Code of Ethics
British Register of Complementary Practitioners (BRCP) Code of Ethics
PRINCIPLES OF PRACTICE
FOR THOSE REGISTERED WITH THE BRITISH REGISTER OF COMPLEMENTARY PRACTITIONERS
The unified profession of Complementary Medicine offers treatments bringing
into play the life force, in addition to other physical, mental and emotional
techniques. This can lead to a patient visiting more than one practitioner or receiving more than one discipline in the course of a
treatment programme and the following guidelines are written with that in mind.
Patients and their families must feel they can trust practitioners of
Complementary Medicine. To maintain that trust, practitioners have a duty to
respect all human and animal life and place the wellbeing of the patient as
their first priority.
This Code provides a framework within which practitioners of Complementary
Medicine are expected to work whilst allowing the public to see the criteria
used to protect their interests.
The Complementary practitioner must:·
Respect the patient's individuality and beliefs ·
reat every patient with care and consideration·
Obtain written consent before and for each and every course
of treatment given·
Explain treatments in a way that a patient can understand and
listen to the patient's views ·
Respect the patient's rights to be involved in their treatment ·
Respect confidential information ·
Ensure that the practitioner's own beliefs do not prejudice the
needs of the patient ·
Recognise the limits of their professional competence and refer
on when appropriate ·
Work with colleagues in ways that best serve the patient's
Avoid any act or situation that could compromise the dignity or
privacy of the patient ·
Respect a patient's right to request a second opinion ·
Be trustworthy in contacts with other health professionals ·
Strive to represent the profession with honesty and integrity ·
Be prepared to explain the chosen course of treatment to
patients and colleagues ·
Be aware of new developments and skills and take part in
Continual Professional Development.·
Be aware of any legislation regarding mental capacity, ensuring
that people who lack capacity remain at the centre of decision making and are
Be aware of any current legislation that may affect your
practice or work as a practitioner·
Be fully insured to protect both practitioner and patient (see
Work within the ethical criteria and ethos of the profession
1. ENTRY TO THE BRITISH
REGISTER OF COMPLEMENTARY PRACTITIONERS
1.1. The British Register
of Complementary Practitioners is a listing of professional practitioners
offering treatment using specific skills. The range and application of these
skills varies from complex structural manipulation (Osteopathy) to Eastern/
Chinese Medicine, soft tissue work, mental and emotional treatments, vital
energy level assessment and diagnostic techniques of various types
1.2. The standards, range
of competences and appropriate supporting knowledge for each
discipline/therapy/technique are stipulated by the Registration Panels of each
Division of the British Register.
1.3. Each Division of the
British Register is autonomous and able to recommend variations and additions
to this Code from time to time.
1.4. If assessment is
necessary practitioners will be required to make a diagnosis within the terms
of their own discipline, determine a programme of treatment where appropriate
and/or refer a patient on to another health professional.
Insurance must include full Professional Indemnity, Public Liability and where
appropriate Product Liability. This insurance must be in accordance with the
current ICNM Approved Insurance Scheme and be in force before practising.
1.6. Practitioners living
and working abroad must have insurance according to the legal requirements of
1.7 Nurses who practice CAM in their daily nursing care must ensure that it has
been stipulated as part of their formal working practice in their contract of
1.8. Practitioners who
treat family members or close friends must ensure that clear boundaries are
kept between social and professional relationships.
2. RELATIONS WITH OTHER PROFESSIONAL
2.1. This Code provides
the basis for a professional working relationship between healthcare
professionals in conformity with the requirements of patient safety and the
2.2. All members of the
British Register of Complementary Practitioners are required to abide by this
Code of Ethics and Practice and if also bound by other ethical codes of
practice (e.g. Nurses) have a personal responsibility to check that this code
has no apparent ethical conflicts in their practice
2.3. The Institute for
Complementary Medicine has a procedure to consider claimed infringements of
3. THE PHILOSOPHY OF COMPLEMENTARY MEDICINE
3.1. The aim of the
complementary practitioner is to assist the patient back to full health,
strength and wellbeing at physical, mental, emotional and life force areas of
Medicine seeks to "complement" the needs of the patient at the time
of treatment at the levels of consciousness stated in 3.1.
3.3. Practitioners should
be aware of the forms of treatments of other complementary disciplines /
therapies / techniques to facilitate co-operation between all the professional
services that may be involved
.4. DEVELOPMENT OF SKILLS
AND LIMITS OF COMPETENCE
4.1. The purpose of the
Code of Ethics is to ensure that members of the British Register of
Complementary Practitioners maintain the highest level of responsibility for their
4.2. The Code is
concerned with the welfare of the patient, as well as the integrity and the
relationship of the practitioner with other healthcare professionals.
practitioners must always ensure that the patients interests are given
practitioners must take all reasonable steps to monitor, develop and advance
their professional competence to the highest level and to work within that
competence. Professional development may include in-service training,
supervision, counselling, research and other consultative support.
practitioners must make clear contracts with patient. The contract must clearly
state the practitioner's name and disciplines currently registered with the
BRCP. It is not possible to guarantee the outcome of any course of treatment,
therefore the terms on which it is offered should be clearly stated before the
first session of treatment. Subsequent revisions should be agreed in advance of
any change in the treatment.
4.6. When Complementary
practitioners offer treatment without payment of a fee they work under the same
professional obligation to the patient as when a fee is paid.
practitioners must take all reasonable steps to ensure patient safety and
conform to health regulations as appropriate to the practice.
practitioners must record findings and clinical data methodically, without
distortion and take account of the patients' right to inspect their case
practitioners must be supportive of other health professionals and maintain
patient confidentiality at all times, except with the patient's permission to
discuss with colleagues when making a formal referral to another qualified
5. CLINICAL PRACTICE
5.1. The Code of Practice
offers general guidance on the presentation of Complementary Medicine and the
ways to make or receive referrals from other practitioners or services.
practitioners must conduct their practices at the highest professional standard
in their personal appearance, hygiene and appropriate decorum.
5.3. The premises must be
clean, adequately furnished, heated when appropriate and provide washing
facilities. A changing room and/or shower facility should be available where
appropriate. The clinics must comply with the National Health and Safety laws
of the land.
5.4. The consulting room
should be fully insulated for sound from the waiting area
5.5. Patients should be
warned when a specific treatment requires the removal of clothing where this is
not immediately obvious. Practitioners must appreciate the patient's need for
privacy and modesty and allow them to have another person of their choice present
if they so wish.
5.6. Case records, which
are subject to the Data Protection Act, must be kept secure at all times.
Practitioners must conform and be fully familiar with the Data Protection Act
practitioners offering products or a dispensing service must ensure that these
items are under supervision when not locked away.
practitioners on the British Register must not:-
5.8.1. Use the title
"doctor" before their name unless they are registered physicians with
the Medical Association in the country of practice. Complementary practitioners
who are not registered physicians but are entitled to use the term
"doctor" may state it after their name with the appropriate
qualification i.e. Doctor of Acupuncture, China.
5.8.2. Refer to or
address an assistant as "nurse" unless that assistant holds a nursing
qualification in the country in which the practice is being operated.
5.8.3. Practitioners must
not make a genital examination but should refer clients to their GP or Medical
5.8.4. Conduct a physical
examination of a child under age of 16 years of age except in the presence of a
parent or guardian or other responsible adult.
5.8.5. Make any claim,
either oral or written, for the cure of any given disease.
practitioners must be aware of those diseases which are notifiable in their
country of practice and take appropriate action to conform with the
requirements of the local Health Authorities or laws. See Appendix 1
5.10. When Complementary
practitioners refer a patient, the following considerations apply:
5.10.1. They consider the
case is beyond their technique, capacity or skill, the usual referral procedure
appropriate to the discipline will be followed.
