18:51:55 Hi. Looking forward to the meeting. Thanks. 18:52:06 Good Evening All 18:52:09 hi everyone 18:52:12 hello 18:52:12 based in Stamford, thank you for having me! 18:52:18 Hi! 18:52:19 Hello! 18:52:44 Hello everyone 18:52:45 Hi everyone 18:52:48 good evening - I've sneaked in from North Norfolk to hear what you folks think etc 18:53:18 Hi everyone 18:53:48 Hello everyone 18:55:47 Hi All, CSP PPE faq can be found here: https://www.csp.org.uk/news/coronavirus/clinical-guidance/ppe-faqs 18:57:38 The Enquiries Team contact details can be found here: https://www.csp.org.uk/about-csp/contact-us/enquiries-team 19:00:29 My main question around PPE is do I need a visor if seeing a patient face-to-face in private practice who has been screened as not having any symptoms of covid-19 and been risk assessed around who they live with, etc. 19:03:09 here is some Screening Guidelines for Physiotherapy Involvement with COVID-19: https://www.csp.org.uk/system/files/documents/2020-04/screening_guideline_COVID19.doc 19:05:36 We have screening in place. But it is whether we need a visor or not please? 19:06:18 very good response from trust with regards to ppe 19:07:02 working well in partnership with stewards and our trust are now making our own ppe and supporting north east with supply 19:07:14 PPE in our level 1 specialist hospital and mental health services CNTW was an issue as not a priority hospital area. However PPE now available and no big issues. Still some confusion at times and some visors have been recalled. 19:07:18 Does a client who has not been tested need to wear a protective cover to protect the therapist entering their home? Is this necessary or advisable? Who is deemed responsible for providing this if it is necessary? 19:07:53 Good response by Trust and mangers with regards to PPE. If problem highlighted dealt with rapidly 19:09:17 If a client has been tested as positive to COVID19 over a week ago and are now home and symptom free is PPE indicated? 19:09:40 Some Private Practitioner guidance mentioned earlier: https://www.csp.org.uk/news/coronavirus/private-practiceindependent-sector 19:11:45 our trust is treating all patients as positive so still using ppe for everyone 19:12:22 also links are up on twitter already 19:12:28 If a therapist has had Covid +ve but now symptom free, when can they return to work and what level of PPE do they need to use? 19:15:59 Some info about Remote Service Delivery options here: https://www.csp.org.uk/news/coronavirus/remote-service-delivery-options 19:17:24 we are delivering all services nationally remotely @connect 19:17:36 using a mixture of telephone and AccuRx 19:18:06 We are seeing patients virtually using Zoom. And we use TM3 electronic notes. Physio Tools for exercises and can add advice to that too. 19:18:08 we're trying to use video assessments in the community, but we find many of our clients struggle with the IT,, or don't have up to date technology 19:18:14 Zoom worked well, now shifted to NHS attend anywhere which is unreliable 19:18:26 In private clinics: patients received virtual appts very well, especially orthop rehab etc 19:18:37 There is a lack of telephones and staff are using their own mobiles. Some staff are already suffering some neck, shoulder pains and headaches due to using the computers more 19:19:02 our service is joint with connect so working with continuing physio line consultations 19:19:24 I'm finding video consultations tricky at times as not all clients familiar with the platforms and internet reception can be poor. Also, positioning devices at the client's end is tricky. I'm in Private practice 19:19:46 Agree, virtual working well for private practice and well received by patients. Entertaining at times too! 19:19:48 I’m in private practice and have found patients are finding it very helpful. We use Whereby, zoom, facetime, whatever the patient is comfortable with. 19:20:08 We have had a positive response to our online consultations in private practice and use an app to support our exercise prescription to help with patient engagement. Our online classes are doing well and now have no geographical limits 19:20:12 Also, limitation that if someone is frail and reduced balance, then you are limited by the extent of assessment and keep people safe 19:20:54 We are providing Skype/ Whatts app to provide video consultations, assessments and treatments with support from client families or care teams for Neuro-Rehab. some clients have enjoyed this routine and regular contact and make some progress. More challenging for some interventions. 