Following is our current guidance for the Covid-19 crisis. Please read the following before contacting us, but if you do have any questions please email firstname.lastname@example.org
The Joint Committee on Vaccination and Immunisation (JCVI) are the independent experts who advise Government on which vaccine/s the United Kingdom should use and provide advice on prioritisation at a population level. The JCVI have advised that the first priorities for any COVID-19 vaccination programme should be the prevention of COVID-19 mortality and the protection of health and social care staff and systems.
In line with the recommendations from the JCVI, the vaccine will be initially rolled out to priority groups, including frontline health and social care workers. This includes all staff who have frequent face-to-face clinical contact with patients and who are directly involved in patient care in either secondary or primary care/community settings. It should also include those working in independent, voluntary and non-standard healthcare settings such as hospices, and community-based mental health or addiction services. As such, registered psychotherapists and other accredited practitioners not employed by the NHS would still receive priority access to the vaccine.
In terms of being identified - Local vaccination providers, including hospital trusts and primary care networks are playing a significant role in coordinating with the health and social care system and continue to work with employers of eligible staff to arrange vaccinations at the appropriate time. Nationally, the Department of Health and Social Care and NHS England and Improvement are also working with staff groups and representative bodies to ensure that both employers and staff receive accurate information about both the delivery mechanisms, and the safety and effectiveness of the vaccine.
The Society and the PSA have asked for further clarification on how Accredited Registers and/or practitioners will be contacted.
- National Lockdown/Tier 4
The UK Government advises that we work from home where possible. This remains the case when in a Tiered system, as well as during a National Lockdown.
The Society's advice to members is to continue to offer services remotely where it is possible to do so.
Members may make individual decisions to work in the room with a client if it is not possible to work remotely due to a risk to the client.
Point 47 on page 32 of the Health Protection Regulations 2020, under businesses permitted to remain open, lists services relating to mental health.
This is reiterated by the Government's advice that support that is essential to deliver in person, where formally organised to provide therapy, can be allowed to continue. This includes support to victims of crime, people in drug and alcohol recovery, new parents and guardians, people with long-term illnesses, people facing issues relating to their sexuality or gender, and those who have suffered bereavement.
Please read the section on Counselling Face to Face - Updated Guidance if you decide to offer in-the-room therapy.
The Department of Health and Social Care (DHSC) has provided some guidance in relation to the new Covid-19 guidance and regulations for England which was published the on the 4th of January:
- Personal care services provided for medical and health treatment may continue. The guidance on safer working in Close Contact Services should be followed https://www.gov.uk/guidance/working-safely-during-coronavirus-covid-19/close-contact-services
- Where applicable, practitioners should also take into account any guidance issued by the healthcare regulators or a relevant professional body.
- The Government cannot provide comments on individual cases of whether or not a business is permitted to open. It is for each business to assess whether they are a business required to close having considered the Regulations and guidance on business closures: https://www.gov.uk/government/publications/further-businesses-and-premises-to-close/closing-certain-businesses-and-venues-in-england#businesses-permitted-to-remain-open
- Localised Restrictions & Tiers 1 - 3
When Localised Restrictions and a Tiered approach are in force, the following are examples of ethical practice; however, in all cases our advice is superseded by the Government at all times.
Covid Alert Levels
Tier 1: Medium - It is ok to practice in-the-room provided that you adhere to the social distancing rules, and ensure that the room and surrounding areas (if relevant) are Covid-secure including hand sanitiser, wipes/spray etc. Nonetheless, we recommend continuing to work online where possible.
Tier 2: High - This tier involves a ban on the mixing of households indoors, so we would advise using online in every case, working in-the-room only when entirely unavoidable, and maintaining the social distancing rules and a Covid-secure environment.
Tier 3: Very High - Local Government will decide whether close contact services are allowed to remain open, however this tier asks people to avoid non-essential travel. We recommend ensuring all work is online only, and we would ask you to take advice from local authority if you feel a client is at risk from discontinuation of in-the-room work.
For Tier 4 / National Lockdown please see the separate guidance above
- Close Contact Services & Face Masks
The Government has provided guidance for those providing close contact services including wellness businesses, as well as well-being and holistic locations.
You can find the guidance for England here: https://www.gov.uk/guidance/working-safely-during-coronavirus-covid-19/close-contact-services
The guidance for Wales is here: https://gov.wales/keep-wales-safe-work#section-47135
The guidance for Scotland is here: https://www.gov.scot/publications/coronavirus-covid-19-retail-sector-guidance/pages/close-contact-services/
The guidance for Northern Ireland is here: https://www.nibusinessinfo.co.uk/node/23151
It includes steps that will usually be needed to ensure a safe workspace, and ideas for consideration.
