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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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What?

At the beginning of 3rd year, I had a patient come in with low back pain, this patient also had early onset dementia and had come in with her husband to her appointment. This patient had very acute low back pain and was unable to perform some of the testing routine including struggling with lying on the plinth. My patients husband had opted to remain in the reception area while his wife was in the appointment but I realised that as I was asking her questions, she was unable to answer some of them because of her memory impairment.

So What?

I adapted to doing all my testing seated and my treatment as it took a long time for the patient to lie down on her back. To complete the case history fully I asked my patients husband with her permission to come into the treatment room so that he can help with my patients recollection so that I could take a more accurate case history.

Now What?

Ultimately the seated position was also not suitable for the patient and I tried to get het lying on her side which also did not help, because of this I signposted my patient back to her GP for further investigation. (OPS C1, GoSC, 2019), (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. Safety and quality in practice. Available at: C. Safety and quality in practice – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

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develop mechanisms for storing and retrieving patient information, including financial and other practice data to comply with legal requirements in relation to confidentiality, data processing and storage, and requests for information from patients, healthcare professionals or other authorised parties.

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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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What?

As part of increasing and consolidating knowledge for common presenting shoulder pathologies, we were set a an assignment to complete where we chose to do a presentation on either subacromial pain syndrome (SAPS) of thoracic outlet syndrome (TOS).

So What?

For this assignment I chose to present SAPS, this is because of the many presenting complaints I get in the student clinic, I have not seen many true shoulder complaints, therefore I had started to forget my shoulder anatomy and possible differential diagnoses.

Now What?

This assignment has allowed me to revise my anatomy and also my diagnostic process which has enabled me to be able to confidently diagnose SAPS. Even though my assignment was only on SAPS, I have also been able to revise TOS and have been able to confidently diagnose TOS in clinic as well. This assignment has also enabled me to revise my osteopathic principles and be able to apply them with every patient now, where before I was only concentrating on the orthopaedic and medical aspect of patient complaints. (OPS B1, GoSC, 2019), (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. B. Knowledge, skills and performance. Available at:B. Knowledge, skills and performance – Osteopathic Practice Standards. [Accessed: 18 May 2025]

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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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What?

As part of the agreement to be treated at the ESO clinic, patients are advised that there may be students observing during the session. (BCNO, 2025).

So What?

I was the only student with a new patient and some of my colleagues requested to observe the appointment. I left my colleagues in the appointment room while I went to pick up my patient from reception. While we were walking to the appointment room, I reiterated that there would be student observers in the room. My patient told me she felt uncomfortable with that, and I told her I would tell my colleagues that I could not take any observers today

Now what?

I left my patient in a place where my colleagues would not see her as they left the room, then I went into the treatment room and informed them they could not observe, they understood and left the room. This incident highlighted to me the importance of patient consent and making sure that my patients’ needs are always met within the scope of my practice. (OPS, A1, GoSC, 2019). (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. A. Communication and patient partnership. Available at: A. Communication and patient partnership – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

BCNO Group, 2025. What to expect. Available at: What To Expect At ESO Kent | BCNO Group. [Accessed: 18 May 2025]

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A. Communication and patient partnership

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This theme sets out the standards relating to communication, the formation of effective patient partnerships, and consent. Patients must be at the centre of healthcare and must be given the information that they need in order to make informed choices about the care they receive.

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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?

A patient in her early 70's presented a the school clinic with low back pain that started while she was on holiday asleep. patient went to get out of bed but felt a pop in her low back which hurt but as the day went on the pain became better.

So What?

Patients symptoms gradually increased and now is unable to walk very far without pain, patient has bee diagnosed with osteoporosis, had a full hysterectomy at age 34 and had never been on HRT's

Now What?

I had to refer this patient back to her GP as patients pain was still very acute and could not move very much due to pain during examination. Patient also had a positive vibration test and only relief from pain was lying still. Therefore because I could not differentiate between mechanical pain and possible fracture this patient was referred back to GP. I had also giving the patient the option of going to A&E but she declined because of having to sit for hours and no being able to do that for too long. (OPS, A2, GoSC, 2019), (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. A. Communication and patient partnership. Available at: A. Communication and patient partnership – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

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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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Context.

A patient aged 14 years old presented to children's clinic a the ESO complaining of left knee pain after she has played netball. Patient was walking off the court when she heard her knee click then was unable to walk properly. Over the next couple of weeks the patients knee began to swell and lock, patient need walking aids and knee brace to be able to go to school. Patient saw GP who said that patient must take painkillers, ice the knee and it will be fine after a few days, at time of consultation 6 months had passed since initial onset and patient was experiencing flare ups 1 to 2 times a month.

