The West Point Practice – Standard Operating Procedures during COVID 19

As per current guidelines from the Chartered Society of Physiotherapy (CSP), remote triage must be completed using the CSP Covid-19 triage flowchart to determine the appropriate treatment channel between face to face or virtual assessment.

All of our clinicians will have undertaken the following online training as provided by the World Health Organisation prior to returning to face to face practice:

• Standard Precautions: Waste management
• Standard Precautions: Hand hygiene
• Covid-19: How to put on and remove personal protective equipment
• Infection Prevention and Control (IPC) for novel coronavirus (Covid-19)

If face to face physiotherapy treatment is appropriate:

• Pre assessment health screening questions must be completed, via telephone, by a physiotherapist at the time off booking the appointment and in the 24h period prior to appointment (Just once if the appointment is within 24h of initial screening).
  • If they pass, an appointment will be scheduled.
  • If they fail, they will be advised that face to face appointment cannot be offered currently and appropriate self-isolation advice and directed to the nhs.uk website for further details.
• A pre assessment consent form will be signed by client prior to attending appointment if they are able to print, sign and email back a photo or scan of the signed document. If they are unable, this will be completed in clinic upon arrival at their appointment.
• Clients will be advised to attend only at their specified treatment time. Any clients attending early will be asked to wait outside the building until the therapist meets them and escort them to the clinic room.
• Clients will be asked not to bring anyone with them to their appointment unless they are under 18 years of age or require a chaperone/translator/carer to be present during their appointment.
• Clients will be asked to ensure that they have appropriate clothing with them for their appointment to enable appropriate assessment/treatment and minimise the use of towels.
• Clients will be asked to wear a facemask to their appointment if they have their own. If a client declines to wear a facemask, a face to face appointment will not be possible.

On arrival at clinic:

• On arrival at West One, the client will be required to text or call the clinic to advise the therapist of their arrival.
• The physiotherapist will ensure that clinic windows are open and air conditioning/heating is not used.
• The physiotherapist will wash their hands and then go down to reception area to let them in the building and escort them to clinic. The physiotherapist will wear a 3-ply fluid resistant facemask during this time.
• The main lifts can be used during this time with a maximum of 4 people in the lift at any time, in line with the West One Return to Work guidance.
• The clinic door will remain locked during clinic opening times to ensure that footfall through clinic can be appropriately monitored and documented.
• On entering the clinic, the client and physiotherapist will be required to clean their hands with alcohol gel which will be dispensed by the physiotherapist.
• Following hand cleaning the client will be required to put on a face mask if they are not already wearing one. This will provided by the clinician.
• The client will either sit on the available wipe downable chair or single use couch roll covered treatment couch Disposable paper roll will cover the treatment couch, no pillowcases, towels, soft treatment couch covers or non-individual gym equipment will be used.
• The client should place all of their belongings in the plastic box provided in the clinic room.
• The Covid-19 symptom screening questionnaire will be completed again and client temperature will be taken using a non-contact digital forehead thermometer. Provided the client passes screening, they will be asked to sign a consent and declaration and assessment/treatment will proceed. If they do not pass the health screening, the client will be asked to leave clinic, return home and commence self-isolation. They will be directed to the gov.uk and 111 websites for further guidance as appropriate.  The clinician will then conduct a deep clean of the clinic premises as per cleaning protocol.
• The physiotherapist will wear a 3-ply fluid resistant surgical face mask during subjective assessment and add goggles/face shield, apron and gloves during objective assessment and treatment.
• The therapist will conduct the subjective and objective assessment and treatment as clinically appropriate, minimising client contact where possible.
• The therapist will remove gloves and apron after treatment, place in the waste bin and clean their hands with alcohol gel, prior to touching the laptop to complete documentation or process client payment.
• Payments will be made either contactless card payment, direct bank transfer or via stripe. Cash will not currently be accepted as a method of payment.

On conclusion of treatment:

• The client will remove the face mask and place in bin provided unless they wish to wear the mask to exit the building, in which case they will be advised to dispose of the mask in a bin when they remove it.
• The client will again be asked to clean their hands with alcohol gel which will be dispensed by the physiotherapist.
• The physiotherapist will unlock the clinic door and open it for the client to leave.
• Once the client has left the premises, the therapist will wash their hands and then lock the door before undertaking clinic cleaning as per the cleaning checklist

In between Clients:

• A up to a 30-minute gap will be left between clients to ensure sufficient cleaning time and no client crossover.
• Only one physiotherapist will run a clinic at any one time.
• The small treatment room with wipe downable flooring will be used for all client appointments.
• All contact surfaces including door handles, treatment couch, seating, pens, reflex hammer etc. will be cleaned with Clinell wipes and/or disinfectant spray and disposable paper towel which will be disposed of in the waste bin provided.
• A cleaning check list will be completed with time and date and signed by the physiotherapist at the start and end of their shift and between appointments.
• The therapist will wash their hands as per NHS guidelines before and after each client.
• Windows will be opened to increase ventilation during clinic hours. Air conditioning and heating will not be used.
• Completed health screening questionnaires, consent, declaration and pre-client cleaning checklists will be scanned onto the client’s record for secure storage.

Personal Protective Equipment (PPE):

• The therapist will wear a 3-ply fluid resistant surgical face mask, plastic apron, goggles/face shield and gloves during each consultation. The apron and gloves are single use and will be changed after every appointment. Facemasks are sessional use and will be changed every 4h. Goggles/Face shields will be cleaned with disinfectant between clients.
• The client will be asked to wear a face mask which will be provided if they don’t have their own.
• Musculoskeletal (MSK) Physiotherapy is categorised as non-aerosol generating, therefore, the use of FFP3 masks and full-length gowns is not indicated or advised in clinical guidelines.
• PPE will be placed in waste bags and stored safely for 72h before being disposed of by The West Point Practice.