The Department for Business, Energy and Industrial Strategy (BEIS) has provided detailed guidance for specific workplace settings. For the guidance please click here
The Government has also provided some guidance on reopening your business, including some useful information on Test & Trace and Social Distancing. For the guidance please click here
- Counselling Face to Face - Updated Guidance
Members may make individual decisions to work in the room with a client if they consider that it is not possible to work remotely. Decisions should take into account:
- The heath risk factors for yourself and your client, especially those connected with age, pre-existing health conditions, and so on.
- Your ability to create and maintain an appropriately socially distanced and hygienic space for face to face client work.
- The risks to yourself and your client in travelling to and from your clinic space.
- Your ability to understand whether you and your client should instead self-isolate, for example, if either of you or anyone living with you has developed potential symptoms of COVID-19.
- That you continue to be aware of Government guidelines and are up to date with them.
- That alternative ways of conducting your client sessions, or postponing their sessions, are not possible or detrimental to your client's wellbeing and welfare.
Taking into account the above, it is your responsibility to make an informed decision regarding face to face practice at this time. The Society recommends raising concerns with your supervisor as well as engaging with your clients as much as possible regarding this issue.
Best Practice for Face to Face Counselling
If you do need to provide in-the-room therapy, we recommend following the guidelines below, and taking all possible steps to limit the risk of exposure for both you and your client.
- When seeing clients face to face, ensure that both you and your client practice appropriate hygiene procedures before and after meeting, including hand sanitisation.
- Maintain a good distance of at least two metres from your client.
- Refrain from shaking hands and ensure you have explained to your client why this protocol is being followed.
- Refrain from other physical contact, for example, hugging a client.
- If possible, where providing tissues do not use one central box of tissues. Pre-divide tissues into portions so that different clients do not touch the same tissue boxes. Alternatively, advise clients to bring their own tissues.
- Remember to clean surfaces: phones, laptops, door handles etc, regularly.
Other things to keep in mind:
- Be prepared in case of evolving Government advice to cancel in-the-room therapy again for a temporary period. It is best to communicate with all clients and inform them that their sessions could be liable to postponement or disruption on a temporary basis. Where possible, offer to clients the option of continuing sessions by phone or video conferencing.
- Be aware of your clients' increased levels of stress and anxiety, and take extra self-care during the current public health crisis. If you feel overwhelmed, seek supervisor and peer support.
- Communicate with the Society when you need to and we will try to help as much as we can
- Inform clients that future sessions will be postponed if they are advised medically to self-isolate, or if they have any symptoms of a cold, cough, respiratory issues or a raised temperature.
- Inform clients that if you are diagnosed with coronavirus the NHS will require that you divulge a list of people you have come in contact with. In such circumstances you will inform the NHS of your contact with your client.
- Make sure you are prepared to communicate with clients in the event that you must self-isolate or fall ill. Rearrange appointments if you have any relevant medical symptoms.
This advice is superceded at all times by Government advice and the law and is subject to change at short notice. Please ensure you are aware of the rules in your local area i.e. England, Scotland, Wales, Northern Ireland.
For further English Government advice please click here
For further Scottish Government advice please click here
For further Welsh Government advice please click here
For further Northern Ireland Government advice please click here
For further NHS advice please click here
- Insurance Cover - Working Face-to-Face
We asked Howden and Balens if they are covering face to face client work for therapists at this time. Here were their answers:
Howden: Yes, provided that it is essential to work face to face and that you follow government guidelines you will be covered.
Balens: We can confirm your policies with Balens are in place to cover against any work you perform. This is subject to you adhering to government guidelines about practicing safely, and any advice you receive from your governing body/associations.
Your training school will be your primary source of information during the coronavirus.
- Many Trainers are offering temporary postponements and rearranging classes so that your training will still take the same amount of time overall.
- Many Trainers are offering temporary online alternatives to face to face training.
- Many Trainers are offering more theory modules first where possible so that face to face practical work can happen later.
- Trainers will be following Government advice.
- The NCS is preparing to allow slight variations in face to face hours if necessary to ensure your registration is not delayed, and is liaising with the Professional Standards Authority about this.
- Remember this will be a temporary issue and that training normality, if disrupted, will resume and there are lots of contingency plans for this.
- Many Trainers are offering temporary postponements and rearranging classes so that your training will still take the same amount of time overall.
We are listening, we are with you.
We have answered some recently raised questions below which we hope might be useful to you. Ongoing updates are published under 'important news' or in the 'Covid-19 Hub' on our website.
ONLINE WORK QUERIES
How do I decide whether I can work competently online?
Whether to work with a client online and what you can do if this is not an option is potentially the most challenging decision we have faced. What resources do you have to help you?
· Supervisor advice – use this trusted resource to help you risk assess:
. Client needs
. Client suitability for online work
· Online training to help move practise to online work, these can be short courses to move a current practice or more in depth study to help you move to dedicated online work with new clients.
