Peak practice

Members have to  feel their way through professional dilemmas. New CSP guidance should help them, as Graham Clews finds out

Physiotherapists who are considering entering a pole-dancing competition, working as a burlesque dancer, or appearing in a Calendar Girls-style risqué charity events, now have  clear and concise guidance from their professional body to inform their decisions.

All of these are actual dilemmas that have been put to the CSP professional advice service by concerned members. Now, both members and professional advisers can consult the CSP’s new code of professional values and behaviour for guidance on these kinds of questions, as well as on issues that relate directly to day-to-day physiotherapy activity.


The four principles

The code is designed to help members take decisions on issues, rather than providing a set of strict instructions. It is structured around four principles:

  • members taking responsibility for their actions
  • behaving ethically
  • delivering an effective service
  • striving to achieve excellence.

There are supplementary statements under each principle outlining the behaviour expected of CSP members.

In reaching their decision about appropriate behaviour, CSP members will be able to draw on the assertions in the code. These are that they:

  • understand the impact of their beliefs, values and behaviours on their practice
  • recognise the impact that their behaviour, lifestyle and activity outside work might have on their physiotherapy role
  • take responsibility for their actions, both for themselves as individuals and for the reputation and standing of the UK profession at large.

While the principles and supporting statements might seem straightforward, the questions that they can help members to answer are often not.

Complex questions involving members’ relationships with patients and colleagues on social media, and in the real world, are frequently put to the society’s professional advisory service. The code stresses the legal, regulatory and ethical requirements that members need to meet. Members must act with integrity, honesty and openness in all their activity.

The CSP Code of Professional Values and Behaviour is explicitly not a ‘rule book’.

CSP assistant director of practice and development, Sally Gosling, who led the production of the code, says the intention is to turn round the concept of rule book. Instead the society wanted to create a basis on which members could make their own informed decisions on acceptable behaviour. Members need to be able to justify their decisions and actions, based on their compliance with ethical principles.

‘These situations are not cut and dried,’ she said. ‘How they are interpreted will vary.’

The code is intended to be positive. It sets out the CSP’s expectations of how members conduct themselves rather than being prescriptive or proscriptive.

‘Precisely how a member demonstrates their professionalism, including their professional integrity and advocacy for the profession, will depend on the issues at stake,’ says Dr Gosling.

‘It is not for the CSP to prescribe what members should do. However, we can support members on the issues that they need to think about, both for their own professional integrity and standing and  the reputation of the whole profession.

‘We can also support members in ensuring that their conduct fits with what is expected of them by the Health Professions Council , their employer, or – in the case of physiotherapy students – their educational institution.’


Social networking

Two of the most difficult current issues for physiotherapists are the rise of social networking and the ongoing reforms and financial shortages in the NHS.

On social media, Dr Gosling says the code reminds members that their responsibility as a physiotherapist, physiotherapy support worker or student does not stop when they leave their place of work or study. They must bear this in mind when in the ‘virtual’ world.

Health service reforms and economic pressure in the NHS can potentially compromise members’ fulfilment of their duty of care to the individuals they serve.

Dr Gosling says the code should help members to make the case for using their professional judgment in how they best meet patients’ needs, based upon their assessment and diagnostic skills.

This will be underpinned by the range of approaches they have to draw upon within their personal scope of practice and knowledge of the evidence base, and working in partnership with individual patients and their carers.

The code can help members to make the case for exercising their autonomy in ways that meet patients’ best interests in clinically – and cost-effective – ways. It will also help them to speak up if they feel that the quality of the care they deliver is at risk of being compromised.

The document also includes an explanation of the core professional concepts that underpin the code: competence; person-centred practice; professional autonomy; professionalism; and scope of practice.

An important role of the code is to support physiotherapy students develop their understanding of the responsibilities attached to becoming a health care professional and prepare for practice as a qualified physiotherapist.  The code also relates strongly to associate members’ roles. It will become explicit on CSP membership application and renewal forms that members agree to seek to meet the code’s expectations.

The code is also relevant to members working in all jobs and occupational roles and at all career stages and practice levels. It therefore avoids mention of patients specifically, because not all members work directly with patients. All members need to demonstrate their professionalism, whether this relates to management, education, research or clinical practice.


Supportive tool

The new code was developed as part of the CSP’s Charting the Future project and replaces the existing Rules of Professional Conduct and Assistants’ Code. It was piloted for a year from June 2010.

Feedback was overwhelmingly positive, with members reporting that they found they could apply the code across various settings roles and career stages; it provided a common-sense view; it supported their decision-making on ethical issues; and it formed a useful tool for both individual and team-based continuing professional development.

‘As physiotherapy aims to adapt to the changing shape of healthcare in the UK,’ said Dr Gosling, ‘we believe that the CSP Code of Professional Values and Behaviours provides a flexible, supportive tool to help members deal with the increasingly complex professional and ethical dilemmas that they face.’ fl


Where to find the code

A summary of the code is provided as a hard copy with this issue of Frontline.  If your copy is missing contact

The summary is also available on the CSP website for patients, healthcare colleagues, and the wider public. The full text is also available online for members only. See

The code will be reviewed after two years. New CSP Standards of Physiotherapy are due in 2012.

Graham Clews

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