Covid-19 protocol

Protocol for seeing clients – Covid-19 Revised (1st June 2022 – withdrawal of guidance for healthcare settings)

NOTE

Covid-10 is a notifiable disease and therefore if The Centre, or any of the practitioners working at The Centre, is contacted by the clinical contact tracing team, The Centre and/or practitioners will need to give out names and contact details (phone and email, no other information) of any clients deemed at risk due to the over-riding duty to Public Health.

Guidance changes regularly and often at short notice. Please bear with us if a change to guidance means we need to move or change your appointment.

Please note that The Centre is a healthcare facility for the purposes of Test and Trace and the contact is The Centre, rather than the individual practitioner. By providing these details to Test and Trace, The Centre is able to access tailored advice which will ensure we can continue to provide treatment for those who need it while also protecting clients, staff and practitioners.

This is intended to be a working document, based on best practice and current knowledge (WHO, PHE, HSE). It has been developed based on information provided by the Institute of Osteopathy, cross contamination training provided by FHT but also from looking at other professional situations including dentistry and blood transfusion service where practitioners need to get closer than 2 metres in order to deliver treatment. The aim it to mitigate the risks of transmission of Covid-19 while also recognising that no protocol can completely eliminate that risk. All guidance regarding Covid 19 in a healthcare setting was withdrawn on 27th May, leaving all responsibility with providers and the current protocol has been updated to reflect that.

I’ve divided the protocol into sections to try to separate out the different areas that need to be considered but it is long and likely to increase as we increase both types and numbers of practitioners.

The Centre

  1. Sign on door giving current guidance
  2. Automatic dispenser for hand sanitiser, table with sign asking clients to use this to wash their hands and then use the bell to let the practitioner know they’ve arrived
  3. Clients are no longer required to wear a facemask but individual practitioners reserve the right to ask this of their clients. If you would prefer your practitioner to wear a face mask, please let us know when booking your appointment or on your arrival. NB wash hands before removing mask carefully, and then wash hands again after removing. Masks should be managed carefully to avoid risk of contamination – disposed of or washed, as appropriate
  4. Clients will be met at the bottom of the stairs by practitioner and temperature may be checked before admission. If client is early or practitioner running late, client may be met by receptionist and shown where to wait (if space is available) or ask to return later (if no space is available).
  5. In most instances, clients will be shown straight into treatment rooms
  6. Toilet facilities to be available as required – sign on toilet and wall asking clients to close the toilet seat before flushing to reduce risk of transmission
  7. There is a hand sanitiser at the top of the stairs and clients are encouraged to use this before they enter the stairwell to reduce risk of cross contamination.

Client will be shown out by practitioner or escorted to reception. Receptionist will take fees, book next appointment and ensure client can leave safely. Reception has been set up to allow for two to three clients to sit, pay, etc and allow for social distancing.

  1. All surfaces within treatment rooms to include couch, chairs, table, tablet, iZettle to be cleaned between clients where used – the increase to contactless limit means most clients should be able to use contactless payment.
  2. All surfaces in communal areas will be cleaned regularly by the receptionist. We will continue to clean as needed and not less than twice a day. If a client is deemed to be particularly vulnerable by either the client or the practitioner, the stairwell will be cleaned before they enter and leave by either the practitioner or receptionist.
  3. The toilet will be cleaned at least twice a day.
  4. All carpets are steam cleaned regularly, usually weekly.
  5. In addition to the cleaning conducted above, The Practice Manager is responsible for ensuring that The Centre has a thorough clean each week, according to the cleaning schedule.

Clients

  1. All new clients will be pre-screened by reception prior to booking an appointment. Clients should contact The Centre if they develop symptoms of Covid-19 or are unable to attend for any other reason and asked to inform The Centre if they develop symptoms within 2 days of attending The Centre. Some practitioners may undertake screening or case-taking for clients via phone or video call prior to appointments and clients will be advised of this on booking. Clients may be asked to complete and sign a form relating to Covid confirming that they do not have symptoms of Covid-19 before the start of each treatment session.
  2. All current clients who wish to attend The Centre and have not attended since before lockdown, will be asked to confirm they are well when they book appointments. The current system will be explained and clients will be asked to attend at their appointment time. Dependant on practitioner and modality they may also receive a pre-appointment screening call (see 1) and be asked to sign a consent form.
  3. Clients are asked to attend on time as there is very limited space for clients to wait. All appointments are staggered to minimise clients arriving or leaving at the same time.
  4. Clients are booked in appropriately to allow for cleaning between clients.
  5. Only one person to attend per appointment, unless the practitioner deems it necessary for more than one person from the same household to attend, e.g. parent and child, someone requiring assistance to attend etc.
  6. The reception area is set up to enable clients to distance from each other while waiting for treatment or paying.

Practitioners

  1. Practitioners will use the hand sanitiser on the way in.
  2. Practitioners will wear appropriate PPE as stipulated by their professional body.
  3. Practitioners are responsible for ensuring appropriate cleaning of treatment rooms prior to each client.
  4. Where more than one treatment room is in use during a session, practitioners need to be mindful of timings of all treatment rooms to ensure social distancing for both clients and practitioners. In general, clients will leave directly or via reception. If reception is busy, clients should wait in the treatment room with the door open and the receptionist will advise once reception is available.
  5. At the end of the session, practitioners are responsible for cleaning their room.
  6. If, after reception has closed, practitioners need to use any of the communal areas, they need to will clean any surfaces as appropriate to ensure The Centre is ready for the following session/day.
  7. Other practitioner’s professional bodies might require different protocols and it will be necessary to ensure that these do not conflict.

Other issues

  1. If a practitioner or a member of their household develops Covid-19 symptoms, they will test and only attend The Centre if they test negative AND are well and fit to work.
  2. If a client becomes obviously unwell with symptoms suggestive of Covid-19 such as a temperature, dry cough etc, during treatment then they will be advised to get tested and required to leave immediately. Any further steps necessary to protect practitioners, staff and other clients will be determined on a case by case basis.
  3. If a client advises The Centre that they have developed symptoms within 2 days of visiting The Centre, they will be advised to get tested and asked to inform The Centre of the results. Any further steps necessary to protect practitioners, staff and other clients will be determined on a case by case basis.
  4. In any situation where a practitioner or member of staff has been in contact with a case of Covid-19, the Practice Manager will be involved in any discussions about likely risks to clients, staff and other practitioners, advice will be taken and any potential contacts notified.

NB

With the ending of free testing, it is likely that clients, practitioners and staff may become infected with Covid without being aware of it. Practitioners and staff are encouraged to test if they develop any of the main symptoms of Covid and advise the Practice Manager accordingly. Increasingly, it will be more challenging to assess the likely levels of circulating Covid but we are well placed to make these assessments as our clients are really good at informing us in relation to their health. We will be keeping an eye on any figures available and may revert to earlier versions of the protocol should the need arise.

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