Private practices and the independent sector – coronavirus FAQs

Physio First and the CSP have collated advice for members intended to enhance but not replace the guidance provided by Public Health England (PHE) and the relevant government departments. 

See also government and financial support to businesses and self-employed members.

These FAQs have been specifically written for members working in the independent sector. Please also see our coronavirus clinical guidance section, especially the maintaining safe services page.

To find a wider set of resources for members working in the independent sector, visit our independent practitioners section.

Sports massage

Can I offer sports massage during lockdown?

  • Physiotherapists are able to continue to offer sports massage as part of their physiotherapeutic management of a patient within a healthcare context.  However, please be clear that this is different to standalone sports massage that would not be classed as a healthcare intervention. Check your local/national restrictions for whether close contact services are open in your area. When such restrictions allow, our PLI scheme will once again provide cover for those students members who hold additional cover with us (subject to terms and conditions). 

    (Last reviewed 12 March 2021)


Can I continue to offer sports therapy / massage in my physiotherapy clinic during lockdown?

  • Members must not attempt to seek loopholes in the current government guidance as a means to offer services that should otherwise cease during lockdown. This includes using delegation to support workers as a means of continuing with services which would otherwise be prohibited, such as sports massage and sports therapy.     

    The physiotherapist must understand that they are accountable for their decision to delegate and must be able to justify their reasons for doing so. Where members are implicit in disregarding the legal conditions of lockdown and seeking ways to circumvent these, there may be potential criminal and regulatory consequences. 

    Members are reminded that while negligent acts and omissions will be covered by the CSP PLI scheme (subject to policy terms and conditions), a deliberate disregard of good practice guidelines could be seen as reckless. This may affect your indemnity cover under the CSP’s insurance scheme and thus the ability to seek support from the CSP scheme's insurer should any claim arise against you.

    (Last reviewed 12 March 2021)


Insurance

Is my public liability insurance affected by the Covid-19 pandemic?

Members can be reassured that the CSP's PLI scheme provides cover for medical malpractice and professional indemnity liabilities subject to the terms and conditions of the policy. This means no special restrictions or conditions are contained within the policies relating to Covid-19. However, we direct members to be clear on the following:

  • The policies do not operate where members practice illegally. This includes not adhering to PHE guidance on PPE.
  • In situations where members are returning to practice after lockdown, they would be expected to introduce and follow all of the precautionary measures required and recommended to ensure the safety of themselves, patients and staff. The PLI scheme does not provide employers liability insurance, so members with employed staff should seek separate guidance on this class of insurance.

(Last reviewed 15 Oct 2020)


Will my Business Interruption Insurance policy cover me for Covid-19?

Businesses are encouraged to check the terms and conditions of their specific policy and contact their providers.

However, we are aware of significant concerns from members with regards to their ability to claim. We understand that concerns include insurers rejecting claims based upon:

We are working with Physio First and the CSP insurance broker Greybrook Hallam to understand how we might best pursue this issue. 

When enquiring about what your policy covers or indeed how insurers are interpreting your cover, remember that your insurance broker acts for you, so do make them your first point of enquiry.

Graybrook Hallam have provided the following advice in the meantime:

Members should consider a personal accident or illness policy to protect their own incomes whilst unable to work or refer to their clinic insurance for potential covers that may apply due to closure. Some clinic insurers may include closures due to an outbreak of a “Notifiable Disease” at the premises, others may specify the nature of the disease which Covid-19, as a new virus, is unlikely to be included. Helplines are also available under some clinic policies to help with Health & Safety issues and contingency planning if current locations become untenable.

Steps you can take in the meantime: 

Step 1. 

Business insurance policies are broken into sections covering different types of events, which means you might have a section for damage to your property and another for injury to customers.

If you are covered at all, then the Business Interruption section of your policy will be the relevant one for coronavirus (note we are focusing on general cover for the business itself; some businesses will have other types of more specialist cover with its own sections and terms, such as Group Personal Accident or Health Insurance for your employees).

You can find this section by looking at your policy schedule to see if the Business Interruption section is included, then follow this into your policy wording to see what it covered and if there are any extensions applicable or restrictions to this cover.

Step 2. 

Read the policy wording to see if you have cover against coronavirus Covid-19
Typically, business interruption cover can protect against virus outbreaks and diseases like coronavirus. 

