THE GCC CODE and code exam

Principle A - you must put the interest of patients first (Always put interest of patients first)

1. put patient needs/safety at center of their care

2. show respect, compassion and care for the patient, consider their needs/preferences, be honest and open

3. provide care based upon person centered approach, engage effectively with patient, enable and support patient in care, involve patient in decisions about their care, support and manage patient with complex of biological, social and psychological

4. respect patient privacy/dignity and right to choose who is present

5. treat patient fairly, respect culture

6. safeguard children and vulnerable adults (16 normally but WIOC is 18)

principle B - ensure safety and quality in clinical practice (Be safe and quality in clinic)

1. protect patients, maintain safety by preventing harm before it occurs

2. act promptly/appropriately if concerns for patient and record what you did

3. practice safe, hygienic environment, identifying control risk, all equipment safe and meets standards with first aid

4. recognize safety incidents that risk safety of patient or another person, report incidents to learn from them through suitable safety system

5. promote accessible healthcare for all patients and recognize how this can be supported

6. collect, evaluate and use feedback/data about quality of care of patients to improve practice

principle C - must act with honesty, integrity and maintain highest standards of professional and personal conduct (Can you be honest, integral and maintain high standards of personal conduct)

1. look after your health and seek support when necessary, must protect others from harm caused by your health, conduct or performance

2. seek appropriate advice if you have concerns about your own health, character, behavior etc which may compromise safety of patients or damage your reputation

3. have insurance for full scope of your own individual practice, make it clear you are employed with the GCC

principle D - you must provide a good standard of care and professional practice (Do you provide a good standard of care and professional practice)

1. take and record a thorough case history for patient

2. find out patients goals for their care, establish planned health outcomes using recognized outcome measures

3. with consent carry out physical exam, prioritizing best evidence that is available at the time, explain and record results of exam

4. valid consent before diagnostic investigation with patient interests and health put first to minimize risks

principle E - establish and maintain clear professional boundaries (everyone gets treated the same)

1. recognize power imbalances, not abuse position of power/trust, don’t cross any professional boundaries

2. ensure you/colleagues treat all patients, careers etc with respect and dignity

3. explain and obtain consent if clothing needs to be removed, respect their privacy to change and offer a gown

4. consider need for chaperone if possible offer chaperone and record when offered or if vulnerable

principle F - obtain appropriate valid consent ( follow protocol for consent)

1. give necessary accurate, relevant and clear info in format accessible to them so they can make informed decisions about their health

2. give due regarding capacity of patient to give valid, consent, considering capacity may change overtime

3. ensure patient consent is voluntarily gien

4. obtain and record valid consent from PT before care, research, recording or disclosing identified Info about them

principle G - communicate professionally properly and effectively (talk better than you would your g)

1. take steps to understand, meet language communication needs/preferences of patient

2. communicate info clearly, sensitively and effectively, use language to enhance care of patient

3. have easy to understand info for patient on fees, charging policies and how to complain including changing their mind about care

4. communicate with other professionals in interest of meeting patients health and care, needs and goals

5. tell patient who is responsible for their care if arranging other care be clear if person is registered with UK health regulator

principle H - foster collaborative health care, effective professional relationships and safe, supportive workplace practice (help colleqaues, professionaly and safe in practice)

1. collaborate appropriately and effectively with other professionals

2. delegate tasks or duties only if safe and appropriate to do so, must ensure person you delegate is qualified, competent/supervised if needed

3. demonstrate effective team working and professional interpersonal relationship as required by your role, including contributing to improvement of healthcare services

4. demonstrate leadership appropriate to your role

principle I - maintain, develop and work within your professional knowledge and skills (independent study time to devlop and work within professional skills)

1. engage in reflective practice, seeking feedback and anlaysing info about your practice and care you provide

2. adapt/improve your practice considering new developments, technologies and evidence from research

3. seek critically appraising evidence, you must integrate findings of best quality of evidence available at the time

4. maintain/develop your competence and performance taking part in relevant and regular learning and professional development activities, competent in all aspects of your work

Principle J - maintain and protect info about patients (just keep info safe)

1. adapt to technology, including date sharing, media sharing/social media

2. be accountable for patient records up to date and legible/attributable, records must represent each interaction with patient

