The Chartered Society of Physiotherapy The Chartered Society of Physiotherapy

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Pilates

Physiotherapists may practice a broad range of modalities from the breadth of the scope of the profession, or they may choose to specialize in just one aspect of practice. Pilates is one common modality that members may wish to practise as a standalone service, and is covered by the CSP PLI scheme when used as part of physiotherapy practice.

Can Pilates be part of physiotherapy practice?

Yes. Pilates is an exercise based intervention that physiotherapists may use if they identify the evidence for its use is suitable for a specific individual or group of patients and their condition. If you choose to focus your physiotherapy practice on offering, for example, solely Pilates based services, you may do so provided that make it clear that you are working as a physiotherapist. The essentials of physiotherapy practice are that practitioners deliver the reasonable ‘standard of care’ that patients can expect of physiotherapists, which comprises appropriate examination, clinical reasoning and professional judgment in your activities at all times.

Do I have to make it clear I am a physiotherapist, even it’s not my job title?

Yes, if you want your Pilates based activity to be considered ‘physiotherapy’ and therefore covered by the terms of the CSP PLI scheme. Many clients may be reassured to know that their Pilates classes are being delivered by a registered health professional and so you may find it useful in promoting your services.

What should I call myself?

How about ‘Physiotherapist Pilates Instructor’? You don’t have to have the word physiotherapist in your job title but your clients must clearly understand that they will be engaging with a physiotherapist and that they can therefore expect the reasonable standard of care that a physiotherapist will deliver, so it would seem practical to use it.

Do I have to offer my Pilates classes in a Physiotherapy department?

No. You can offer your services wherever you feel your clients would best benefit. This might be in their homes, in gyms, village halls, clinic rooms or physiotherapy departments, inside or outside.

Can I only offer Pilates to patients recovering from injury?

No. You can offer Pilates as an exercise based intervention in whatever context you feel it has a physiotherapeutic benefit. Here are some examples, but you may think of others:

  1. You may wish to offer Pilates classes to patients recovering from injury or requiring other types of rehabilitation and offer the classes in private practice rooms or as part of your private practice that might be situated within a gym etc. You may wish to offer the classes as 1-1 classes or as group classes.
  2. You may wish to offer Pilates classes in a village hall etc as part of a wider ‘public health’ remit of physiotherapy. You may wish to offer Pilates classes to individuals or groups, who are generally fit and healthy, but who wish to get more active or fit and address silent health issues such as obesity or a sedentary lifestyle.
  3. You may wish to offer ante-natal and post-natal Pilates classes to women as part of the management of a healthy pregnancy and early motherhood.
  4. Pilates may be offered  to either the fit and healthy (including pregnant and post-natal women) as part of the public health initiative to increase exercise for its positive health benefits  OR to those with known or underlying illness/disease or injury considerations, such that both are seen as being equally within the scope of the profession.

Am I a delivering a Pilates class as a Pilates Instructor or a Physiotherapist?

Only you can answer this question and you may wish to do both at different times. You must be aware that there is a difference between the two activities and how you practise will affect what insurance you need.

When you take classes as a ‘physiotherapist’ you must deliver the reasonable ‘standard of care’ of a physiotherapist, which will include appropriate examination, clinical reasoning and professional judgment in all your decisions relating to the participation of your clients in the Pilates programme. Record keeping is an essential activity to help you demonstrate, if challenged, that you were working as a physiotherapist.

The level and complexity of record keeping that you do will vary according to the context of the Pilates class and the background health status of your client. Particularly where the client group is inherently healthy with no underlying health issues, there is no reason why a client-completed screening check list should not serve as adequate assessment, and retention of these assessments and/or a class/client register with space for comments can serve as documentation.

When you take classes as ‘Pilates Instructor’ and make it clear that that you are a ‘Pilates Instructor’ then you are not working as a physiotherapist. We cannot comment on the practise of Pilates Instructors and you may wish to seek further advice elsewhere.

Is ‘Pilates’ covered by the CSP PLI scheme?

The CSP PLI scheme does not have a list of activities that the scheme covers. It simply covers ‘all activities within the scope of physiotherapy practice’. This is why it is essential that you work out for yourself if you are delivering your Pilates activities as part of physiotherapy practice or something else. When Pilates – like any other activity – is delivered as part of physiotherapy practice, it is covered by the terms and conditions of the CSP PLI scheme, and you do not need additional insurance.

When you are delivering your Pilates as part of another activity, such as your work as Pilates Instructor or Personal Trainer, then it is clear you are not working as a physiotherapist and you will need separate insurance.

Why do I need to understand this difference?

This is because of the small print contained within insurance policies that often says cover under one policy will not be provided if cover is provided elsewhere e.g., by another policy you hold at the same time.

It is your responsibility to read and understand the terms and conditions of any insurance policy you currently benefit from, before you take out any extra polices. It is also your responsibility to be clear which  of  your work is physiotherapy based, and which is not. We provide help for you to do this on our Scope of Practice pages.

For example, the CSP PLI scheme may not provide any cover for any claim if you have taken out another policy for the same activities. This could happen if you take out another insurance to cover ‘Pilates’. Remember, if you are providing Pilates programmes as part of physiotherapy practice, you do not need extra insurance.

For example, members have told us that some bespoke Pilates insurance policies only cover Pilates classes providing that no physiotherapy advice or treatment is given as part of the class.

So it is essential that you are clear how you are working in order to make the right decisions regarding your insurance needs.

What about if I offer Pilates but don’t want to say I am a physiotherapist?

You will not be covered by the CSP PLI scheme. You should make alternative arrangements for your insurance.

What about if I want to offer Pilates as part of my other work as, for example, a Personal Trainer?

You will not be covered by the CSP PLI scheme. You should make alternative arrangements for your insurance.

I’ve been told by my Pilates Course provider that I need separate insurance to offer Pilates as a physiotherapist. Is this true?

No. When you are offering Pilates programmes as part of physiotherapy practice it is covered by the terms of the CSP PLI scheme. Your course provider may have learners who are not CSP members, or who are not physiotherapists, and it is correct to say that individuals should have insurance to practice, but as a CSP member you already have the benefit of insurance, subject to policy T&C’s.

Further Information

For specific insurance related enquiries you can contact the CSP insurance brokers:

Graybrook Insurance Brokers Ltd
8 Chandlers Way
South Woodham Ferrers
Essex CM3 5TB
01245 321185
www.graybrook.co.uk





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