To find out if you’re covered, you need to:

  • Look for a list of specific diseases that are covered. Generally the insurer's list of covered diseases will include: Acute Encephalitis, Acute Poliomyelitis, Anthrax, Chickenpox, Cholera, Diphtheria, Dysentery, Legionellosis, Legionnaires Disease, Leprosy, Leptospirosis, Malaria, Measles, Meningococcal Infection, Mumps, Ophthalmia Neonatorum, Paratyphoid Fever, Bubonic Plague, Rabies, Rubella, Scarlet Fever, Smallpox, Tetanus, Tuberculosis, Typhoid Fever, Viral Hepatitis, Whooping Cough or Yellow Fever.
  • Look through this section for any applicable cover relating to ‘Notifiable Disease’ (without a specified list) or contagious and/or infectious disease. You may find this under the ‘Extensions’ section of your policy wording.
  • Coronavirus Covid-19 has been labelled by the government as a ‘Notifiable Disease’, which means if your policy covers these diseases (without a specified list), you may have some cover in specific scenarios.

    Step 3 

    Read the wording to determine how broad your cover is and in what scenarios it applies
    Even where coronavirus can be covered (as a Notifiable Disease, for example) your Business Interruption section won’t cover you simply because the virus exists, and certain events will need to happen before your insurance kicks in, such as:

  • Your business being closed by the government or a local authority.
  • The Notifiable Disease is present at your premises or within a specified distance of your premises (refer to your individual policy wording for the specifics to your policy).
  • Insurance policies, and particularly the Business Interruption section, will be in place to potentially provide cover for loss of income or profit (depending on your policy) should your business be closed.
  • If you’ve suffered a reduction in customers due to coronavirus or Covid-19, it’s unlikely there will be cover in place for this. Similarly, if there is a delay with suppliers or stock, it’s unlikely that cover will be in place to recover these costs or any money lost as a result of the delays or cancellations.

    It’s also worth considering that the ‘normal’ risks involved in running a business, such as accidents, and thefts, could also increase as a result of the coronavirus outbreak, particularly if your business is operating with fewer staff, or if police forces are stretched and crime rates increase.

    It’s worth making sure your business insurance is up to date and covers you against these ‘everyday’ risks.

    (Published in conjunction with Physio First)

    (Last reviewed 15 Oct 2020)


Informed consent

Are there any Covid-19 considerations I need to think about as part of gaining informed consent for my patients to proceed with a face-to-face physiotherapy appointment?

Yes. Informed consent means that there is evidence of information exchange and shared decision-making between you and your patient, so that the patient is able to make their own decision to agree to treatment based on receiving information that is relevant to them. In the current situation, that will also include a patient agreeing to a face-to-face appointment and understanding what the impact of Covid-19 has on their expectations of treatment and the clinic/visit processes.

Informed consent cannot be evidenced by a tick in either a box or a template. There must be evidence that demonstrates the information exchanged and/or conveyed to your patient, and any discussion that have taken place as a result of any questions that the patient has asked, which must now include things related to Covid-19.

Please also see our template Consent form for face-to-face consultations during Covid-19 which was developed with PhysioFirst.

Remember:Disclaimers and declarations that seek to require patients to sign that they absolve you of your duty of care to them are legally invalid. There is no guarantee any such wording will protect you from any legal claim arising at a future date from an alleged failure on your part to discharge your duty of care to your patient, and/or any health and safety workplace legal obligations you may have. Similarly, whilst you can expect patients to provide honest, accurate and complete information to the best of their knowledge when they attend for treatment, it is unreasonable for you to seek to hold patients liable for any harm caused to others caused as a result of the information they provide.

You have a professional duty to explain to patients how you are adapting your practice and your clinic/visit environment in the light of Covid-19 to ensure a safe working and clinical environment for both staff and patients. You are not expected to know everything about Covid-19, but you are expected to draw on relevant advice and guidance from Government and professional sources to understand the implications for your particular scope of physiotherapy practice. You must keep records of what adaptations you have put in place and/or your risk assessments, in case you are ever called upon in the future to justify your decision to see a patient face to face and describe what measures were in place at that time.

Remember, there will be a variety of information sources that can be used to evidence the information about Covid-19 provided to patients, some of which will be open access and some of which may be contained within individual clinical records. For information that is open access, you must ensure that, if you have responsibility for them, you manage version-control of documents and that you retain accessible copies of information contained in web-pages or in e-mails.