Actions.

During consultation, in conjunction with my clinic tutor we diagnosed patient with possible osteochondritis dissecans but could not rule out any possible tears in her ligaments, tendons or menisci. Therefore, patient was advised that imaging was required to ascertain the extent to the injury, ultrasound was booked for patients which patient attended.

Results.

Ultrasound results for the patient came back inconclusive with a 15 degree increase in medial joint space of the patients knee but with no reason why. I then advised patient and her mother that an MRI might give a better understanding as to the extent of the injury. This was also a recommendation given by the ultrasound technician.

Learning.

This case helped me realise that not all musculoskeletal presentations are straightforward and other healthcare professionals are needed to help correctly diagnose patients. I also need to understand where my competency ends and also have to be able to signpost patients in the right direction. (Tidy and Knott, 2022), (OPS B2, GoSC, 2019), (Jones,2018)

General Osteopathic Council, 2019. B. Knowledge, skills and performance. Available at:B. Knowledge, skills and performance – Osteopathic Practice Standards. [Accessed: 18 May 2025]

Jones, A., & Brown, B. 2018. The CARL framework for reflective practice. Journal of Reflection, 22(3), pp. 150-160

Tidy, C., Knott, L. 2022. Osteochondritis dissecans. Available at: Osteochondritis Dissecans (Causes, Symptoms, and Treatment). [Accessed: 18 May 2025]

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There are two main types of osteochondritis dissecans, Adult osteochondritis dissecans and juvenile osteochondritis dissecans.

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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?

I had been struggling to properly explain to my patients what their possible diagnosis and treatment is.

So What?

Using the body charts with skeleton and muscles has been helpful in explaining diagnosis, treatment and management to patients, including the 5 models of osteopathy

Now What?

Giving patients informed consent is an important part of patient care to make sure patients are making decisions with the all the information they need. (OPS, A3, GoSC, 2019), (Driscoll, 2007)

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. A. Communication and patient partnership. Available at: A. Communication and patient partnership – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

Anatomycharts.net, 2024. Muscular System Anatomical Poster - LAMINATED - Muscle Anatomy Chart - Double Sided (18 x 27). Available at: Palace Learning Muscular System Anatomical Poster - LAMINATED - Muscle Anatomy Chart - Double Sided (18 x 27) : Amazon.co.uk: Home & Kitchen. [Accessed: 18 May 2025].

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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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What?

For some time I have been obtaining patient consent for examination and treatment all my examination findings including the tests used would be properly documented and the techniques used on the patients including the position the patient was in when I treated the.

So What?

I have been forgetting to record on the clinic form that informed voluntary consent had been obtained.

Now What?

Now that I have noticed that, I am now making sure that I am recording informed voluntary consent obtain for every patient and if not then I am recording that patient has refused treatment for whatever reason they give. (OPS A4, GoSC, 2019), (Driscoll, 2007)

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. A. Communication and patient partnership. Available at: A. Communication and patient partnership – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

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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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What?

A patient I had seen presented to the ESO clinic with stiff and restricted movement in their right shoulder following a fall while skiing that resulted with a break in the greater tuberosity of the humerus and GH joint dislocation

So What?

Patient has has been given exercises by her NHS physiotherapist, and had tried to do the but was being restricted by pain and loss of range of movement on GH joint. As part of treatment patient was advised that any exercise would increase the benefit of pain reduction and increased ROM.

Now What?

Together with my patient we came up with a rehabilitation set of exercises that would slowly strengthen her shoulder and increase ROM, patient has adhered to the exercises and is seeing improvement in her shoulder in terms of pain reduction and increased ROM. (OPS A5, GoSC, 2019), (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. A. Communication and patient partnership. Available at: A. Communication and patient partnership – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

Rehab My Patient, 2015. How to do a pendulum exercise. Available at: (635) How to do a pendulum exercise - YouTube.[Accessed: 18 May 2025]

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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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Context.

Apart from being a student and treating patient in the ESO clinic, I currently work as a sports massage therapist. My sports massage clients have to undress far more than the patients I have at the ESO clinic.

Actions.

