the osteopath Dec 15/Jan16 in a nutshell

Our regular quick flick through the Council’s official mag..

The new CPD Scheme is in development

Yes it’s on its way, but not in place just yet. Click here for my informal take on it, just in case you don’t know what’s involved.

Feedback from osteopaths is in.  Click here for the full report.  We apparently like the fact it’s 90 hours over 3 years, rather than 30 hours every year come rain or shine.  The new scheme allows for years which are more or less intense (to fit in with births, deaths, divorces, lazy years, crisis years, growth spurts and strange years).  We like the structured approach (yes, a bit of guidance is welcome), the compulsory categories (in fact some people want more compulsory categories), and the focus on reflection and feedback.  The people who are more worried about it are the part-timers and non-practising osteopaths, the teachers and researchers, geographically isolated types, non-tech users, dyslexics, and co-professionals (i.e. people on other registers as well).

People are most interested, and concerned, about the new Peer Discussion Review; largely about who is going to review them, and if it’s going to cost anything, and how it is going to be conducted.  It seems that fear of the unknown is at a high pitch, and the mention of complaints and appeals procedures is not the most reassuring, but the GOsC seem to be doing their best to de-escalate any threat by familiarising us with the process and giving us a guiding template.

Patients like the idea of us doing CPD:  and most would find the greatest reassurance from inspections by an independent regulator, however this is not going to happen.  It’s just not viable.

What next? Well, it’s still in development, and that will include a GOsC workshop in March for regional societies and organisations.  So it’s not yet ready, and there doesn’t seem to be a definite date, but you will be kept posted.

News in Brief

Make sure you have a complaints procedure, and make it easy to see

You are required to have a complaints procedure, as one of the Osteopathic Practice Standards, but it’s a good idea anyway, as you can nip things in the bud.  You might direct patients towards another osteopath at your practice to talk something over, or towards the iO’s complaints resolution service.  If there is no publicized route for patients with concerns or complaints, they are more likely to end up taking an issue prematurely to the GOsC where it is more likely to become a formal complaint even though that might not be what the patient is after, which could just be to be listened to or advised.

The new duty of candour requirement also affects how we are obliged to deal with complaints, and if you want to be involved in developing the guidance, email candour@osteopathy.org.uk.

The GOsC wants you to renew registration online if you can.  It’s quicker and cheaper.

 

Go to a GOsC Meeting – They’re public

Many people still don’t realise that you can attend the actual meetings of the General Osteopathic Council.  Most of it is done in the morning, so if you can get to London for 10am, and want to see governance in action, book a morning off, phone them up and request permission to attend.  Next one is Thursday Feb 4th 2016, but they happen every few months.  I always include the date of the next one on the osteofm front page.  Various decisions were made at the November GOsC meeting.  Probably of most interest to us all is that the fees will remain unchanged.  You can read my unofficial account of the meeting here.

Final Year Students

Between January and March 2016 the GOsC will be visiting you.  You can download some guidance already from the website here.  When I was an undergraduate, there were only three colleges.  The cranial one (ESO), the most established one (BSO), and the naturopathic one (BCNO which became BCOM).  Sorry about any offence I have caused, but this is how I thought of them.  There was also one for doctors which I knew nothing about but thought might be in Regents Park.  Now there are ten of them listed, including ones in Hendon, Stoke on Trent and Leeds, although I think two are closing.  Not sure which ones.

BSO granted degree awarding powers

I understand this is really quite a big deal.  The BSO has shown itself worthy of calling its own shots.  No longer will the BSO degree have to be validated by an outside authority (currently Bedfordshire).  It will also receive direct funding.    There was even a big article about it in the Times Higher Education Section although it was rather hijacked by Edzard Ernst, who you won’t be surprised to hear thinks this is a bad thing.

New international website

Yes everything’s gone global, and a new website, www.osteointernational.uk, includes contact details from around the world, information about regulatory status in other countries, other useful information and links to upcoming conferences and events.  This is one of the projects of the ODG (osteopathic development group).

Leadership programme

Another of the ODG projects: last year twenty participants completed this programme, and they’re running it again in 2016.  I understand it is 2 days of workshops at the beginning and the end (July and October), and an Open University Course e-learning course in the middle.  The 2016 programme is being planned now and is open for applications.  Apply by April 1st.

The era of Data Security – the future is coming soon

If you watch the news you will have noticed that data security is high on the list of important and topical issues now that everything is going digital.  Why, what’s the world coming to when you can’t even join an online adultery service without being exposed?  Is nothing sacred?