· Practise using new tech with colleagues or friends
There is no simple answer, but you can access resources to help you make a professional judgement
Which technology should I use?
This is an individual offering which may differ to suit individual clients.
· Professional or readily accessible video conferencing platform
· Audio (phone)
· Text based (email)
All have different strengths and weaknesses and ultimately the decision sits with you, your experience, your clients’ needs.
There can be no absolute safe way to work online, but you can maximise your security and mitigate the risks.
· Use secured Wi-Fi (private access)
· Update firewalls and virus protection
· Help clients secure their own electronic device against data breach
The way you store personal data of clients and this may have changed due to recently taking up online working. This is not just about paper v electronic, it is about protection.
· Consider if you now hold new electronic data about a client
· Are you holding information on a new device?
Further information about complying with the General Data Protection Regulation and the Data Protection Act 2018 (GDPR) is available on https://ico.org.uk/
The ICO have acknowledged the extraordinary times and state that special consideration is being offered at this time but If you are in doubt you can take the quick quiz to identify if you need to sign up.
· Check with your insurance company if you switch to online work.
Howden, Balens, and Towergate, all confirm that counsellors holding insurance with them are covered for online and telephone counselling throughout this period
There are new issues to be aware of, these are likely going to be specific to your new working practise but the basics to consider include:
· Detailing your new security for online information, confidentiality and ways of working
· Clarify Client expectations for working online
· Take Emergency details and update crisis management steps to suit present situation
· Cyber Boundary setting, how will your work differ online.
· Managing a response to tech failure or if a client chooses to disconnect from a session
· Payments – Fees may be changed for a specific time or purpose ie for online work or for periods of exceptional hardship – clarity is key, agree change boundaries in writing.
· Disclosure tracing if a counsellor is diagnosed with Covid 19, ensure your client is aware of your potential responsibilities to the NHS.
GENERAL SUPPORT QUERIES
How can I use my skills to support my community?
· Join the NCS Key Workers referral initiative – this directly supports counsellors with key workers from any industry.
How do I join? log in to the Members' Area of the website and edit your profile. At the bottom of the page under ‘Charities you work with’ select 'Key Worker Counselling' from the dropdown menu and save.
A logo will show on your profile and customers will be able to search for you through the NCS Register.
I am recently qualified or not feeling confident to work online, what can I do now?
It is not ethical or reasonable to simply stop working with a client but if you do not feel comfortable to work online there are still things you can you do. Keep mindful that this is a temporary crisis and it will pass.
· Signposting clients to alternative sources ie referral to online counsellor or mental health apps ie https://www.nhs.uk/apps-library/ (tip: try them out yourself first?)
· Holding work - a remote ‘Check in’ rather than new counselling arrangement with clients may be more comfortable for you both
. Supervisor support, you both know your clients’ needs, it is a decision you can make together.
· Practice your self-care, you are going through this crisis too
· Enhance skills set – do online CPD https://www.counsellingcpd.org (check your member emails for some NCS online CPD discount codes!)
· Joint a webinar for live training (see newsletter for latest NCS dates)
· Review your accreditation or training level, what are you able to work towards?
What if I cannot work due to ill health?
If you are not well your responsibility is to make an ethical decision regarding working with clients, we know this could happen at any time but it is especially relevant now.
How you manage decisions making to take time away for physical or mental welfare in a proactive and positive way is also modeling important behaviors to your clients.
· Refer to other services or online therapists, can peers or your supervisor assist you?
· Have client contact details logged with access authorized for an appropriate colleague (ie supervisor or peer) and explain to clients that this is in place.
· If you take a specific time away, take care to only offer clients achievable timebound expectations and check in with supervision prior to returning to your practice to ensure your own set up as priority.
This is a stressful time for those in private practice. If you are unsure about your rights, check government updates. https://www.gov.uk/work
Taking a break
Continue to update your register page through the members area of the website to keep potential clients aware of latest developments.
· Advise us if you are taking a complete break from practice for a time as it may be appropriate to change to a NIP (Not in Practise) marker. If you are unsure, contact us for assistance.
Should you choose to leave the profession or simply no longer wish to be associated with the Society you can resign your membership at any time. However, if you are coming towards a membership renewal, please be mindful of the following:
- Ensure you contact the admin team at least 30 days prior to membership renewal date. This date can be found via your membership portal on the NCS website or is printed on your NCS newsletter.
- Instruct your Bank to cancel your Standing order mandate, the Society has no authority to stop this payment.
Sharing best practice
If you have any information you would like to share with your colleagues and peers please do keep in touch with us via email or Social Media. Our team are naturally working from home at the moment but we will always do our best to respond as quickly as possible and continue to share important information.