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GOsC publishes independent review of professional boundaries in osteopathy

3 August 2022

We have published Supporting Professionals, Protecting Patients, for further discussion and reflection across the sector.

Produced by medical ethicist Julie Stone, this review is an update of the previous Thematic Analysis of Boundaries Education and Training (2017).

The review, which we commissioned in November 2021, highlights areas of good practice within osteopathic educational providers and beyond, along with opportunities for further development for GOsC and across the sector.

Taking into account the changing social, political and cultural climate and context within which osteopathic education sits, the review is informed by qualitative interviews with key groups including students, patients, osteopaths and others in the wider health sector.

The focus of the review aligns with D2 of the Osteopathic Practice Standards which sets out the requirement that all osteopaths must establish and maintain clear professional boundaries between themselves and their patients. The review findings highlight the importance of boundaries for the relationship of trust and for the safety of both the patient and the practitioner.

Key findings of the 2022 review include:

  • Education providers are the primary source of professionalism training for osteopathic students. Classroom and clinic teaching combine to provide students with the skills to provide effective, patient-centred care.
  • Boundaries education, as an element of professionalism training, is dispersed throughout the curriculum, and delivered by a range of lecturers, integrated and reinforced by education providers through clinical teaching in lectures and in the clinic.
  • Education and the Osteopathic Practice Standards only partially influence professional behaviour, and in the case of serious boundary violations, do not deter misconduct. 
  • Students identified inter-generational, cultural, and diversity gaps between themselves and staff/tutors. The ‘Me Too’ movement and COVID-19 have opened up helpful conversation spaces about power, sexual harassment, and patient and practitioner vulnerability.

Fiona Browne, Director of Education, Standards and Development, said: ‘We are very grateful for such a rich and extensive piece of work from Julie Stone, which sets out a range of important issues and topics for consideration in partnership with our stakeholders.

‘We will continue to use this review to inform our discussion of these issues with osteopathic educational providers, the professional membership body the Institute of Osteopathy, the National Council for Osteopathic Research and the Osteopathic Alliance as well as the wider health sector.

‘We look forward to continuing to support practitioners and patients to establish and maintain safe boundaries in the provision of osteopathic care for patients.’

Publication of this review is very much the start of further work in this area. We plan to work with key organisations across the sector to examine and discuss the report to understand how it can inform our future work, before developing a fuller response and plan of action as part of our next steps.

Read the boundaries thematic review Supporting Professionals, Protecting Patients and an overview of its findings.