HCPC standards of conduct: in the right direction

Are you referring your patients safely and effectively?

The update requires physiotherapists to ensure that if patient care falls outside their scope of practice, they must refer onto a person who holds the appropriate knowledge, skills and experience to meet the needs of the service user safely and effectively. 

Physiotherapists often refer patients to teams, pathways or organisations rather than specific individuals, which raises the question, how can we ensure compliance with this standard? 

Non-clinical referrals 

The CSP shared similar concerns in our response to the 2023 HCPC consultation regarding this particular update, also highlighting that physiotherapists frequently refer to non-clinical services vital for long-term condition management and health equity, raising concerns that the changes might discourage such referrals.

Taking action

The CSP approached the HCPC to clarify how physiotherapists can meet the updated Standard 3.3 in practice. The HCPC emphasised that the standard applies to both clinical and non-clinical referrals and that registrants must ensure the services they refer any patient into (no matter what the patient’s needs and abilities) have the necessary knowledge, skills and experience to provide care safely and effectively. 

If a concern were raised in relation to this standard, the HCPC would expect a registrant to be able to demonstrate that they considered the safety and effectiveness of the service they have referred to, and held a reasonable expectation that those carrying out the service would have the knowledge, skills and experience to carry out that service safely and effectively. 

So, what should we consider to be able to demonstrate this?

Firstly, it’s likely that most physiotherapists are already taking appropriate action to assure suitability and safety of the services they refer their patients onto so changes to practice may not be necessary. 

Justifiable decisions

HCPC standards are written to support autonomy and allow registrants to apply professional judgment. Whilst we must ensure we refer all patients safely and effectively, the steps required to meet this standard will vary depending on the complexity and vulnerability of the patient, as well as how familiar the referrer is with the service and the governance in place to support the referral process; for example, the referral criteria or a triage process assuring the suitability of those referred into the service.

For example, when referring a patient with complex mobility and care needs to a community gym class that you are unfamiliar with, you would likely find it necessary to ask if the team running the class has the correct knowledge and access to equipment to support the patient safely and effectively and only refer if this is the case. On the other hand, an independent patient with no mobility issues or complex health needs is unlikely to require such specific checks to assure their safety and ability to effectively access the class, as a standard gym environment would likely meet their needs.

Ultimately, as long as physios can justify their decisions and demonstrate that they considered the safety and suitability of the service they refer to, they are likely to meet the HCPC standards. The key is applying professional judgment to each referral based on the specific needs and risks of the patient.