British Association for PERFORMING Arts Medicine
BAPAM Code of Practice for Educators
Introduction
This code of practice is also available as a downloadable PDF. Keeping performers healthy and reducing the risk of performance-related injury supports performance excellence and is an educational as well as a clinical goal. A combination of both skill sets can often provide the best outcomes for performers. To this end, BAPAM welcomes the contribution that music and other performance educators can make to the care of performer patients.
Professional Standards for Educators working with clinical practitioners at BAPAM (includes Vocal Rehabilitation Coaches)
Keeping performers healthy and reducing the risk of performance-related injury supports performance excellence and is an educational as well as a clinical goal. A combination of both skill sets can often provide the best outcomes for performers. To this end, BAPAM welcomes the contribution that music and other performance educators can make to the care of performer patients.
Educators cannot act as clinicians but can provide educational advice on performance technique and professional lifestyle / health-related behaviours to support health improvement.
For educators who are working alongside clinicians to care for performer patients, there is no professional framework or guidance to adhere to which would offer protection in the event of a complaint or adverse outcome. This new guidance has been adapted from the type of Professional Standards adopted by healthcare practitioners and should be used by educators working alongside clinical practitioners.
Professional Indemnity Insurance
You must take out and maintain the necessary Professional Indemnity Insurance and any other insurance the law says you must have, such as public liability insurance if you work from your own premises. You are personally liable to individual performers for any assessment, advice or care you provide. This applies wherever you work. You will need tell your insurance company about any changes in your circumstances that affect your policy to make sure that your insurance has enough ‘run-off’ cover to protect you when you finish practising.
Disclosure and Barring
You should have an Enhanced DBS Certificate which is kept up to date.
Code of Conduct
Educators working to improve the health of performers must:
- promote and protect the interests of the individual performers that they are caring for;
- respect confidentiality;
- communicate appropriately and effectively;
- work within the limits of their knowledge and skills;
- identify and minimise risk;
- report concerns about safety;
- be open when things go wrong;
- be honest and trustworthy and display professional standards of behaviour; and
- keep good records of their work.
What the standards mean for different groups
Performers and the public
If you are receiving care or advice from one of our Educational Practitioners, or you might do so in the future, the standards will help you to understand how our practitioners should behave towards you.
On the rare occasions that something goes wrong, anyone can raise a concern through our complaints process. We will investigate and take action when there are serious concerns about a practitioner’s knowledge, skills or behaviour.
We use the standards of conduct to help us decide whether we need to take action to protect the public.
Educational Practitioners
If you are registered with us, you must make sure that you are familiar with these standards and that you continue to meet them. If you are applying to be registered, you will need to sign a declaration to confirm that you will keep to the standards once you are registered.
As practitioner, you are personally responsible for the way you behave. You will need to use your judgement to make informed and reasonable decisions about how you meet the standards. You must always be prepared to justify your decisions and actions.
Making informed and reasonable decisions might include getting advice and support from clinicians, colleagues, education providers, employers, professional bodies, trade unions or other people. In particular, we recognise the valuable role professional bodies play in representing and promoting the interests of their members. This often includes providing guidance and advice about good practice, which can help you meet the standards. BAPAM has designated Clinical Practitioners who can provide clinical supervision when required by an Education Practitioner, as set out in these standards.
The standards
1. Promote and protect the interests of individual performer patients
As a provider of care and advice, you must treat individual performers with respect, listen to their views and involve them in decisions about their own health and wellbeing, including providing appropriate information and seeking consent to the actions that you propose. You must not discriminate against individuals or let your personal views affect your professional relationships or advice, and you should challenge discrimination if it comes to your attention.
2. Confidentiality
You must treat the information you obtain during consultations with individual performers as confidential. This includes all information about personal data, appointments, medical history and personal circumstances. You may also be told confidential information about third parties, such as colleagues or other performers, during the course of your work with a performer. You must only reveal or pass on confidential information if you have the performer’s consent, or where the law allows disclosure in the public interest (such as if it is necessary to protect public safety or prevent harm to other people).
3. Communicate appropriately and effectively
- Communication with performers
You should be polite and considerate at all times and provide clear information in a way that individuals can understand, including taking any language or communication needs into account.
- Communication with colleagues
You should communicate clearly with colleagues for the benefit of individual performers. You must share relevant information, with the patient’s consent, with any other colleagues involved in the care or treatment of that performer.
If any third party (health professional, colleague or other) requests information or a report about the health or care of a performer, you must get the consent of the performer before providing any information.
- Agreeing responsibilities
If you work jointly with others on the care of an individual performer, you must agree who holds what responsibilities for that individual. When a performer is referred to you by a healthcare professional, they are passing accountability and responsibility for the performer’s care to you. It is particularly important to agree who is responsible for the safekeeping of the performer’s records.
- Social media and networking websites
You must use all forms of communication appropriately and responsibly, especially public comments made on social media and networking websites. Remember that all forms of electronic communication can potentially be copied or forwarded beyond your control.
4. Work within the limits of your knowledge, skills and scope of practice
You must be aware of the limits of your knowledge, skills and experience and keep within your scope of practice by only giving care or advice in the appropriate areas. You must refer a performer to another practitioner if the care, treatment or other services they need are beyond your expertise or scope of practice. You should reassess your approach to a performer’s problem, andconsider referring to someone else, if progress is not being made or if your advice is not being effective.
You must maintain and develop your knowledge and skills and keep up to date through Continuing Professional Development, including keeping up to date with relevant evidence-base and research, guidelines and legislation (for example in Data Protection and Safeguarding).
You should routinely ask for feedback from patients and colleagues and use it to monitor and improve your practice.
