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Reflection:
I struggled with the movements we were doing in the first G.O.T lecture, I wasn't holding the leg in the right place and it wasn't close enough to my body. One of the class assistants came over and pointed out where I was going wrong and helped me get into the correct position and made sure it was correct before leaving. This experience made me feel a little embarrassed to begin with as the assistant came over because she spotted I was struggling, however once the help was given I felt a sense of relief and a little bit of joy as I realised that I would know what to do for next time. This started off as a negative experience but by the end it had turned into a positive as I had acquired my first osteopathic movement. In conclusion I started off not knowing what to do and then was corrected, now I am confident in what I need to do for next time.

Action:
Next time we are going through techniques I will make sure I am checking my positioning throughout to ensure I am not causing myself or my client any discomfort.

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Reflection:
Today in the formative assessment I didn't do it very well, I didn't communicate with my patient and I didn't gain consent which was a massive issue. This made me feel a great deal of disappointment in myself which was horrible as well as feeling ashamed and embarrassed about the entire situation. This was a very negative experience for me. In conclusion I didn't perform to the best of my ability or within the OPS guidelines around communication and partnership, next time I will make sure my communication is clear and informed consent is gained prior to treatment and during if needs be.

Action:
I took on board the feedback from the assessor and used it to better myself and improve my performance in the OSPE 1 exam which I scored very well in.

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Reflection:
Today we got our grades for our OSPE 1 back and I did very well. I was very nervous naturally which is to be expected, however when I saw my result I was very pleased and relieved. This is a good situation because I have used my feedback from all my lecturers to hone my skills and become a better practitioner as a result. In conclusion I have done well in my OSPE 1 exam and I will continue to work hard to improve upon what I have already done. Next time I will make sure I am using the bed height to my advantage and try to remain calm as I believe by doing this I am well able to achieve above 70% which is where I want to be.

Action:
I will carry on working hard and ensuring the content we are learning is going in to my head and going over areas I am not sure on or asking my lecturers for a hand explaining information further. Also following any feedback given to me by my lecturers.

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Today during observation we came across a patient who's complaint was about a numbness and tingling in their hands and wrists. After a number of tests and assessments the student practitioner consulted the tutor and they both agreed that it would not be advisable to treat this patient due to the reduced likelihood that it would work effectively. The student then wrote out a referral letter for the patient and let them take it to their doctors for further testing. The experience made me feel proud of the student for realising that the situation was beyond her expertise and chose to refer to a relevant professional. This was a good experience for me as this is the first time I have observed someone refer rather than treating due to the knowledge that it would not be best for the patient. I believe they done a good job and wouldn't have changed anything in this scenario. In conclusion you need to know when an issue is too large or outside of your area of expertise and to do this you need to know your limits.

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Whilst observing this morning a patient presented with pain in their right knee which had been present for a few weeks and was reducing their ability to play rugby as they had to go off after 10 or so minutes due to the pain and feeling of instability in the knee itself. After the student actively listened to the patient and carried out a few examinations of the joint and surrounding areas they were able to work out it was likely to be damage to the medial meniscus and possible cartilage damage, a couple of drainage techniques and mobilisations were done by the student to help reduce the swelling of the area and improve quality and quantity of motion. I was in awe of the knowledge and skill the student had shown in diagnosing this issue and so was the tutor. The experience was definitely a good one as it showed me the true scope of what an Osteopath is able to achieve within such a short time frame. This situation was great to witness as you could see the relief on the patients face when he was told what it may be and when the swelling was reduced after a few weeks of it being there. I believe the student could have possibly referred the patient to the GP asking for their opinion on this and to speed up the process if surgery was required but other than that the student showed great skill and knowledge to diagnose and help reduce the symptoms the patient was showing.

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During my time in clinic this morning one of the patients I observed was quite a shy and nervous woman and the student was excellent at relaxing the patient and making them feel comfortable in the clinic all the way through treatment from greeting them to when they left. This experience made me feel warm and happy because you could see the patient really benefit from the kind nature of the student and this allowed her to open up and offer more information to the student, as a result the patient got a better quality treatment. This was in my eyes a great experience because it shows how much you can affect the situation just by the way you act. the impact the student had on the patient was unbelievable and you could see the patient warming to the student as the appointment went on. Next time in that situation I believe the student should double check with the patient whether they are happy for them to have an observer in the room as well just to make sure they have the option of refusing if they felt too anxious or awkward. In the future if I am ever presented with this issue I would talk with the patient in a calm and relaxing manner and ensure they are happy for an observer to be in the room as well so they feel fully comfortable and relaxed.

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B1. You must have and be able to apply sufficient and appropriate knowledge and skills to support your work as an Osteopath.

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B1. You must have and be able to apply sufficient and appropriate knowledge and skills to support your work as an Osteopath.

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New patient 12/02/2024

WHAT: Today, I treated a new patient during the first appointment of the morning who presented with nerve-related pain radiating down the left leg and into the gluteal region. Although I completed a thorough case history, it took too long and so did my examination. I became aware that this was likely due to my lack of knowledge and confidence in performing a lower limb neurological (LEx) screen efficiently. After the session, my tutor asked me to go through the LEx screen in the tutor room with my peers. During this, the tutor commented that I was too slow and had missed several elements. I immediately felt like I had let both the patient and myself down. I was especially disheartened because I knew the patient hadn’t received the most confident or efficient assessment possible.

SO WHAT: This experience made me reflect on the importance of competence and confidence in core clinical assessments, particularly neurological screens, which are essential when patients present with nerve-related symptoms. OPS B1 requires me to have and apply appropriate knowledge and skills, and in this case, I realised I hadn’t met that standard. The feedback (though difficult to hear) was necessary. It made me feel disappointed in my performance, but also gave me clarity: if I want to provide safe, effective care, I need to take ownership of the areas where I’m not yet competent. I also realised how my learning gap could affect patient experience, safety, and trust in osteopathic care.

NOW WHAT: As a result of this I took a long look over the key areas which I need to work on as a student and have made a list of testing and examination routines which alongside my peers we will go through and master throughout the next year and a half at the ESO. I will take on board all feedback, no matter how hard to hear at the time to improve and better myself. Not just to pass examinations but to become a better and safer Osteopath for my patients.

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A1. You must listen to patients and respect their individuality, concerns and preferences. You must be polite and considerate with patients and treat them with dignity and courtesy.

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A1. You must listen to patients and respect their individuality, concerns and preferences. You must be polite and considerate with patients and treat them with dignity and courtesy.