I only ever get my sports massage clients to undress only to the area I need to work with. Usually if my female patients have regular bras that clip at the back I tend to let these patients keep their bra on and ask for permission to unclip the bra when I work on that area of the back then clip it back in place when I finish. If patient are wearing sports bras and they feel uncomfortable with fully undressing I will ask to move the bra slightly higher when I get to that part of the back as well. With all my massage patients I will leave the room as they undress and ask patients to let me know when they are lying down on the plinth, I also provide towels for patients to cover themselves with.

Results.

These method works well with all my patients who do not feel comfortable with undressing fully and allows them to be more in control of the appointment.

Learning.

By implementing this standard of operating in my treatment room, I am able to build a respectful and professional relationship with patients with clear boundaries that make me and my patients comfortable, this also protects me and my patients and if I ever need patients to further undress, they will be informed for the reason for this and consent will be obtained. Rejection of this will also be accepted and adjustment for treatment and alternatives will be given to the patient. (OPS A6, GoSC, 2019), (Jones, 2018).

Jones, A., & Brown, B. 2018. The CARL framework for reflective practice. Journal of Reflection, 22(3), pp. 150-160

General Osteopathic Council, 2019. A. Communication and patient partnership. Available at: A. Communication and patient partnership – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

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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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Facts

In the student clinic, I had a patient of a different religious faith to me who came in with pelvic pain predisposed by her current pregnancy. Patient had requested female practitioner and tutor because her religion does not allow her to be seen undressed by a man.

Feelings.

My priority was making sure that my patient was always comfortable therefore I informed all my male colleagues that wanted to observe me conduct the initial appointment that they could not do so at the patients request. I felt bad for my colleagues as they would loose out on an opportunity to learn from a maternity patient but the patients wishes where more important and had to be upheld.

I also changed tutors half way through the term and my new tutor was male, I made sure to let reception know that this patient was only to be seen by female student and tutors which they also respected and upheld.

Findings.

I learned that making sure that my patients requests, as long as they are reasonable, within the scope of practice and I am able to adhere to them, must come first. Patients come to us clinical and professional support and no matter what background they come from they deserve to be treated with respect.

Future.

Making sure that accommodations for patients like the one I saw in the future are always met, this will include patients of differing faiths, abilities, race, gender and sexuality. This means that educating myself on these differences will be important especially when those differences affect patient care. (OPS A7, GoSC, 2019), (Greenaway, 2019)

Greenaway, R. 2019. The Four Fs of Active Reviewing. Journal of Reflective Practice, 10(2), pp.123-145.

General Osteopathic Council, 2019. A. Communication and patient partnership. Available at: A. Communication and patient partnership – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

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Anatomycharts.net, 2024. Muscular System Anatomical Poster - LAMINATED - Muscle Anatomy Chart - Double Sided (18 x 27). Available at: Palace Learning Muscular System Anatomical Poster - LAMINATED - Muscle Anatomy Chart - Double Sided (18 x 27) : Amazon.co.uk: Home & Kitchen. [Accessed: 18 May 2025].

BCNO Group, 2025. What to expect. Available at: What To Expect At ESO Kent | BCNO Group. [Accessed: 18 May 2025]

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. A. Communication and patient partnership. Available at: A. Communication and patient partnership – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

General Osteopathic Council, 2019. B. Knowledge, skills and performance. Available at:B. Knowledge, skills and performance – Osteopathic Practice Standards. [Accessed: 18 May 2025]

General Osteopathic Council, 2019. C. Safety and quality in practice. Available at: C. Safety and quality in practice – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

General Osteopathic Council, 2025. Continuous Professional Development. Available at: Continuing Professional Development[Accessed: 18 May 2025]

General Osteopathic Council, 2019. D. Professionalism. Available at: D. Professionalism – Osteopathic Practice Standards. [Accessed: 18 May 2025].

Gov.uk, 2025. Discrimination: your rights. Available at: Discrimination: your rights: Types of discrimination ('protected characteristics') - GOV.UK [Accessed: 19 May 2025).

Greenaway, R. 2019. The Four Fs of Active Reviewing. Journal of Reflective Practice, 10(2), pp.123-145.