For example, you may describe your clinic/visit Covid-19 adaptations and processes in e-mails to patients, website information, clinic policies and procedures and information displayed in waiting areas. You may also wish to include information about specific Covid-19 requirements in Patient Information Leaflets or appointment letters that are sent to patients. You can use our 7-Factor checklists as evidence of your risk assessment in adapting your clinic and justifying the decisions made to see patients face to face

Within individual clinical records, you must keep a record of any Covid-19 screening questions and/or assessments made as part of a virtual or face-to-face appointment. Your clinical record of any face-to-face appointment must record what PPE was used and/or was not available. As is already required, your clinical records must include evidence of relevant clinical findings, decisions made and actions taken, information provided and questions raised by the patient. Your record must also include your clinical opinion, details of any advice, treatment and intervention provided, warnings given and plans for progress, monitoring and follow-up and discharge from care. 

(Last reviewed 15 Oct 2020)


Business considerations 

What if the practice can’t meet any contractual obligations (e.g. NHS or corporate contracts) because of the disruption?

Most contracts have a force majeure clause to help a practice if it cannot meet its contractual obligations, because of something happening outside their control; known as a force majeure event.

Covid-19 can amount to a force majeure event. If, because of issues with Covid-19, a practitioner is ill or the practice has to close, the practice can claim that they have been prevented from meeting their obligations because of a force majeure event.

(Published in conjunction with Physio First)

(Last reviewed 15 Oct 2020)


I have additional business questions. Where can I find answers to these?

Physio First is the CSP professional network for private practitioners. It is a membership organisation but at this time they have generously made business advice for any private practitioner accessible on their website.   


Animal physiotherapy

Animal Physiotherapy & Rehabilitation Working Practices – statement from ACPAT

For the latest advice and statement, please visit ACPAT’s website.

You should still take care to risk assess for yourself, your team, clients and the public. Your risk assessment should also include consideration of movement of people to, from, and around the premises. Please continue to document your risk assessments, mitigation actions and informed consent as per CSP standards.

The CSP still requires us to uphold their standards of assessing and managing risk, and establishing and maintaining a safe environment. If you employ or engage others to work in your practice with you, you should understand your additional duty of care as an employer for the health and safety of staff and ensure all staff are trained and competent in new procedures.

ACPAT cannot make clinical decisions on behalf of its members; the clinical decision making and risk assessment process rests with the individual physiotherapist, who must decide for themselves whether to see a client face-to-face or not.

We have a number of resources for members to provide guidance to facilitate clinical judgements, evaluate PPE needs, and determine the prioritisation of cases. These can be found in the Member’s Area of the website under “Policies & Procedures.”

Please refer to the Government guidance on the NHS 'test and trace' service as it appears you may not have to self isolate after coming into contact with a person that has tested positive for Covid-19 if PPE is being worn in accordance with current guidance on infection, prevention and control.

(Last reviewed 3 December 2020)


 Covid testing 

Can I undertake Covid testing / Fit to Fly testing as part of my physiotherapy role?

No. Undertaking asymptomatic Covid testing of people is not physiotherapy and is not part of the scope of physiotherapy practice. These activities are not covered by the terms of the CSP PLI scheme.

Asymptomatic Covid testing must not be confused with the separate activity of delivering Covid vaccination, or other vaccinations.

(Last reviewed 12th March 2021)


Can I undertake Covid testing / Fit to Fly testing as a separate activity to my physiotherapy role?

Yes. You must ensure that you are educated, trained and competent in asymptomatic Covid testing. You should not hold yourself out to be a physiotherapist when undertaking this role to avoid confusing people.

You must also ensure that you have appropriate insurance place for asymptomatic Covid testing. This should be from your employer if you are employed, of from another insurance provider if it is your responsibility to hold individual insurance.

(Last reviewed 12th March 2021)


Additional sources of support

  • Visit the Government or FSB website for further information about matters pertaining to your business. 
  • For support and friendship from our Physio First community join and participate in our private forum on LinkedIn. 
  • Keep reading these FAQs as they are updated and as things change we will be talking to Physio First regularly. 
  • The CSP Members’ Benevolent Fund (MBF) – for those experiencing financial hardship please consider approaching the MBF, a registered charity which supports past and present members of the CSP who are experiencing financial difficulty or hardship. 

(Published in conjunction with Physio First)

Last reviewed: