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Discussions regarding Age Concern providing this service have been ongoing for quite some time however this is the first letter inviting patients that I have seen in my area.
I was surprised to see that they advertise 'NHS trained' individuals providing the service. Indeed the Rotherham NHS Podiatry team must also be aware that patients are advised to 'purchase' their own 'instruments for the sum of £15.00 during their assessment appointment, to be returned on each subsequent visit for their individual use to prevent infection.
I can only surmise that the 'instruments purchased' are the 'single use only' instruments currently advertised.
If this is the case how can the NHS justify such double standards? Nationally the NHS have spent millions of pounds in transferring sterilisation to central sterilisation or disposable instrumentation to meet standards!
During infection control updates in the NHS clinicians are told that 'single use' means just that. Use once & dispose. The instruments are NOT autoclavable & I do not anticipate that Age Concern have any detailed knowledge on infection control or surely they would not advise the repeated use of such instrumentation.
Hardly a move in the right direction. I would be interested in anyones thoughts.
Regards, Mandy.
__________________
:)
twirly
Mandy Brooks
Brooks Podiatry
S64 0DE
Suffering a fondness for odd things.
Thanks for posting that letter, perhaps now we professionals in PP know what we are up against.
Interestingly it does not mention where or in what conditions the 'treatment' will take place.
I know that after the furore caused by the endorsement of Age Concerns 'Foot campaign' by the Society steps were taken to try and get them to adhere to the same standards that HPC registrants have to. All attempts have been ignored.
I have met with a local organiser for AC in her planning stage of offering just such a service at the same sort of prices. I pointed out that some PPs already offered a nail cutting service at just those sort of fees, having put my offer in writing there was never a reply.
I still contend that AC are a social enterprise not a Charity and they see this as a 'nice little earner'.
Hence why some of us dinosaurs bang on about Functional closure.
What will it take before the 'modernisers in charge' are called to task for allowing 'amateurs' to do professionals jobs?
And coming to you very soon independently insured assistant practitioners working using scalpels remote from a supervising Podiatrist, both in the NHS and PP and under the 'flag' of the Society.
No wonder the Americans object to us using the term Podiatrist.
I was surprised to see that they advertise 'NHS trained' individuals providing the service. Indeed the Rotherham NHS Podiatry team must also be aware that patients are advised to 'purchase' their own 'instruments for the sum of £15.00 during their assessment appointment, to be returned on each subsequent visit for their individual use to prevent infection.
Mandy,
Perhaps this is a bit of income generation for the NHS? Stacks of NHS staff do a bit of "private" on the side and I'm sure in some cases NHS resources of one form or another are being usurped for this purpose, so why not out-flank the "privateering NHS staff" by bringing some of the money back to the NHS?
Insert the word "cross" in front of infection, it makes much more sense then.
Quote:
Originally Posted by twirly
I can only surmise that the 'instruments purchased' are the 'single use only' instruments currently advertised.
Why? How much is a cheap pair of nippers?
__________________ Science is the antidote to the poison of enthusiasm and superstition
Any instument used upon the foot of a patient may become contaminated with the patient's own blood, serum, pus, urine and faecal matter - quite apart from household fluff and dirt. To use these instruments upon a patient more than once at intervals and without cleaning is morally unacceptable. It may be their dirt, but it is still dirt!
Single use instrument sets are advertised in our Journals at £4.50 per set.
As for the charge, £15 is rather less than a professional fee and rather more than a charity should be charging. The service is not an essential service (the NHS's justification for discharging this category of patient) and the same service is readily available throughout most of our country at a fee of £20 or so from Podiatrists and Foot Health Practitioners.
And why 50 and over? Given expanding lifespans, 50 is hardly 'aged'.
Age Concern is dabbling where it should not, and any support given to it by government, SOC or individuals does our profession no service.
Not too sure which Journal you refer to, but you make a very good point about decontamination.
However two counterarguments often prevail.
