Updated 8th January 2020

  England

The government has now published relevant guidance on the current lockdown requirements. Businesses that can remain open include “dental services, opticians, audiology services, chiropody, chiropractors, osteopaths and other medical or health services, including services relating to mental health” contained in Section 17(o), Schedule 3A of The Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020.

We must stress that the following is our current interpretation of the regulations; the government regulations do not give any more detail than specified above. You should, therefore, carefully read the regulations, as well as our guidance, before deciding whether to work during this lockdown.

Please exercise extreme caution before seeing clients and use your professional judgement as to whether you think it is safe and appropriate to provide any treatments at this time. The new strain of coronavirus is spreading rapidly across the UK and is 70% more transmissible than the original strain, putting increasing pressure on the NHS.

Who can work?

The relevant part of the exemption clause (see above) “is health services”. This means that you need to justify that the treatments you provide clearly fit under this heading. It is our view that you may choose to work if –

• You clearly provide “massage therapy” (not relaxation massage, beauty massage, or facials, etc).
• You only work with clients who have a clear, clinical need for treatment, e.g., severe pain, mental health, injury, or mobility issues that are impacting their quality of life.
• The client should have a clear need, not just want, the treatment for clinical/health care reasons.
• Their clinical need is clearly documented on their consultation form and on-going treatment notes.
• You work alongside statutory regulated health professionals such as doctors and nurses, in clinical settings (e.g., hospitals and hospices), where the therapy service is part of the overall healthcare plan for patients.
• You work alongside clinical professionals such as chiropractors and osteopaths in designated clinic settings, and your clients are referred by them for specific health/clinical reasons.
• You receive client referrals from other statutory health and medical professionals for specific health/clinical reasons.

Home based clinic rooms

There is a higher risk of infection when clients access any part of your home which is not a dedicated clinical space, including hallways and stairs. It is possible that you may also be at increased risk of falling foul of the current restrictions relating to “gatherings”. For these reasons we strongly advise that you only work from a home practise if your clinical space is totally separate from your home and has its own entrance, e.g., a converted garage which client’s access through a garden gate.

Non-clinical massage/other massage

Many of our members solely offer relaxing massage, beauty massage etc. Whilst wonderful treatments, they do not fulfil the requirement of clinical need, as explained above. The regulations also state that no-one is permitted to leave their home without a reasonable excuse. Although the above government clause states “services relating to mental health”, our view is that you need a much stronger case than a need for general relaxation to justify working. Therefore, we strongly advise that the exemption does not apply to non-clinically needed treatments.

If you choose to work during the lockdown you MUST –

1. Update your risk assessment.
2. Follow IFPA’s “Return to Work” guidelines.
3. Follow the Government’s “Close Contact Services” guidance.
4. Ensure you closely adhere to the law regarding infection control. We strongly advise that this includes wearing gloves.
5. Take comprehensive consultation notes from each client, justifying that your client’s treatment is absolutely necessary for health purposes, as explained above. It may be advisable to ask relevant triage questions before booking a treatment.
6. Provide your consultations digitally, including COVID-19 screening questions.
7. Limit your treatment times. We recommend that treatments are limited to 30 minutes, in-line with many physiotherapy and chiropractic appointments.
8. Clearly discuss infection risks with your client before confirming any bookings and note this in your risk assessment.

You may NOT work if –

1. You are a mobile therapist.
2. You offer beauty therapy or other types of massage not in-line with clear clinical need.
3. You do not have a recently updated risk assessment in place.
4. If your home treatment space is located inside a private home (yours or others, see above).

People who are defined as clinically extremely vulnerable are at very high risk of severe illness from coronavirus and are advised to follow shielding advice.

For clients who have less urgent healthcare needs, please defer treatments until after the lockdown. In the meantime, you can support your clients remotely, if possible, e.g., Zoom, FaceTime or over the phone.

If your local authority questions why you are working during lockdown it is important that you are able to evidence that you are only treating clients that have a genuine healthcare/clinical need.

  Northern Ireland

Ministers met on Thursday 17th December 2020 amid growing concern about the rise of coronavirus cases in Northern Ireland.

The Northern Ireland Executive agreed to go into a six-week lockdown from 26th December 2020.

The restrictions came into effect from 00.01 on 26th December 2020. Ministers will review the measures after four weeks. This means that all close contact services will have to close until further notice.