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Reflection written using the model of what, so what, now what (Rolf et al. 2001).

WHAT: This morning I had a new female patient who presented with pain across the lateral aspect of the left ribs as well as the costochondral region. When I asked if she was happy to remove the top she was wearing in order for me to examine the area through observation and palpation she was hesitant and didn't want to remove the layer, once I explained the reason and that she didn't have to if she preferred to keep it on I would palpate through the layers the patient did agree to examination but keeping the top on.

SO WHAT: I was still able to provide a thorough examination and diagnose the patients complaint accurately then carry out treatment on this patient without her taking off any layers that she wasn't comfortable removing. therefore listened to her concerns and preferences and treated her with dignity and courtesy.

NOW WHAT: As a result of how well this interaction went I will continue to check with patients whether they are comfortable or not removing layers for examination and I am more confident that I can provide a good service without the patient being made to feel uncomfortable or that they haven't had their concerns or preferences adressed.

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A2. You must work in partnership with patients, adapting your communication approach to take into account their particular needs and supporting patients in expressing to you what is important to them.

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A2. You must work in partnership with patients, adapting your communication approach to take into account their particular needs and supporting patients in expressing to you what is important to them.

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WHAT: This morning I had a new patient who turned up to clinic after having a rather rough week in terms of physical activities which resulted in Shoulder pain, Low back pain and Knee pain. This was tricky to manage because the patient was rather talkative and wanted to explain in thorough detail everything about each injury. However, working with the patient, we discussed severity of each and which area we wanted to focus on for the first session to optimise recovery whilst also taking down information which was relevant to the patient in terms of their pain.

SO WHAT: My tutor noted this as a skill which was important for Osteopaths to have because a lot of the time we will be faced with people who present with multiple complaints and we need to work with them to prioritise what is of importance whilst not making them feel like they are not having their thoughts and feelings understood.

NOW WHAT: As a result of this experience I will take into account what happened and how it made the patient feel heard and respected whilst also trying to focus in on what the patient really wants out of the session and what would be most important to improve the patients current complaint.

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A3. You must give patients the information they want or need to know in a way they can understand.

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A3. You must give patients the information they want or need to know in a way they can understand.

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WHAT: Children's and Maternity clinic was interesting today. A couple came in with their 2 month old baby who had been examined by a tongue tie and lactation specialist who had noted that no tongue tie was present however the child was not pushing the tongue out further than the lip line. They wanted me to assess for any tension in the sub lingual muscles and neck. The issue was that they Ukrainian and the mother did not speak much English, the father did but even his wasn't great. Therefore, I had to speak to the father in basic English ensuring he understood, who then passed information on to the mother, who then wanted to ask questions which took a little longer than if the parents were both fluent English speakers and I had to be as clear as I possibly could and get the father to repeat the information to me before translating for his wife to ensure they both got the information they wanted or needed.

SO WHAT: This interaction opened my eyes to the importance of being clear in the information which is being given as well as ensuring the information has been understood by the patient. My tutor picked this fact out in my feedback as being one of the best examples of communication skills she has seen which made me feel very proud of myself and happy about how I handled the situation.

NOW WHAT: I will continue to provide my patients with information which they require in a way they understand by adapting my communication style or language I use to ensure that the patient is fully informed and the information is clear and able to be repeated to me by the patient as then I can be certain that they have understood what has been told to them to avoid any confusion which could have an impact on consent.

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A4. You must receive valid consent for all aspects of examination and treatment and record this as appropriate.

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A4. You must receive valid consent for all aspects of examination and treatment and record this as appropriate.

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Reflection written using; Description, Feelings, Evaluation, Analysis, Conclusion and Action Plan (Gibbs. 1988).

DESCRIPTION: Today in clinic I had a patient who was quite anxious and came in presenting with upper cervical pain which was causing headaches, after a thorough case history I asked their consent to examine the cervical and thoracic spine which involved removing the top they were wearing, after I explained the importance of why they were happy to remove it just for examination. After examination I proposed the option of cervical manipulation as there were no contraindications. I made sure that my explanation was clear giving the risks (however minimal) and potential benefits from having this treatment as well as alternative techniques we can use and gave the patient time to think and ask questions if necessary, in the end they were happy to continue with the manipulation and treatment plan as proposed with the understanding they could stop at any time.

FEELINGS: At the beginning of the session I wasn't sure how the patient would react to being asked to remove the top and once they were happy to do this, I was more confident that they were engaged in addressing the issue. Once the suggestion of manipulation was bought up the patient seemed somewhat hesitant at first, after speaking through everything with them and offering alternatives I was happy I had done what I needed to in order for them to make an informed choice.

EVALUATION: Overall I was happy with the interactions between the patient and myself in this situation as we really communicated well and addressed any concerns which the patient had about both examination and treatment approach and I was able to gain fully informed consent for the above.

ANALYSIS: This above interaction reinforces the importance of gaining fully informed consent for both examination and treatment because if I were to miss out any information or not explain why I wanted to do what I did the patient may feel as though they were taken advantage of or weren't involved in the decision making behind their own recovery as well as opening the door for potential claims/complaints made against me.

CONCLUSION: In conclusion I worked hard to gain informed consent from this patient even more so than normal due to their anxiety which mainly surrounded their health and self image. Respecting their personal views as well as informing them of why it is important, giving them the option to withdraw at any point.

ACTION PLAN: In the future I will use this experience to make sure I am gaining fully informed consent and explain everything to the patient in order for them to be up to date and allowed to ask questions about what is happening in all cases not just those who may be anxious.

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A5. You must support patients in caring for themselves to improve and maintain their own health and wellbeing.

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A5. You must support patients in caring for themselves to improve and maintain their own health and wellbeing.

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DESCRIPTION: I had a patient today present with what we diagnosed as mechanical lower back pain but the cause of the pain was due to an anterior tilted pelvis and weakened posterior chain muscles. Therefore I sent him a list of 4 exercises to complete every day before the next session to see if this helps to address the issue as well. I also reiterated the importance of doing work outside of the session as they are only a fraction of time in which we are trying to address a long term complaint so recovery will speed up if they take control of their own care.

FEELINGS: My overall feelings of this session were that I was able to educate the patient in order for them to improve their own health and wellbeing through showing exercises and answering questions in order for them to have a more primary role in their recovery and overall health.