Health and Safety at Work Act 1974. Available at: Health and Safety at Work etc Act 1974 - HSE.[Accessed: 18 May 2025]

Jones, A., & Brown, B. 2018. The CARL framework for reflective practice. Journal of Reflection, 22(3), pp. 150-160

Public Health England, 2024. Available at: Public Health England - GOV.UK. [Accessed 18 May 2025]

Rehab My Patient, 2015. How to do a pendulum exercise. Available at: (635) How to do a pendulum exercise - YouTube.[Accessed: 18 May 2025]

Social Care Institute for Excellence, 2025. Safeguarding adults and children training courses. Available at: Safeguarding adults and children training courses - SCIE.[Accessed: 18 May 2025]

Tidy, C., Knott, L. 2022. Osteochondritis dissecans. Available at: Osteochondritis Dissecans (Causes, Symptoms, and Treatment). [Accessed: 18 May 2025]

Versus Arthritis, 2025. Versus Arthritis. Available at: Versus Arthritis | A future free from arthritis. [Accessed: 19 May 2025]

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

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

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What?

Currently as a student, I am able to keep up to date with a lot of relevant information regarding osteopathy including anatomy, pathology, principles of osteopathy and NICE guidelines because of the amount of hand in assessments, practical exams and written exam we have to complete as part of the requirements of the course.

So What?

This has given me a sense of safety as there has been a framework that I have been working to in order to be able to qualify as an osteopath. There has also been guidance available at all areas of this course. This includes working in the student clinic where there are clinic tutors that are able to assist when I am confused or stuck with something a patient has presented with.

Now What?

Adapting to qualified life will have its adjustment. GoSC offers a wide range of CPD courses that are available to help keep up with the requirement of GoSC and ensure that my knowledge is always up to date. There will not be any formal structure to this like I have had in university, but I will be able to curate my CPD to include to the areas I need more knowledge in and areas that I have more interest in including keeping up to date with any foundational knowledge. (OPS B3, GoSC, 2019), (GoSC, 2025), (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. B. Knowledge, skills and performance. Available at:B. Knowledge, skills and performance – Osteopathic Practice Standards. [Accessed: 18 May 2025]

General Osteopathic Council, 2025. Continuous Professional Development. Available at: Continuing Professional Development[Accessed: 18 May 2025]

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Our CPD site is packed with resources, case studies, ‘how to’ guides, templates and blogs including from osteopaths engaging with the scheme.

Objective activity

You’ll need to include at least one objective activity during the three-year CPD cycle which involves gathering external feedback on your practice, which you can then analyse and reflect on.

Find out more

Completing your CPD

Over three years, you’ll need to do CPD across all four OPS themes; at least one objective activity, and one communication and consent activity; you will need to keep records and complete a PDR.

Find out more

Peer Discussion Review

A Peer Discussion Review is a structured, formal discussion with at least one osteopath or other health professional, that will need to be completed by the end of your three-year CPD cycle.

Find out more

All about Verification and assurance

We randomly select 5 to 10% of osteopaths each month to look at evidence of their CPD, such as records of the activities they have completed, and to provide feedback and support.

Find out more

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A Peer Discussion Review is a structured, formal discussion with at least one osteopath or other health professional, that will need to be completed by the end of your three-year CPD cycle.

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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?

As part of my training as a osteopath I have to treat patients in the student clinic. once a term we have mini clinical exams where my clinical process is assessed.

So What?

The above attached document shows a CEX I did where I felt I did not do as well as I usually do because my knowledge of hip pathologies has regressed because I had not seen a patient with any hip pain in a long time in clinic, most of my patients were either low back or neck and shoulder patients

Now What?

I have now revised and know I need to always keep on top of all my knowledge in every area on the body especially after I qualify to be able to make sure I am not missing anything or misdiagnosing patients. (OPS B4, GoSC, 2019), (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. B. Knowledge, skills and performance. Available at:B. Knowledge, skills and performance – Osteopathic Practice Standards. [Accessed: 18 May 2025]

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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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What?

From my previous experience in other health care setting, I know the importance of making sure that patients notes are correct, legible and up to date. I have always done my notes hand written as shown in the above picture.

So What?

Currently the student clinic still uses a hand written system because it is much easier for everyone. However, having worked in private clinics, having a digitalised system is also important because there is less risk for misunderstanding previous practitioners notes and maintaining continuity.

Now What?

Should I ever decide to set up my own clinic, maintaining my clinical notes digitally using software like the Jane app will be my chosen method because of better legibility, reduced risk of loosing files and safety. There is however, a risk of patient database being hacked but I will make sure that all appropriate safety measures are employed to ensure the risk of hacking is dealt with. I also have Rheumatoid arthritis and over time my hand writing may deteriorate therefore keeping digital clinic note will also ensure uniformity. (OPS C2, GoSC, 2019), (Driscoll, 2007)

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. Safety and quality in practice. Available at: C. Safety and quality in practice – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

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

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

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What?

