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.

Quality Assured Clinic

How do part time subscribers participate in Data for Impact and Quality Assured Clinic?

Part time subscribers will have to join Physio First by going through our join online application, click here.

Once confirmation has been sent to you via email from Physio First that you are a part time subscriber of Physio First then please follow the next steps:

  • You will need to sign up to Data for Impact using the UoB application process here 
  • Once confirmation has come through from the UoB that your application has been successful then you will begin inputting data.

If your practice principle wishes to apply for QAC status, then they will apply to the UoB who will send a delaration to the practice principle who will confirm your part time working hours to the UoB.

If you join Physio First as a part-time subscriber, the initial cost is £188

This is made up of:

  • £74 for October - March 2018/19 +
  • £114 for 2019/20 subscription

[Reviewed - September 2018]

How is part-time subscription defined?

A part-time subscription level has been created for private physiotherapists that work 20 hours or less and work for a clinic working towards Quality Assured Clinic (QAC) status by collecting data on all their new patients where possible. This new part-time subscriber category allows part time colleagues to pay a proportionally lower subscription rate and allow them to participate in a QAC status.

To apply for this rate, your practice must confirm in writing that you meet the definition of a part-time subscriber, and you work 20 hours or less per week. You must also begin to collect patient outcome data on Data for Impact (DfI) and be collecting PROMs within one calendar month of joining Physio First. Part-time subscription is not available to practice principals, sole practitioners or those who are not participating in DfI.

When joining Physio First as a part-time subscriber you will be asked to input the number of hours you work through our join online application.

Private physiotherapists who work alone or are the practice principal and have a stake in the business then you are not eligible for part-time subscription.

[Reviewed - Septemver 2018]

How do I join under the part-time subscription?

Part-time subscriptions

  • Go to join online - https://www.physiofirst.org.uk/join.html
  • Complete step 1 all the way through to our privacy policy and payment screens
  • You will be sent a confirmation email which will confirm you have joined Physio First as a part-time subscriber
  • We will send you details on how to sign up to Data for Impact (which you must do within 1 calendar month from joining to obtain your part-time subscription)

If you work alone or are the practice principal you are not eligible for part-time subscription.

Introducing part-time subscriptions for Quality Assured Clinics

  • When we first started exploring Quality Assured Clinic status we realised that a very important section of our industry would miss out on QAC status unless we created a new subscription category to allow for those working part time. Many clinics rely on part time staff and we felt it was only fair to make the scheme as open to them as possible.
  • A part time subscription level has been created for private physiotherapists that work 20 hours or less and work for a clinic working towards QAC status by collecting data on all their new patients where possible. This new part-time subscriber category allows part time colleagues to pay a proportionally lower subscription rate and allow them to participate in Quality Assured Clinic.
  • To apply for this rate your practice principal must confirm in writing that you meet the definition of a part time subscriber, and you work 20hrs or less per week. You must also begin to collect patient outcome data on Data for Impact and be collecting PROM’s within 1 calendar month of joining Physio First. Part time subscription is not available to practice principals, or those who are not participating in Data for Impact.
  • We have also created an ‘on hold’ subscription category for MSK clinicians who are on maternity leave, or absent from work in clinics working towards QAC status. This allows clinics who have absent staff during the data collection period to still take part. If the staff member returns within the next measuring period they will be required to become a member, or part time subscriber, before the clinic can be measured again and gain or regain their QAC status.

[Reviewed - September 2018]

How does my practice become a Physio First Quality Assured Clinic?

To become a QAC in the first wave of awards, you and your MSK colleagues will need to continue inputting your data if you are already doing so or start now. Our University of Brighton team will download your data in January 2019 and will confirm the first clinics to be awarded with QAC status early in 2019.

Here’s the criteria for becoming a QAC:

  • All clinic staff must be collecting their patient data through Data for Impact. To do this, each team member will receive their own login, username and password and will also be collecting PROMs
  • All clinic MSK practitioners must be Physio First members or part-time subscribers, no matter their employment status – self-employed associate or employee (Part-time subscription is not available to practice principals, or those who are not participating in DfI). If you have any physiotherapists that need to join, you can benefit from significant discounts via Refer a Colleague
  • This is open to all clinics of any size, from single-practitioner clinics to multi-practices
  • If you have part-time colleagues they can still participate through our new part-time subscription. They will be assessed on a pro-rata basis based on the number of hours they work.

Clinics will have their individual data amalgamated into one clinic report once consent is obtained from each participant. Only the practice principal will receive the clinic report. Individual participants who are also QAPs will have their own individual reports which can be used for CPD and peer review purposes.

[Reviewed - September 2018]

 

GDPR

What has Physio First done about GDPR compliance?

As Physio First we have had to go through exactly the same processes as everyone else.

In a nutshell, we have had to complete an audit to determine the legal basis upon which we process personal data and then produced our privacy statement.

For a copy of our Audit – see here

For a copy of our Privacy Statement – see here

What help can Physio First provide about GDPR compliance?

As Physio First we have had to learn about the new GDPR rules along with everyone else.

In doing so, we were acutely aware of the danger of directing members to so-called experts who simply re-hash what is available at no cost from the Information Commission’s Office website, as well as the danger of directing members to services that prove inadequate.

From December 2017, we had planned and worked with our transformational partner Blue Zinc, who ran nationwide evening workshops on how to become GDPR compliant and which proved very popular and very helpful.