In the meantime, you can support your clients remotely, if possible, e.g., Zoom, FaceTime or over the phone.

The Stormont Executive has said previous financial support schemes will continue for businesses forced to close.

To read the full statement please click here.

  Scotland

The First Minister announced that mainland Scotland entered a national lockdown from midnight on 4th January 2020.

To minimise the risk of spreading the virus, you must stay at home as much as possible. By law, in a level 4 area, you can only leave your home for an essential purpose.

Until we receive further guidance from the Scottish Government, our advice is to stop all hands-on treatments and only support your clients remotely e.g., Zoom, FaceTime or over the phone.

The Scottish island areas will remain in Protection Level 3, which the government will continue to review. In a Protection Level 3 area, close contact services from fixed premises are permitted, but not mobile therapy services.

For further information on the lockdown rules please click here.

  Wales

The First Minister confirmed the accelerating coronavirus rates across Wales meant that Wales has met the criteria in the new traffic light Coronavirus Control Plan to move to alert level 4.

This meant that the whole of Wales went into full lockdown with Tier 4 restrictions from 28th December 2020. The Welsh government cannot predict how long this will last. It will last for three weeks in the first instance.

Some measures came into force on Christmas Eve, 24th December 2020, with all non-essential retail, including close contact services and all leisure and fitness centres being forced to close from the end of the day.

In the meantime, you can support your clients remotely, if possible, e.g., Zoom, FaceTime or over the phone.

For further information, please click the links below to read the government’s latest press release and regulation guidance –

https://gov.wales/higher-level-restrictions-come-force-control-coronavirus
https://gov.wales/coronavirus-regulations-guidance

Self-employed people may be eligible to claim financial support through the Self-Employment Income Support Scheme.

  Return to Work Guidelines

  Insurance

  Creative Ways of Working During Lockdown

• Offering consultations over Skype or Zoom to formulate bespoke aromatherapy inhalers and other products.
• Inhaler sticks and diffuser blends to aid a range of issues including immune support (whilst recognising that essential oils cannot guarantee protection against the Coronavirus), anxiety, sleep, and deep breathing.
• Massage oils.
• Shower gels and bath oils.
• Hand creams.
• Hand massage tips for clients over Skype, Zoom or similar platform.

  Tips for making bespoke products

• Hold a consultation first. This could be over a digital platform such as Skype, FaceTime, or a regular phone call. In many cases consultations need not take very long. You could also consider creating an on-line consultation form (for instance via Google Forms) or email a Word document, which you could follow-up with a quick phone call.
• Label your products carefully and give your clients clear instructions for use and storage.
• Record the consultation and blend details, just as you would with your face-to-face clients.
• Consider sanitising your product before packaging, e.g., by wiping it with hand sanitizing gel.
• Consider in advance how you will get the product to your clients. Some post offices are currently closed, and packages may take longer to arrive than usual. UK members can check the Post Office website to see how your local branch is affected.
• Instead of posting your products can you deliver them by car, foot, or bike, perhaps by combining delivery with a food shopping trip? If you choose to personally deliver products decide the maximum distance you are prepared to travel.
• Instead of delivering products, can you offer a collection service? Invite clients to collect their products from your doorstep whilst taking their daily, permitted exercise.
• Decide in advance how you will you charge for your time, resources, and expertise. If you do not already accept payments via bank transfer or PayPal, then this could be a good time to start!

  Government Lobbying

Our colleagues at the Integrated Healthcare Collaborative have written to the Health Ministers in all the UK’s governments and issued an accompanying press release. Why not post this to your social media platforms and/or send it to your local paper? To read the full press release click here.

  Mental Health & Wellbeing

Mental Health and Wellbeing Health professionals and mental health charities are reporting surges in stress and anxiety caused by the coronavirus pandemic. It can be helpful to be aware of talking therapy and other mental health support options, so that you can pass reliable information to your clients or others when needed. There is a lot of excellent information about mental health and available support on the internet and most mental health charities have added information on their homepages relating to the COVID-19 pandemic. Click here for information about a selection of services that you may find useful. These services are UK based; however, many have information on their websites which is useful wherever you live in the world.

  Pandemic Information Sources

UK government
BBC
NHS
World Health Organisation

  UK Regional Public Health bodies