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Common Scope enquiries

Common Scope questions with answers to help define your scope and understand the CSP’s approach.

1) Exercise Classes (Pilates)

Sample enquiry:

I have recently completed a Pilates course through the APPI. I would like to know what I am covered to do within the scope of my CSP insurance. In particular, can I run Pilates classes in the following circumstances:

  • with a small group from work at my workplace, at lunch time?

  • outside my workplace, at a local gym or hall?

CSP Professional and public liability insurance is a benefit for physiotherapists with a current ‘full practising’ CSP membership (subject to terms and conditions).

The information paper PD027 Insurance and Physiotherapy Practice and the CSP Summary of Members PLI Insurance Scheme will assist you in determining whether you have PLI cover.

Exercise sessions and/or classes with a physiotherapeutic purpose, which may include the prevention or management of physical inactivity related health, are within the scope of physiotherapy practice in the UK.

You may offer the sessions as one-to-ones or to appropriate groups in any safe, suitable venue. You need to meet the following conditions for CSP PLI coverage:

  1. you advertise the sessions are being delivered by a physiotherapist
  2. your clients are aware that they will be engaging with a physiotherapist
  3. you undertake appropriate risk assessments of both the environment and the participant(s)
  4. you maintain relevant records of the session content and participant(s)

If you hold additional specialist training in an exercise based modality, it is acceptable to say you are a ‘physiotherapist trained in Pilates’ (or whatever the modality is).

However, such sessions are not covered by the CSP PLI scheme in other contexts, for example, if you are working in the role of a ‘Pilates Instructor’ or ‘personal trainer’ and not delivering your services as a physiotherapist, you will require additional PLI cover. For further advice, please contact Graybrook insurance brokers.

The CSP PLI scheme covers you only in the event of an incident related to the malfunction of equipment in use as part of your professional practice.

This includes when a client purchases a specific piece of equipment from you on your express recommendation to progress or maintain their exercise programme elsewhere.

The CSP PLI cover does not cover any equipment theft, loss or damage. You will need to insure your equipment and other assets under separate cover for loss, damage and theft.

The CSP PLI cover does not cover you to sell equipment on to third parties by way of retail or wholesale sales.

2) Dry-needling

Sample enquiry:

Does my current PLI covers me for dry needling? I am about to undertake a course run by the Dry Needling Institute and wanted to check that it is covered in my standard PLI insurance through the CSP.

Dry needling is within the overall scope of the UK physiotherapy profession.

The terms of the CSP's Professional and Public Liability Insurance (PLI) cover (subject to the terms of the policy) are such that cover is provided for members working within the scope of practice of physiotherapy.

Please see the CSP’s PLI Information paper PD027 and associated guidance.

You will need to ensure that you distinguish dry-needling from acupuncture. A dry-needling qualification is not an acupuncture qualification and may not entitle you to use acupuncture in your practice or join any acupuncture professional network, nor should you say that you are trained in 'acupuncture', nor lead your patients to believe that they are receiving 'acupuncture'.

You need to be very clear to everyone that you are using 'dry needling' and to that end be able to justify your actions using the technique.

3) Shockwave therapy

Sample enquiry:

Can physios administer shockwave therapy for tendinopathy? If so are there any training courses?

Extracorporeal Shockwave Wave Therapy (EWST) is accepted as being part of the scope of the physiotherapy profession as it is deemed to be an electrotherapy modality.

You will need to ensure that you are educated, trained and competent to carry out such treatment, and you are administering shockwave therapy as part of your Physiotherapy role.

We are not in the position to recommend specific training courses but would advise using the CSP’s iCSP network.

Some other potentially useful contacts that may be able to advice you on training courses, including the Association of Chartered Physiotherapists interested in Electrotherapy.

4) Injection Therapy

Sample enquiry:

Is injection therapy part of the scope of practice and therefore covered by CSP insurance?

Injection therapy in neurological and musculoskeletal settings is well accepted within the scope of physiotherapy practice.

The CSP makes no further distinction as to what type of injections may be performed beyond saying that only therapeutic purposes are considered within scope.

This means that purely cosmetic use, such as the use of botox for cosmetic reasons, is outside scope.

Since 5April 2011 the CSP has set formal expectations as to the training standards for the use of injection therapy in general.

Therefore if you plan to use injection therapy in your practice from now on you must ensure that you can demonstrate that your training meets the requirements as laid down in CSP publication PD071 Expectations of educational programmes in injection therapy.

Further information that may also be useful:


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