Who, how & when can Scottish therapists return to work?
Those who can legally return to work on Monday includes those with the following qualifications:
- Level 4 / SCQF level 8 - Remedial & Sports Massage therapists holding a diploma qualification that took them 8-9 month to attain, most typically delivered by Scottish Massage Schools, Western School and AMTS in Scotland
- Level 4 / SCQF level 8 - Sports Event Massage / Therapy therapists holding a diploma qualification that took them 6 months to attain, delivered by Scottish Massage Schools
- Level 4 / SCQF level 8 – Sports Therapy (including HNC in Soft Tissue Therapy, HND in Sports Therapy) delivered by Glasgow, Edinburgh, Inverness and Perth Colleges
- Level 5 - Advanced Remedial Massage therapists holding a diploma qualification that took them 11-12 months to attain, most typically delivered by Scottish Massage Schools and AMTS in Scotland
- SCQF Level 9 – BSc in Sports Therapy - delivered by Perth College UHI
- SCQF Level 10 - BSc (Hons) in Sports Therapy and Rehabilitation - delivered by Perth College UHI
- Manipulative Therapy therapists
Only therapists with a qualification from the above list may return to work from Monday 6th July 2020.
The following therapists do not yet meet requirements, therefore need further guidance from The Scottish Government before returning to work:
- Level 3 - Swedish / Holistic / Therapeutic massage therapists – regardless of CPD
- Level 3 - Sports Massage therapists – regardless of CPD
Hopefully, the time for you to return to work is not far away but it will be at some point after the 23rd July. We will keep you posted.
Returning to work – conditions which must be adhered to at all times.
For those of you now able to return to work, there are strings attached! Please understand that this is not an allowance to go back to normality, as there are many restrictions still in place and only certain types of treatment will be allowed to go ahead.
- The return to work is only to treat clients / patients who are in pain, and you must be able to justify that your specific Remedial & Sports massage treatments can reduce your client’s pain. Please inform your clients of this when you email your client base. I’m sure a lot of them will then choose their words carefully when they reply to you to book.
- You MUST, MUST, MUST follow Government guidelines and complete a risk assessment of your clinic space. Any risks identified, must be mitigated before you return to work. Also, you must DOCUMENT your risks and the changes you are putting in place.
- You MUST adhere to Hygiene for Close Contact Work Guidance. https://assets.publishing.service.gov.uk/media/5ef2889986650c12970e9b57/Keeping-workers-and-clients-safe-during-covid-19-close-contact-services-230620.pdf As this return to work comes earlier than expected, it means that you will have to comply with the guidance for this phase of returning to work in the same manner as for Physiotherapists, Osteopaths and Chiropractors. This means wearing PPE – mask, visor and aprons – and cleaning of surfaces, to mitigate the risks of being within the 2 metres of another person that Scotland still adheres to.
- You MUST screen your clients and ask them to complete a Covid-19 disclaimer before they come to your clinic. This has been agreed by my lawyer and must be adhered to. (SMTO will share this with you over the next 24-48 hours).
- Reduction in face-to-face appointment length – do as much of your consultation and assessment before the client comes to your clinic. Keep your massage activity time as short as possible.
- We cannot stress enough how important hand hygiene is now, more than ever. Please ensure that you thoroughly wash your hands (for at least 20 secs) before and after every patient. Every patient should be met with a mask and hand sanitiser when you welcome them into your clinic.
Issues with working from home
Those of you working from home must also adhere to social distancing rules which currently state that 2 other households can come together outside only.
But from the 10th July, in Scotland, these 2 other households will be able to meet indoors. This may impact on the number of clients you can treat each day:
- Having a designated workspace separate from the rest of your domestic house enables you to carry on as detailed in points 1-6 above. If your home clinic space has a separate entrance or is right next door to your client’s entry point to your house, then you can call this space ‘workspace’, as long as it does not interfere with anyone else in your household.
- However, if your client enters your house and has to walk through your home to get to your treatment room, then you cannot return to work until Government guidelines enable you to have up to 2 other households enter your home. This will limit the number of clients you can see each day to only 2. Consider moving your treatment room to another part of your house to comply with Government guidelines.
From Monday 6th July 2020, all SMA members who hold a Level 4 Sports Massage qualification or above, and holds Balens Insurance policy, can return to work as long as they adhere to the above guidelines. You do not need to individually call Balens.
Meeting others in Phase 2 – currently only outside
Phase 3 - Scottish households can meet indoors with up to a maximum of two other households (with physical distancing) – from 10 July
What PPE should I be wearing?
- There is much conflicting information about PPE requirements and a lack of advice that is specific to our industry, so the recommendations from the SMA are advisory not mandatory. However, we strongly recommend you wear PPE as other healthcare professionals in similar fields are doing to demonstrate due diligence, build confidence and trust with clients, to show professionalism and from an insurance perspective.
- We know there is much conflicting advice about this but we strongly suggest you wear what is suggested. Should any problems occur at a later date you would have to justify why you chose not to wear it. Better to be safe than sorry.
- Face mask – fluid repellent which are known as Type IIR
- Face visor - It may be useful to have a face visor for situations where the client does not have Covid-19 but are still generating aerosol i.e. hay fever or asthma
Should I be taking my clients temperature?