Clinical Supervision
We recommend that you seek regular advice about the performers that you see from a BAPAM Clinical Supervisor, to support your practice and help you to understand when to make referrals. You should choose a clinical supervisor in the specialism closest to your educational practice, e.g. a laryngologist or SLT if you are a vocal coach. You will see many performers with psychosocial issues, which may sometimes be distressing, and you should have access to an experienced psychosocial practitioner for advice and supervision if necessary.
5. Identify and minimise risk
You must not do anything, or allow someone else to do anything, which could put the health or safety of a performer or colleague at unacceptable risk.
This includes complying with health and safety law (for example accident prevention and fire safety) and assessing and managing infection risk: this is especially relevant if you practice from your own premises. The risk of infection is relatively low in the practice of education and coaching, however it does exist because of the number of members of the public who may visit your practice and be cared for by you. Measures that will help you to reduce the risk of infection include: general cleanliness of the premises, hand washing/sanitising and providing fresh paper towels for each performer.
Your own health
You must make changes to how you practise, or stop practising, if your physical or mental health might affect your judgement or ability to carry out your practice, or put others at risk for any other reason.
6. Report concerns about safety
You must have a Safeguarding Policy for both Children and Vulnerable Adults and report any concerns about the safety or well-being of individual performers promptly and appropriately. You must also support and encourage others to report concerns and not prevent anyone from raising concerns. You must make sure that the safety and well-being of your patients always comes before any professional or other loyalties.
You must follow up any concerns you have reported, or that have been reported to you, to make sure that they have been acted upon. If necessary, you should escalate your concerns higher.
7. Complaints
Be open when things go wrong
You must be open and honest when something has gone wrong with the care or advice that you have provided by informing and providing an explanation to the individual concerned, apologising and acting to put it right if possible.
Dealing with concerns and complaints
You must support performers who want to raise concerns about the advice, treatment or other services they have received. You should have a Complaints Policy and make it easily accessible to performers via your office or website. You must give a prompt, helpful and honest response to anyone who complains about the care or advice they have received from you.
You must have clear justification for refusing to continue to care for any performer and you must explain to them how they can find another healthcare or educational practitioner to help them.
8. Be honest and trustworthy
Personal and professional behaviour
You must make sure that your conduct justifies the public’s trust and confidence in you and your profession at all times. This includes being honest about your experience, qualifications and skills and making sure that any marketing or promotional activities you are involved in are accurate and are not likely to mislead.
Conflicts of interest
You must develop awareness of issues that might create conflicts of interest and make sure that they do not influence your judgement. This is especially the case if you are receiving payment for your services from a performer that you are caring for.
Relationships
You should develop and maintain courteous, professional and respectful relationships with your patients and colleagues based on confidence and trust.
This includes establishing and maintaining clear personal and sexual boundaries with performers whom you are caring for. If you are sexually attracted to a performer (or if you believe that a performer is sexually attracted to you), it will affect your professional relationship: you should ask for help and advice from a colleague or an appropriate professional body before any personal relationship develops and, if necessary, hand over care to another healthcare practitioner.
Information about your conduct and competence
You must tell us as soon as possible if:
- you accept a caution from the police or you have been charged with, or found guilty of, a criminal offence;
- another organisation has taken any action or made a finding against you; or
- you have had any restriction placed on your practice, or been suspended or dismissed by an employer, because of concerns about your conduct or competence.
You must co-operate with any investigation into your conduct or competence, the conduct or competence of others, or the care, treatment or other services provided to performers.
9. Records
You must keep full, clear, accurate, legible and contemporaneous records for everyone you provide a service to. You must complete all records promptly after each session. Each entry must include accurate patient identifiers and be signed and dated.
Records should include
- the performer’s personal data
- the case history of the performer
- the performer’s consent to assessment and care (or in the case of a child under 16 the consent of someone with parental responsibility)
- details of your assessment, and any subsequent reassessment, of the performer’s needs including the outcomes of any plan or advice.
Responsibility
If you are working jointly with a clinician, you should be clear about who has responsibility for the safekeeping of the performer’s records.
Keep records secure
You must keep records secure and protect them from loss, damage or inappropriate access in line with Data Protection legislation. You should check whether you need to be registered with the Information Commissioners Office https://ico.org.uk/for-organisations/data-protection-fee/self-assessment Paper records should be stored in a locked filing cabinet or equivalent; electronic records must be password protected with passwords kept secure and without the use of any automatic log-in facility. Records must never be stored on shared-access or mobile devices.
Performers have the right to access to their personal records within specified time limits according to the law.
(Records must be kept safely and in good condition for ten years from the date of the performer’s last visit to you or, if the performer is a child, for ten years after their 18th birthday. You must arrange for performer records to be stored safely if you close down your practice to make sure that performers can have access to their recent health records and to protect you if any complaints are made. When you close your practice, you must publicise the arrangements that you have made to keep the records safe so that performers know how to obtain their records if they want to. If the responsibility for the performer’s records is yours, it is also recommended that you make provision in your will for their safe storage so that they can subsequently be released to a performer or their legal representative if necessary.)
Letters and reports
You should report back in writing, at the end of each phase of care, to the clinician who initially referred the performer to you and you should consider, with consent, copying in the performer’s GP (as GPs have overall responsibility for individuals’ complete health records). You should also provide a copy of the report to the performer. Reports should include details of the performer’s presenting problem(s), your assessment, the advice or care that has been provided and any outcome or further plans.
You must get the consent of the performer before providing any information following requests for information from other health professionals and third parties.
Data transmission
You must ensure that confidential information is secure whether it is sent electronically or via hard copy. Hard copy letters need to be addressed accurately with the recipient’s full name and most up-to-date postal address and marked “Confidential”. Electronic data must be sent by encrypted email only.
BAPAM is happy to provide further help and guidance in line with the BAPAM Data Protection and Data Transmission Policies
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