For someone as irrationally paranoid about having a complaint made against them as I am, it is somewhat paradoxical that I find Osteopathy House, the headquarters of GOsC, to emit such a homely and inviting feel, pulling me like a subtle magnet to Tower Bridge Rd. I can never entirely dislodge the fear that one day I might be on the wrong side of the Fitness to Practise process, in which instance I’m sure the Hygge effect will vanish with neither trace nor memory, but on this rainy, dark, February morning, I was entirely happy to take on the battle with Southern Rail, delegate the school run, and hotfoot my way to yet another meeting of our regulator.
Jobs for osteopaths
A minor skirmish with Southern Rail had me turning up 15 minutes late, and as I slunk in they were already off, talking about appointments. There are actually quite a few opportunities for osteopaths to be on various committees, and indeed on the Council itself. The Council have managed to fill spaces for recently available posts with entirely, suitably, talented people, but I think they want more people to give it a go, and they are keen to do more to encourage us. However seeing as I don’t think I ever really had a formal interview for an osteopathy job – it was more a case of ” I need someone, are you available?” – I imagine that many osteopaths are also like this, and don’t have the confidence, know how or experience to apply for this sort of thing. The Council have held recruitment days to help teach people how to apply, and given lots of feedback, and are looking to help encourage us more. They also have a message for the once bitten, twice shy who have been unsuccessful in the past and haven’t reapplied, and that is to please have another go if you still want to be involved. If at first you don’t succeed….
Tim (the registrar) then told us that the move to charitable status is in process, but we’re waiting to hear more from the charities commission.
The Osteopathic Education Foundation has regenerated
I only learnt recently of the existence of the Osteopathic Education Foundation which has been around for 60 years. It is quite wealthy, (well, it has funds to the tune of about 2 and a half million), and has now transferred its operations to iO, and changed its name to the Osteopathic Foundation, making it sound a bit more snappy and less fusty all round. This noble organization has provided funds to struggling students for years, and has done a great job of managing its money, and is now going to start discussing having a strategy for how and where they might most usefully distribute this money, and ensure that funds continue to stream in.
Osteopathic Practice Standards
These are being rewritten, and the first draft of the consultation is due around May.
There are a few regulators for professions a bit similar to us all grouped under the same overseer – off the top of my head I think nurses and midwives, chiropractors, dentists, opticians, physiotherapists, podiatrists. (Brief pause….) Now I’ve looked it up I’ll add pharmacists and doctors, and put podiatrists and physios in their proper place of “health and care professionals” (this HCPC is an umbrella which actually includes loads of different occupations including nutrition, occupational health, hearing aids, arts therapists and speech and language therapists ). They all had a high-powered joint meeting before Christmas to discuss how much and how officially they could work together. There is quite a bit of collaboration below the radar, but the assumption is that they work separately. Should they shift to presuming joint collaboration? That’s the question.
Are there going to be bigger, political changes to regulation? Well, the prospect of that, which was somewhat alive last year, seems to be drifting further away and is not anticipated in the near future.
Mmmmm..the Good Thinking Society saga continues. The name of this society sounds a little like a morally self-righteous, Victorian organization imagined by Charles Dickens and something Bounderby and Gradgrind would approve of:
NOW, what I want is, Facts. Teach these boys and girls nothing but Facts. Facts alone are wanted in life. Plant nothing else, and root out everything else (from Hard Times)
but I digress – the Good Thinking Society had a joint meeting with some GOsC people then another 3-way meeting with the GOsC and the ASA. There was no knocking down of walls, meeting of minds and sharing of dreams, by the sound of it, but at least it was clarified by the ASA that the General Osteopathic Council is not competent to, or expected to, or required to judge whether advertising is compliant with the CAP code. The GTS are still on a mission, but have halted fire for the moment. They have not lodged a new complaint in a while, but you DO still need to comply. If we are all good osteopaths and abide by the rules, they will stop flooding the Council with complaints. Indeed they won’t be able to because our advertising will all be impeccably compliant. Whatever you might think of their methods, they make the very good point that if we do bang on and on about treating the “person, not the condition”, we should probably only claim to treat the “person, not the condition”, until we get proper stats in on individual conditions.
The money bit is always quite interesting to me. The Council has a healthy income of about £2.88 million and spends almost £2.87 million leaving about £10 000 to spare. That seems a fine balancing act to me – that contingency would be swallowed up in the first week if you were building a house on Grand Designs – but they clearly know what they’re doing and spend a lot of time analysing various risks and “stress-testing”. Most of the money is from our fees, which are not going up, by the way, but a bit is from advertising, booklet sales and interest.
The new CPD scheme will cost about £100 000 over three years. At this point “reserves” were mentioned, so clearly there is a savings pot and the finely balanced income and expenses don’t seem quite so precarious then. They have to have a certain amount of cash reserves in order to be awarded charitable status in any case.
