All of our practitioners adhere to the guidance the BAcC has produced to ensure they comply with the current government guidance relating to practice.
There are three main criteria that our member’s practices meet in order to be considered ‘COVID-19 secure’:
- Carry out a COVID-19 risk assessment and share the results with the people who work at their practice.
- Have cleaning, hand washing and hygiene procedures in line with guidance.
- Do everything practical to manage transmission risk
All communal areas of the building will be cleaned thoroughly, and high frequency contact areas should be disinfected regularly throughout the day. Other commonly touched objects and surfaces outside the treatment room (e.g. telephones, keyboards, door handles, desks and counter tops) must be regularly cleaned.
Any furniture surface or piece of reusable equipment that has come into contact with a patient will be cleaned and disinfected before and between patients as well as at the end of the treatment session.
Appointments will be spaced accordingly so that there is sufficient time between patients for adequate cleaning.
Frequent handwashing to reduce the potential for coronavirus to spread, is expected as it plays a critical part of making and keeping our practices COVID-secure.
If you or someone you live with develops symptoms of COVID-19 by the time of the appointment, please contact me before attending the clinic.
Please wash your hands immediately upon entering the clinic. You will be directed to the appropriate facilities. There will be a poster nearby to demonstrate handwashing techniques recommended by the NHS.
Please also wash your hands before leaving the clinic.
Face mask and respiratory hygiene
Please speak to your practitioner beforehand about mask wearing expectations and raise any concerns you have at this time. Your practitioner will determine their minimum requirements based on a through risk assessment.
If you need to sneeze or cough while in the clinic, please do so into a disposable tissue and throw it away immediately. Please wash your hands immediately after doing so.
We are also encouraging cashless payment where possible.
Most clinics have introduced new procedures to minimise risk of transmission of COVID-19. A pre-appointment assessment is an established part of the procedure.
Your practitioner my ask you to complete this assessment by telephone or email before you can attend your appointment. So, please fill in and return any forms sent to you by your practitioner making sure you inform them if anything changes before the appointment.
Please discuss yours and your practitioners` expectations regarding facemask wearing with your practitioner beforehand.
It is recommended that you do not attend with an empty stomach (ie not having eaten that day) but try not to eat immediately before treatment either.
If you require a carer/parent/guardian to attend, please let the practitioner know beforehand as they will require COVID-19 screening and consent forms.
If the treatment room is not big enough to social distance, there may be additional concerns for the practitioner and carer if one of you tests positive for COVID-19 within 48 hours of the treatment.
As a best practice approach we recommend our practitioners continue to wear an FRSM IIR mask during your treatment. As this is no longer a legal requirement, our practitioners may change their requirements based on a thorough risk assessment. This should be communicated to you beforehand.
All of our practitioners use single use, pre-packed sterile needles which will be incinerated after your treatment. As our practitioners wash their hands before handling these needles as well as before inserting and removing them, there is next to no risk of catching COVID-19 from a needle.
You should wait a few days until any immediate ill effects wear off after having the vaccine before having any treatment.
This is not a hard and fast rule, and a practitioner may use their professional judgement to advise on this, as certain treatments are time dependent.
An increasing number of studies show that acupuncture can have a direct impact on the immune system and in addition, that it has an anti-inflammatory action, particularly useful in cases of patients suffering from symptoms caused by COVID-19. These studies show that the levels of immune cells change in an immune enhancing, overreaction dampening fashion.
In other words, the studies have shown clear evidence that acupuncture increases the body’s ability to fight infections, while at the same time calming the body’s occasional but detrimental tendency to overreact.
In England it is no longer a requirement that close contact businesses collect basic contact information from customers, and gain consent to share it with the relevant contact tracing scheme upon request, although your practitioner may do this.
In the normal course of an appointment, you will give your name, contact information and the date and time of your arrival and exit. However, you must give prior consent for the practitioner to supply this data to the test and trace scheme should the situation arise.
For Scotland, Northern Ireland and Wales please see the information below.
What happens if I refuse to share details or give consent for them to be shared with the contact tracing service?
The requirement for this varies by nation.
According to the guidance at time of writing:
- In England, a practitioner must ask clients to provide data and consent but if you do not agree they are not required to refuse you
- In Northern Ireland, this situation is not explicitly referred to, but it is a legal requirement to collect and share the data (see section 2.1, page 12 and Annex B of the Close Contact guidance).
- In Scotland, ‘Collecting contact details, in the settings which this guidance applies to, is voluntary’.
- In Wales, ‘If the individual still does not want to share their details, practitioners are under a duty to collect those details, therefore patients should not be allowed on the premises.’
The answer to this also varies by nation.
- England, close contact services are no longer required to display a QR code poster.
- Northern Ireland’s contact tracing scheme works very differently to the other nations. It is our current understanding that there is no QR code scheme in Northern Ireland.
- Scotland, displaying a QR code is only mandatory for pubs, bars, restaurants and cafes. It is optional for close contact services.
- Wales, there is no mention of a requirement to display the QR code. Hence, by default it appears to be optional.
The current guidelines in all nations are clear, that the need to self-isolate is only mandatory once your nation’s contact tracing team has instructed you to do so (i.e. after the results of a practitioner’s test).
However, some of the guidance does refer to taking more cautious measures within the workplace, if this is the case. For example, in the English guidance, the following paragraph about managing employees is
‘At this stage (until the test result is known), those people do not need to self-isolate, but they should take extra care in practising social distancing and good hygiene, like washing their hands regularly. They should also watch out for their own symptoms.’