My patient notes are still on paper, in a filing cabinet, but once things go electronic, and the Internet of Things takes over, the future will be here and we will be living Smart.  Our move into the age of the Jetsons is nearly complete.  We will be the family of the future, only with potentially terrifying issues of control and security.  And if you don’t know what the Internet of Things is, keep up for goodness’ sake.  Everything will be speaking to everything.  Your watch, even your clothes, might be measuring your blood pressure, your nutrient levels, your sugar, your cholesterol. Someone will be alerted if there’s a problem.  As a consequence a doctor’s appointment will be automatically booked, making sure it doesn’t conflict with your other commitments.  You will travel there in your driverless, electric car, while your fridge checks its content  and places its own ocado order, according to your medical readings and preferences.  You arrive at the doctor’s not sure if the  receptionist is a robot or a human being (well, I suppose at least some things won’t change, ho ho!).

OK, it might not be exactly like that, but information will be flying around all over the place.  I’d recommend that if you are in charge of patients’ data, you read the entire article in the magazine.  It IS a boring subject, but it IS important, and you have an obligation to hold patient data securely and in confidence, AND comply with data protection law.  So a couple of important things:

You might not realise you are a data controller

  1.  You might need to register as a data controller with the ICO if you process personal info in an automated form.  You can check this with ICO here.
  2. If you ARE a data controller (and I have just realised I might be one) you can register here. It costs £35 a year but if you don’t do it you are breaking the law.  Wow, it’s very easy to break the law without realising these days.

You need a written contract with your IT support person

You need to make sure the data is safe, using the usual physical security (doors, cabinets, locks etc.) and cybersecurity (firewalls and anti-virus software).  If you have a data processor (often your IT support provider) you must have a written contract specifying that the data processor acts only on your instructions, and complies with information security measures comparable to those in the DPA.

If this sounds a bit daunting, well, at least there is a guide from the ICO (in case you’re wondering who this shadowy ICO is, it’s the Information Commissioner’s Office and has legal clout).  Find their security guide here.

Some other things to consider

  • Is your home pc secure (I’m guessing they mean a secret password), so no one can access it if it is stolen or used by someone else?
  • What do you do with your pc when it’s reached the end of its useful life?
  • Are your USB memory sticks encrypted?
  • Are your USB sticks scanned to prevent importing malware?

If this is all still a mystery to you, this will apparently shed some light on it.

Asking patients for feedback

Do you want to find out what your patients think of you?  Well, if you do, this looks like a good way to do it.  Kenneth McLean and practice colleagues carried out a trial of the CARE (Consultation and Relational Empathy) Measure to elicit patient feedback.  It is a set of 10 questions.  Find and download it here on the o zone.  They wanted at least ten responses for each practitioner.  It sounds like it was very easy to administer, the main problem being remembering to offer one to patients, and remembering not to offer one to patients who’d already done it.  So if that was the main drawback, it’s hardly fundamental flawed.   It was also fairly cheap to do, took Kenneth about four hours to set up, manage and analyse, and the practitioners spent about an hour discussing and reflecting on the results.  Simple, cheap and effective.

It sounds like this could be an easy way to get your feedback bit of CPD when the new scheme kicks in, and a reassuring confidence boost, or a message that things could be better in some areas, both of which will be a help to your clinical practice.

CPD AUDITS

2% of osteopaths’ CPD record folders are audited each year.  So the GOsC are processing about 100 CPD folders a year.   I have already been audited, so does that mean I can relax for the next 45 years?  Well, since I was audited I have made sure I kept better records, so I am fairly relaxed.  And by the way, I made it through the audit with some truly awful mistakes and a bad attitude, so don’t be too rattled.

It’s always a bit of a struggle, though, to know how to fill in the “how is this relevant” bit of the form.  I often think it’s self-explanatory and doesn’t need explanation.  But you have to write something.  The GOsC provide a useful example here to show that you don’t need to overdo it.  The relevance of a group practice anatomy meeting is that:

“We discussed the techniques in these areas and how they can be applied in practice.  This was helpful as it ensured my anatomical knowledge was current, which is important for osteopathic diagnosis.”

Simple, relevant and straightforward is the key.  And don’t just describe a book you’ve read (I wrote a 2000 word review of one – not necessary!).  You’ve only got to show that the reading has effected some sort of change; such as helping you to understand something, or do something better.

Now let’s get interactive.  Here is a test:  a list of evidence for CPD activities.  Do you think the GOsC would accept them?

  1.  A promotional leaflet about the course
  2.  Your train ticket to the course
  3.  A photocopy of the article you read

No.  Of course not.  You see, you know it all already.

Now here is another list.  Is this acceptable evidence?

  1. A certificate of attendance
  2. Signed meeting notes
  3. A review of an article

Yes that’s right.  That’s the way to do it.  Don’t do what I did and tell the GOsC that they can just phone up the course provider who should confirm I was there.  I didn’t get a friendly response and a gold star.  But I survived to tell the tale.

And by the way, keep evidence of activities for the last 5 years.  It’s a bit like tax, only not quite as long.

Can you countersign passport photos?

Yes!  We are not on the official list (however that is only a list of examples of professions), but the UK Passport Agency says that as long as you meet the other criteria (not being a relative etc.) you can countersign.  As an aside, Australia have a list of approved professions which includes chiropractors but not osteopaths.

Starting your own business tutorial online

Useful link here.  HMRC have an online tutorial, which  might be useful for new graduates or anyone starting their own practice.

Patients that can’t give Consent

Interesting case scenario here,  about a teenager brought by his birth mother’s civil partner for a treatment.  Usually consent seems straightforward, but with children there seem to be many grey areas.  16 is officially the age of consent, but if the child seems too immature they do not have “capacity” to consent, and this is a matter of judgement.  So under 18 it is better to involve their family in decisions.  And just because someone is a civil partner or a step parent, does not necessarily mean they have parental responsibility.  Apparently it’s even more confusing in Scotland.  If in doubt, don’t do it until you’ve clarified the particulars.

FGM

If a girl under 18 tells you she is a victim of female genital mutilation you must immediately inform the police.  I think it’s unlikely that an osteopath will see physical signs, but if you do you also have to inform the police. This applies to England and Wales.

Problems with patients – try PILARS

This is a website where you can go to report on incidents in practice, or view and comment on incidents reported by other osteopaths.  I’m still unclear if it’s pronounced more like Corinthinian PILLars or PILau rice.  But it’s a supportive place by the sounds of it.  The address is www.ncorpilars.org.uk and you get a username and password at the o zone here.  You can be assured that if you go there, someone will comment on what you say.  (Every post has received at least one comment.)  Issues range from side effects to misdiagnosis, but most incidents actually cover a few different things, and often include a mismatch between patient and practitioner expectations.  It sounds like a really valuable service, so please go and add something to it if you have occasion, as it will help us all to feel more connected, and to know what problems are going on out there.  You can go just to have a browse around and comment.

IJOM Plus surges in popularity

Who says osteopaths aren’t interested in research?  Oh that’s right, it might have been me.  Well, apparently that is changing and over 4000 articles were viewed online through the IJOM plus package over the first half of last year.    We can look at many journals for free, so apart from IJOM we can view

  • Clinical Biomechanics
  • Journal of Bodywork and Movement Therapies
  • Journal of Manipulative and Physiological Therapeutics
  • The Lancet
  • Manual Therapy
  • The Spine Journal
  • Pain (to end 2014)

NCOR will direct you to the relevant ones here

If you are trying to use IE8 (Internet Explorer 8) you will probably need to update to a different browser, or more recent version of Internet Explorer.  Elsevier will no longer support IE8.

 

BOOKS

Contact the editor@osteopathy.org.uk if you would like a free copy of Brian Fulton’s The Placebo Effect in Manual Therapy:  Improving Clinical Outcomes in your Practice, or Leon Chaitow’s Positional Release Techniques (4th edition).  There’s no such thing as a free lunch, so you will have to provide a review.

Functional Atlas of the Human Fascial System by Carla Stecco reviewed by David Rodway

Over 300 photos of freshly dissected, unembalmed, cadavers, and access to 30 minutes of video material,  make this an outstanding atlas.  The clinical implications (described as “clinical pearls” – a phrase also used by homeopaths) are apparently somewhat less dazzling, but David Rodway still gives this book superlative praise and describes it as “an essential” for anyone “whose work involves the fascia”.

The Concise Book of Muscles (3rd edition) by Chris Jarmey and John Sharkey reviewed by Susana Weiner

Susana Weiner found this straightforward and easy to follow.  She was looking for a good muscle book to recommend to students at the College of Osteopaths.  She thought it good for students to learn and equally good for more experienced osteopaths as a revision aid. It sounds fairly comprehensive and includes information on biotensegrity, active and passive insufficiency, and concurrent and counter-concurrent movement.

BACKCHAT

A letter from Professor Stephen Tyreman on VBP, or values-based practice, responding to Peter Buxton in the last edition.  This debate seems to be rumbling on and I can’t quite get my head around what the debate is.  Some people don’t think there is any need for these values to be defined.  But for those who do,  the root issue is that there is no agreed set of professional values in osteopathy, or many other healthcare professions.  We are currently trying to establish an answer to the question “What makes a good osteopath?”.  And we will define it in terms of our values rather than our techniques or scope of treatment?   Tyreman concludes “We are not mechanics mending machines, but clinicians attempting to help a living person who has expectations, dreams, memories, fears and a desire to live well.  Achieving this inevitably entails engaging with people’s values:  we need to ensure that we do it most effectively.”

Find out more about VBP here

Sorry this took me a while to get out. I think I’ll be lucky if it makes it before the next edition drops on the doormat, but I do find it a handy run through of what we need to know, and it’s a snapshot of the state of play with the GOsC now, so worth taking the time to digest.

 

 

 

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