About the Review
Last year we launched a call for evidence inviting osteopaths, patients and the public to comment on the current standards for osteopaths and their experiences of using them in practice. Using the responses we received as well as incorporating best practice from other regulators and changes in the law, we are now consulting on updated osteopathic practice standards.
We hope the updated standards are clearer and will support osteopaths to continue to deliver high quality care for their patients, but we want to hear your views whether you are an osteopath, a patient, a member of the public or another interested party.
What are the Osteopathic Practice Standards?
The Osteopathic Practice Standards and associated guidance published by the General Osteopathic Council:
- Describe the standards that all osteopaths must practice.
- Explain to patients, other health professionals, students and others the standards which they can expect all osteopaths to practise to.
- Define the standards that all UK-qualified osteopaths must meet in order to be awarded a ‘Recognised Qualification’ leading to registration with us. This means that all UK osteopathic educational institutions develop detailed curricula and assessments mapped against the Osteopathic Practice Standards and this in turn is the standard against which qualifications and institutions are quality assured.
- Define the standards that internationally-qualified applicants must substantially meet before being registered with us through our GOsC assessment processes.
- Are used to support osteopaths returning to practice after two or more years out of UK practice to identify appropriate CPD.
- Define the standards that osteopaths are judged against in our fitness to practise procedures when considering whether conduct amounts to ‘unprofessional conduct’.
The development of revised standards and guidance
The development process included a call for evidence (January-May 2016) in which osteopaths and others were invited to comment on the current standards, and their experience of implementing these in practice. The revisions were informed by the responses to this call for evidence, and developed further in conjunction with a Stakeholder Reference Group. This group included input from various stakeholders, including the Council of Osteopathic Educational Institutions, National Council for Osteopathic Research, Osteopathic Alliance, Institute of Osteopathy and patients.We have undertaken a comprehensive review in order to update our standards and guidance, enhancing clarity and ensuring fitness for purpose for today’s patient-practitioner consultation.
Proposals for consultation
The Osteopathic Practice Standards and application to practiceThe Osteopathic Practice Standards comprise part of a range of components that influence practice, and the relationship between patient and practitioner. In order to enhance implementation, the GOsC Council determined that the scope of the consultation on revised Osteopathic Practice Standards should embrace four levels:
|Overarching values / principles||Possible inclusion of a set of high-level over-arching values/principles. Alternatively, reflect those developed and owned by the profession (e.g. ‘Patient Charter’).|
|Standards||The existing 37 standards with modifications where required.|
|Guidance||Revision and strengthening of the current guidance, incorporating revisions identified in the review.|
|Learning resources||A range of material explicitly linked to the OPS, providing more explicit explanation of why standards are in place/how they apply in practice. In support, also additional resources, or sign-posting to relevant external resources, case studies, and interactive educational material, etc. This would largely be provided online.|
Overarching values / principles
What is important to patient and practitioner will influence the decision making within the osteopathic consultation. We are working closely with the Collaborating Centre on Values Based Practice at St Catherine’s College in Oxford, the General Dental Council and independent consultants Community Research, in order to develop a clearer understanding of the values that are important to individual patients and practitioners and thus better inform the interpretation and application of standards.
The Institute of Osteopathy is introducing a Patient Charter and set of service standards for osteopaths which will also influence this area.
Standards and Guidance
The Osteopathic Practice Standards and associated guidance can be used together and collectively to inform all the functions of the Osteopathic Practice Standards outlined at paragraph 4 above, supporting consistent and clear practice. This means that standards and guidance are synonymous in their effect .
However, standards should provide a comprehensive summary of all the information which is outlined in the guidance. They should be regarded as universal – applicable to all osteopaths in all contexts. The standards collectively inform the overarching framework whereas guidance informs and supports their interpretation of the standards, whilst still being authoritative and applicable in all the contexts outlined above.
Research undertaken for the GOsC by Professor Gerry McGivern and others suggests it is not just the ‘what’ but the ‘how’ and the ‘why’ which is important in supporting implementation of standards. However, some of this ‘how’ and ‘what’ is not suitable for guidance, and might best be demonstrated through learning resources, for example, case scenarios, e-learning or videos, or ‘think pieces’ published in the osteopath journal to help to implement, describe or explain a particular aspect of the Osteopathic Practice Standards or supporting guidance.
We suggest that ‘learning resources’, therefore, would be a range of material specifically linked to the Osteopathic Practice Standards, providing more explicit explanation of why standards are in place and how they might apply in practice. We envisage that these would include a much more dynamic range of additional resources, or sign-posting to relevant external resources, case studies, and interactive educational material, largely provided online. Examples of such learning resources are available on our dedicated CPD website at: http://cpd.osteopathy.org.uk . We have also referred to specific examples in response to some of the feedback we have already received and outlined below.
Developments in the health environment within which standards are applied
The current Osteopathic Practice Standards were published in 2011 and implemented from 1 September 2012.
Since then, there have been developments in health, health regulation and research, for example:
- clarification of the duty of candour
- commissioned research about the application of standards in practice indicating that understanding the ‘why’ of the standards was as important as understanding the ‘what’ in ensuring the application of standards to practice
- commissioned research suggesting that in the specific osteopathic context:
- communicating risks and gaining consent from patients: clarifying how osteopaths can communicate risks of osteopathic treatments to patients in ways that do not alarm them or undermine their confidence in osteopathy
- keeping patient notes: addressing osteopaths’ concerns about what constitutes adequate note-keeping and why notes are necessary
- patient dignity and modesty: clarifying what is expected in relation to these standards to prevent some osteopaths interpreting them in ‘black and white’ terms, which do not reflect the intent of the Osteopathic Practice Standards and undermine their confidence in the Osteopathic Practice Standards more generally’
- clarification about raising concerns (including in relation to mandatory reporting of Female Genital Mutilation)
- changes in the law relating to consent (the Montgomery judgement)
We also have the experience of implementation in practice and editorial feedback to better support accessibility and clarity in the standards.
We welcome comments on all areas of the proposed revised Osteopathic Practice Standards, but are particularly interested in views on the following areas:
- combining the standard of proficiency, Code of Practice and four themes of the Osteopathic Practice Standards
- clarity around the duty of candour, consent, boundaries, notes and modesty and understanding the ‘why’ of standards
- osteopathic principles and philosophy
- the role of osteopathy in public health and in relation to other health professionals
- the content of the standards and guidance
- period of implementation.
All the comments we receive will be taken into consideration before we publish the updated Osteopathic Practice Standards in 2018.