EVALUATION: The session was positive. The patient appreciated the practical and personalised advice. I observed his technique to ensure he could safely perform the exercises. I could have asked him how likely he is to do these exercises between sessions or whether the load is too much.

ANALYSIS: This experience shows the importance of supporting patients to care more for their own recovery and health and wellbeing rather than relying on health care professionals. Teaching them about the importance of exercise and correct posture during work can be vital in reducing return of patients pain.

CONCLUSION: I was able to successfully make the patient realise his role in the recovery and maintenance of his complain as well as improving his overall health and wellbeing.

ACTION PLAN: From now on I will make it a personal goal of mine to provide patients with exercise and fitness plans to improve their general health whilst also targeting the affected areas. I will check patients understanding of the exercises and in the following session make sure they are doing them correctly.

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A6. You must respect your patients’ dignity and modesty.

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A6. You must respect your patients’ dignity and modesty.

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WHAT: During a session today with a 74 year old lady, I wanted to examine her left hip due to the location of the complaint, however she was not happy to remove her trousers due to not having any shorts underneath and issues with incontinence causing embarrassment around undressing to underwear.

SO WHAT: I managed to examine the hip through the trousers and due to osteoarthritis in the left hip the trousers didn't change the end range anyway just the palpation was hampered but we agreed next time she would come in thin shorts so I can feel through and get a better feel of what is going on.

NOW WHAT: From now on I will respect peoples modesty and dignity and only get them to remove layers which they are happy to remove for examination and treatment to avoid any discomfort or embarrassment for the patient whilst advising for the next visit to wear more appropriate clothing.

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A7. You must make sure your beliefs and values do not prejudice your patients’ care.

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A7. You must make sure your beliefs and values do not prejudice your patients’ care.

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WHAT: The new patient I had today expressed a few views and ideas which I considered to be bordering on racism/prejudice about non white people throughout the session. It was tricky for me to engage in conversation with this patient as the views and opinions do not fit my own. Although this was difficult I still managed to give him the best possible care in regards to Osteopathic practice that I could and was able to provide help to this gentleman without taking some comments loosely aimed towards me to heart. At the end of the session he thanked me for my work and said he would rebook with me again, I spoke with my tutor after this session and explained what happened and was told that I handled the situation in an exemplary manner.

SO WHAT: This showed to me that underneath the external views and beliefs people may hold we can still make a meaningful change in these patients complaints and concerns whilst not having to engage in language or behaviour which we do not feel comfortable expressing. If it got too serious I would have referred this patient to one of my colleagues who wouldn't have been the centre of some of the comments.

NOW WHAT: I will always take into account patients beliefs and values and put them to the back of my mind but in terms of their care this will not affect how I treat them, views and beliefs should not affect our performance as an Osteopath and I will treat all patients with the same level of care.

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B2. You must recognise and work within the limits of your training and competence.

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B2. You must recognise and work within the limits of your training and competence.

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DESCRIPTION: This week in clinic one of my patients presented with right sided shoulder pain and right sided neck pain. During case history taking it seemed as though the pain was mechanical until I got to the medical history. This patient had a long term issue surrounding increased alcohol intake (up to 50 units per week) for about 30 years. raising alarm bells for me that the pain was liver referral. As well as this, the examination showed he had swelling in his ankles and wrists, possible ascites and slight yellowing of the skin and eyes which are all signs of liver disease. He also had an incredibly high blood pressure (160/110). I told the patient I would not treat him until he gets his symptoms checked with the GP as I cannot rule out something more serious underlying. Understandably, the patient was annoyed but after I called my tutor in to explain my decision and him agreeing with me the patient calmed down. He agreed to go to the doctors and get checked then come back when he gets the results if all were clear so we can look at the shoulder and neck.

FEELINGS: Once the session had finished and I was reflecting upon it I felt very pleased with my decision and was glad that my tutor had agreed with me to send this patient to their GP to get further investigations. I felt that even though the patient may be upset with the outcome initially, he was on the correct path and I did not overstep the line in terms of trying to treat something outside of my area of expertise and potentially make it worse.

EVALUATION: The correct decision was made and the situation was handled well, I hopefully began the journey for this patient to get the correct care without the possibility of medical neglect or letting my ego take over. I was able to detect that his symptoms didn't quite fit the typical musculoskeletal complaint of shoulder and neck pain and that there may be something systemically wrong.

ANALYSIS: Although to begin with this experience was a negative on due to the fact I couldn't treat and give relief for this patient, it shows the importance of knowing where our limits as Osteopaths lie and that knowing when not to treat is so important for the safety of our patients.

CONCLUSION: This experience shows that I successfully complied with OPS B2 because I knew that this patients presenting complaint was outside of our scope of practice and managed to explain this to the patient with the tutor to get them to get checked before returning.

ACTION PLAN: To improve further in this guideline I will review and keep updated with systemic red flags and once graduated book on to CPD courses which outline pathophysiology to know what to keep an eye out for when a patient walks through the door.

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B3. You must keep your professional knowledge and skills up to date.

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B3. You must keep your professional knowledge and skills up to date.

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Headache clinic:

WHAT: I had headache clinic at the beginning of the year, in the first session we ran through common presentations for headaches and variations of headaches with clinical features and symptomology. I quickly realised that my knowledge when it comes to headaches was much lower than I would have liked it to be. Keeping in line with the OPS B3, I spent the next 6 weeks in headache clinic reviewing common presentations for migraines and headaches, alongside referral routes and common treatments. By the end of the 6 weeks I was able to confidently talk through headache types with key characteristics and treatments alongside the typical referral patterns for these. My tutor was thoroughly impressed and my feedback reflected this as she stated that "I was up there with the most sound practitioners" she has ever met and that my "dedication was refreshing"

SO WHAT: This to me indicates the importance of keeping up to date with knowledge and skills in the field of Osteopathy because I was able to go from not knowing the bare minimum about headaches to being one of the most successful in the group through keen research and hard work. This enabled me to give better care to my patients in terms of reducing their symptoms and giving them advice about how to deal with their headaches in their own daily life.

NOW WHAT: I have carried this attitude through my whole degree but even more so from this point forward where I will assess my weakest areas in my knowledge base and work hard to bring those up to a standard that myself and my tutors are happy with to allow better care and service for my patients.

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B4. You must be able to analyse and reflect upon information related to your practice in order to enhance patient care.

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B4. You must be able to analyse and reflect upon information related to your practice in order to enhance patient care.

