Code of Conduct, Performance and Ethics for SMTO members
Your main duty as a massage therapist registered with the Scottish Massage Therapists Organisation (SMTO) is to protect the health and wellbeing of all those who use your services
The care of your client must be your first concern
You must provide a high standard of care at all times
Clients must be treated with respect, as individuals
Your professional knowledge must be kept up to date
You must act lawfully in your professional and personal practice
You are personally accountable for your professional activity
All SMTO members must confirm that they have read, and agree to observe, the standards set out in this document. Every SMTO member must be familiar with the standards and must ensure that they are observed. The standards apply to all SMTO members.
The SMTO will establish and keep under review the standards of conduct, performance and ethics expected of SMTO members and give them such guidance on these matters as is seen fit and proper.
B. Your duties as an SMTO member: the standards of conduct, performance and ethics that you must follow
Members engaged in the accepted practice of Massage Therapy, having satisfied the Committee of the SMTO of their competence in such therapies, shall adhere to the SMTO Code of Conduct and Ethics, and comply with the SMTO Code of Practice.
This document explains the standards of conduct, performance and ethics which all SMTO members must keep. They are also the basis against which the SMTO will assess possible complaints made against an SMTO member.
The main responsibilities of an SMTO therapist are summarised below, grouped into the categories of conduct, performance and ethics. Each responsibility is explained in more detail further on in this document. Please remember that this is not a fully comprehensive list of all the issues that can arise in relation to your conduct, performance and ethics.
As an SMTO therapist you must always seek to protect the health and wellbeing of people who use your services.
You must always maintain high standards of conduct. You must:
Act in the best interests of your clients (see C1).
Respect the confidentiality of your clients (see C2).
Maintain high standards of personal conduct (see C3).
Provide to the SMTO, on request, any relevant information about your conduct, competence or health (see C4).
You must always observe high standards of performance. You must:
Keep your professional knowledge, skills and performance up to date and relevant to your field(s) of practice (see C5)
Act always within the limits of your knowledge, skills and experience and, if necessary, refer on to another SMTO therapist, CNHC registered practitioner or healthcare professional (see C6)
Maintain appropriate and effective communication with clients, carers and other SMTO members and professionals (see C7)
Effectively supervise tasks you have delegated (see C8)
Obtain informed consent to give treatment (see C9)
Keep accurate client records (see C10)
Be aware of and manage effectively and safely the risks of infection (see C11)
Limit your work or stop practising if you or another person has any reason to believe that your performance or judgement is affected by your physical, emotional or mental health (see C12).
You must always maintain high ethical standards. You must:
Carry out your duties in a professional and ethical way (see C13)
Behave with integrity and honesty (see C14)
You must follow SMTO guidance in relation to advertising your services (see C15)
You must not be involved in any behaviour or activity which is likely to damage your profession's reputation or undermine public confidence in your profession (see C16).
C. The main responsibilities of SMTO members
1. You must always act in the best interests of your clients
You are personally responsible for making sure that you promote and protect the best interests of the people you care for. You must respect and take account of these factors when providing care, and must not exploit or abuse the relationship with a client or carer. You must not allow your views about clients’ sex, age, colour, race, disability, sexuality, social or economic status, lifestyle, culture or religious beliefs to affect the way you treat them or the professional advice you give.
You must, at all times, act to protect the interests of clients, carers and other members of the public. You must try to provide the best possible care, either alone or with other SMTO therapists, health and social care professions. You must not do anything, or allow anything to be done, that you have reason to believe will put the health or safety of a client in danger. This includes both your own actions and those of others.
When working in a team you remain accountable for your professional conduct, any care or professional advice you provide, any failure to act and any tasks you may delegate. You must protect clients if you believe that they are actually or potentially at risk from a colleague’s conduct, performance or health. The safety of clients must come before any personal and professional loyalties at all times. As soon as you become aware of any situation that puts a client at risk, you should discuss the matter with the SMTO.
2. You must respect the confidentiality of your clients
You must treat information about clients as confidential and use it only for the purpose for which it was given. You must not knowingly release any personal or confidential information to anyone who is not entitled to it, and you should check that people who ask for information are entitled to it. You must only use information about a client:
to continue to care for that person; or
for purposes where that person has given you specific, signed permission to use the information.
You must also keep to the conditions of any relevant data-protection legislation and follow best practice for handling confidential information relating to individuals at all times. Best practice is likely to change over time and you must stay up to date. You must be particularly careful not to reveal, deliberately or accidentally, confidential information that is stored on computers.
Confidentiality can be a particular challenge when treating minors. In most circumstances it would be most appropriate to have an adult present at the consultation but the issue of confidentiality would need to be carefully considered and decisions made depending upon individual circumstances.
