Complementary Therapies - Devon Academy

Complementary Therapies
Acupressure
Concept

Acupressure is an alternative medicine technique similar in principle to acupuncture. It is based on
the concept of life energy which flows through "meridians" in the body. In treatment, physical
pressure is applied to acupuncture points with the aim of clearing blockages in these meridians.
Pressure may be applied by hand, by elbow, or with various devices.

Acupoints used in treatment may or may not be in the same area of the body as the targeted
symptom. The traditional Chinese medicine theory for the selection of such points and their
effectiveness is that they work by stimulating the meridian system to bring about relief by
rebalancing yin, yang and chi.

Many East Asian martial arts also make extensive study and use of acupressure for self-defence and
health purposes. The points or combinations of points are said to be used to manipulate or
incapacitate an opponent. Also, martial artists regularly massage their own acupressure points in
routines to remove supposed blockages from their own meridians, claiming to thereby enhance their
circulation and flexibility and keeping the points "soft" or less vulnerable to an attack.

Therapy objectives

    Acupressure is used most commonly as a helping treatment for the relief of chronic or acute pain,
    particularly pain involving muscles and joints. Some hybrid forms, in particular acu-yoga, may also be
    used to improve flexibility and range of motion. Most Americans who use acupressure do so in
    addition to rather than in the place of normal mainstream treatments.

    Acupressure is claimed to be effective for:

•   Stress relief
•   Headaches
•   Migraines
•   Neck Pain
•   Shoulder Pain
•   General aches and pains
•   Menstrual Problems
•   Anxiety
•   Nausea
•   Allergies
•   Insomnia
•   Chronic conditions
•   Eye Strain
•   Back strain
•   PMS
•   Salt imbalances
•   Fatigue

Regulations & Legal obligations

In the United Kingdom there is no overall governing body to provide national standards for
acupressure treatment. However, there are a number of professional associations, organisations and
bodies in which professionals can choose to register with and who have taken on the role of self-
regulation such like the ATCM association of Chinese medication and the FHT federation of holistic
therapists to name a couple. The therapists of course should be suitably insured and fully covered
for all the treatments they practice, along with this they should also be adequately qualified with
certification relevant to their relevant fields of treatments offered, and be able to keep these skill
sets consistently updated and expanded on through using continuing personal development (CPD),
to maintain a consistent level of standards for treatments given.

Key aspects of a good clinical practice

• Treat each client with respect, dignity and privacy

• Always use professional communication with clients

• Ensure the treatment environment is safe to work in and complies with Health and Safety at Work
Act 1974

• Ensure client consent is granted before treatment commences

• Work within your limitations of knowledge and skill set

• Ensure you are fully insured to practice

• Seek other professional advice when needed

• Maintain your skills and knowledge of treatments given with Continued personal development

Acupuncture

Concept
Acupuncture is a form of Chinese medicine that is used to treat patients with various conditions
ranging from cancer to shoulder pains. Needles are inserted in the body at very specific points to get
rid of pain or disease. It is said that when a person is experiencing pain there is a blockage of the Qi
energy flow and that acupuncture can bring it back to normal. Acupuncture is best used when health
conditions are in its beginning stage before it is too serious and cannot be treated.

Origins

The theory and practice of acupuncture originated in China. It was first mentioned and recorded in
documents dating a few hundred years before the Common Era.

Earlier instead of needles sharpened stones and long sharp bones were used around 6000 BCE for
acupuncture treatment. These instruments could also have been used for simple surgical procedures
like lancing an abscess etc.

Earliest documentation that refers to acupuncture procedures is The Yellow Emperor’s Classic of
Internal Medicine, dating from about 100 BCE. In this book the knowledge is in the form of

questions made by the Emperor that his learned minister, Chhi-Po has replied to. The book includes
the detailed knowledge regarding the concepts of channels (meridians or conduits in which the Qi
flows. The details of precise sites of acupuncture points however were developed later.

The tradition of acupuncture theory believes that energy flows within the human body and this
energy can be channelized to create balance and health. This energy flow is called qi and
pronounced “chee”.

Acupuncture theory believes that this qi moves throughout the body along 12 main channels known
as meridians. These meridians represent the major organs and functions of the body. These
meridians however do not follow the exact pathways of nerves or blood flow.

Further the tattoo marks seen on Ötzi the ‘Ice Man’ who died in about 3300 BCE are similar to some
form of stimulatory treatment that involves the meridians. The Ice Man was found when the Alpine
glacier melted.

Development

Acupuncture developed over the next few centuries and gradually became one of the standard
therapies used in China. It was complemented and supported by use of massage, diet, herbs and
heat therapy or moxibustion.

It was in the fifteenth century that Bronze statues with acupuncture points that are in use today
were depicted. These were used for teaching and examination purposes. From the 17th century on,
the interest in this tradition declined. It was considered irrational and was laced with superstitions.
The Emperor’s decree in 1822 excluded acupuncture from the Imperial Medical Institute. The rural
healers and some scholars held on to the knowledge of this practice.

With rise of Western medicine in the 20th century, acupuncture practices further fell into disrepute.
In 1929 it was outlawed in China along with other forms of traditional medicine.The Communist
Government in 1949 revived the traditional forms of medicine including acupuncture. Acupuncture
research institutes were established in the 1950s throughout China and the practice became
available in several hospitals.

The practice spread to several other countries. Korea and Japan received the knowledge in the 6th
century. European physician Ten Rhijne who worked for East India Company described the practice
medically in around 1680. Within the first half of the 19th Century both America and Britain
developed interest in this ancient therapeutic form.

It was in 1971 that a member of the US press corps was treated with acupuncture during recovery
from an emergency appendectomy in China which he was visiting. He described the experience in
the New York Times and created interest in the success of the procedure.

Acupuncture was finally accepted in the USA when an NIH consensus conference reported that there
was positive evidence for its effectiveness, at least in some conditions.

Theory objectives

Currently, acupuncture is used to treat conditions like:

    •   muscle spasms and pain
    •   chronic back problems and pain
    •   headaches, including reducing the frequency and intensity of migraines
    •   neck pain
    •   osteoarthritis
    •   knee pain
    •   allergies
    •   digestive problems
    •   mood, depression

Acupuncture is considered to be a family of procedures, not one single exact approach to pain or
disease management. All acupuncture practices involve the stimulation of specific points on the
body using a variety of techniques, usually needles. The type of acupuncture that has been studied
most so far in clinical, scientific research settings is the type that uses thin, solid, metal needles to
lightly puncture the skin.

Acupuncture is usually done by hand, with a trained practitioner carefully inserting the needles into
specific points in the body very shallowly into the skin. Normally about 10 to 20 thin needles are
used at one time. The needles are small enough to fit inside of a normal-sized needle that would be
used to take blood, making the process pretty painless for most people.

There are also types of acupuncture that use light electrical stimulations that flow through the
needles, or no needles at all. For example, acupressure is often thought of as simply “acupuncture
without the needles” and uses targeted massage-type techniques to stimulate energy in the body by
pressing on certain points.

Acupuncture points, or “acupoints,” are specific locations on the body that are the focus of
acupuncture treatments. TCM explains acupuncture as a technique for “balancing the flow of energy
or life force,” and that energy can be reached by stimulating small specific channels on the body.

TCM practitioners believe that there is a flow, known as chi, that is located in certain “meridians”
throughout the body. Chi is thought to be what separates the sick from the healthy — and when chi
is not balanced, illness, pain, poor sleep, and fatigue can all occur.

    •    There are 14 major energy-channel meridians on the body, with hundreds of points located
        along each meridian where acupuncture needles are inserted.
    •   These include some 360 different points on the hands, arms, feet, head, back and over the
        major organs. The belief is that by inserting needles lightly into certain points on the body,
        the chi flow can be tapped into and the patient’s energy can be rebalanced.
    •   Acupuncture points tend to be located where nerves enter a muscle, the midpoint of a
        muscle, or at a point where muscle joins with bone.

Some of the major acupuncture meridians include:

    •   Lung Meridian
    •   Large Intestine Meridian
    •   Stomach Meridian
    •   Spleen Meridian
    •   Heart Meridian
    •   Small Intestine Meridian
    •   Urinary Bladder Meridian
    •   Kidney Meridian
    •   Liver Meridian

Regulations & Legal obligations

There is no regulation of acupuncture by law in the UK, what is termed statutory regulation, and in
theory anyone could undertake a short course in acupuncture and start up in business. In practice

there is health and safety regulation in law about all forms of skin piercing which means that all
practitioners have to either registered or licensed. Different rules apply in Scotland and Greater
London from the rest of the UK, with practitioners having to hold an annual licence unless they
belong to a professional body which has exempt status, like the BACC, or are already regulated for
their primary activity like physiotherapy or osteopathy. In the rest of the UK everyone except
doctors and dentists has to be registered for every practice in which they work, but only pays a one-
off registration fee.

Key aspects of good clinical guidance

    •   Professional duties should be constant and steadfast
    •   Obligation to patients are always met, maintaining client/patient satisfaction
    •   Ethical boundaries should be maintained, adopting a therapeutic relationship with the
        client/ patient and not under involvement or over involvement and to be mindful of social
        media
    •   Legal & commercial obligations are to be outlined and constantly maintained
    •   Standards of behaviour should be met and maintained, the therapist’s responsibility is to
        delineate and maintain these always
    •   Clinical standards are always met and upheld
    •   The disposal of clinical waste is properly maintained by using a licensed carrier who will
        remove the waste away to a licensed waste disposal site
    •   Personal injury guidance for all clients should be discussed and options given for informed
        decisions to be made
    •   Ensure the maintenance of written records is kept securely and safely in line with the data
        protection act 2018
    •   Commitment to Health & safety within your business and that of your place of treatments
        fall under the Health and Safety Act 1974

Lymphatic Drainage Massage

Concept

Manual lymphatic drainage is a type of massage based on the hypothesis that it will encourage the
natural drainage of the lymph, which carries waste products away from the tissues back toward the
heart. The lymph system depends on intrinsic contractions of the smooth muscle cells in the walls of
lymph vessels and the movement of skeletal muscles to propel lymph through the vessels to lymph
nodes and then to the lymph ducts which return lymph to the cardiovascular system. Manual lymph
drainage uses a specific amount of pressure and rhythmic circular movements to stimulate lymph
flow.

Origins & Development

1622

Gaspard Asselli (1581 – 1626). The first historical discovery of the lymphatic system was documented
in 1622 which refers to the findings of `milky veins` in a dog after digestion.

1628

English physician to King James I, William Harvey, M.D (1578 –1657) published his latest findings
accurately describing how blood circulates around the body and how the heart is central to this
process he had discovered a circulatory system that makes a Complete circuit.

1647

Jean (John) Pecquet (1622-1672) discover the lacteal vessels and the flow of lymph fluid in the
largest lymphatic vessel into the vena cava. He had of course revealed the `Pecquets cistern` or as it
is known today the `Cisterna Chyli`.

The biggest revelation and true discoverer of the lymphatic system was Swedish anatomist Olauf
Rudbeck (1630 – 1708) who declared that the lymphatic system was actually a complete and definite
system within the human body and compared this to the venous circulatory system.

1637

Thomas Bartholin a young Dane studied Aselli’s work and injected gum resin and indigo into the
lymph vessels to make them visible. He was the first to describe the entire lymphatic system. Wrote
4 papers in Latin describing the – Lymph system as a natural process that purifies the body and
regulates irritation, swelling and oedema – No official terminology was used to this stage.

1848 - 1910

Alexander of Winiwarter from Belgium (18481910) who was the first medical practitioner to use
manual lymph drainage in hospitals for relieving lymphoedema symptoms. This self- education of
lymphatics was at last starting to show.

Johan Conrad Peyer (Schaffhausen) some 20 years later described the intestine Lymph Nodes
‘Payers Patches’

1878- 1951

Add 20 or so years and the first International Lymphatic Society was formed. The Founder and
president Fredrick.P. Millard (1878 – 1951) coined the phrase “lymphatic drainage” suggesting
different techniques would affect the lymph flow. His work and discoveries were 10 years ahead of
Emil Vodder Ph.D., M.T (1896 – 1986) and Estrid Vodder (1898 – 1996).

1935

Emil Vodder developed the first ever known massage technique MLD - Manual Lymphatic Drainage,
and his method first became known to the general public when he published his findings and his
methods became recognised as effective treatments for ailments relating to lymphatic system in
1935.

1969

30 years later in 1969 physician Johannes Asdonk scientifically used and tested the Vodder
technique establishing the first training school for MLD in Germany. In the first lymphatic study, 347
years after its first discovery, 20,000 patients were tried and tested.

1980

In the early 1980`s Professors Michael Foëldi M.D and Ethel Foëldi advanced to another level by
combining techniques known today as CDT, Complete Decongestive Therapy in the treatment of
Lymphoedema. Their dedication and practice grew, incorporating specific training alongside Klose
Training and Consulting and their methods continue to be used today amongst worldwide
Lymphoedema practitioners.

1980- 1990

In America, Dr Bruno Chickly a member of the International Society of Lymphology created Lymph
Drainage Therapy, LDT. His work has incorporated adapted techniques to `work the lymphatic
system`. He is eminent in the fight to understand lymphatic’s and sourcing successful and faster
treatments for Lymphoedema.

Manual Lymphatic Mapping, MLM, differs from CDT as it creates alternative pathways for lymph and
interstitial fluid. This safe and non-invasive technique more accurately helps identify alternate
pathways in lymphoedema patients. The research is on-going but only in the field of diseased tissue.
Area of great interest and work is the sports related fields and recovery and sports injury
management need to be addressed.

Theory Objectives

Lymphatic Massage is commonly referred to as Lymphatic Drainage. Lymphatic drainage is a gentle,
rhythmical massage treatment performed by a specially trained lymphatic massage therapist to
stimulate the circulation of lymph fluid around the body. This helps to rapidly speed up the removal
of wastes and toxins from a sluggish lymphatic system. Lymphatic massage can also aid in the
prevention of swelling after injury or surgery. It is also thought to provide a major boost to your
immune system.

Lymphatic massage aims to increase the efficiency of your lymphatic and circulatory system. By
reducing the volume of retained fluid and the pressure associated, it can reduce the risk of impeded
circulation. This increases your circulatory system's capacity to rapidly move out retained fluids and
any toxic waste build ups. In some cases, we have found that a patient feels quite “energized” post-
drainage.

Lymphatic massage improves circulation, increases your metabolic rate, and. Has the potential to
improve your immunity. It has also been shown to be very beneficial in post-operative conditions
that affect your lymphatic systems such as post-mastectomy. 25-33% of all breast cancer sufferer
develop lymphoedema. (Kelly D 2008, Stubblefield M 2011)

Some of the conditions that may benefit from lymphatic drainage massage include:

Swollen legs or arms due to fluid retention.

Swelling of a limb: pre- or post-surgery.

Lymphoedema. (Hock K, Colby L 2012)

Post-mastectomy or breast cancer treatment. (Torres Lacomba M et al 2010)

Breast tenderness & congestion.

Fibromyalgia & Lupus

Chronic Fatigue Syndrome

Depression & Anxiety

Hormonal & emotional imbalances

Cellulite fat accumulation.

Recurrent infections such as colds, flu, tonsillitis, sinus & yeast infections.

Lymphatic massage sessions range from 30 to 90 minutes depending on the condition being treated.
For an initial lymphatic massage, the session is a 60-minute treatment to stimulate your lymphatic
flow. This will stimulate drainage in one limb. Initial treatments will be 90 minutes.

In your first session, your lymphatic massage therapist will gain a thorough history & understanding
of your condition to ascertain how to effectively treat your specific condition. Lymphatic massage is
performed on a massage table. The massage strokes used in the massage are light and rhythmic, and
the lymphatic massage should not be painful. Massage oil may or may not be used.

Your lymphatic system’s major roles are to collect excess fluid from the tissues, purify it and return it
to the blood stream. This role is important because many substances are continuously leaking out of
the blood capillaries into the surrounding tissues. When your lymphatic system fails to sweep up
these excess fluids, they can accumulate, cause swelling and potentially increase the risk of
infection. An efficient lymphatic system helps to defend your body against germs such as bacteria,
viruses & fungi that may cause illness. Luckily, an effective lymphatic system silently works in the
background keeping you healthy.

The lymphatic system drains the fluid into specific regions of your body such as your armpits and
groin where there is a concentration of lymph nodes. The lymph nodes contain lymphocytes (a type
of white blood cell) & some of these lymphocytes contain antibodies that fight off germs (including
cancer cells) & stops infection from spreading throughout the body. The good news is that lymphatic
massage rapidly speeds up your lymphatic system and its capacity to fight disease and viruses,
remove toxins and waste products, reduce swelling, filter lymph fluid and your blood, leading to
your better health.

Lymphatic massage is a specialised treatment that requires additional qualifications. If you are
interested in lymphatic drainage, please ensure that your massage therapist is appropriately
qualified.

Regulations & Legal obligations

The GCMT is the governing body for massage and soft tissue therapies that form all bodyworks and
soft tissue techniques in the United Kingdom. All the authorities to do with this are voluntary,
meaning that due diligence should be done in finding a therapist for a treatment, or for anyone who
thinking of becoming a therapist. Adequate qualifications should be reached as a minimum along
with the therapist following a decent set of ethics. Therapists should be registered with at least one
or more governing body, but this isn’t a pre requisite

Key aspects of good clinical guidance

    •   Professional duties should be constant and steadfast
    •   Obligation to patients are always met, maintaining client/patient satisfaction
    •   Ethical boundaries should be maintained, adopting a therapeutic relationship with the
        client/ patient and not under involvement or over involvement and to be mindful of social
        media
    •   Legal & commercial obligations are to be outlined and constantly maintained
    •   Standards of behaviour should be met and maintained, the therapist’s responsibility is to
        delineate and maintain these always
    •   Clinical standards are always met and upheld
    •   The disposal of clinical waste is properly maintained by using a licensed carrier who will
        remove the waste away to a licensed waste disposal site
    •   Personal injury guidance for all clients should be discussed and options given for informed
        decisions to be made
    •   Ensure the maintenance of written records is kept securely and safely in line with the data
        protection act 2018
    •   Commitment to Health & safety within your business and that of your place of treatments
        fall under the Health and Safety Act 1974

Osteopathy

Concept

Osteopathy is a drug-free, non-invasive manual therapy that aims to improve health across all body
systems by manipulating and strengthening the musculoskeletal framework.

An osteopathic physician will focus on the joints, muscles, and spine. The treatment aims to
positively affect the body’s nervous, circulatory, and lymphatic systems.

Manual medicine means that both diagnosis and treatment are carried out with the hands.

Osteopathy is a complementary therapy. It is used alongside conventional treatment to improve
health, based on the concept that the body can formulate its own remedies against such things as
diseases or muscular and skeletal damage, when its parts are in a normal structural relationship, it
has a normal environment, and enjoys good nutrition. Osteopathy is particularly concerned with
maintaining correct relationships between bones, muscles, and connective tissues.

Origins & Development

Osteopathy was founded in the late 1800s by physician and surgeon Andrew Taylor Still in Kirksville,
Missouri. The son of a surgeon, Still soon discovered that in order to achieve the highest possible
form of health, all parts of the body should work together harmoniously. His goal was to restore the
body to optimum health with minimal surgery and medicine, influenced in part by the realisation
that medical treatments of that time were largely ineffective and, in some cases, harmful.

Over time, during which he treated patients with a wide range of conditions, from dysentery to
sciatica and arthritis, with varying results, he gained a reputation as an effective practitioner.

Patients from all over America flocked to Kirksville for treatment. Soon demand was so high,
boarding houses were built and train routes were altered to cater for the amount of people seeking
treatment.

In 1892, Still took on the first wave of 22 osteopathic students at the American School of
Osteopathy. The first class of both men and women (symbolic of Still’s strong sense of liberalism)
were taught over a period of two years, and included in-depth education in physiology and anatomy.
He drew in full practice rights for his students, and upon graduation, awarded them the title of D.O
(Doctors of Osteopathy).

One of Still’s early students was J Martin Littlejohn, who, after taking on a job as physiology lecturer
at the American School of Osteopathy, registered as a student. He was made Dean of the school that
same year. Following bitter disagreements with some of A.T. Still’s followers regarding the role of
physiology within osteopathy, as well as other factors, he was released from his role as Dean, and
moved to Chicago, where he established the Chicago College of Osteopathy in 1900. Theoretical
education was expanded upon and physiology became a core subject. Despite criticisms from the
American School of Osteopathy, the Chicago College of Osteopathy went from strength to strength
and was seen as a key scientific osteopathic institution. Due to the onset of political changes, J

Martin Littlejohn moved back to Britain with his family in 1913, where he worked in hospitals in a
variety of jobs, until he helped found the British School of Osteopathy (BSO) and the Journal of
Osteopathy in 1917. This helped to lay foundations for osteopathy in Europe.

When the BSO opened, the British Osteopathic Association (formed in 1903 as a British branch of the
American Osteopathic Association, where American-educated osteopaths came to live and practice)
wanted a school based on American tradition where graduates practiced both osteopathy and what
is known as ‘allopathic medicine’, meaning conventional medicine. The BSO did not share the same
views, and the BOA eventually made some leeway with this ambition with the establishment of the
London College of Osteopathic Medicine (LCOM) (London Bridge Osteopaths, 2013) in 1946, which
saw shorter osteopathic courses being offered to medical professionals, and therefore, the
professionals graduating from the courses became the first British-trained osteopaths to start
practice. In 1935, the BMA campaigned for a new parliamentary bill, which saw osteopathy being
refused any official recognition. Osteopathy was considered to be outside of mainstream medical
practice in Britain and was not a legally regulated profession until the introduction of the Osteopaths
Act in 1993, which led to the establishment of the General Osteopathic Council, as well as the
Register opening, in 1998. Like other medical professions, osteopathy is now subject to statutory
regulations and qualified practitioners need to register with GOSC in order to practice and use the
title of ‘osteopath’.

The education and support for osteopathic students has continued to improve, with more and more
colleges and universities accredited to teach osteopathy or support osteopathic colleges (both full
courses, and shorter courses for medical professionals), such as Swansea University, Bedfordshire
University and Anglia Ruskin University.

Therapy Objectives

  •   Osteopathy uses a drug-free, non-invasive form of manual medicine that focuses on the
      health of the whole body, not just the injured or affected part.
  •   The osteopathic physician focuses on the joints, muscles, and spine.
  •   Osteopathic intervention can help treat arthritis, back pain, headaches, tennis elbow,
      digestive issues, and postural problems.
  •   Treatment can also assist with sleep cycles and the nervous, circulatory, and lymphatic
      symptoms.
  •   Osteopathy takes a holistic, whole-body approach to healthcare.
  •   It uses manual ‘hands-on’ techniques to improve circulation and correct altered
      biomechanics, without the use of drugs.
  •   An osteopathic physician does not concentrate only on the problem area, but uses manual
      techniques to balance all the body systems, and to provide overall good health and
      wellbeing.
  •   Diagnosing and treating conditions using these techniques is called Osteopathic
      Manipulative Medicine (OMM).
  •   Techniques include stretching, gentle pressure, and resistance, known as osteopathic
      manipulative medicine.
  •   An osteopathic physician may also issue prescription medicine and use surgical methods to
      support the holistic, manual treatment.

•   Many osteopathic physicians also serve as primary care physicians in fields such as family
        medicine, internal medicine, and paediatrics.

Regulations & Legal Obligations

By law, osteopaths must be registered with the General Osteopathic Council (GOsC).

The General Osteopathic Council only accepts registration from practitioners who have a
qualification in osteopathy that's recognised by the General Osteopathic Council and who comply
with their standards of practice.

Osteopaths are required to renew their registration each year. As part of this process, the General
Osteopathic Council checks they have the correct insurance, are meeting professional development
requirements, and remain in good health.

If you use an osteopath and they don't adhere to this standard of practice, you can complain to the
General Osteopathic Council. It has a duty to investigate the complaint.

The General Osteopathic Council has a register of osteopaths you can use to find one in your local
area.

www.osteopathy.org.uk/register-search/

Regulation aims to protect patient safety, but it doesn't mean there's scientific evidence that a
treatment is effective.

Osteopaths complete a 4- or 5-year honours degree programme (bachelor's or master's), which
involves at least 1,000 hours of clinical training. Some osteopaths are qualified to PhD level.

Training Required & Key aspects of good clinical practice

Communication and patient partnership

This theme sets out the standards relating to communication, the formation of effective patient
partnerships, and consent. Patients must be at the centre of healthcare and must be given the
information that they need in order to make informed choices about the care they receive. These
standards support therapeutic relationships built on good communication, trust and confidence.

    •   You must listen to patients and respect their individuality, concerns and preferences. You
        must be polite and considerate with patients and treat them with dignity and courtesy.
    •   You must work in partnership with patients, adapting your communication approach to take
        into account their particular needs and supporting patients in expressing to you what is
        important to them.
    •   You must give patients the information they want or need to know in a way they can
        understand.
    •   You must receive valid consent for all aspects of examination and treatment and record this
        as appropriate.
    •   You must support patients in caring for themselves to improve and maintain their own
        health and wellbeing.
    •   You must respect your patients’ dignity and modesty.
    •   You must make sure your beliefs and values do not prejudice your patients’ care.

Knowledge, skills and performance

All osteopaths must have the knowledge and skills to support their practice as primary healthcare
professionals, and must maintain and develop these throughout their careers. They must always
work within the limits of their knowledge, skills and experience. The standards in this theme set out
the requirements in this respect.

    •   You must have and be able to apply sufficient and appropriate knowledge and skills to
        support your work as an osteopath.
    •   You must recognise and work within the limits of your training and competence.
    •   You must keep your professional knowledge and skills up to date.
    •   You must be able to analyse and reflect upon information related to your practice in order to
        enhance patient care.

Safety and quality in practice

Osteopaths must deliver high-quality and safe healthcare to patients. This theme sets out the
standards in relation to the delivery of care, including evaluation and management approaches,
record keeping, safeguarding of patients, and public health.

•   You must be able to conduct an osteopathic patient evaluation and deliver safe, competent
        and appropriate osteopathic care to your patients.
    •   You must ensure that your patient records are comprehensive, accurate, legible and
        completed promptly.
    •   You must respond effectively and appropriately to requests for the production of written
        material and data.
    •   You must take action to keep patients from harm.
    •   You must ensure that your practice is safe, clean and hygienic, and complies with health and
        safety legislation.
    •   You must be aware of your wider role as a healthcare professional to contribute to
        enhancing the health and wellbeing of your patients.

Professionalism

Osteopaths must act with honesty and integrity and uphold high standards of professional and
personal conduct to ensure public trust and confidence in the profession. The standards in this
theme deal with such issues and behaviours, including the establishment of clear professional
boundaries with patients, the duty of candour, and the confidential management of patient
information. These contribute to ensuring that trust is established and maintained within
therapeutic relationships.

    •   You must act with honesty and integrity in your professional practice.
    •   You must establish and maintain clear professional boundaries with patients, and must not
        abuse your professional standing and the position of trust which you have as an osteopath.
    •   You must be open and honest with patients, fulfilling your duty of candour.

•   You must have a policy in place to manage patient complaints, and respond quickly and
    appropriately to any that arise.
•   You must respect your patients’ rights to privacy and confidentiality, and maintain and
    protect patient information effectively.
•   You must treat patients fairly and recognise diversity and individual values. You must comply
    with equality and anti-discrimination law.
•   You must uphold the reputation of the profession at all times through your conduct, in and
    out of the workplace.
•   You must be honest and trustworthy in your professional and personal financial dealings.
•   You must support colleagues and cooperate with them to enhance patient care.
•   You must consider the contributions of other health and care professionals, to optimise
    patient care.
•   You must ensure that any problems with your own health do not affect your patients. You
    must not rely on your own assessment of the risk to patients.
•   You must inform the GOsC as soon as is practicable of any significant information regarding
    your conduct and competence, cooperate with any requests for information or investigation
    and comply with all regulatory requirements.