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WHAT: I had one patient who didn't seem to be improving in her complaint. She was 65 and presented with a chronic non-specific low back pain since 40 and my treatments were helping for up to 48 hours then the pain was returning. After looking back through my notes and further questioning I realised that I was not following the NICE guideline NG59 about low back pain and sciatica because I hadn't showed any exercises to strengthen the area so the pain would persist until the underlying weaknesses were corrected. Therefore by reflecting upon the patients feedback and analysis of case notes I was able to correct my mistakes and improve the quality of care for the patient.

SO WHAT: This showed to me the importance of continually reflecting upon and analysing our performances as Osteopaths because if I hadn't I would have carried on blissfully unaware that I hadn't prescribed exercises and this patient would have continued to have persistent low back pain lowering her trust in Osteopathy as a profession. However, because I did show reflection and analysis she returned 4 more times and then was discharged because her back pain had reduced to the point where she didn't need to see us.

NOW WHAT: The whole situation has prompted me to look more closely into historic case notes from myself and other students whom I may be covering to assess whether or not there are areas which could be improved to increase the quality of the patients care and support.

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C1. You must be able to conduct an osteopathic patient evaluation and deliver safe, competent and appropriate osteopathic care to your patients.

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C1. You must be able to conduct an osteopathic patient evaluation and deliver safe, competent and appropriate osteopathic care to your patients.

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DESCRIPTION: During clinic this morning I had a new patient, a 29 year old female who was presenting with low back pain and a shooting pain down the posterior right thigh and calf which was worse for flexion of the lumbar spine and better for rest and heat. The pain came on one week prior after a work out in the gym involving heavy loading of the lumbar spine and deadlifts. I therefore had disc herniation/lateral stenosis as my top Differential as well as muscular strains. Due to the nature of the pain I wanted to clarify whether or not it was in fact caused by dural tension/pressure from the disc pressing on the nerve therefore I conducted a Slump test and an SLR to check for increase in neurological symptoms. Both of these tests came back positive which for me is indicative of a disc buldge/lateral stenosis, as well as showing neurological changes during the Lower extremity neurological screen. This allowed me to form my treatment plan around this diagnosis and carry out safe and effective treatment to aid recovery for this patient.

FEELINGS: My overarching feeling from todays session was how well I managed the case, coming up with appropriate differential diagnoses and able to support my diagnosis clinically to the tutor through my testing whilst also being safe and considerate to the patient. It showed me how far I had come in my studies because I previously struggled with a lower extremity neurological screen and I have learnt from this to improve my skill and safety as a practitioner.

EVALUATION: On the positive side I was able to safely and effectively conduct a case history and examination on a patient who came in presenting with neurological symptoms showing I am developing well as a student. On the down side I may have been too narrow minded and not considered other differential diagnoses which may have also been relevant.

ANALYSIS: This situation shows the importance of using a structured examination and using the patients case notes to carry out specific investigations to rule in or out our differential diagnoses whilst also taking into account the patients safety and wellbeing. Informing them that certain tests may increase symptoms or pain. By doing this you can make sure the patient is receiving the best possible care.

CONCLUSION: In conclusion I believe this whole experience taught me that to carry out a safe and effective assessment and analysis one must consider the information in front of them as well as the patient who presents in front of them. Certain patients may require different tests/examinations which is something as Osteopaths we must be conscious of an adapt as and when needed to ensure the level of care remains high.

ACTION PLAN: I will continue to look at the patient as a whole to include experiences, wishes and the case itself to ensure I carry out the most thorough and effective assessment and allow this to aid in the development of my management plan and treatment of the patient.

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C2. You must ensure that your patient records are comprehensive, accurate, legible and completed promptly.

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C2. You must ensure that your patient records are comprehensive, accurate, legible and completed promptly.

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Clinic 14/03/2024

WHAT: I had a cover patient today for one of my colleagues, I made sure that I read through thoroughly before going into the session just to familiarise myself with the patients complaint and any systemic issues which may be present that I need to be aware of. After chatting to the patient who came in presenting with neck pain about the techniques I proposed to use which were contraindicated in certain patients i.e. patients with cardiovascular concerns but from reading the notes they seemed fine. The patient then told me that actually they had reported to the previous practitioner that they suffered from an increased blood pressure and so where on blood thinners. I immediately stopped talking through treatment and then noted down the information given to me from the patient to update the case notes and ran through the previous notes to ensure nothing else had been missed.

SO WHAT: The omission of such important information in a patients case notes was rather worrying, if I had not been diligent and double checked everything was okay the techniques I used with the patients consent could have resulted in a dangerous adverse effect leading to potential legal action being taken against the clinic. This highlighted to me the importance of taking accurate case histories and ensuring that ALL information is noted in the case notes about conditions and medications as well as being as thorough as possible about what was done.

NOW WHAT: I make sure now to underline certain pieces of information I believe to be important to the case and make thorough detailed case notes so that if the patient needs to be covered I am able to rest assured that the practitioner covering me will be able to pick up my case notes and realise exactly what has been done, what the patient is coming in with and any contraindications or conditions which make them unsuitable for particular techniques.

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C3. You must respond effectively and appropriately to requests for the production of written material and data.

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C3. You must respond effectively and appropriately to requests for the production of written material and data.

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WHAT: I had the privilege of writing out a treatment overview document to one of my patients today, they had requested it due to the fact they were foreign and English wasn't the mothers strong suit in case they needed to inform any other medical professionals about treatments which had been done to ease their son's hesitancy to protrude his tongue. This was done the same day as requested to ensure the patient didn't have to wait unnecessarily and in case they had an appointment in the coming days.

SO WHAT: I managed to respond to a patients request for production of written material and data which the patient emailed the next day to thank me for the promptness in which it was sent. They included the fact that they had mentioned my name to a few different friends who either have children they want to get checked for certain issues or they themselves have pain. Therefore my general professionalism and forthcomingness with information has proved to be worthwhile.

NOW WHAT: I will from now on try to get patients requests for written material completed on the same day of request or as soon as practical to make sure they feel like they are a priority and show that their care as important to me.

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C4. You must take action to keep patients from harm.

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C4. You must take action to keep patients from harm.