Decontamination will be arguably no worse than that which the client would have experienced had they cut their own nails.
Single use instruments at that price have to have compromised on quality, exposing users to RSI and are ecologically unacceptable.
A fee of £15 for a surgery based ‘simple nail cut’ is more than sustainable, infact it can be a good income stream, and should other problems arise then the client can simply be transferred to a conventional Chiropody patient.
It could be argued and is by some AC clients that Charities should not charge, they are supposed to be Charities.
You state that ‘this service is not an essential service’, this translates into NHSese as this is not a Podiatric/medical need but a social need/want.
Hence Admin 2 guiding us to ACs wants Podiatry included in targets’ demonstrates the duplicity of AC.
In collaboration with the DOH/government they operate as a Social Enterprise, thus fulfilling a government agenda, to supply an unquantified ‘unmet’ need at a commercial rate, using unpaid or minimally paid ‘volunteers’ minimally trained at tax payers expense by hard pressed NHS Podiatry departments.
Unfortunately this is compounded by the Private Trainersopenly claiming that ‘the demand for Chiropody cannot be met by the Registered Sector, so FHP training represents a recession proof career.
Twirly posted:
"I was surprised to see that they advertise 'NHS trained' individuals providing the service. Indeed the Rotherham NHS Podiatry team must also be aware that patients are advised to 'purchase' their own 'instruments for the sum of £15.00 during their assessment appointment, to be returned on each subsequent visit for their individual use to prevent infection."
An advertisement for single use instruments appears in the latest Podiatry Now and the cost is presented at something like £4.50 a set. If AC is charging £15 for these instruments then they are adding a considerable mark-up, and I agree that this is both commercial and not good for the environment.
What do you think is meant by 'to be returned on each subsequent visit for their individual use to prevent infection.'? Who retains the (used uncleaned) instruments? This is not clear.
The letter Twirly has posted clearly says NHS Trained and NHS approved - the Society of Chiropodists and Podiatrists has certainly devised a course for training nail cutting personnel.
The private trainers have quite rightly always pointed to the fact that the NHS was unable in itself to provide foot servicing for the entire populace.
As for FHPs, the AC charges compromise their livings and undercut their fees too. I want to reiterate that AC have 'identified a need' that I, and many others, do not believe exists, and the AC service does nothing for any other practitioner.
At a meeting I was at last year, we were talking about the volunteer nail cutters. Someone was saying that a lot of "customers" were expecting their corns and callous to be treated, which of course the volunteer nail cutters can't do. Also, a lot of OAPs in general apparently are not at all satisfied with the service that they get from the voulunteer nail cutters, and go back to a proper chiropodist.
Another quote that you hear is, "£xx just to do my feet! that's robbery!" They do not realise what the overheads are in doing the job properly in accordance with legislation.
This is not helped by NHS pods doing a "bit on the side" home visits for pin money. Age Concern volunteers may say, "the poor OAPs haven't got a lot of money." That may be true in some cases, but in others, that is the pathetic excuse that has been used for as long as I can remember! The vet, dentist etc doesn't put up with this excuse, why should we!
Volunteer! Not a bad little earner for AC at my reckoning. The average allocated time for a routine pod' asst. nail appointment in the NHS was 10 minutes.
There is (as far as I am aware) currently no legislation against scalpel use so perhaps Age Concerm may be looking to 'train' to include that in the future? Is there a grade of assistant for that yet? Hmmm? A titled position & a badge perhaps!
Why waste money on a degree? I do not take exception to people cutting toenails, I take umbrage at a charity organisation pretending to be something they are not. ie. competant. I only hope that in the event of things going awry the no win no fee merchants make a killing.
Unfortunately, as always it will be at the expense of others.
__________________
:)
twirly
Mandy Brooks
Brooks Podiatry
S64 0DE
Suffering a fondness for odd things.
The Following User Says Thank You to twirly For This Useful Post:
I found an interesting quote from Age Concerns Director General. I have edited by underlining a phrase which I found interesting.
