I’m a private practitioner, can I return to face to face work with my clients?
The Government has announced that, in England, the recommended social distancing measurement will be reduced from two metres to a “one metre plus rule” from 4 July. This allows for certain businesses to resume trading.
We recognise that relaxing of the social distancing measures offers potential for members wishing to resume face to face work. We want to best support you in your efforts to do so while being aware of the risks, as the COVID-19 virus is still very much in active circulation.
Over the coming weeks we'll be working on providing additional guidance and resources to support those returning to face to face work. In the meantime, please still consider the factors in our previous guidance (listed below) in making decisions on a case-by-case basis. Remember that while you might feel ready to return to face to face work, some of your clients may not be.
In addition, consider the following points if you're planning to return to face to face work. We'll be updating these with supporting guidance and resources:
- does the space you plan to work from allow for social distancing of at least one metre – this includes any entrances, exits, corridors and waiting areas?
- have you conducted a risk assessment of your premises and created a procedure checklist to mitigate the risk of contamination before, between and after seeing clients?
- if you work with others from a shared space, have you spoken with those you work alongside to ensure they're also applying appropriate measures and there's no risk that any of these will be compromised?
- if you work from a rented premises, have you checked with your landlord whether they have any risk assessment or sanitisation process that you need to follow?
- will your indemnity policy cover you for face to face work?
- does your supervisor support your decision?
- will you need to make any amendments to your contract?
- have you considered the use of face masks?
What if I'm based in Northern Ireland, Wales or Scotland?
If you're based in Northern Ireland, Wales or Scotland, regional devolved governments are lifting restrictions at a different pace. See our latest guidance on returning to work.
How will a return to face to face work affect my insurance cover?
We've received confirmation from several insurance providers that they are providing policy cover in relation to claims arising from COVID-19.
However, we recommend speaking with your indemnity insurance company to specifically check whether you're covered under your existing policy.
If you're reviewing your insurance cover and considering switching to another provider, check:
- the cancellation policy of your current provider - some insurers will not cover claims made against you for past practice if you don't follow their cancellation procedure
- any associated cancellation costs
- whether your potential new insurer covers you for claims against COVID-19 as well as your general practice needs
If you're in Northern Ireland, Wales and Scotland, our previous guidance still stands. Our advice is that you should continue working remotely with clients wherever possible.
Whichever part of the UK you're based in, if for any reason you cannot work remotely with clients, we recommend that you consider the factors below on a case by case basis:
- the client's need and safety
- your needs and safety
- the context of the service
- whether other options are possible and the ethical and practical risks of any decision
- the known risk factors of age and any pre-existing health conditions for both yourself and your client
- advice on social distancing
- clients with particular needs who may not be able to engage using online platforms
- if your clients could be putting themselves at risk during the journey to and from your premises
We'd encourage you to work through the ethical decision-making process with your supervisor to make a personal decision that takes these factors into account.
Can you clarify whether counselling is deemed essential or non-essential contact? Has there been any official clarification from the Government or the Department of Health?
We'd like to have more clarity on this from the Government or the Department of Health. We’ll keep you posted as and when we hear anything to help with any decision making.
At the moment, we believe this is a judgement that needs to be made with each individual client. For some clients counselling is an essential contact, and you could consider whether telephone or online therapy may be possible, while others may be able to manage or choose to take a break in therapy.
We'd encourage you to work through the ethical decision making process with your supervisor to make a personal decision on this.
What happens if I contract the virus and can’t continue working with clients?
The Ethical Framework has a section that specifically looks at breaks and endings. In respect of unplanned endings, it states:
“Any unplanned breaks due to illness or other causes will be managed in ways to minimise inconveniencing clients and, for extended breaks, may include offering to put clients in touch with other practitioners.” (Good Practice, point 41)
The Ethical Framework also commits members to make plans for who will contact their clients if they are unable to because of serious illness. This is sometimes referred to as a making a clinical will.
Practitioners need to ensure that their “wellbeing is sufficient to sustain the quality of their work” (Commitment 2d) so you need to pay attention to self-care and take steps to ensure that, if you have to take breaks from practice, your clients are informed, supported and referred to other appropriate services if needed.
If you test positive for coronavirus, the NHS is undertaking contact tracing, which means you'll be interviewed about people you've been in contact with. The NHS will then contact them to provide support and testing. What's your advice about identifying clients to the NHS if you're diagnosed with coronavirus?
As discussed above, you may want to revisit your contract with your clients.
Your existing contract may refer to the limits of confidentiality relating to the balance of public interest. Public interest is the general welfare and rights of the public that should be recognised, protected and advanced. Disclosures in the public interest, based on the common law, are made where this is essential to prevent a serious and imminent threat to public health, national security, the life of the individual or a third party, or to prevent or detect serious crime.
You could explain to your clients that this clause may become relevant if you contract the virus and are obliged to inform the NHS of people you've been in contact with. In this case, you may need to share their name and contact details but not the context in which you know them. However, they may be contacted by the NHS.
If you want to separate this out to make it clearer to clients, you could add a coronavirus contingency clause, stating that confidentiality will be broken if necessary for reasons of public interest in the area of public health.
Is there any guidance for employers or employees?
We offer a free employment law advice line through the Ethics hub, provided by Law Express. You can email the ethics team to request a call-back. They also list employment law considerations relevant to coronavirus on their website.
We've also published an FAQ page for members working in private practice or for small organisations, which provides some information for employers.
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