- There is much debate about the worth of taking a client’s (or your own) temperature with regard to whether or not the results are relevant. A hot day, rushing to get to the clinic etc. can increase a client’s temperature and also there is a question about the efficacy of contactless thermometers. The SMA feels it provides some indication of possible illness, demonstrates due diligence and once again, may instil confidence in the therapist from the client’s perspective.
- If a client’s temperature is raised but screening results are negative, maybe give the client time to sit quietly and cool down. Be aware of their potential to infect others if they subsequently do have Covid-19 and have entered your premises.
What are you doing to try to get us back to work?
- We have been seeking clarity on the return to work situation for weeks. We found ourselves in the grey area between Physiotherapy and Massage Parlours and having to navigate ambiguity in Government guidelines. Our sector has only just come on the Government radar with the correct terminology finally being used. We have lobbied MPs and that process is still going on. Our objective is to ensure our profession is firmly placed in the healthcare sector to avoid misunderstandings in the future. Having said that we have a responsibility to ensure that our members and the public are protected so we will err on the side of caution and adhere to Government guidelines no matter how unpalatable they may be.
Why aren’t we regulated?
- Regulation in the UK is on a spectrum based on perceived risk. Statutory regulation is not the badge of honour it once was and is largely reserved for professions regarded as high risk. At the other end of the spectrum is voluntary and self regulation for low risk professions such as our own. The Professional Standards Authority described UK regulation as ‘not fit for purpose ‘...and we agree. There is a compelling need for a form of regulation for the Soft Tissue Therapies industry beyond that currently offered. We are actively looking at licensing models that operate in other countries.
Why don’t you work with other Professional Associations and lobby government?
- The SMA are part of GCMT (http://www.gcmt.org.uk/), a council composed of 12 other Professional Associations and Awarding Organisations. Paul Medlicott, our current Chair, chaired the GCMT for ten years, taking it from near collapse to the major driving force that it is in our industry now. Paul no longer chairs the GCMT but we have two representatives on the council and regularly attend their meetings, working closely with them at all times. In the current situation we are having multiple meetings weekly to do what we can to improve our situation. Collectively, and individually, we have approached the Government, the Health and Safety Executive, Public Health England and many others. We also work with CNHC (https://www.cnhc.org.uk/) who will be imminently opening a category for Sports Massage Therapists – a form of voluntary regulation for our industry. To demonstrate how long it takes to achieve change, this process has taken four years!
Why can physiotherapists, osteopaths and chiropractors work?
- These industries are regulated, which means they are controlled by Government rules. In other words, they are a controlled industry and members can be struck off and unable to work if they break the rules. Our industry is not regulated (see above) and consequently advice we give is just that, its advisory, we cannot enforce it. If sports massage therapists do not follow our advice, we can remove that person from our Association but that doesn’t mean they can no longer work. It is not a necessity for sports massage therapists to be a member of a Professional Association at all and therefore there are many people working within our industry with minimal qualifications. Should the government say massage therapists can return to work, it includes ANYONE, not just the appropriately qualified, professional therapists.
Why have Soft Tissue Therapists (STT's) that work in elite sports been allowed back to work?
STT's that work in elite sport have to conform to very specific conditions which are much more controllable than working with the public. They also have to be associated with a relevant sporting body. Here are all the Guidelines if you want to read them specifically.
Elite Sport return to training guidance: Stage One
Elite Sport return to training guidance: Stage two
Elite Sport return to domestic competition guidance: Stage Three
As a summary, an Elite Athlete is defined as:
- an individual who derives a living from competing in a sport
- a senior representative nominated by a relevant sporting body
- a member of the senior training squad for a relevant sporting body, or
- aged 16 or above and on an elite development pathway.
A “relevant sporting body” is the national governing body of a sport which may nominate athletes to represent either
- Great Britain and Northern Ireland at the Summer Olympic and Paralympic Games to be held in Tokyo, or the Winter Olympic and Paralympic Games to be held in Beijing, or
- England, Wales, Scotland, Northern Ireland, Gibraltar, Guernsey, Jersey and the Isle of Man at the Commonwealth Games to be held in Birmingham in those sports which are not part of the Tokyo Olympic and Paralympic Games programme.
There must be a named medical Covid officer who manages all risk, treatments and testing.
In Stage 3, the following is stated: Plans for physiotherapy and soft tissue therapist treatments. This should be limited to an essential need only and the need for routine or maintenance therapy should be risk assessed on a case-by-case basis.
Why are acupuncturists allowed to return to work?
- The main reason that acupuncturists have been able to return to work is because of the limited time they spend with clients and therefore the reduced risk. They can take consultations electronically prior to meeting the client. When the client arrives, they insert needles, leave them to take effect and return to remove the needles. Contact time can easily be less than 15 minutes, which is considered low risk exposure.
Why can’t you produce a letter (proforma) that we could all send to our MP’s arguing our case?
- Proforma letters are recognised as spam in the Parliamentary email system and so this would be ineffective. However, we have recently sent out guidelines to help you produce a letter yourself and details of how to find your MP’s details
Will mobile therapists be able to work?
- The latest version of our Risk Assessment details contains a section for mobile therapists. When sports massage therapists are allowed to return to work, we presume you will be able to work too unless it states specifically that you cannot.