Feet for Purpose: Major New Campaign from Age Concern (20.08.07)
Quote:
Gordon Lishman‚ Director General of Age Concern‚ said:
“Foot care services are failing older people‚ and a postcode lottery is leaving those in some areas without any services at all.
“Some of the older people we have talked to are taking desperate measures including cutting their nails with gardening shears or kicking solid walls in their bare feet to break their nails. This would have been unacceptable in 1948 when the NHS was created‚ and it is certainly unacceptable nearly 60 years later.
“Footcare services should be free and universally available to those who need them – yet increasingly in many parts of England they are being restricted or withdrawn. Age Concerns do their best to help bridge the gaps in services‚ but many people are left without adequate footcare.
The AC nail cutting service is available across the country. Charges vary from £5.00 -£15.00 for the purchase of instruments & also a varying charge for appointments. More information: http://www.google.com/search?q=age+c...rlz=1I7GGIH_en
Not all staff are volunteers.
JOB OPPORTUNITIES
RELIEF TOENAIL TRIMMER
Required to join a team providing this essential service for older people across Essex. Based at Writtle, Chelmsford
Occasional days as and when required; £7.59 per hour
To apply you may complete and send the form below.
Age Concerns have been faced with the choice of charging for their service‚ in order to be able to run it or leaving vulnerable older people on low incomes without any service at all.
Ah, so it isn't a money spinner then. It is all about altruism. There I was thinking £5 - £15.00 for a nail trim every 8 weeks was about Age Concern raking it in. Tsk at me!
__________________
:)
twirly
Mandy Brooks
Brooks Podiatry
S64 0DE
Suffering a fondness for odd things.
The Following User Says Thank You to twirly For This Useful Post:
it is a joke when on my national placement in winchester, age concern sell the single use intrusments to the pt's i believe or they charge £15 for a cutting. It is a joke they are trained by pods on how to cut nails.
does it just shout law suit due to infection, i thought these single use intrusments was ment to cut that out now giving them to pt, i know age concern can give a partially blind pt with my be un-dx DM and lets she the infections come to us, so this is a sore spot for me and i am only a student.
Also the single use intrusments with cause more NHS staff sueing the NHS with RSI than pt's with infection. the record number of packs for one tx for me is 5 so far thats £25 just on insturments. Grrrrr the costs
Here's a thought.
Auntie Doris purchases a disposable set of instruments and attends a nail cutting clinic.
Unknown to her, Uncle Peter has just used the same nippers that morning to cut their mangey dogs overgrown claws.
Johnny come-lately's clinic is behind that day and he manages to compromise Doris's tissue viablity with a small haem.
Seven days later a wound is oozing and has become infected with a nasty bacteria usually found around the anus of dogs.
Many months and courses of antibiotic treatment follow, but unfortunatley Doris has her toe amputated. Several nibbling amputations later, Doris will only be buying her court shoes in singles.
Luckily for her, she is put in touch with a no win no fee solicitor..........
After sucessfully suing the society, the NHS and AC for £12million she retires to Scarborough.
I don't wish to cause upset to any one, or risk the wrath of the forum but where does it say 'single use' in the Ad that has been posted by Mandy? There are cheap clippers available that are not single use. I have used some of the single use ones in practice and am appalled that they are thrown away after one use, I can't even give them to the patient as they are clearly marked single use. Also what is the problem about people keeping instruments for THEIR OWN use? Don't we all cut our own nails without sterilising the nippers first, indeed do all members of our families have their own individual clippers and / or files? I'm not saying I agree or disagree with other agencies carrying out nail care, but until such time as there is acceptable foot care for every person who needs it regardless of health, wealth, social status or postcode for that matter, then this is something we will have to work with. Surely if so long as it is HPC registered podiatrists (whether NHS staff or private practitioners) that are involved in the training of other agencies, with appropriate retraining and monitoring then surely this is better than wholly untrained people doing the work?
Just as an aside, if the men in this forum (or partners of the females) cut themselves shaving (assuming they wet shave) do they change their razor blade immediately? Do they worry about an infection? No they use sensible hygiene precautions as far as they practically can. I believe it is called common sense.
The local ad in my area fror Age Concern does say that their service is only suitable for those who do not have Diabetes or other medical condition (quite what that means I am not sure!).
Nikki;I don't wish to cause upset to any one, or risk the wrath of the forum but where does it say 'single use' in the Ad
You are correct, nowhere does it specify that 'single use' instruments are being used. It was merely an assumption (perhaps a wrong one)? If anyone can provide more accurate information I would be grateful.
Other issues you have raised:
Quote:
Also what is the problem about people keeping instruments for THEIR OWN use?
I mentioned I personally have no issues about people cutting toenails. I do take issue with a 'Charity' dressed in the garb of a professional (they are charging for this service after all, so from that viewpoint they are deemed to be offering a professional service to customers ie. the elderly)
Professional: Definition
A professional is a worker required to possess a large body of knowledge derived from extensive academic study (usually tertiary), with the training almost always formalized. Professionals are at least to a degree self-regulating, in that they control the training and evaluation processes that admit new persons to the field, and in judging whether the work done by their members is up to standard.
Our Mission Statement
Age Concern groups across the UK have a common objective:
"To promote the well being of all older people and help make life a fulfilling and enjoyable experience"
Age Concern believes that an older person, like any other, is an individual and a full member of society who has a right to:
Respect for her or his individuality
Independence
Privacy and Dignity
Genuine and informed choices
The chance to develop new skills and knowledge
The forming and continuation of friendships
Have her or his views be known, listened to and accepted.
Perhaps you disagree with the opinion that Age Concern are stepping away from their chosen role of providing information, advice & offering 'Genuine and informed choices ' to a group of individuals who may be unwittingly offered this service. Rather than offering people the 'informed choice' of professional care by an expert.
Quote:
The local ad in my area fror Age Concern does say that their service is only suitable for those who do not have Diabetes or other medical condition (quite what that means I am not sure!).
Here you make a very valid point. Indeed certain disease processes may be insidious in onset. We (as professionals) may see thousands of feet every year. Your professional training is what tells you that something is changing, sometimes even before the patient is diagnosed with a condition. This doesn't occur by accident or by knowing how to trim a toenail. Nailcare may be why the person attends. It is your underpinned expertise & education that make you a professional. Not your ability to weild a pair of clippers.
Quote:
Just as an aside, if the men in this forum (or partners of the females) cut themselves shaving (assuming they wet shave) do they change their razor blade immediately? Do they worry about an infection? No they use sensible hygiene precautions as far as they practically can. I believe it is called common sense.
If Himself inflicts an injury whist shaving then I believe you are right.
However, if he was cut by a professional barber then yes, a new blade please & antiseptic.
__________________
:)
twirly
Mandy Brooks
Brooks Podiatry
S64 0DE
Suffering a fondness for odd things.
The Following User Says Thank You to twirly For This Useful Post:
Basically you beat me to it. The only thing I would add is that because AC charge for this 'service', I assume it is a legal contract. I'm no lawyer but I think certain obligations go along with contracts.
I find using the expression NHS trained implies all sorts of 'standards' non of which the ACs product IMO achieves.
All of this can be fairly laid at the NHS Podiatry service door. They for their own benefit redefined non 'at risk foot' care as 'social need'.
The implications have been massive, I for one can no longer service a small Learning difficulties home because Mind have taken it over, and the local NHS Pod has said the residents do not need Podiatric care. They can however still receive reflexology and hairdressing but the paid carers have to attend to their feet.
Good in it?
The Following User Says Thank You to R.E.G For This Useful Post:
This practice has been going on in my area for some time now and more and more disgruntled oldies are coming to me to get them out of pain and have remained with me.