3. store records safely and securely so they remain in good condition

4. have documented arrangements in place to protect or transfer patient records

management of records

• maintain records for 8 years from date of pt last visit or if child hold records until 25th bday or 26th if patient was 17 at conclusion of treatment

GDPR and exceptions

what is GDPR

• general data protection regulation sets main responsibilities for those handling personal/special category data

• information commissioners office is independent body to uphold info rights

exceptions

• if you believe it to be in patients best interest to disclose information to another health professional or relevant

• if you believe that disclosure to someone other than another health professional is essential for sake of patients health/wellbeing

• if having sought advice you are advised that disclosure should be made in public interest (pt may be harm to others)

types of consent

explicit = when patient gives you specifc permission in writing or orally to do something (only if they know and understand what consenting to)

implied = patient indirectly indicates their agreement to undergo procedure such as offering arm in response to BP test (amounts to valid consent if they know and understand what they agreeing to)

4 prerequisites of consent

• voluntarily

• sufficent/balanced info to make informed decsion

• capable of using and weighing info provided

• has capacity to give consent

mental capacity

• mental capacity 2005

assess this

• understand info relevant to decision

• retain info for long enough to make decision

• use or weight up info as part of process of making decision

• communicate decision in any way

decisions made on behalf of patient

• over 18 years of age, authorized to make decisions for them under lasting power of attorney (LPA much hold explicit power to make medical/care decisions)

• someone who has authority to make treatment decisions for person such as court appointed deputy can give consent

what must be recorded in notes with pt who lacks capacity

• reason treatment is in patients best interests

• reason patient lacks capacity

age/consent

• at 16 patient asumed to have capacity unless assumed otherwise

• if under than 16 can give consent if deemed gillick competent (understand issue/risks/advice/alternatives)

4 ethical principles

autonomy = patients have right to make their own decisions based on their values and beliefs, includes right to privacy and confidentiality

beneficence = healthcare professionals have active duty to help patients in need, including preventing harm and providing benefits

justice = weighing up if something is ethical or not, consider compatible with law, patients right and if fair/balanced

non-maleficence = healthcare professionals should not cause harm to others

candour

• fulfill duty of candour by being open and honest with patient. inform them if something goes wrong with their care which causes, or could cause, harm or distress. you must offer an apology, a suitable remedy or support, and an explanation of resulting actions

4 steps when something goes wrong

1. tell patient at earliest opportunity (or carer) that something has gone wrong

2. apologise to patient

3. offer appropriate remedy or support to put matters right

4. explain fully the short and long term effects of what has happened

what should be in apology

• what happened

• what can be done to deal with any harm caused

• what will be done to prevent someone else being harmed

fitness to practice

stress and health = cases of chiros that have severe health impairments that effects their fitness to practice are investigated by health committee

sanctions of professional conduct committee

• convictions

• sexual misconduct

• dishonesty

• failing to provide an acceptable level of treatment or care

a - admonishment

b- conditions of practice order

c- suspension order

d- removal from register

sanctions available to HC

a- conditions of practice order

b- suspension order

acknowledge signs of sexual attraction

1. revealing intimate personal details about oneself

2. giving or accepting inappropriate or unprofessional social invitations

3. visiting a patients home without an appointment

4. meeting patient outside of normal practice hours when no staff/patients around

5. asking questions unintended to be and not related to patients health

how to respond to sexual attraction

1. find alternative chiro for patient

2. ensure proper transfer to another chiro to take place

3. transfer care in a way that does not make patient feel they have done anything wrong

considerations for relationship with patient

1. how long the professional relationship landed and how recently ended

2. whether former patient was particularly vulnerable at time of professional relationship and whether they might still be considered vulnerable

3. the nature of previous professional relationship and whether it involved a significant imbalance of power

4. whether an exploitation of power, trust or knowledge obtained whilst there was a professional relationship has influenced the development or progression of sexual relationship

5. whether you are, or in future likely to treat members of their family

advertising

• any info or claim that present or make public this includes but not limited to info/claims:

• printed and included or signage

• website, email, tv

regulatory standard

• advertising standards authority

• committee of advertising practice (writes/maintains rules and provides advice/guidance)

actions GCC take regarding breach

1. progression for consideration by GCC investigating committee

2. referral to ASA in first instance before complaint considered by GCC investigating committee

3. closure without further action