Fitness to Practise
There are 73 complaints still in process. Fortunately this topic, which could so easily provoke shivers, twitches and tension, is delivered by barrister Sheleen McCormack, who has a voice so warm and lilting, and language so beautifully articulate, that she somehow makes the subject seem strangely soothing. A lot of time is spent in discussing why cases are lasting so long, and how they can speed up the process. There was a semantic discussion over whether there was in fact a “backlog” or merely a “caseload.” It was pointed out that due to the activities of the GTS there has been a bulge passing through the system (this could indeed qualify for metaphor of the meeting), but this is being dealt with efficiently and quite a number of cases are due closure soon. There was also a bit of a discussion over whether osteopaths found not guilty of unprofessional conduct might be issued with an “advice letter” following proceedings, and whether this could be fed into their CPD requirements. It’s all in development, but it was stressed that if this happened it would not be made public and the purpose would not and could not be to publicly “tick off” the osteopath.
2 interesting things I learnt about men on this day
- They are more likely to have a complaint made against them
- They are more shy of having their photo taken for this blog
Then there was a comment on updating the governance handbook, to be in line with the future charitable status. Tim had spent some time mapping the one to the other, and come up with some changes which needed to be made. He apologized in advance that this was going to be dull, and judging by the total absence of a single comment or question it seemed the Council members were in full agreement.
Better value auditing
Even though the old auditors were very good, the GOsC have found some who were not only impressive in their proposals but also charge less. They are called Crowe Clark Whitehill.
Can you jump before you’re pushed?
This is an interesting one. If you are going through Fitness to Practise proceedings, can you just ask to be removed, and thereby avoid going through a highly stressful process? I think if there is a compelling reason you can. The GOsC has been reviewing this and seeking feedback. In practice, voluntary removal usually happens when there is no patient complaining, but when it is a health issue, in which case the registrar, at their discretion, can enable the osteopath to be removed. However if there is a complainant, their views are now going to be taken into account along with everything else. I suppose if they were happy with the osteopath simply ceasing to be an osteopath, that would be OK, but it is also likely that some complainants want their “day in court”, as it were.
The challenge of being in a profession with so much touching
Apparently complaints around touch, boundaries and communication feature quite strongly in complaints data. It is quite a difficult area for us, because through our training we become desensitized to prancing around in underwear in front of a roomful of people. We do touch patients all the time, we stare at their pelvic area quite a bit, and also ask them to take their clothes off quite a lot. You can see how problems might occur. The GOsC are going to conduct a literature review around this, working jointly with the GCC, and also with some involvement from the HCPC (that umbrella regulator). The Council is very keen on this, it’s going to happen this year and Fiona Browne told us this NEEDS to happen. They are aware though how important touch is to what we do, and one osteopath on the Council flagged up the need to ensure that what we do is not going to be unecessarily restricted.
Yes the new scheme is coming. It is a big deal for the profession, and even requires legislative change involving the Department of Health and the Privy Council. From a quite triumphant feel over the last year, about how well it’s all been going and what a great programme it is, the Council now seem to be in that pre-takeoff, jittery state, doing lots of risk analysis, and trying to eliminate any potential problems. One of the big ones with this scheme is reaching those osteopaths who aren’t interested or who just don’t want to do it; the disengaged and the disaffected. As an aside, another risk I noticed in the paperwork was to consider the possibility that legislative change to fully implement the scheme might not be forthcoming from the Dept of Health, because “DH has other legislative priorities, for example, BREXIT.”
- There is a new CPD website (judge for yourself how inviting and cosy it looks, as Alison White, the Chair, didn’t get a hugely fuzzy feeling from it even though she thought the content was “excellent”)
- early adopters are beginning their trial webinars (Consent and Communication being the most popular, followed by a surprise entry at number 2 – Clinical Audit),
- e-portfolios are being trialled and
- efforts will be made to ensure that general guidance is as clear and jargon-free as possible.
The Peer Discussion Review is also a thing which the Council focusses on a great deal. I had previously thought this was not going to be difficult, and in fact have been quite looking forward to it as a chance to set some goals and have someone else’s input, but then I am fortunate to know many osteopaths who are friends, several of whom live literally round the corner, and who I can trust to do this pleasantly and professionally. However, not everyone lives in such an osteopath-saturated area as Brighton and Hove, and not everyone has heard as much as me about the scheme. One risk is that osteopaths will leave it till the last minute, and 5000 people will be trying to figure out how to do a Peer Discussion Review at the same time, all trying to call the confidential helpline and generally in a total tizz. Even though CPD years vary, I think about 2000 osteopaths renew all at once in May (which is why they’re starting it in September). Another concern is that we don’t manage to do it very well, or sensitively. It could give the opportunity for those osteopaths who don’t have the most sophisticated communication skills to undermine others’ confidence by giving feedback that has not been asked for, or which is inappropriate, judgemental or just plain brutal. It’s a bit like choosing your partner for practical technique sessions at college. Choose carefully is all I can say. The GOsC are doing trial sessions, at any rate, to make sure that their guidance for the PDR is good.
Feedback about the CPD scheme has generally been really good, and it seems to me that the more you are exposed to it and the more you know about it, the more reassured and positive you feel.
By the way,something else I wasn’t clear on, was that I honestly thought that the 90 hours over 3 years meant just that – you could do your 90 in the first month and sit back and relax for the next 2 years 11 months, but it sounds like you are still really meant to do 30 hours per year and possibly have to get permission to run extra hours into another year. When I’ve got it clear I’ll let you know…
Or you can come to the next meeting yourself, Tuesday 2 May 10am. Be there or be square…
Glamour at the GOsC: Jurate Baranskiene, Facilities Assistant, and Jemima Francis, Regulation Assistant.