Bog standard nippers £15 , nail cut ( and some scalpel work) £12 , + £12 for you next appointment "because we know you wont come back unless you have paid for it"
I referred a letter of complaint about the treatment a patient received from A C to a professional body who did take action and the person I understand has been removed.
BUT
I've got to make the point, was it not the NHS pods who complained bitterly about "cutting toe nails" etc etc which resulted in the NHS doing away with the service.
No point in complaining now because another body has taken the treatment over, the bed was made we now have to lie in it .
Great shame we couldn't have kept it "in house" then a few pods that are now feeling the pinch in the economic downturn would have had more of an income.
Still that takes us back to unity within the profession
True to form Del what is someone else's misfortune is to your benefit.
The tip about paying in advance is good thanks.
So which professional body do you allude to and exactly how did their intervention make a difference, please share in the spirit 'unity'.
NHS Pods complaining? Anecdote the changes were mainly made by a 'consult management pod' who ended up with an Honour. NHS pods only ever complained about over work until their 'bosses' told them cutting toe nails was beneath their education, you once had to bow to the NHS system did you rebel?
AC is not in anyone's description 'another body'! Or do you refer to FHPs?
'We' could have kept it 'in house' exactly who do you refer to as WE and which 'house'.
You can hit your head against that wall as long as you like, some of US think you are one of the very big bricks in it.
Quote:
The local ad in my area fror Age Concern does say that their service is only suitable for those who do not have Diabetes or other medical condition (quite what that means I am not sure!).
When I contacted the local AC (incognito) I was informed they do not treat anyone with Diabetes, RhA or anyone taking Warfarin - they get sent back to the NHS
True to form Del what is someone else's misfortune is to your benefit.
The tip about paying in advance is good thanks.
So which professional body do you allude to and exactly how did their intervention make a difference, please share in the spirit 'unity'.
NHS Pods complaining? Anecdote the changes were mainly made by a 'consult management pod' who ended up with an Honour. NHS pods only ever complained about over work until their 'bosses' told them cutting toe nails was beneath their education, you once had to bow to the NHS system did you rebel?
AC is not in anyone's description 'another body'! Or do you refer to FHPs?
'We' could have kept it 'in house' exactly who do you refer to as WE and which 'house'.
You can hit your head against that wall as long as you like, some of US think you are one of the very big bricks in it.
M8
Reasonably vindictive Bob, even for you.
To throw a bit more light on the Pods not willing to cut nails in the NHS. DTT is quite right. I believe the original idea came from ACCO (Association of Chief Chiropody Officers) but it may well have eminated from the person you allude to at an ACCO Conference Bob. Most of ACCO were also members of the SCP, and some were on Council, so it seems fairly obvious to me why the SCP colluded with this idea in the first place instead of looking at the possible consequences later down the line.
I had first-hand experience whilst working as a Pod for South Tyneside NHS Trust in the early 90's. I was not part of the Pod Dept (our Project had separate funding) so it was easy for me to "rebel" and not cut non-pathological nails, but train Support Workers to cut them instread - thus keeping it all "in-house". Any opposition to the idea came from the Pod Dept. Everyone else - patients, Support Workers, GPs and community Nursing Staff were delighted that the patients were being seen quickly and having basic needs attended to.
All written up and published in the SCP Magazine of the time under the heading of The Comcare Experience (or somesuch).
If I remember rightly South Tyneside and other Trusts dealt with Podiatry "overwork" by inserting another level or two of admin into the works in the name of "prioritisation". I believe, although I don't know for certain, that this also came from ACCO.
At one point the ComCare footcare arm (me and six Support Workers) were seeing more patients/providing more footcare than the whole Pod Dept - mind you, we held less Meetings.
It is worth bearing in mind NHS Podiatrists tend to see patients for nail care as their specific local podiatry team policy advises. These policies tend to filter down through management and patients are not declined by the NHS podiatrist. They are in part, but not wholly, influenced by the teams caseload capacity (i.e. money!)