Usually the student clinic requires us to write all patient referral letter in one week. Recently I have been trying to make sure that all my referral letters are written and edited by the end of my clinic session.

So What?

I have managed to do this within my clinic session for that most part but if I had a patient in the last slot then the letter would have to wait until the tutor who supervised me was back in the student clinic to review the letter make any edits and sign the letter to be sent.

Now What?

This means that letters can be delayed sometime more than a week which can have an affect on the patients further care. (OPS C3, GoSC, 2019), (Driscoll, 2007}.

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. Safety and quality in practice. Available at: C. Safety and quality in practice – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

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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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Facts.

As part of our ability to work in the student clinic, we were required to do safeguarding training. This is because if we where to encounter any incident where we suspected that a patient was in harms way, we are required to report it.

Feelings.

I have currently not seen any patient that was at risk of harm but one of my colleagues has a patient in children's clinic who has been adopted by their aunt because their biological mother had lost custody due to negligence. My colleagues patient is now safe and in a loving home with their aunt. Observing my colleague manage this situation even though the patient is no longer in any danger has made me think how I would manage.

Findings.

Looking at my certificate, we completed this at the beginning of 1st year and I feel like I would benefit from a refresher course into safeguarding both vulnerable adults and children and making sure that I know the chain of command when I have to report any suspicions.

Future.

Since most osteopaths are self employed, the responsibility of making sure that all my relevant training is up to date will be entirely on me. I also need to research where I can report should I ever encounter a safe guarding situation. This will be part of my CPD schedule. (OPS C4, GoSC, 2019), (SCIE, 2025), (Greenaway, 2019).

Greenaway, R. 2019. The Four Fs of Active Reviewing. Journal of Reflective Practice, 10(2), pp.123-145.

General Osteopathic Council, 2019. Safety and quality in practice. Available at: C. Safety and quality in practice – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

Social Care Institute for Excellence, 2025. Safeguarding adults and children training courses. Available at: Safeguarding adults and children training courses - SCIE.[Accessed: 18 May 2025]

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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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What?

Currently at the student clinic and the private clinic I work in, we are requires to clean up after every patient we see so that out working areas are clean for the next patient and we minimise the chance of spreading disease.

So What?

In both clinics there is couch roll which id used to line the plinth for every patient. There is sanitiser to clean hands after every patient however washing hand with soap and water is better to reduce chance of contact dermatitis. there are also disinfectant sprays and blue roll to clean the plinth after every patient.

Now What?

These measure have the potential of increasing running costs for osteopaths but this is important to be able to keep a safe environment for patients and practitioners, both clinics have cleaners that arrive at the end of business everyday to make sure the premises is clean and all waste is properly disposed of. (OPS C5, GoSC, 2019), (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. C. Safety and quality in practice. Available at: C. Safety and quality in practice – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

Health and Safety at Work Act 1974. Available at: Health and Safety at Work etc Act 1974 - HSE.[Accessed: 18 May 2025]

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For straightforward guidance on how to comply with the health and safety law, go to The basics for your business.

The Health and Safety at Work etc Act 1974 is the primary piece of legislation covering occupational health and safety in Great Britain. It's sometimes referred to as HSWA, the HSW Act, the 1974 Act or HASAWA.

It sets out the general duties which:

employers have towards employees and members of the public

employees have to themselves and to each other

certain self-employed have towards themselves and others

You can read the Health and Safety at Work etc Act 1974 in full on legislation.gov.uk.

You can find out about health and safety law in our guide Health and safety at work: criminal and civil law.

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Contains links to various pieces of legislation, as well as the Health and Safety at Work etc Act 1974

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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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What?

The Covid19 pandemic has been the most recent and most impactful public health concern. At the beginning of the my time as a student in the ESO, it was the second year of the pandemic and there were still some protocols in place to minimise the spread of the disease.

So What?

As the years have gone, there the world had gone back to pre covid regulation with the introduction of the covid vaccination that has helped to reduce the spread of the disease with its mutations. The ESO clinic has also relaxed its covid measure and due to this. Around the winter time the cold and sometime stomach bugs seem to make their rounds in clinic meaning patients and students tend to stay home to avoid further spread of disease.

No What?