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15/11/2023

DESCRIPTION: During my observation session in children's clinic today the patient was a 12 year old who was coming in with his mother and complaining of hip and low back pain, the patient was already wearing shorts and a t-shirt and when asked if it was okay if the boy took off his t-shirt so the student could examine the low back he looked very uncomfortable and looked over to his mother who also seemed very uncertain. The mother then replied "Is it completely necessary?" to which the student then replied "It would be beneficial just so I can see what could be causing the pain your son is experiencing". The boy agreed to as long as he could put it back on for treatment. However when the boy removed his t-shirt, along the upper back were bruises and what seemed like a burn on the left side. When asked what had happened the boy started crying and opened up that his father had been abusing him physically. The mother then also admitted this and was guilt ridden. The student spoke to the tutor and the incident was reported to the necessary authorities. I left the student with the mother, tutor and child to not make it too uncomfortable for anyone involved.

FEELINGS: The overarching emotion felt in this reflection was sadness, sad that the child had been putting up with this abuse and not been able to open up to anyone about it and sad that the mother was also in a similar position to the child and felt powerless to help. However it did make me feel proud of the student who followed their instincts in getting the teenager to remove his t-shirt and asking about the marks on his back leading to him hopefully starting the path towards recovery and care.

EVALUATION: The student done really well here to notice that something wasn't quite right to begin with when the teenager looked uncomfortable and to then delve deeper to find the true cause of the injuries. I would like to think in the same situation I would have handled it in a similar manner, creating a safe space for the patient and getting them the necessary help to protect them from further harm.

ANALYSIS: This incident shows the importance of being diligent with patients and trusting your instincts to make sure the patient is safe not only in the session but in their everyday life as well, asking simple questions such as how certain marks have appeared or whether they know about them can have a truly meaningful impact and potentially save someone.

CONCLUSION: takeaway from this the importance of what is happening outside of the session not just when they are in the room. The student could have just assumed the marks were from sport or falling over but decided to ask and found the true reason.

ACTION PLAN: After seeing this situation I will try and replicate it should I ever assume that a patient is in an unhealthy situation outside of the session which could not only prolong a complaint but could be a harmful environment for them.

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C5. You must ensure that your practice is safe, clean and hygienic, and complies with health and safety legislation.

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C5. You must ensure that your practice is safe, clean and hygienic, and complies with health and safety legislation.

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23/08/2024

WHAT: Treating today was a struggle due to the weather being so hot and the lack of adequate ventilation in the clinic. This was particularly true after one of my patients whom suffered with body odour, we always disinfect the couches and head blocks after every patient anyway but I ensured that the room got ventilated after to ensure no lingering smell was present for the next patient. I also went and changed my top to make sure that my own hygiene was in order for the patients' comfort and out of respect. I made sure the room was an acceptable temperature by opening the window fully and putting the fan on full for a period of 5 minutes after the bed had been disinfected. The result was a clean, fresh room with no lingering odour from the previous session. The tutor came into the room during the treatment and commented that it was "very clean and cool" then mentioned how happy he was that I made sure the room was clean and fresh before taking in my next patient.

SO WHAT: Through compliance with clinical health and safety legislation as well as personal hygiene and cleanliness I was able to provide a safe, clean and comfortable environment for my next patient who seemed appreciative of it. It was nice to have tutor feedback about room layout and cleanliness because as a student I often think this is something which is overlooked by many but has such a large impact on the patients experience as if it is clean, comfortable and aired out they feel much more relaxed and allows you to bond with them better.

NOW WHAT: I always have aired out the room after every patient and as I said above we all spray down the couches and pillows and anything which the patient has come into contact with as well as washing our hands before and after every patient thoroughly to ensure than any contact conditions will not be passed on. This is something I will carry on doing as I believe it is a huge part of the job.

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C6. You must be aware of your wider role as a healthcare professional to contribute to enhancing the health and wellbeing of your patients.

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C6. You must be aware of your wider role as a healthcare professional to contribute to enhancing the health and wellbeing of your patients.

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DESCRIPTION: A patient presented with chronic non-specific low back pain, exacerbated by prolonged sitting and sedentary habits. During the consultation, in addition to manual therapy, I discussed the importance of physical activity, ergonomic changes at their workstation, and general lifestyle factors like sleep and stress management. I created a basic exercise plan tailored to their capacity and encouraged them to set realistic movement goals. At the follow-up appointment, the patient reported improved symptoms and expressed appreciation for the practical, non-manipulative support provided.

FEELINGS: Initially, I felt slightly unsure about how much lifestyle advice was appropriate to give in an osteopathic setting, especially when deviating from hands-on treatment. However, as the patient responded positively, I felt more confident and encouraged. I began to feel that I was making a broader contribution to their wellbeing, not just treating the immediate symptoms.

EVALUATION: The positive aspect of this encounter was seeing how small behaviour changes, guided by health promotion helped the patient feel more in control of their symptoms. They became more engaged in self-care. However, I could have signposted more specific resources or community programmes to support their goals.

ANALYSIS: As Osteopaths it is our role to educate patients to understand how lifestyle factors like movement, posture, sleep, stress, and nutrition impact musculoskeletal function. The experience taught me that patients often value this advice as much as or more than hands on treatment. It also showed me that integrating such discussions builds rapport and long-term trust.

CONCLUSION: This experience confirmed that I can (and should) use my role to positively influence a patient’s broader wellbeing. Osteopathy isn’t limited to physical techniques — it includes listening, educating, and helping patients take charge of their own health. It also reinforced the need to communicate clearly and without judgment when giving lifestyle advice.

ACTION PLAN: Continue learning about evidence-based lifestyle interventions relevant to common MSK conditions. Develop a bank of resources (exercise sheets, ergonomic tips, etc.) to offer patients. Practise delivering lifestyle advice in a concise and engaging way. Explore local services (e.g. community physio, dieticians, smoking cessation) to improve referral options.

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D1. You must act with honesty and integrity in your professional practice.

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D1. You must act with honesty and integrity in your professional practice.

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DESCRIPTION: During a busy clinic session, I realised partway through treating a patient that I had forgotten to obtain verbal consent for a particular technique I was about to use. The technique was a supine Thoracic spine manipulation, and although I had explained the general plan earlier, I had not clearly confirmed their consent to this specific part. I paused the treatment, explained what I had planned to do, discussed with them the benefits of this technique for them in relation to their complaint and that they didn't seem to pose any red flags or contraindications to this technique but it might leave them feeling a bit tender and achy for up to 48 hours and asked if they were happy to proceed. The patient appreciated the clarification and agreed. After the session, I discussed the oversight with my tutor who appreciated my honesty and then informed me about why it was so important to be up front and honest with patients.