19:20:58 Limited in paediatrics due to relying on parents handling skills 19:21:08 Using FaceTime to do balance session with client. Independent neuro community service 19:21:17 I still don't sit very long during a zoom consultation! I am up demonstrating - entertaining at times as I say! 19:21:25 At our staffside today we have discussed how important it will be to ensure risk assessment for home working will need to be done. 19:21:29 We don't have headsets, so have to hold a phone and write so not able to keep good posture - and reduced efficiency as can't type at same time 19:21:47 our trust have good risk assessment document for working from home and carrying out physio line work 19:21:52 Using Microsoft teams at CNTW with good success so far although early days. 19:21:58 It definitely takes longer! 19:22:01 Our trust is using attend anywhere which is crashing all the time the platform has been offline all day for the 3 day. Very frustrating 19:22:45 Great for younger neuro patients but some of our patients are anxious about this but no more than would be over telephone appts. 19:23:00 I try and use my computer and ask patients to if possible, bigger screen so easier to communicate. As Catherine says, I am up demonstrating…my sitting room has never been so tidy! 19:23:11 attend anywhere seems really unstable - not hearing anything massively positive about it. despite most trusts going with it 19:23:12 Our Trust does not enable zoom due to significant security issues 19:23:33 In community rehab, it is not so successful. Many people are hard of hearing, and don't like phone calls or video 19:23:42 hello, I have done a little research on platform security, and seen NHS does not advise Zoom - it is at risk of hacking during sessions. What platforms are people finding are approved? 19:23:48 I prefer tp start my consultations via phone and offer a video consult if they want one 19:24:25 ACcu Rx seems most stable from my experience of testing and is stable and encrypted. Free to anyone using S1 or EMIS at present 19:24:44 Airmid is hareder to use due to need to register with the full app 19:25:15 We've looked at using in care home, but would take a lot of input from care home staff to hold the camera, and they don't always have the resources 19:25:30 Some telephone guidance: https://www.csp.org.uk/news/coronavirus/remote-service-delivery-options/telephone-guidance-msk-practice 19:25:41 WE are looking TEAMS for group consultations as by inviting people as guests email addresses are kept private 19:25:56 And some digital case studies: https://www.csp.org.uk/news/coronavirus/remote-service-delivery-options/digital-physiotherapy-case-studies 19:28:44 Here's the link to the Digital and Informatics Group: https://www.csp.org.uk/professional-clinical/digital-physiotherapy/digital-infomatics-physiotherapy-group 19:29:05 Question : are there any particular apps or technology which people have found esp. Helpful or that CSP can recommend? 19:29:58 We have used Whereby which has been stable and is supposed ot have 19:30:16 App library: https://www.csp.org.uk/professional-clinical/improvement-innovation/app-library 19:30:38 We have used Whereby which has been stable and is 
supposed to have better security 19:31:15 Wonder if anyone is looking into financial Implications for staff working from home, such as data, electric increases etc 19:31:21 Thank you for those suggestions - I will check into them! 19:33:54 Community physio team: minimal experience so far for rehab. We have delivered equipment and met urgent safety needs. We are developing a rehab programme to train the team and offer a baseline package 19:33:57 Further info on Covid-19 & rehab: https://www.csp.org.uk/news/coronavirus/clinical-guidance/rehabilitation-coronavirus 19:35:30 How is the CSP supporting Therapists who have been emotional affected by treating (and losing) COVID + patients? 19:36:21 *emotionally 19:36:42 Our trust have developed a self management resource for our patients on discharge which has been expedited due to C-19. 19:36:54 concern is that community services were already under pressure pre covid and that there will be an influx of covid rehab as well as “normal” patient rehab that’ll be delayed 19:37:23 community paeds: most of my patients are shielding so have only done the odd visit to adjust equipment so that they can continue therapy at home. Not yet sure what therapy will look like. Will have to wait and see what happens with special needs schools. 