UPDATE FROM RAMP

Preparation for the relaxation of lockdown 

Dear all, 

As you are aware, the release of guidelines by the RCVS takes effect in England and Northern Ireland as of the 12th April, This enables practitioners across these counties to join our colleages in Wales and Scotland in returning to full clinical practice rather than essential/urgent services. 

RCVS will remove the flow charts previously used to support decision making and practitioners are asked to provide services in accordance with their professional judgment whilst remembering to continue undertaking the ongoing required biosecurity and social distancing measures as well as additional relevant government guidelines and restrictions. 

This has been a long road, and whilst we are not fully out of the end yet, many of our animal patients need MSK attention. RAMP holds animal welfare as a priority and while we have previously advocated treatment for urgent cases only inline with government and RCVS guidlines, we are aware that many regular patients are deteriorating without on-going treatment. We welcome the ability for our practitioners to offer care as appropriate to the wider animal population once again. However, the threat of Covid remains and social distancing is still in place which provides us with our biggest logistical challenge therefore we highlight that the professional judgement of the practitioner should always lead the decision as to whether it is safe to attend and treat an animal and remain conscious not only of their own safety but that of their owners and animals. 

Beyond the change in scope of practice, many of the previous guidelines remain regarding biosecurity, social distancing and safety measures. 

To remind you, here are some points that should be taken into account: 

  1. Animals with demonstrable pain and welfare issues should be seen, these may include all pathologies. 

  1. A pre-visit risk assessment and telephone call is essential. Gain as much information prior to the visit as possible to minimise contact time. If appropriate, would the use of an oral sedative, supplied by the clients’ vet to the client, mitigate risk? Do you have access to a responsible ‘safe’ handler that can attend with you? 

  1. No appointments should be made with anyone who has Covid symptoms or who is in close contact with anyone with Covid symptoms. There must be a 10-day quarantine period for them, prior to seeing them. Consider the suitability of wearing a mask to reduce the risk of the practitioner spreading Covid between yards/clients. Consider asking owners/handlers to wear masks to reduce the risk of transmission to the practitioner. 

  1. If you have symptoms do not treat, get tested, and await a clear result, prior to seeing any clients. 

  1. Animals with owners in the vulnerable categories should not be treated in the normal way. Try to see if any other approach other than face to face can be used or if there are mediated ways of treating the animal in person. 

  1. Small animals should be seen in a clinic setting, (physio or vet) rather than home visits if possible, as cleanliness, disinfection and biosecurity are easier to control. If home visits are necessary, ensure that no other pets/family etc are present. In a clinic setting explore the possibility of treatment without owner present. Risk assess home visits very carefully. 

  1. Yard visits- Risk assess individual setups. As a professional you will be aware of the situations, and risks, at each of your regular yards. Some may be relatively ‘safe’, others less so. The decision to attend a client should be dictated by the risk assessment. 

  1. Home/yard visits, ask for gates to be opened and closed for you to minimise touching surfaces. No loose dogs/cats around that could transmit virus via petting, ensure animal is ready and waiting for you (ie no putting on headcollars, leads etc and unnecessary handling of owners equipment), carry your own soap and towels to wash between visits and ask for a fresh bucket of warm water or easy access to sink to wash. Accept no refreshments. 

  1. Other considerations, can the animal be left tied up with the owner at an appropriate distance? If not, are there any other strategies to improve safety and appropriately handle and restrain the animal. Is this a safe approach for you, the client and the animal? 

  1. Is this animal safe to treat with these restrictions in place? 

  1. All visits should be risk assessed and the results documented. Including those where treatment is refused and the reasons why, with documented details of the explanation to the client. 

  1. Payment- attempt to remove the need to handle payments. Request payment by BACS/credit card/paypal. 

  1. This is not a return to normal, please follow all PPE, and government guidelines and advice.. 

This is not an exhaustive list of all the possible considerations and scenarios but some guidance. Your professional judgement and expert opinion should be used at all stages to ensure yours and the client’s safety while also minimising the risks of spreading Covid 19. 

The professional judgement of the practitioner, based on a thorough risk assessment, should always lead the decision as to whether it is safe to attend and treat an animal. 

Your professional Associations will offer instruction of their plans for relaxation of lockdown restrictions, please pay heed to their guidance. 

The RAMP team

Update from RAMP

Update from RAMP

Release date 5/4/21

RAMP have been made aware of a couple of issues around title use so, as a reminder, RAMP Registrants who are not regulated with HCPC,GCC or GOSC may use the term chiropractor, osteopath or physiotherapist ONLY if it is prefixed with an animal term.eg equine, canine or animal etc. It must be made clear on any website, leaflet or other marketing that you do not use these techniques on humans. Failure to do so could result in prosecution as this is a criminal offence.
Please ensure that you comply with the law as it applies to you.
Thank you

To clarify the law as it stands here is a copy of the Barristers advice that RAMP commissioned. It makes it clear that the current laws around protected titles only cover human practice BUT that if they are used in the animal field it must be made clear that the practitioner does not treat humans unless also qualified to do so.

1. Introduction: The Issues. I have been asked to advise upon the scope of the protection of title for Chiropractors, Osteopaths and Physiotherapist (“the professions”). Specifically, I have been asked whether the protection of title which exists for these professions applies when the practice of the individual chiropractor, physiotherapist or osteopaths relates to and is carried out upon, an animal and not a human patient.

2. This Advice has been commissioned by the Register of Animal Musculoskeletal
Practitioners (“RAMP”), which is concerned to understand the legal parameters in which its members operate. RAMP has established a voluntary Register of professionals who are trained in chiropractic, osteopathic and physiotherapy techniques and treatments for animals. They are regarded by RAMP as one occupation, i.e., animal musculoskeletal practitioners.

3. Summary of Advice.
a. The Acts and the Order governing the practice of osteopaths, chiropractors and
physiotherapists are concerned exclusively with the regulation of the treatment of human patients (paragraphs 9 – 21 below); Legal Advice, 28 January 2020 2
b. As a result, the titles concerned are not protected titles, outside of the context of the treatment of human patients. There is no statutory or other legally binding regulatory framework governing their use outside of that context;
c. In my view, provided that any description makes it plain that the practitioner does not purport to be qualified to, or to treat, human patients, and is not on the Register of those professionals who would do so, an exclusively ‘animal’ practitioner may use the title ‘physiotherapist’, ‘osteopath’ and ‘chiropractor’ provided that these terms are always accompanied by a clear and proper explanation of their animal practice so as to make these vital distinctions.
d. The question of what is a sufficiently clear explanation is a question of fact. It would be for the individual practitioner to satisfy himself or herself that the rules on the protection of title had not been infringed. Clearly, a protocol which had been agreed with the three regulatory bodies concerned with human treatment would be the best way forward. I would suggest that merely using the title ‘animal physiotherapist’, etc, (or ‘equine chiropractor’, to take a similar example) may not be enough to achieve complete clarity – it ought to be accompanied by an
explanation, on websites and other literature, of the distinction and the fact that the
practitioner does not purport to be qualified to, nor offer treatment to human patients.

The RAMP team