What to consider when your scope of practice moves online
More and more of us are working remotely, whether that be online or over the phone.
Remote working brings many opportunities and advantages for healthcare professionals, services and service users. However, it also brings risks and new challenges for practice.
This page sets out our advice and resources for registrants who are delivering care and treatment remotely.
Remote working and the standards
Technologies which allow healthcare to be delivered online have been so important during the pandemic. They have allowed the vulnerable and shielding to still access the healthcare they need and have helped us to keep infection rates down.
Here at HCPC, we are really supportive of registrants taking advantage of new technologies and ways of working in their practice. We know this has huge potential to advantage everyone you work with.
As with any area of your practice, you will need to consider how our standards apply. The key areas for remote working are:
Our standards of conduct, performance and ethics say:
2.3 You must give service users and carers the information they want or need, in a way they can understand
2.4 You must make sure that, where possible, arrangements are made to meet service users’ and carers’ language and communication needs
2.7 You must use all forms of communication appropriately and responsibility, including social media and networking websites
You will need to adapt your communication style when you are working remotely.
So much of how we communicate is about how we say it and our body language, rather than what we say. But when you are working remotely, you can’t rely on body language or visual aids (if you are communicating by phone) in the same way.
You may need to talk slower or repeat more information, to account for poor internet connections that affect the quality of the image or audio.
Some service users might also struggle to understand people over the phone or on a video call, who they cannot physically see. For example, someone with a hearing impairment might rely on lip reading.
Our standards of conduct, performance and ethics say:
Using information
5.1 You must treat information about service users as confidential.
Disclosing information
5.2 You must only disclose confidential information if:
- you have permission;
- the law allows this;
- it is in the service user’s best interests; or
- it is in the public interest, such as if it is necessary to protect public safety or prevent harm to other people.
Confidentiality is especially important when you are working remotely.
If you are working from home, think about who might overhear your conversation or have access to your work computer and files.
Always lock your computer screen when you leave your desk, and wear a headset or headphones for calls, so these cannot be overheard by those around you.
Our Guidance on confidentiality is a great resource to understand more about this area and the impact on your practice.
Our standards of conduct, performance and ethics say:
6.1 You must take all reasonable steps to reduce the risk of harm to service users, carers and colleagues as far as possible.
6.2 You must not do anything, or allow someone else to do anything, which could put the health or safety of a service user, carer or colleague at unacceptable risk.
Not every service can be delivered remotely. You might miss particular symptoms without seeing your service user in person.
It is important to keep this in mind when deciding whether to work remotely. It might be that you need to ask the service user more questions, to assess risk, and arrange for a follow up face-to-face appointment if necessary.
Think about the following…
- Does the service user need an assessment or test that cannot be done over the phone?
- Am I legally required to see the service user face-to-face in order to provide this service? (e.g. prescribing particular medicines)
- Does remote working hinder your ability to make informed decisions in the best interests of the service user?
- Is the service user safe at home to talk freely about their condition / care and treatment?
- Is remote working accessible for the service user?
If you do decide to work remotely, it is important you are open and honest with your service user about any limitations to your advice and practice remotely.
You should communicate this with the service user before offering them care and treatment online, so they can give valid consent.
Offering remote services to patients in the EU, Iceland, Liechtenstein, Norway, or Switzerland
Following the UK’s exit from the European Union, UK based healthcare professionals must abide by the individual rules and regulations of the relevant EU Member State. If their patient is based in the EU, Iceland, Liechtenstein, Norway, or Switzerland, they will need to check the national regulations of that country to understand how best to operate. Individual EU states reserve the right to stipulate conditions for non-EU nationals providing services in their countries. For example, by requiring local residency as a condition of providing some types of services. Austria is one country that only permits telehealth services to be provided to patients in Austria if the healthcare professional is resident in Austria.
The HCPC does not maintain a list of countries which have reservations in place which could impact UK based professionals. If a professional wishes to provide services to someone based in the EU, we would strongly urge them to check with the relevant body or to seek independent advice to ensure they are working within that country’s laws.
Principles for good practice in remote consultations and prescribing
HCPC and the other professional regulators have produced key principles for remote consultations and prescribing.
Remote working and your wellbeing
Working remotely can be enormously stressful.
Video call technology is a brilliant way of bringing together colleagues and service users. However, it also means your personal and workspaces become blurred. You are inviting people into your home. Traditional barriers between health professionals and their service users can become blurred.
In addition, face-to-face interactions at work can be really important to check in on others and how they are feeling. By losing those interactions, you may find the impact of day-to-day stresses at work building up.
It is important to be kind to yourself and seek out support if you think you need it. We signpost to some great wellbeing resources on our website. You can also reach out to your employer or supervisor if you are struggling.