FEELINGS: At the time, I felt embarrassed and slightly anxious. I knew I had made a small but important mistake. However, I also felt relieved that I had caught it in time and corrected it. I was proud that I didn’t try to cover it up or carry on regardless. Speaking to my tutor about it helped me feel supported and learn from the situation in a way which it didn't feel like I was being told off but more helped through an untoward experience.

EVALUATION: The positive part of the situation was that I recognised my error and acted immediately with honesty. I upheld the patient’s autonomy and preserved trust in the therapeutic relationship. The downside was that my oversight reduced my honesty with the patient and could have undermined the patient’s confidence or worse yet, exposed them to treatment without informed consent, which goes against both ethical and legal standards.

ANALYSIS: OPS D1 emphasises honesty and integrity as fundamental professional values. This experience showed me that acting with integrity means acknowledging errors, not hiding them. It also reinforced the importance of clear communication and gaining not only informed consent at the start of the examination and treatment but procedural consent throughout to ensure the patient is up to date with what I am planning. Integrity in practice helps build trust, both with patients and with colleagues. sticking with what you believe to be morally correct shows strength and confidence which increases the respect and trust of patients as well.

CONCLUSION: I learned that professionalism isn't just about clinical skill it’s about being transparent, reflective, and ethical. Even small lapses can become valuable learning moments if approached honestly. By choosing to be open and take responsibility, I strengthened my confidence in acting with integrity, even in potentially uncomfortable situations.

ACTION PLAN: I will double-check that I have obtained and recorded explicit consent before each new High Velocity Low Amplitude Thrust including risks and change in the treatment plan if necessary. I will continue to be open with my tutors and peers when I make mistakes so I can learn from them. I will continue to do reflective feedback on all aspects of the case to ensure I have been following the OPS.

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D2. You must establish and maintain clear professional boundaries with patients, and must not abuse your professional standing and the position of trust which you have as an osteopath.

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D2. You must establish and maintain clear professional boundaries with patients, and must not abuse your professional standing and the position of trust which you have as an osteopath.

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Morning clinic 21/02/2025

WHAT: I was treating a follow up patient this morning who I have seen many times due to the chronicity of the complaint which she was coming in with. We get on well with one another and tend to be able to have a joke and good open conversation regarding her complaint. However, today I mentioned that it had been my birthday recently to which she asked a few questions about what I got up to. She asked my age and I responded. She then made a few comments which I believed were slightly flirtatious and one rather explicit comment about myself. This made me feel uncomfortable, I bought the conversation back to the reason which she came in for and bought into the conversation in a tactful way about professional and personal boundaries, she apologised for any offence from her comments and reassured me that she would refrain from doing so in the future. I spoke with my tutor who assured me I had done the correct thing and asked if I was happy to continue seeing this patient, which I am.

SO WHAT: I was happy with the way I handled the situation and made it so no one felt any awkwardness at the end of the session. It was clear to me in this situation that there was some confusion between a professional and personal relationship. I was pleased to be able to address the situation to bring it back to where we should be in a professional sense to ensure she got the best possible care.

NOW WHAT: I will be more diligent from now on with how I communicate and be open and honest about the relationship between myself and a patient and limitations to this. I will continue to correct patients if a similar situation ever arises ensuring they are aware of the boundaries so that no lines are crossed and we can maintain a professional practitioner - patient relation.

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D3. You must be open and honest with patients, fulfilling your duty of candour.

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D3. You must be open and honest with patients, fulfilling your duty of candour.

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WHAT: A patient came in complaining of ankle pain on the lateral left ankle. After a thorough case history it seemed to be a potential grade III Anterior Talofibular Ligament tear caused by a fall down some stairs 1 week ago forcing the ankle into excessive plantarflexion. I examined the ankle which only reinforced my diagnosis due to excess movement in inversion and plantar flexion as well as anterior draw of the talocrural joint. He wanted me to reduce the pain of the joint and to make it work properly again. I had to manage his expectations and explain to the patient that I may not be the best person for him to see and told him to go to get it scanned at hospital to ensure the damage isn't more severe, however there are strengthening exercises which I can prescribe to improve stability in the area which MIGHT reduce the pain and techniques I can do to help improve the drainage of swelling, but it is common for injuries like his may not heal fully without surgical intervention and if not it can take months for it to fully recover. My tutor came in when I was explaining what I thought was happening in the ankle and agreed with me much to the patients dismay.

SO WHAT: I was pleased with how I managed the patient, he was someone who didn't like having to wait and wanted everything done there and then. Naturally with patients like this he was agitated that I told him I couldn't miraculously cure his ankle and that it will be a persistent problem if he does nothing. Once I explained the physiology behind what had happened and what I think that means in terms of prognosis as well as options which are open to him medically he started to actually listen and take on board what I could do to help other than curing the ankle injury. It was important I was open and honest with this patient because they came in with an issue outside of our expertise, I did however say if he gets it scanned and nothing needs surgery then come back and we can treat the surrounding area.

NOW WHAT: I will continue to be open and honest with patients regarding their concerns and complaints to allow them to make an informed decision about what they want to do and whether or not I believe they are in the correct location. I will update my knowledge on patient complaints which are outside of our area of expertise and general recovery times for certain injuries so I can give updated and accurate information to the patient.

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D4. You must have a policy in place to manage patient complaints, and respond quickly and appropriately to any that arise.

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D4. You must have a policy in place to manage patient complaints, and respond quickly and appropriately to any that arise.

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Fortunately I haven't had to respond to any patient complaints whilst I have been in clinic. However, it is important we understand the procedure of how a patient complaint works. A senior member of staff will talk with the patient either by phone or face to face within 24 hours of the initial complaint where a full detailed description will take place. The complaint should be made within 6 months of the event and if the patient isn't happy with the outcome then a formal complaint is to be made to clinic lead. Final decisions aim to be made 25 working days post complaint and the patient making the complaint will be updated at least once per week of updates. An appeal process is in place should a patient not be happy with the outcome and results from the appeal will be posted to the patient 25 working days post appeal. Any further appeal has to be made to the GOsC for individual process.

As a student it is important we try and manage patients complaints within sessions should they not be too serious and we should also support patients through the complaint process should it be necessary.

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D5. You must respect your patients’ rights to privacy and confidentiality, and maintain and protect patient information effectively.

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D5. You must respect your patients’ rights to privacy and confidentiality, and maintain and protect patient information effectively.