19:37:46 Mental Health & Wellbeing during Covid-19: https://www.csp.org.uk/news/coronavirus/taking-care-yourself 19:38:02 I personally don’t work in community or rehab but noticing readmission of frail elderly who have had covid positive 19:38:11 Concern re. Neuro rehab. Patients with. Londstanding neuro conditions who have been shielding and the impact of no physio and/or covid on top of existing neuro conditions. 19:40:08 In addition to the Mental Health & Wellbeing link above, here is some guidance on having difficult conversations: https://www.csp.org.uk/news/coronavirus/clinical-guidance/having-difficult-conversations 19:40:46 Key pressure will be the ongoing hygiene protection and social distancing for both clients and staff in community settings, clinics gym area. Also, how does the CSP envisage hydrotherapy services to be re-established as this will be a key intervention for pain and strengthening following Covid-19 and infection prevention ? 19:41:49 I’m nodding 😁 19:43:39 There are also people who have had a fracture that was managed conservatively, that would normally have had surgical fixation. These people may need additional support with rehab to ensure they receive optimal outcome 19:43:40 Agree with previous comment as our Trust is trying to work out how to have 'clean' and 'dirty areas' (don't like the expression but it is what is used) and how we clean all areas and equipment. Staffing levels are also a concern as the services are already pushed 19:43:45 supporting children and young adults: https://www.csp.org.uk/news/coronavirus/clinical-guidance/supporting-children-young-people-send 19:45:18 Please could we have the link on here for the rehab standards please. 19:45:56 When is the private practice flowchart being updated please? 19:46:50 I work with long term neuro disability in paeds, often many co-existing disabilities, ; blind, deaf, dumb; learning disabilities, many from second language speaking families - I work with horses, hippotherapy. This is 1;1, with a family member supporting; and a horse leader who is 2 meter distance from the child at head of the horse. 19:46:58 The info/guidance/policy is good and with Physio First stuff alongside is helpful. But an updated flow chart to aid risk assessment and clinical reasoning would be really helpful please? 19:47:26 I am intending to restart when the R in our area is reduced; and the Alert level approaching 2. 19:49:51 Student resource here: https://www.csp.org.uk/news/coronavirus/students-higher-education-institutes 19:50:36 The face to face flowchart is in the process of being revised and will be out ASAP (hopefully end of the week). Also we are working on an additional tool to use alongside the new resource. Keep an eye on the website and your email (if signed up to CSP email bulletins) 19:52:32 Hi. As we are a new programme at Sunderland we only have first years currently. 19:52:36 Great, thank you Abi and Haroon. I am signed-up to emails. :) 19:52:51 No 19:52:59 Not aware of any in my trust 19:53:01 not yet 19:53:13 we have capacity 19:55:28 we have been exploring this 19:55:37 Ideas from placement providers would be welcomed. 19:56:06 definitely have the scope to support at specialist emergency care hospital 19:57:45 https://www.csp.org.uk/news/coronavirus/private-practiceindependent-sector/government-financial-support-businesses-self 19:57:54 https://www.csp.org.uk/news/coronavirus/private-practiceindependent-sector/faqs-advocating-private-practice 19:58:36 Thank you 19:59:42 Thank you. The lobbying the CSP and Physio First are doing and the information you have been sending out to private practitioners has been very welcome 20:00:12 Thank you, this has been very helpful. 20:00:14 Thank you. Really appreciate this discussion & support. 20:00:27 Lots of reading! Thank you for arranging this. 20:00:36 Thank you for the discussion and information 20:00:43 www.menti.com 19 09 36 20:01:03 Thank you. This has been really helpful. 20:01:06 Thank you, very informative. The CSP has given clear guidance and support throughout this time. 20:01:48 enjoyed meeting but the menti.com did not work for me tonight. Probably me as I am not good with computers 20:02:10 Thank you, good to see CSP f2f 20:02:13 thank you 20:02:17 Thank you 20:02:17 thankyou 20:02:25 Thank you 20:02:25 Helpful meeting thank you 20:02:27 thanks