First is changing. But why are we changing and, more importantly, what does it mean for us as members?

In our latest edition of InTouch Summer 2016, Physio First’s outsourced Marketing Director; Laura Pegg answered a Q&A section about our re-brand and will help you all understand the reason to our re-brand.

Read the story of its conception *here

*InTouch Summer 2016 reference

 

 

Other useful information

AXA PPP: a brand to be trusted?

You will no doubt remember our article in our May 2016 edition of Update about AXA PPP’s apparent change to their proposed cuts to their physio panel, and the letter to them published from our General Secretary Paul Donnelly.

Since then (and at the time of writing) we have had no substantive response to this communication. We have also had no response to an invitation to their representatives to meet with our General Secretary and Chairman.

In an email to them dated 27 June 2016, Paul pointed out that:

“I do not appear to have had any response to my email to you of the 13th May and our Chairman and I would be grateful if you could reply.

In addition I have been notified that AXA PPP’s Specialist Relationship Advisor has been communicating ‘I can confirm that Mr Donnelly has been in contact with Julia and having discussions for the past six weeks’.

Both the lack of any reply and such statements are worrying because, other than our brief chat on the telephone, we have had no discussions or communications with you or indeed anyone else at AXA PPP during this very worrying time for our members.

In the circumstances could we please hear from you (or someone at AXA PPP) with a substantive response to the points in my email of the 25th March?”

As a significant stakeholder in the private physiotherapy healthcare marketplace, we are very careful to remain professional at all times. This means communicating with those that contact us, even if we are in dispute with them.

We have understood that the essence of a good brand is “trust”. So our question to AXA PPP remains as per Paul’s email to them on 25 March 2016:

“Are you able to give us an explanation to enable us to understand what decisions you have made, why you have made them, why the decisions are irreversible and why (if at all) our members should not have to move to a position of simply not trusting AXA PPP going forward?”

 

Update - July 2016 "It's all about relationships..."

 

CSP members

Are you a member of the CSP considering joining Physio First? You can join as a CSP registrant and gain access to some member-only areas of the site.