I am sure many NHS pods are frustrated by the line " my Doctor sent me for my nails as I am over 65 so I'm entitled" ....... "yes, I can do they myself, but...."
Equally frustrating is to hear the pod saying, "I'm really sorry Mrs. Smith, I know you're 92 but you're just too fit, healthy, mobile and independent, I wish I could see you, sorry we can't see you, even if you pay us"
However, I was glad when the 60 year old came to me for a nail trim with a painful toe and I identified her critical ishaemia and had her under the vascular consult that day.
Do AC triage all over 65's or ask clients if they have peripheral vascular disease, before treatment?
Whether this is done by the private or public sector podiatrist should be irrelevant, as long as those clients that need more specialist care within Multidisciplinary teams, are given this oppportunity.
There lies the question, should we be screening those with 'healthy' feet, for example, annually, to detect deteriorating foot health, if they are seen regularly by a carer for nail trimming?
As always, it boils down to the availability and importantly, use of funding. No Podiatrist in either public or private sector, or indeed any other FHP can legally magic this from thin air. However, I believe NHS healthcare is at last learning how to try to use funding more efficiently as it becomes more front line clinician focused and slightly less management top heavy.
Does anyone from AC read this forum..............?
True to form Del what is someone else's misfortune is to your benefit.
I thought you would be pleased the patient is now getting proper treatment ??
Quote:
The tip about paying in advance is good thanks.
That (if you notice by the quotes) is what she was told by A C, but if you want to do that in your practice... glad to have given you the info
Quote:
So which professional body do you allude to and exactly how did their intervention make a difference, please share in the spirit 'unity'.
The RGN / chiropodist / podiatrist claimed many pod qualifications one I recognised and forwarded the letter of complaint to that professional body who dealt with the situation in that particular incident.
The patient concerned WAS a T2D and from what I can make out NO form of screening was done infact part of the complaint was "she was cut badly during the Tx of a vp left undressed and bleening when she left AC
Quote:
NHS Pods complaining? Anecdote the changes were mainly made by a 'consult management pod' who ended up with an Honour. NHS pods only ever complained about over work until their 'bosses' told them cutting toe nails was beneath their education, you once had to bow to the NHS system did you rebel?
I ALWAYS REBEL Bob especially where I see injustice made it a lifetimes mission actually
But nevertheless the NHS pods did not want to cut toenails enter the Podiatry assistant /FHP call them what you will, and now you complain at the outcome
Quote:
'We' could have kept it 'in house' exactly who do you refer to as WE and which 'house'.
Just somewhere within the profession, IPP's for example.
George Brandy was a keen supporter along with may others as you know.
Quote:
You can hit your head against that wall as long as you like, some of US think you are one of the very big bricks in it.
Ahh bob well that is a very different argument and one I am not going into here as I havent the time or the interest on dwelling in the past and frankly couldnt care less of what "US" thinks
Age concern are charity, as such they hold money in trust for beneficiaries. If more podiatrists got involved with, or actually became trustees of their local branches a lot of these problems could probably be better addressed. There is no reason why grants could not be awarded for those of slender means to have proper professional attention.
Best wishes
Colin
Quote:
The local ad in my area fror Age Concern does say that their service is only suitable for those who do not have Diabetes or other medical condition (quite what that means I am not sure!).
When I contacted the local AC (incognito) I was informed they do not treat anyone with Diabetes, RhA or anyone taking Warfarin - they get sent back to the NHS
This is how the service in our area used to work. However, in an effort to increase numbers of patients attending the AC "clinics", they have now begun to write to the GPs requesting "permission" to treat those on warfarin, with diabetes etc. As an NHS pod, I can safely say that patients with these conditions are see in the NHS clinics, and have not been routinely discharged from our caseload. I find this practice extremely concerning as the volunteers (who are not "trained" by us in any shape or form) work in rooms that are not up to recognised clinical standards for infection control, do not have access to hand washing facilities in some cases, do not have specialist dressings in case of haem, etc etc....the list goes on
I would be interested to know if Age Concern holds insurance for their 'foot care provision'. Can anyone shed a little light?