We currently still have PPE that is available a the student clinic to prevent spread. Patients will also be sent home and asked to return when they feel much better and so will any student or clinic tutors. This is done to maintain a safe working environment. As healthcare professional who will soon be practicing in the public, there is a need to make sure that I know where to report any public health concerns and how to manage anyone that would present to me in a private clinic. (OPS C6, GoSC, 2019), (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. C. Safety and quality in practice. Available at: C. Safety and quality in practice – Osteopathic Practice Standards.

[Accessed: 18 May 2025].

Public Health England, 2024. Available at: Public Health England - GOV.UK. [Accessed 18 May 2025]

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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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What?

As a healthcare professional I have a duty to my patients to make sure that they have the correct and relevant information at all times to be able to make informed decisions about their care.

So What?

In the private clinic I work in, I have seen patients that I was not able to treat and had to refer these patients to the correct healthcare professionals so they can get the correct care.

Now What?

Working in private health care, making sure that patient care is at the centre of my practice is essential to avoid situation where I am providing unnecessary treatment to patient to make money, this can put patients in harms way and can delay necessary treatment, therefore I must also make sure that my knowledge is always up to date as well. (OPS D1, GoSC, 2019), (Driscoll, 2007)

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. D. Professionalism. Available at: D. Professionalism – Osteopathic Practice Standards. [Accessed: 18 May 2025].

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Osteopaths must act with honesty and integrity and uphold high standards of professional and personal conduct to ensure public trust and confidence in the profession. The standards in this theme deal with such issues and behaviours, including the establishment of clear professional boundaries with patients, the duty of candour, and the confidential management of patient information.

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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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What?

As an osteopath, I will see patients in a state of undress. This is why making sure that informed consent is obtained, patients are aware of what I am doing at all times and why I am doing what I am doing. My patients also have the option of refusing treatment and this can also be after they had consented and after I have started treatment. I also avoid talking about any personal information to patients and never ask any personal information from my patients either.

So What?

I am constantly obtaining consent with my patients making sure I am aware of anything that makes them uncomfortable and I stop any testing or treatment that patients are not comfortable with. I also do not undress patients unnecessarily and will only ever require patients to undress to the area that requires treatment. I will have small talk with patients as a way to build a professional relationship with my patients but should I feel like conversation is going in an uncomfortable area, I will redirect conversation back to their presenting complaint.

Now What?

In addition, providing patients making sure that patients are clearly informed about the type of environment they are in, I also avoid having anything personal in my treatment room, everything has a clinical relevance. Making sure that their are chaperones available for patients and maybe for me as a practitioner should I feel uncomfortable. Lastly refusing to treat patients that continually violate boundaries that go beyond my scope of practice and theirs as a patients. (OPS D2, GoSC, 2019), (Driscoll, 2007)

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. D. Professionalism. Available at: D. Professionalism – Osteopathic Practice Standards. [Accessed: 18 May 2025].

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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?

As part of our duty of candour in the student clinic and when I am qualified, I have to inform patients of the possible side effects of treatment, and any further support should this occur.

So What?

One of my patients that had booked into the clinic had presented with low back pain. Upon testing patient has had mechanical low back pain. I lowered the plinth and asked patient if they wanted to sit up while I went to present to my tutor and patient decided remain lying down but with option of standing up should the require it. As I present to my tutor my patient decided to stand up and low back spasmed again causing an acute episode of pain. I called my tutor for help, pain subsided a little and patient still requested treatment, I tested the patient again to make sure nothing else had been injured and low back pain was still mechanical. treatment was conducted seated to avoid another episode of spasming.

Now What?

I reiterated the possibility of adverse reaction to treatment before I treated the patient and they agreed to be treated. I sent patient home with advise to use hot and cold in the low back to help with the pain. I also apologise for the pain they were in after trying to stand up from the plinth and reinjuring themselves. The good thing about private clinic is that I will not need to leave the room multiple times to try and talk to other practitioners, therefore any incidence of this will be minimised. (OPS D3, GoSC, 2019), (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. D. Professionalism. Available at: D. Professionalism – Osteopathic Practice Standards. [Accessed: 18 May 2025].

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

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

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What?

Currently, I have not had to manage any complaints from patients during however knowing how to manage this is essential

So What?

At the end of second year, we had an assignment that required us to reply to a complaint letter from a patient. This was very helpful in the sense that when if I decide to set up my own clinic, I will then have some background in managing complaints. At the student clinic, patients have an option of filling out a form as part of the complaint process

Now What?

As part of onboarding after I qualify, I need to make sure I know the complaint process for all my work places and I can sign post patients in the right direction so that they can access the correct information they need. (OPS D4, GoSC, 2019), (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. D. Professionalism. Available at: D. Professionalism – Osteopathic Practice Standards. [Accessed: 18 May 2025].