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WHAT: After taking a case history from a patient my tutor was outside the room in the clinic corridor and asked me to present the case to them there and then, I unintentionally mentioned a patient’s first name and specific condition in a space where others (including patients) could overhear. I quickly realised this was inappropriate and stopped the conversation, suggesting we continue it privately in the discussion room. I raised this after the session about how I feel like we could have done it better by going straight to the room. The tutor also apologised for their oversight and mentioned that not as many students would be as bothered by this incident as they should be.

SO WHAT: This incident reminded me how easy it is to breach confidentiality unintentionally, especially in casual settings. Although no harm came from it, it was a clear violation of professional responsibility and could have damaged the patient’s trust had they overheard. It made me realise that confidentiality is not just about what we write or record it’s about how we speak and behave at all times.

NOW WHAT: Always check my surroundings before discussing patient information and ensure conversations happen only in private, secure areas. Avoid using any identifiable information when discussing cases with peers. Refresh my knowledge of data protection policies and clinic protocols. Be more proactive in reminding others gently and professionally if I observe similar behaviour.

This experience reinforced that protecting patient confidentiality is an active, ongoing duty, and lapses however minor must be taken seriously and learned from.

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D6. You must treat patients fairly and recognise diversity and individual values. You must comply with equality and anti-discrimination law.

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D6. You must treat patients fairly and recognise diversity and individual values. You must comply with equality and anti-discrimination law.

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WHAT: I recently treated a patient who identified as non-binary and preferred they/them pronouns. During the consultation, I unintentionally used incorrect pronouns when summarising their case to my tutor. The patient gently corrected me. I apologised immediately, thanked them for pointing it out, and ensured I used the correct language for the remainder of the appointment. After the session, I reflected on the situation and recognised the importance of inclusive, respectful communication. I reviewed the Equality Act 2010, which protects gender reassignment as a characteristic, and discussed the experience in supervision.

SO WHAT: This moment helped me realise how small slips in language can significantly affect a patient’s comfort and trust. In line with the Equality Act 2010, I am professionally and legally obligated to treat patients without discrimination and to acknowledge their identity and individual values. Misgendering, even if accidental, can feel invalidating and may discourage someone from seeking future care. The way I responded with humility, openness, and a willingness to learn was key to preserving rapport and upholding inclusive standards in practice.

NOW WHAT: Ask patients their preferred name and pronouns during case history, and make a note of it. Complete CPD on equality, diversity, and inclusion (EDI) in healthcare. Review my clinic’s documentation to ensure it aligns with the Equality Act 2010, particularly around gender identity. Continue to reflect on unconscious bias and improve my ability to deliver equitable, person-centred care to all patients, regardless of identity, background, or protected characteristics.

Equality act 2010 available at: https://www.legislation.gov.uk/ukpga/2010/15/contents.

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Legislation is available in different versions:

Latest Available (revised): The latest available updated version of the legislation incorporating changes made by subsequent legislation and applied by our editorial team. Changes we have not yet applied to the text, can be found in the 'Changes to Legislation' area.

Original (As Enacted or Made): The original version of the legislation as it stood when it was enacted or made. No changes have been applied to the text.

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An Act to make provision to require Ministers of the Crown and others when making strategic decisions about the exercise of their functions to have regard to the desirability of reducing socio-economic inequalities; to reform and harmonise equality law and restate the greater part of the enactments relating to discrimination

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D7. You must uphold the reputation of the profession at all times through your conduct, in and out of the workplace.

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D7. You must uphold the reputation of the profession at all times through your conduct, in and out of the workplace.

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DESCRIPTION: I was running late for my first patient of the day due to arriving just before the scheduled start time. As a result, I rushed the consultation and felt flustered. I realised afterwards that my body language, the lack of a proper greeting, and my distracted demeanour may have left the patient feeling uncertain or undervalued. My tutor noticed my behaviour and reminded me of the importance of professionalism not just in treatment, but in what they referred to as the three P's: punctuality, preparedness, and presence.

FEELINGS: I felt embarrassed and disappointed in myself. I knew I hadn’t given the patient my best, and I worried that I may have impacted their trust in Osteopathy. I also felt frustrated that something as simple as time management had influenced the quality of my conduct and possibly my patient's impression of the profession.

EVALUATION: The negative aspects were that I failed to present myself as calm and professional which could have reflected poorly not only on me but on osteopaths in general. However, the positive was that I recognised this issue quickly, took accountability, and had a constructive conversation with my tutor. The situation served as a reminder that professionalism extends to how we prepare, communicate, and compose ourselves.

ANALYSIS: Showing professionalism includes punctuality, communication style, appearance, and the ability to manage time and emotions under pressure. As healthcare professionals, our conduct even in seemingly minor moments can influence how the public views osteopathy. My actions that day did not reflect the standards expected, but recognising that helped me realign with those values.

CONCLUSION: I learned that every patient interaction is an opportunity to represent the profession well. Even when things go wrong like running late, how I recover, communicate, and learn from those mistakes matters greatly. I now understand that being seen as professional is an active responsibility.

ACTION PLAN: Arrive at clinic with adequate time to prepare mentally and physically for the day. Prioritise calm, clear communication even when rushed. Reflect on situations where my conduct positively or negatively impacted patient care or professional image.

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D8. You must be honest and trustworthy in your professional and personal financial dealings.

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D8. You must be honest and trustworthy in your professional and personal financial dealings.

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WHAT: Throughout my 4 years at the ESO I have also worked as a Sports Massage Therapist. Mostly through a company which provided a monthly income not reaching the tax bracket anyway but I recently went self employed and have had to inform HMRC of any payments for when I am graduated it will still count as the same tax year meaning I will be required to fill out my first tax return. I have done this to ensure I am in keeping with governmental guidelines around income. We are also not allowed to receive monetary gifts from patients which is something I have turned down in the past.

SO WHAT: By doing this not only am I ensuring I am following government legislation through the Income tax act 2007 but also ensuring I am following OPS D8 about being honest and trustworthy in personal and professional financial dealings. I believe it is important to keep in top of finances to ensure you are not in any breach because the results of breaking legislation or OPS could result in a hefty fine or potential loss of employment.

NOW WHAT: I will continue to be open and honest about my personal finances and will make sure that I go through an accountant to assist with financial calculation and if needs be seek advice from a financial advisor to ensure I am doing as much as I can to ensure my finances are all above board.

Income tax act available at: https://www.legislation.gov.uk/ukpga/2007/3/contents.