Quote:
This is how the service in our area used to work. However, in an effort to increase numbers of patients attending the AC "clinics", they have now begun to write to the GPs requesting "permission" to treat those on warfarin, with diabetes etc.
I detect they (AC) are stretching their 'professional wings' already.
Quote:
As an NHS pod, I can safely say that patients with these conditions are see in the NHS clinics, and have not been routinely discharged from our caseload.
I believe the same scenario is also in place locally (Doncaster) ie. Not discharging patients who are perceived (following professional assessment by a Podiatrist) to be at risk.
Quote:
I find this practice extremely concerning as the volunteers (who are not "trained" by us in any shape or form) work in rooms that are not up to recognised clinical standards for infection control, do not have access to hand washing facilities in some cases, do not have specialist dressings in case of haem, etc etc....the list goes on
Consider if you will: Abraham Clegg (AC for short) decides 'Oh! I have a grand idea . I (Abe') have a plan. I asked the local community centre if I can use a broom cupboard twice a week, plus the loan of 2 plastic chairs during Darby & Joan bingo & sing-a-long. It's not well lit & there's no sink but hey ho I can clip nails all day long & make some money at the same time. '
All would go well for Abe' until something goes awry. Poor Abe' was unaware that clipping nails (I feel sure he was utilising a yellow bag for his clinical waste) was happily unaware that a tiny weeny nick on Mavis's toe could become septic & cause the poor old love to develop an ulcer, leaving the dear in hospital on IV antibiotics because she told him, 'Not to fuss it will be fine'. Poor Abe' never considered Mave was incontinant & gravity + fluids & solids will usually follow a downward path! I understand that ignorance is no defense in a court of law.
In stark contrast are those (ie. us) who to be permitted to offer such a service (& receive financial recompense for such) must follow strict policies & adhere to accepted guidelines. http://www.hpc-uk.org/
Vicarious liability in English law
The primary exception arises through statutory interpretation where the verb used to define the action in the actus reus is both the physical action of the employee and the legal action of the employer. For example, the activity of "driving" is purely a physical activity performed by the person behind the wheel. But when a cashier takes money as payment for goods, this is only the physical activity of selling. For goods to be sold, the owner of the goods must pass legal title to those goods. In default, the customer would commit the actus reus of theft. So the owner sells the goods at the same time that the employee takes the money. Similarly, only the holder of rights can grant a licence to another or permit another to do something that would otherwise have been unlawful. The verbs "possess", "control" and use may also have dual relevance depending on the context. Many of these are strict liability or regulatory offences, but the principle has been used to impose liability on a wide range of activities undertaken in a business or commercial environment.
ie. If money changes hands for a service perhaps?
Quote:
Nevertheless, the idea of imposing liability on another despite a lack of culpability never really disappeared and courts have developed the principle that an employer can incur liability for the acts and omissions of an employee if committed by the employee in the course of employment and if the employer has the right to control the way in which the employee carries out his or her duties (respondeat superior).
Very interesting post I felt I had to contribute working in private practice. I echo the concerns of twirly ad others regarding AC and this so called service. A number of questions spring to mind; Where will treatment take place? In a clinical environment with provision for clinical waste removal and infection control? I fear not, and having read your post Ella it is worrying to say the least that in some cases there are no hand washing facilities and no provision for dressings etc. Will medical records be taken? Who is liable should litigation follow? The list goes on. In a society where infection rates are headline news on a regular basis I find this whole idea unbelievable.
__________________
Ollie
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This situation demonstrates the 'wrongness' of the present legislation. The body that can speak for the profession, that regulates the profession, that sets the standards for the profession, is not interested in protecting either the public OR the profession. I mean, of course, the HPC. It takes our fees in payment for a licence to use two words - nothing else.