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

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

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What?

In the university we have assignments that require us to use out patients and records as part of the assignment.

So What?

Recently I had to copy my patient note to be able to use them as part of my case presentation. To make sure that all patient information was concealed, patients personal information was covered and was not used as part of this assignment or any other previous assignments.

Now What?

Even though we are a student clinic and we can use our patient notes as part of our assignments, it is important for me to protect my patients by making sure that no one has access to their information who does not need it. In the clinic reception patients files are also kept locked away only accessible through the administration team to protect patient confidentiality. (OPS D5, GoSC, 2019), (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. D. Professionalism. Available at: D. Professionalism – Osteopathic Practice Standards. [Accessed: 18 May 2025].

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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?

Our student clinic is divided into upstairs and downstairs treatment rooms. Usually we are assigned to a tutor who is assigned a group of particular rooms to be able for us to treat from

So What?

For some months, I was assigned a patient who could not go upstairs, therefore I would be assigned a room downstairs for me to treat from for this patient. This meant that patients care would still continue and accommodations where made to ensure that they received their care. the student clinic also has a hoist available in the student clinic that can be used for wheelchair patients to move them from their chair to the plinth and back.

Now What?

It is important that difference of any kind does not affect patient care as this could have adverse effects for the patient. Students are not currently trained to use the hoist that is available in the clinic, this is only for a select few members of staff to use to minimise accidents. However should those members of staff not be available for us to be able to use the hoist, there would be an effect on patient were treatment may need to be delayed or be incomplete. (OPS D6, GoSC, 2019), (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

Gov.uk, 2025. Discrimination: your rights. Available at: Discrimination: your rights: Types of discrimination ('protected characteristics') - GOV.UK [Accessed: 19 May 2025).

General Osteopathic Council, 2019. D. Professionalism. Available at: D. Professionalism – Osteopathic Practice Standards. [Accessed: 18 May 2025].

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It is against the law to discriminate against anyone because of:

age

gender reassignment

being married or in a civil partnership

being pregnant or on maternity leave

disability

race including colour, nationality, ethnic or national origin

religion or belief

sex

sexual orientation

These are called 'protected characteristics'.

You're protected from discrimination:

at work

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as a consumer

when using public services

when buying or renting property

as a member or guest of a private club or association

You're legally protected from discrimination by the Equality Act 2010.

You're also protected from discrimination if:

you're associated with someone who has a protected characteristic, for example a family member or friend

you've complained about discrimination or supported someone else's claim

Action against discrimination

You can do something voluntarily to help people with a protected characteristic. This is called 'positive action'.

Taking positive action is legal if people with a protected characteristic:

are at a disadvantage

have particular needs

are under-represented in an activity or type of work

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It is against the law to discriminate against anyone because of their sex, religion, disability or certain other personal characteristics ('protected characteristics')

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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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What?

In this new age of social media, more and more osteopaths are using social media to promote their businesses. Most osteopaths also separate their personal and business accounts. As student osteopaths, we have had a number of opportunities provided by the university to interact with other healthcare professions and other events to network and promote osteopathy

So What?

Even though there is a different with business and personal social media pages, most practitioners will have a link between the two therefore, I should be very mindful about what I post in my social media pages as this can affect the perception of not only me but my business as an osteopath.

Now What?

Even though osteopathy is 150 years old, there is still a large population who do not know that we exist as a profession and even if they do, people are not aware about what we do as manual therapists. Therefore, using social media to educate as well as promote the profession is essential. My experience as a student osteopath in the London marathon has also helped with promoting the profession. (OPS D7, GoSC, 2019), (Driscoll, 2007)

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. D. Professionalism. Available at: D. Professionalism – Osteopathic Practice Standards. [Accessed: 18 May 2025].

Versus Arthritis, 2025. Versus Arthritis. Available at: Versus Arthritis | A future free from arthritis. [Accessed: 19 May 2025]

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We’re Versus Arthritis. We won’t rest until everyone with arthritis has access to the treatments and support they need to live the life they choose.

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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?

As part of the course, one of our modules in 3rd year was coming up with a business plan which involved doing some research about available potential competition, price range and cost.

So What?

On average in my area, initial consultation was around £70 and return about £50. When calculating my cost for my potential clinic, I decided to stay within this range because of want to remain competitive and also cover all my costs and potentially make some profit

Now What?