5.10.2. If they require
advice from a more senior practitioner. In this case full details of the
medical history should accompany with the date and details of all treatments
5.10.3. Before referring
a patient on, practitioners must have the permission of the patient to disclose
6. ADVERTISING AND
practitioners may advertise a practice or service, exercising care that nothing
is said or implied that would discredit Complementary Medicine or stating that
they can cure any condition and conform to the requirements of the ASA
6.2. The following
guidelines must be observed:
6.2.1. Stationery and
nameplates should contain the minimal information needed to be descriptive but
make no claims as to quality or effectiveness.
announcements in the Media shall contain the minimal information, as on
classified entry in telephone directories shall contain name, profession,
qualifications, practice title, times of surgeries and address.
6.2.4. Practitioners are
advised to use their first name or other indication of their sex with the
6.2.5. Only professional
qualifications from accepted organisations or Degrees conferred by established
Universities should be displayed in practices. Qualifications from abroad must
be accompanied by the country of origin e.g. James Other, Dr. Acu (Beijing), BRCP (Chinese Medicine).
6.2.6. Practitioners may
add the letters BRCP, followed by the title of the Division/s to which they belong,
e.g. BRCP (Osteopathy, Nutrition). Practitioners may print the title in full if
they wish e.g. British Register of Complementary Practitioners (Homoeopathy)
.7. PUBLIC STATEMENTS AND
7.1. Practitioners are
advised that they must exercise care in making any public statement and should
not present any facts or opinions purporting to represent the views of the BRCP
without obtaining written consent from the Registrar. The BRCP reserves the
right to examine any material before giving such consent.
7.2. Practitioners may be
called upon to give a demonstration of their discipline. In these cases, the
modesty and dignity of the patient must be preserved and they must not be
brought into ridicule. In case of doubt, the matter should be referred to the
8. DEATH OR RETIREMENT OF
8.1. Practitioners should
make arrangements for the correct disposal of case records in the event of
their death. Executors are advised to contact the British Register for advice.
8.2. Practitioners who
sell or otherwise transfer their interest in a practice must inform all their
patients of the change and give the name of the practitioner to be responsible
for their treatment. 8.3. No information on a
patient shall be provided to the incoming practitioner without the permission
of the patient.
9. MEDICAL DIAGNOSIS
9.1. The Complementary
practitioner will use a number of techniques to assess the presenting symptoms
of the patient, the underlying causes and the potential treatment/s which may
9.2. Distinction should
be made, wherever possible, between potentially life- threatening conditions
and chronic states.
9.3. In the case of 9.2.
the patient may bring a medical history based on a series of allopathic
diagnoses, which will serve to provide an indication of a named condition.
However, the Complementary practitioner will need to assess the case from
different criteria and no attempt should be made to describe a Complementary
diagnosis in allopathic terms unless the practitioner is so qualified.
9.4. Practitioners who
wish to refer patients for an allopathic diagnosis or tests should exercise
care in the way in which they describe their appreciation of the presenting
symptoms, e.g. a Reflexologist is qualified to make a complementary medical
diagnosis which might indicate sensitivity in certain areas, but it may be
outside their competence to put a allopathic medical name to the condition.
10. WORKING IN HOSPITALS
OR GENERAL PRACTICE
10.1. The doctor in
charge will usually retain overall charge of the patient's case and will give
permission for the treatment to be DELEGATED to the Complementary practitioner.
10.2. Where the
practitioner is a nurse, he/ she must act within the current guidelines of the
Ethics and Standards Committee of the United Kingdom Central Council of
Nursing, Midwifery and Health Visiting. He / she must also act only under the
guidance of his / her ward management, observing any code of conduct that may
have been devised within the hospital and / or the Area Health Authority.
10.3. Practitioners who
are not nurses but who work in hospital wards must, at all times, act
discreetly and considerately, taking the greatest care to consult with staff in
charge and to avoid any action or behaviour that could obstruct or conflict
with the work of other health professionals. 10.4. Information on
individual cases may be available to those working in hospitals or private
practice, unknown to the patient. Therefore, matters of practice management and
cross infection (see Appendix 1) must be read with this in mind.
10.5. The Complementary
practitioner must always retain the right to refuse to treat a patient.
11. DISCIPLINE AND
11.1. The acceptance of
this Code is the outward sign that practitioners wish to establish the
relationship between themselves and those to whom they have a professional
responsibility. The adoption of such a code is designed to establish the
probity and competence of the profession in the eyes of the public and resolve
complaints in a transparent manner.
11.2. Practitioners are
required to report any complaints or criminal convictions made against them to
11.3. The Disciplinary
Committee for the British Register of Complementary Practitioners will be
convened to investigate complaints.
11.4. The Disciplinary
Committee shall be mindful that it has a duty to sit in a judicial capacity to
decide cases in which it is alleged that a practitioner has been guilty of
unprofessional conduct. 11.5. The Disciplinary
Committee may determine the fitness or competence of the practitioner to
continue to practice. The person's name may be removed from the Register if the
Committee considers s/he unfit to remain in registration. Such a person may re-apply
at a later date for re-registration.
12. INDUSTRIAL DISPUTES
12.1. It would not be
proper for a Disciplinary Committee to become involved in the merits of matters
connected with industrial disputes. However, the Committee will consider any
allegation referred to them, irrespective of whether or not the misconduct has
arisen during industrial action or any other circumstance.
guidelines with special emphasis on acupuncture and other treatments that
involve piercing the skin or taking blood.
Complementary Medicine rely on touch so every care should be taken of the
condition of their hands. In the event of any cut or skin conditions, latex
gloves should be worn.Guidelines for clinical
practise involve the need to ensure that general cleanliness and practitioner
and practice preparation include making washing facilities, clean towels and
gowns available for patients (where appropriate). The policy is designed to
ensure that every attempt is made to avoid cross infection and patients should
be asked if they have been in contact with or suffer from any notifiable
disease. NOTE: The Department of
Health from time to time issues guidance to practitioners. This is circulated
when received by the ICNM. Practitioners are also advised to check direct with
the Department of Health to ensure they have up to date information.
CATEGORIES OF INFECTION
AND INFECTING AGENTS
1. Open lesions or wounds
2. Chronic skin
3. Notifiable diseases
4. Hepatitis B and C
virus, HIV, MRSA, CJD
USE OF ACUPUNCTURE NEEDLES
Disposable needles must
An appropriate dilution
of disinfectant must be used after any suspected contamination.
Overall cleanliness of
the practice must be maintained on a daily basis.Ensure that the couch is
clean and covered by fresh paper or other for each patient.Ensure there is an
accident book to record any unusual incident.
Attire should include
washable clothing; hair should not come into contact with the patient and
jewellery should be removed or covered.Nails should be clean,
short and free from nail varnish. Any cut or abrasions of
the hands should be covered with latex gloves that are discarded after each
treatment of a patient. Waterproof dressings must be changed after each
GUIDELINES FOR USE OF
Care should be taken to
ensure that the patient is not left alone and measures are used to protect the
patient's skin during moxibustion treatment.
GUIDELINES FOR THE USE OF
ensure they are aware of special precautions to be taken and the
contra-indications for electrical acupuncture
Accidents on patients with known infections
MRSA, CJD policy
Needle stick injuries·
Sharpes and Waste Disposal
The Health Services Advisory Committee of the Health and Safety
Commission 1982 has drawn up the following guidelines.·
Categories of Waste
Group A. Normal waste produced during teaching or administrative
duties, which is commensurate with the normal function of a teaching establishment.
Group B. Clinical waste to include all items destined for
incineration, which includes syringes and needles.·
Storage, Transportation and Disposal of Waste
The local Department of Environmental Health will advise on
specific arrangements on a local basis for all refuse under Group B.