Acupuncture and dry needling are two common modalities that members may wish to practise as a standalone service.
Can acupuncture and/or dry-needling be part of physiotherapy practice?
The CSP PLI scheme no longer covers fertility-related acupuncture treatments.
Yes. Acupuncture and/or dry needling may be part of physiotherapy practice and sits within the fourth pillar of practice – kindred modalities.
The essence of physiotherapy practice is that practitioners adhere to the HCPC Standards of Proficiency for Physiotherapists which includes exercising clinical reasoning and professional judgment in their activities at all times.
You may wish to practice within just one pillar of practice, or across all four pillars.
If you choose to focus on offering for example, acupuncture or dry-needling services, you may do so provided that you meet HCPC practice standards and make it clear that you are working as a physiotherapist.
What is the difference between acupuncture and dry-needling?
In the UK there are two main accepted skin piercing therapies. The first is traditional ‘acupuncture’.
The second is ‘dry-needling’ which may also be called ‘western acupuncture’ or ‘medical acupuncture’.
Each modality has differences in its philosophy, physiology, point location and practice.
What training do I need to undertake to use acupuncture and/or dry-needling as part of physiotherapy practice?
The only physiotherapy modality that legally requires evidence of post-registration approved training and registration is prescribing.
You must however ensure that you are educated, trained and competent in the activities you undertake as part of your practice so that you ensure you deliver a ‘reasonable standard or care’ to your patients.
This means that you may choose any acupuncture and/or dry-needling course that meets your requirements, and if necessary the requirements of your employer.
If you have completed an acupuncture and/or dry-needling course overseas you should be sure that the learning outcomes achieved overseas enable you to practise safely in the UK, according to UK standards of acupuncture and/or dry-needling physiotherapy practice.
At the current time, the CSP does not set out any specific educational expectations of acupuncture and/or dry-needling educational programmes, nor does it verify that any programme is approved for UK practise.
We are aware that there a range of courses available to members, which are provided by a range of educational and commercial providers. Members should make sure, before they undertake any training, that the course provides them with the knowledge and skills they need in order to establish their own competence to practise acupuncture and/or dry-needling as a physiotherapist.
Some employers may require you to undertake a specific educational programme, and any course you undertake may not necessarily be transferrable to another employer.
Once you have established your competence in acupuncture and dry-needling you must undertake appropriate CPD activities to ensure that you maintain your ongoing competence in acupuncture and/or dry-needling.
Do I have to say that I am a physiotherapist when using acupuncture and/or dry-needling in my physiotherapy practice?
Yes. Many patients may be reassured to know that their acupuncture or dry needling is being delivered by a registered health professional and so you may find it useful in promoting your services.
All your acupuncture and dry needling services must have an element of assessment, professional judgement and record keeping to them in order to meet the HCPC standards of practice, and therefore be considered part of physiotherapy practice.
Does the CSP PLI scheme cover acupuncture and dry-needling used as part of physiotherapy practice?
The CSP PLI scheme covers all activities within the scope of physiotherapy practice, subject to the policy terms and conditions.
From 1 July 2016 there will be an exclusion relating to the use of acupuncture to treat fertility problems.
This exclusion does not affect other forms of acupuncture or dry-needling used as part of physiotherapy practice.
Do I need to get any additional licenses or registration to practise acupuncture and/or dry-needling?
Yes. Both are skin-piercing interventions and in the UK these are subject to additional Local Authority licensing and registration.
The terms of the licensing and registration varies around the UK. You must contact your local authority and find out what the local rules are. It is likely that you will need to pay a fee to be registered to use acupuncture and/or dry-needling.
Some authorities may take into consideration your requirement to be HCPC registered as a physiotherapist when deciding the licensing requirements they need.
Some local authorities may allow a group practice registration as opposed to each practice physiotherapist registering individually.
Do I have to offer acupuncture and/or dry-needling in a physiotherapy department?
No. You can offer your services wherever you feel your patients would best benefit. This might be in their homes, in gyms, village halls, clinic rooms or physiotherapy departments.
Remember, acupuncture and dry-needling are subject to Local Authority licensing, and you will need to check what additional registrations may be needed in your local area.
You must also ensure the safe storage, transportation and disposal of needles, as well as hygiene and infection control issues.
Do I need to join AACP?
No. Practicing acupuncture and/or dry-needling as a physiotherapist is not predicated upon belonging to a CSP professional network.
Membership of a professional network such as AACP, does not provide exclusive evidence of the ability to demonstrate appropriate standards of education or fitness to practice in acupuncture and/or dry-needling.
Physiotherapists who can demonstrate that they have undertaken an appropriate course in acupuncture and/or dry-needling provided by a commercial, professional body or Higher Education Institution, and maintained their fitness to practice in this modality, should have no difficulty in providing a safe service to patients.
However, joining a recognised professional network may offer additional benefits such as access to CPD activities and peer support.
Some employers and other organisations require their employees to belong to AACP in order to practice acupuncture and/or dry-needling in their workplace.
Members should be aware that this is a local requirement, and an employer is permitted to require such membership, if it is reasonable to do so, for the purposes of employment.
Can I offer cosmetic acupuncture and/or dry-needling to patients as a physiotherapist?
No. This is because purely cosmetic interventions that have no physiotherapeutic purpose are outside the scope of physiotherapy practice.
All physiotherapy practice has an element of therapeutic purpose and professional judgement aimed at addressing health and wellbeing needs relating to human movement, performance and function.
Physiotherapists work with people to optimise function and mobility and to reverse the impact of illness and disability. They build resilience and enable individuals to be independent and healthy.
Using a biopsychosocial, evidence-based approach, physiotherapists target and tailor care in line with individuals' needs and goals.
What kind of record keeping do I need to make when using acupuncture as part of physiotherapy practice?
You must keep some kind of record to show you meet the HCPC standards of proficiency for physiotherapists.
The level and complexity of assessment and record keeping that you do will vary according to the context of your decision to provide acupuncture and/or dry-needling, and the background health status of your patient.
Do I need separate insurance to offer acupuncture or dry-needling?
Yes, if you are not offering these services as part of physiotherapy practice. This is because you are not working as a physiotherapist and your work is therefore not covered by the CSP PLI scheme.
You should make alternative arrangements for your insurance. You will need separate insurance if you are offering acupuncture for fertility related problems as part of physiotherapy practice.
What about if I want to offer acupuncture and/or dry-needling as part of my other work as, for example, an Acupuncturist?
You will not be covered by the CSP PLI scheme.
This is because the CSP PLI scheme only covers activities within the scope of physiotherapy practice, subject to policy terms and conditions.
You should make alternative arrangements for your insurance for your non-physiotherapy work.
Where can I find further information?
Acupuncture Association of Chartered Physiotherapists (AACP)
The CSP Insurance brokers:
Graybrook Insurance Brokers Ltd
8 Chandlers Way
South Woodham Ferrers
Essex. CM3 5TB
The information provided in this document is not exhaustive and does not in any way alter the terms and conditions of the Medical Professional Liability or Public Liability policies forming part of the CSP’s PLI insurance programme.
In the event of any conflict the terms and conditions of these policies will take precedence over this summary document.
Members are strongly advised to read the CSP’s PLI policy details including the wording of the proposed exclusion, which is available on the member’s website or from the brokers on www.graybrook.co.uk/csp-members.
The CSP or their brokers cannot be responsible for insurance covers arranged elsewhere by members, who should ensure such policies are adequate and appropriate for their professional requirements.