I will be working as an associate to begin with for the at least the first 3 years, therefore my pricing for my treatment will depend on the price the principle has already set, in all the clinics I will be working in, this information is readily available on the clinic website and in the clinic itself. (OPS D8, GoSC, 2019), (Driscoll, 2007)

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. D. Professionalism. Available at: D. Professionalism – Osteopathic Practice Standards. [Accessed: 18 May 2025].

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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?

Recently, I had seen a patient who presented with low back pain, however as a sports massage therapist, I was limited in the treatment I could offer this patient.

So What?

I referred the patient to one of the osteopaths in the clinic and made sure that my notes where clear enough so that when they read them they would know what was happening. In addition to that, I also met and talked to the osteopath in the clinic before I left to do a verbal handover.

Now What?

Patient handover was adequately completed and the new practitioner can now manage the patient appropriately with all the information. Patient was informed that a handover to the new practitioner was completed which the patient was happy about. Only relevant information was shared with the new practitioner. (OPS D9, GoSC, 2019), (Driscoll, 2007)

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. D. Professionalism. Available at: D. Professionalism – Osteopathic Practice Standards. [Accessed: 18 May 2025].

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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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What?

I had a patient referred to me by an osteopath who was training to run the marathon, this patient was being treated for IT band pain by the osteopath and being treated with shockwave therapy

So What?

This patient also had hypercontracted quads, hamstrings ant and post calves and glutes which the osteopath could not manage in the time the had with the patient therefore they referred the patient to me. Over 3 treatment I did deep tissue massage with inhibition, assisted stretching and trigger pointing which also help improve the IT band pain. I was also able to use MET which in the osteopathic course to help manage this patients symptoms.

Now What?

The patient was able to complete the London marathon with the help of collaborative work between me as a sports massage therapist and the osteopath. Where appropriate, managing patients with a multidisciplinary approach has better health care outcomes. (OPS D10, GoSC, 2019), (Driscoll, 2007).

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. D. Professionalism. Available at: D. Professionalism – Osteopathic Practice Standards. [Accessed: 18 May 2025].

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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?

I have been diagnosed with rheumatoid arthritis and am under the supervision of a rheumatology team. Recently my symptoms have not been properly managed by my current medication.

So What?

I have gone back to the rheumatology team to inform them of my symptoms. I have had regular blood tests that track disease activity and the health of my kidneys and liver. I am currently undergoing a medication change to see if my symptoms will be better managed on a different drug. When I experience bad flare-ups I will take time off work and university and contact my rheumatology team for further intervention. Part of this is also attending hospital appointments what can fall on time I need to be in clinic. On these days I will take time off to attend the appointments.

Now What?

Because I work with my hands, I am very aware of the importance of making sure that I am listening to my body, reporting any changes in my symptoms whether new or worsening and taking time off to recover when needed. (OPS D11, GoSC, 2019), (Driscoll, 2007)

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. D. Professionalism. Available at: D. Professionalism – Osteopathic Practice Standards. [Accessed: 18 May 2025].

Versus Arthritis, 2025. Versus Arthritis. Available at: Versus Arthritis | A future free from arthritis. [Accessed: 19 May 2025]

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Stress and arthritis: Why it's important to manage your stress levels

We all get stressed from time to time. But there are coping skills we can learn to help us better manage it. Here Yeliz, who lives with axial spondyloarthritis, shares why it's important to manage your stress levels.

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We're Versus Arthritis. We won't rest until everyone with arthritis has access to the treatments and support they need to live the life they choose with real hope of a cure in the future.

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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?

Making sure that I am familiar with the OPS standards and all other relevant guidelines and laws wherever I choose to practice whether in the UK or abroad will ensure I reduce any risk of potentially being disciplined.

So What?

Ensuring that the OPS standards, laws and other relevant guidelines are always part of my CDP schedule. This will mean I am also able to keep up to date with any relevant changes to these and I am able to implement those changes accordingly.

Now What?

This assignment is a good start for this to be able to ensure that as I graduate, I have a good foundation of the OPS and am able to implement them in my practice going forward. (OPS D12, GoSC, 2019), (Driscoll, 2007)

Driscoll, J.J. 2007. Supported reflective learning: the essence of clinical supervision? Chapter 2 in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. London: Bailliere Tindall 2. pp 27-‐50.

General Osteopathic Council, 2019. D. Professionalism. Available at: D. Professionalism – Osteopathic Practice Standards. [Accessed: 18 May 2025].