From April 2018, and based upon really helpful and favourable feedback from our members on our private trusted LinkedIn forum we came to an agreement with our strategic commercial partner Painless Practice, to enable members to have access to a package, that includes templates, that they had developed with Technology Tamed.

So for access to the:

-       Blue Zinc webinar – cost £20 – see here

-       Painless practice GDPR package to include templates – cost £150 – see here

Does Physio First have templates for GDPR compliance?

Yes!

Having learned about what it takes to be GDPR compliant and having listened to members, as Physio First we have come to an agreement with our strategic commercial partner Painless Practice for member access to templates developed by them and Technology Tamed for the same rate as a Painless Practice customer.

The list price is £295, but as part of our agreement Physio First members can have access to these templates and supporting material for the Painless Practice customer rate £150.

Details of the package and how to order it can be found here

In feedback from members on our private trusted member only LinkedIn Forum, members have articulated their various approaches to GDPR compliance. From using the free information on the Information Commissioners Office (ICO) website with others using combinations of Blue Zincs webinars and the Painless Practice package – see here – with still others using local external services.

 

Data for Impact

Is it acceptable to collect data during a patient’s treatment?

We are also aware of the HCPC Physiotherapy Standards of proficiency - Standard 12 which can be found here

This includes the requirement for registrant physiotherapists to recognise the need to monitor, evaluate, and assure the quality of practice and recognise the value of contributing to the generation of data for quality assurance and improvement programmes.

For the collection of data to become a recognised part of patient care, there does need to be a change in culture that we feel confident can be led by Physio First members who join our Data for Impact (DfI) project and who also become Quality Assured Practitioners (QAPs). It really boils down to communication between the clinician and the patient, so that our patients can learn the value of data collection to patient care.

Collection of data during a patient’s treatment session is, in our opinion, not only acceptable but an inevitable development that is supported by the HCPC regulations. It will, however take time for this practice to become something that we all feel comfortable in deploying. 

[Reviewed - September 2018]

 

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 strategy takes into account.

It is firstly a question of “who is Physio First?” 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”, Physio First representatives can allude to our member dissatisfaction but cannot yet address an insurer’s legitimate question as to what Physio First members can do for them in terms of helping insurers to make money, save money or improve their brand – but we have a plan!

If we are too hostile i.e. telling insurers 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 insurers, 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 insurers and commercial intermediaries (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 fine line of raising legitimate complaints, 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 demand that all private practitioners 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 private medical insurers or commercial intermediaries for trying to adversely affect competition – a subject that we have taken legal advice upon and written tomes about.

The likely outcome of shooting ourselves in the foot 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 approach, 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, we would think the same!

Where our 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 help our members to have an impact on the marketplace, we are going to have to create something that marketplace stakeholders value!

Some of us will remember Physio First initiatives such as:

  • Physio First Clinic Accreditation Scheme i.e. to provide an accreditation scheme for our members
  • The Physio First “RehabFirst Scheme” i.e. to become a commercial intermediary service on behalf of our members
  • Change of name from OCPPP to Physio First i.e. to create a name that has the potential to mean 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 ask that can be reviewed quickly and easily.

All of these initiatives have helped to improve our business knowledge and skills and culminated in our executive’s 2013 decision to focus Physio First’s role on championing evidence based cost effective private physiotherapy with Physio First members in the changing healthcare marketplace.

A focus that has helped us produce our Quality Assured Practitioner and Clinic Scheme – see here - both of which are designed to give our members a voice with which to talk to our marketplace about quality in a way that it has never been spoken to before. To express our value, in a way that we could never do before.

Add to this our Physio Co-op project – see here – and, as Physio First members, we have a whole new set of tools with which to impact on our marketplace. Something that we simply could not have achieved in any other way, and certainly not by campaigning for higher fees.   

[Reviewed - November 2018]

 

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 £331.

This is made up of:

  • £103 for Decemebr - March 2018/19 +
  • £228 for 2019/20 Subscription

Affiliated Membership:

If you fulfil the requirements of an Affiliate member, the initial cost is £303.

This is made up of:

  • £94 for December- March 2018/19 +
  • £209 for 2019/20 Subscription

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.

Part-time subscribers

Part-time subscription is for private physiotherapists that work 20 hours or less and work for a clinic working towards Quality Assured Clinic (QAC) status by collecting data on all their new patients where possible.

To apply for this rate, your practice must confirm in writing that you meet the definition of a part-time subscriber, and you work 20 hours or less per week. You must also begin to collect patient outcome data on Data for Impact (DfI) and be collecting PROMs within one calendar month of joining Physio First. Part-time subscription is not available to practice principals, sole practitioners or those who are participating in DfI.

If you join Physio First as a part-time subscriber, the initial cost is £166

This is made up of:

  • £52 for December - March 2018/19 +
  • £114 for 2019/20 subscription

Journal Subscription:

Journal subscription costs only £40 and members receive copies of our Quarterly journal In Touch.

 

 

 

[Reviewed - June 2018] 

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 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

[Reviewed - June 2018]

Do Physio First offer membership on a monthly subscription?

We have looked into this option extensively over the years. The costs for submitting monthly direct debit amounts to the bank make it an unviable option. This increase in cost would need to be passed along to you, and we do not want to do that. So subscription costs remain an annual payment. We are continually investigating ways to change this.

[Produced March 2018]

 

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..."