You might think that the professional bodies could act, but each of them individually and all of them together are probably smaller, have less financial clout and certainly have less influence upon the HPC than Age Concern that masquerades as a charity with public welfare as their goal. We have nobody to appeal to and nobody to speak on our behalf. The professional bodies have been made impotent by the present legislation (all of them) and none dare speak up. Who are they to appeal to anyway? A council of 13 professional representatives (all different) 'balanced' by 13 lay-members and a Chairperson? Bad enough at the moment, but wait until the professional representatives are appointed - not elected. And if the Council is expanded with regulation of further professions, it has been said that any one particular profession may take 'turns' to sit on Council to prevent the Council becoming unweildy.
Put this with the proposed 'Licensed Healthcare Practitioner' regulation and it is clear that the government has discovered a very lucrative 'wheeze' where all are licenced and none are really protected. The public show no interest and are not concerned to understand the issues, and they are easily swayed by the pretence of 'protection' nominally espoused on their behalf. It also raises the question 'do we actually have a profession at all'.
There have been calls for the setting up of a General Council of Podiatry with the view of regulating our own profession. This is a non-starter until ALL of the established professional bodies agree to sit and work together. No professional body is going to sit with the others on terms dictated by any one of them.
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As you may be aware, I have been riding the self-regulation/General Podiatry Council hobbyhorse for many years now. I agree that no professional body will sit with the others on terms dictated by any one of them, hence my suggestion that any such meeting should be open and agreement should be made only on matters which pass unopposed - issues of disagreement would simply be put aside. However, it is a matter of history that The Institute, The British Association and the smaller bodies were willing to discuss issues of interest to all on those terms. However, the Society, and latterly, The Association, have both very clearly stated that under no circumstances are they willing to talk with the other bodies. Hence, sadly, the matter is a dead duck. We have made our own bed and don't like the fact that we are now lying on it.
However, it is a matter of history that The Institute, The British Association and the smaller bodies were willing to discuss issues of interest to all on those terms. However, the Society, and latterly, The Association, have both very clearly stated that under no circumstances are they willing to talk with the other bodies. Hence, sadly, the matter is a dead duck. We have made our own bed and don't like the fact that we are now lying on it.
All the best
Bill Liggins
If there has been an historical precedent set re The Institute and Association willing to discuss there must be a reason why this has now changed, have the powers that be become disallusioned? As far as the Society is concerned there must be a reason why they are unwilling to speak to the others. Are practices SO different?
I cannot believe that the matter is a 'dead duck' it is just a case of new members being aware of the problems within the professional bodies and those who are willing to run with it being able to access historical data to see if there can be some more chipping away at preconcieved ideas......why else do we pay membership - no one body is BETTER than another they just have different ideas on how to acheive the end result - there must be some common ground ie patients (sorry might be a bit naive but if they were not there neither would we!).
Bill I am sure there are like minded people but it is just a case of getting the message across.
Maybe all bodies could have open forums within areas to see if there could be a consensus of opinion to take forward? Just an idea
Wendy
This situation and Bills proposals have been debated endlessly on both this site and the dreaded TFS.
I cannot see the idea of open forums working but could I suggest that Orthopeds would be a good forum for a new debate to take place?
It has reached over 350 members who appear to come from a mixed background.
Both Bill and David are well versed in the 'history' of the profession.
The site in the main is polite and well argued.
I would suggest a good indicator of the 'interest' in this subject would be the number of posters who engage and whether they are prepared to be named.
Depending on the outcome then members of various bodies could take the results back to their governing systems and ask questions.
Hi Bob
I like the idea of a grass roots beginning and would be willing to engage in a debate about this.
I have not visited TFS for many months (apparently I upset them somehow)however I do enjoy the Orthoped site immensely.
Wendy
Age concern
Re: Age concern
Re: Age concern
There I was thinking £5 - £15.00 for a nail trim every 8 weeks was about Age Concern raking it in. Tsk at me! 
If anyone can provide more accurate information I would be grateful.
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