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Changes to Legislation

Revised legislation carried on this site may not be fully up to date. Changes and effects are recorded by our editorial team in lists which can be found in the 'Changes to Legislation' area. Where those effects have yet to be applied to the text of the legislation by the editorial team they are also listed alongside the affected provisions when you open the content using the Table of Contents below.

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Revised legislation carried on this site may not be fully up to date. Changes and effects are recorded by our editorial team in lists which can be found in the 'Changes to Legislation' area.

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D9. You must support colleagues and cooperate with them to enhance patient care.

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D9. You must support colleagues and cooperate with them to enhance patient care.

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WHAT: As our time at the ESO draws to an end we as students in the fourth year are expected to fill out handover forms for the third year student who will be taking on the return patient. The forms include patient details, red flags, findings, diagnoses, treatments given including what the patient prefers and any medical conditions/medications the patient may have to ensure the third year patient is fully updated to improve the overall quality of care the patient receives. I also include my student email to allow the student to ask further questions if necessary.

SO WHAT: This is a clear example of how we as support our colleagues and cooperate with them to ensure that the patient receives the best care possible from our clinic. This falls in line with OPS D9, giving the student a way of contacting yourself via email allows them to ask any additional questions they may have surrounding the case showing additional support.

NOW WHAT: I will continue to fill out these forms as thoroughly as I do now to ensure all relevant information is present for the student taking over. I will continue offering support to lower years as it not only helps them understand the case better but also solidifies the knowledge you have obtained from the case.

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D10. You must consider the contributions of other health and care professionals, to optimise patient care.

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D10. You must consider the contributions of other health and care professionals, to optimise patient care.

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DESCRIPTION: Today, I had a new patient who presented with a complex case. Due to the nature of her complaint, we were not able to treat her directly during the session. However, we provided appropriate care and referred her to her GP for further investigations and scans.

FEELINGS: My general feelings from this session is that it went well, I was able to confidently refer this patient on to the relevant health care professional to ensure she got the best care possible.

EVALUATION: A positive of this session is that my communication and decision making was appropriate for the situation. The only negative on the patients perspective is that they didn't get treatment today.

ANALYSIS: This highlights to me how important it can be to consider the work of other health care professionals to optimise patient care.

CONCLUSION: This session indicated to me that caring for a patients health doesn't always mean immediate treatment but potentially guiding them to the correct healthcare professional.

ACTION PLAN: I will continue to work with this in mind to ensure I always do what is best for the patient even if that means referring them to someone else.

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D11. You must ensure that any problems with your own health do not affect your patients. You must not rely on your own assessment of the risk to patients.

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D11. You must ensure that any problems with your own health do not affect your patients. You must not rely on your own assessment of the risk to patients.

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WHAT: One morning before clinic, I was experiencing symptoms of a mild sickness bug: nausea, stomach cramps, and light-headedness. I debated whether to call in sick but convinced myself I could manage and started driving to clinic anyway. During the journey in, I felt increasingly unwell, struggled to stay focused, to the point where I had to pull into a service station and rest. I called the clinic reception and explained the situation and apologised for the inconvenience that may result from my absence. The receptionist reassured me I was doing the correct thing and that it would be unwise to come in and unsafe as well. I also messaged my colleagues in my group to explain what had happened, they said that they would cover my patients and let the tutor know what was happening and to go home and rest.

SO WHAT: This experience made me realise the risk I would have put my patients and colleagues in by choosing to attend clinic while unwell. OPS D11 clearly states that practitioners must not allow their own health issues to affect their patients and must not rely solely on their own judgment to assess that risk. I had wrongly assumed that because I didn’t feel “that bad,” I could continue. In reality, I risked spreading illness, compromising hygiene protocols, and impairing my decision-making ability all of which could have had serious consequences. I was glad the reception team and my clinic group were so understanding in what could have potentially been a very precarious situation.

NOW WHAT: From this experience, I have learned to: Take early signs of illness seriously, especially in clinical environments. Inform clinic staff promptly if I feel unwell, without trying to push through too much. I will continue to follow health and safety protocols regarding infection control and fitness to practise. Reflecting on the wider responsibility I have as a healthcare professional to put patient safety above personal inconvenience is very important.

This reflection reinforced that professional responsibility includes knowing when not to practise, and that protecting patients sometimes means stepping away from the clinic when we are not well.

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D12. You must inform the GOsC as soon as is practicable of any significant information regarding your conduct and competence, cooperate with any requests for information or investigation and comply with all regulatory requirements.

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D12. You must inform the GOsC as soon as is practicable of any significant information regarding your conduct and competence, cooperate with any requests for information or investigation and comply with all regulatory requirements.

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WHAT: At the beginning of third year we all had to read through a fitness to practice document which outlined which features would be considered not fit to practice and the procedure for non-fit to practice referral and panel. It has always been clear to me how important it is that we do not take our position for granted and even if we have complaints made the aim of the university isn't to punish the student but to support them through the process and provide them with external support and care dependent on the outcome and reason for fitness to practice being bought into question.

SO WHAT: Being aware of the procedures in place allows you to feel comforted and makes you realise you are not isolated but also reinforces the importance of providing safe, effective and high quality care to your patients and makes you more conscious of how you act and your behaviour not only in clinic but also every day life.

NOW WHAT: I will continue to give high quality care to my patients and continue to work in accordance with the OPS to ensure my fitness to practice remains high. I will also do my due diligence and keep an eye out for my fellow students to ensure their fitness to practice is up to standards or whether further support may be required to make sure their mental health and wellbeing is also cared for. This is something I will take into practice when I qualify as well, ensuring I am abiding by clinical guidelines where I am working as well as reviewing the OPS to ensure my standards meet what is expected of me.

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Gibbs, G., 1988. Learning by doing: A guide to teaching and learning methods. Further Education Unit.

GOsC, 2018. Osteopathic practice standards | General Osteopathic Council. Available at: https://www.osteopathy.org.uk/news-and-resources/document-library/osteopathic-practice-standards/updated-osteopathic-practice-standards/ [Accessed May 12, 2025].

Legislation.gov.uk. 2012. Income Tax Act 2007. Available at: https://www.legislation.gov.uk/ukpga/2007/3/contents. [Accessed May 12, 2025].

Rolfe, G., Freshwater, D. and Jasper, M., 2001. Critical reflection for nursing and the helping professions: A user's guide.

UK Government (2010). Equality Act 2010. Legislation.gov.uk. Available at: https://www.legislation.gov.uk/ukpga/2010/15/contents. [Accessed May 09, 2025].

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