There is no detailed instruction pertaining to the kinds of working contexts that relate to acupuncture and adjunctive therapies. Hence, what constitutes ‘extra care’ is left to the professional judgement of the practitioner and your judgement as a patient.
This is a complicated issue. For the designation of a close contact service provider, following IPC measures and wearing PPE will not lead to an exemption from self-isolation.
Government guidelines from the four nations do outline that workers in health and social care settings, can sometimes qualify for exemption from self-isolation if they follow IPC measures and wear correct PPE.
It is the position of the BAcC that our members deliver a medical and healthcare service. However, because of the lack of statutory regulation for our profession, this recognition is not guaranteed by government. Hence, our practitioners can make the argument to the contact tracing scheme that they come under the same rules as workers in health and social care settings, but they are not required to accept it.
If, after you have made your case to the contact tracing scheme, they still tell you to self-isolate, you must adhere to their instruction. When making your case to the contact tracing service either on the phone or by appeal, you can refer to the level of PPE that your practitioner was wearing and the IPC measures that were taken during the encounter.
Masks, visors, disposable gloves and aprons are no longer mandated in the close contact service guidance. It is possible however that wearing these at all times may increase the likelihood of obtaining this exemption, but it is not guaranteed.
Recent guidance from Wales supports this assessment. The issue of adequate training in the use of PPE has been raised by the contact tracing service as a reason not to offer this exemption.
The World Health Organisation offers a free 15-minute certificated online course on how to put on and remove PPE in the context of COVID-19. If your practitioner has qualified for this certificate, it is something that you could mention to the contact tracing team when appealing their decision. However, as above, there is no evidence as yet that this would make the difference in their instruction to you to self-isolate.
A more thorough clean of all spaces and surfaces that the person in question may have made contact will take place.
Using household bleach, disinfectant or a detergent that is listed as killing viruses will be used in addition to regular detergent.
The NHS clarifies this point here:
You can stop self-isolating after ten days if either:
- your symptoms have gone
- you just have a cough or changes to your sense of smell or taste – these symptoms can last for weeks after the infection has gone
Keep self-isolating if you still have any of these symptoms after ten days:
- a high temperature or feeling hot and shivery
- a runny nose or sneezing
- feeling or being sick
Only stop self-isolating when these symptoms have gone. If you have diarrhoea or you’re being sick, stay at home until 48 hours after they’ve stopped.
The NHS (National Health Service) COVID Pass and how it can be used
The NHS COVID Pass lets individuals share their coronavirus (COVID-19) vaccination and test results in a secure way.
The Government has made the NHS COVID Pass available as a means for individuals to demonstrate COVID status and for organisations to check it if organisations choose to use it.
If businesses decide to require evidence of COVID-19 status as a condition of entry, they should ensure that they comply with all the relevant legal obligations (for example, the Equality Act 2010) and guidance that applies (for more information on the Equalities Act please see our mask wearing document here: Patient-mask-wearing-and-the-Equalities-Act-2010_.pdf
There are some settings where the NHS COVID Pass should not be used as a condition of entry, to ensure access for all. This includes essential services and essential retailers which have been able to stay open throughout the pandemic.
If you use the NHS COVID Pass, you should ensure that you comply with all relevant legal obligations and guidance, including not discriminating against those with protected characteristics such as:
- gender reassignment
- marriage and civil partnership
- pregnancy and maternity
- religion or belief
- sexual orientation
Even when using the NHS COVID Pass, it is still important that you follow other relevant guidance and put measures in place.
You may ask your patient if they can demonstrate their COVID-19 status using the NHS COVID Pass. This allows your patient to respond with information about a self-declared medical exemption.
There will also be a small number of exemptions for individuals who have a medical reason, which means they cannot receive a vaccination or obtain a test. These individuals may self-declare their medical exemption directly with you.
Although your patients may declare a medical exemption unprompted, you and your staff should not ask for evidence of the exemption.
If your patient confirms that they have a self-declared exemption, but is unable to show any evidence, you should allow them access to your clinic unless the health and safety needs of you, a member of staff, other patients or clinic users override that.
Individuals under 18 should not be required to demonstrate COVID status in settings where the NHS COVID Pass is used.
What if the patient says they are not exempt but have chosen not to be vaccinated, can I refuse them entry?
The general rule is that a practitioner/member does not need to take on or continue to treat any individual provided that the reason for doing so is not any form of discrimination under the Equality Act 2010. The nine protected characteristics are set out above.
The types of discrimination are:
- third party harassment
- failing to make reasonable adjustments (disability only)
- disability related discrimination
How can I check a patient’s COVID Pass?
Please refer to the following for the instructions and for any further information.
The above information is Government guidance and not a recommendation from the BAcC. We urge practitioners to make their own professional judgements based on their own clinics and risk assessment.
The COVID-19 consent form supplied in the COVID-19 guidelines is a sample template to be used for practitioners to screen patients. Practitioners may adjust it to better suit their requirements and the screening questions are meant as a guide to better inform the risk assessment and decision to treat. The information can be adjusted or removed depending on its relevance for the practitioner and their practice. It remains that COVID-19 is a workplace hazard, and screening should be done for every client on the initial consultation, as well as a reminder to the patient to inform the practitioner should anything change.
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