3. You must maintain high standards of personal conduct
You must keep high standards of personal conduct, as well as professional conduct. You must not do anything that may affect someone’s treatment by, or confidence in you. If you are convicted of a criminal offence or have accepted a police caution, the SMTO must be informed. Each case will be considered individually and a decision made in the light of the circumstances of the case. Your membership may be at risk if you are convicted of a criminal offence that involves, for example, one of the following types of behaviour:
Drink-driving offences where someone was hurt or killed
Serious offences involving dishonesty
Any serious criminal offences for which you received a prison sentence.
4. You must provide, on request, any relevant information about your conduct, competence or health
You are required to tell the SMTO (and advised to inform other relevant regulators and professional bodies) if you have any relevant information about your own conduct or competence, or about other SMTO members you work with. In particular, you must let us know straight away if you are:
convicted of a criminal offence (other than a minor motoring offence) or accept a police caution;
disciplined by any organisation responsible for regulating or licensing a healthcare practitioner or social care profession; or
suspended or placed under a practice restriction order by an employer or similar organisation because of concerns about your conduct or competence.
You are required to co-operate with any SMTO investigation or formal inquiry into your professional conduct, competence or health, or the conduct of any other healthcare provider, or the treatment of a client, where appropriate. Relevant information in connection with your conduct or competence should be supplied to any legitimate enquirer.
You should also provide information about the conduct or competence of other healthcare providers if someone who is entitled to know asks you for it. This relates to your duty to act in the best interests of your clients. A complaint about a colleague should be referred to the SMTO for advice.
5. You must ensure that your knowledge, skills and performance are of a high quality, up to date, and relevant to Massage Therapy
You must be capable of meeting the Continuing Professional Development (CPD) guidelines that relate to Massage Therapy, as defined by the SMTO and the CNHC/GCMT. As of 2007, proof of a minimum of 18 hours per annum is required to be kept in each SMTO member’s CPD log. As an SMTO member you are required to meet these standards, whether you are in practice or not. The Continuing Professional Development guidelines describe minimum standards of clinical practice. You must stay up to date with any changes to the Standards of Proficiency that the SMTO may make for Massage Therapy as knowledge and techniques develop.
6. You must act within the limits of your knowledge, skills and experience and, if necessary, refer on to another SMTO therapist or healthcare professional
You must keep within your scope of practice. This means that you should only practise in those fields in which you have had appropriate education, training, qualification and experience.
Your duty of care to a client includes the obligation to refer them for further professional advice or treatment if it becomes clear that what they need is beyond your own scope of practice. If you accept a referral from another healthcare or social care professional, you must make sure that you fully understand the request. You should only provide the treatment or advice if you believe this is appropriate. If this is not the case, you must discuss the matter with the therapist/practitioner who has made the referral, and also the client, before you begin any treatment.
7. You must maintain appropriate and effective communications with clients, carers and other SMTO members and professionals
You must take all reasonable steps to make sure that you can communicate properly and effectively with your clients, and their carers and family. You must also communicate effectively, co-operate, and share your knowledge and expertise with professional colleagues for the benefit of clients. This is of particular importance when entering into multiple relationships involving the same client.
8. You must effectively supervise tasks you have delegated
People who consult you or receive treatment or services from you are entitled to assume that a person who has the knowledge and skill to practise their profession will carry out their treatment. Whenever you give tasks to another person to carry out on your behalf, you must be sure that they have the knowledge, skills and experience to carry out the task safely and effectively. If they are not SMTO members and healthcare professionals, you must not ask them to do the work of healthcare professionals. If they are SMTO members and healthcare professionals, you must not ask them to do work that is outside their scope of practice. If they are training to be healthcare professionals, you should be sure that they are capable of carrying out the task safely and effectively.
Whoever you ask to carry out a task, you must always continue to give adequate and appropriate supervision and you remain accountable for the outcome. If someone tells you that they are unwilling to carry out a task because they do not think they are capable of doing so safely and effectively, you must not put pressure on them to carry out the task. If their refusal raises a disciplinary or training issue, you must deal with that separately, without endangering the safety of the client.
9. You must get informed consent to give treatment
You must explain to the client the treatment you are intending to carry out, the risks involved and any other treatments possible. You must make sure that you obtain informed consent to any treatment you do carry out. You must make a record of the client’s treatment decisions and pass this on to all members of the healthcare or social care team involved in their care.
10. You must keep accurate client records
Making and keeping records is an essential part of care and you must keep records for everyone you treat or who asks for professional advice or services. All records must be complete and legible, and you should sign and date all entries.
When supervising students, you should also counter-sign any student entries in the notes. Whenever you review the records, you should update them and include a record of any arrangements you have made for the continuing care of the client.
You must protect information in records against loss, damage or use by anyone who is not authorised. You can use computer-based systems for keeping records, but only if they are protected against anyone tampering with them (including other healthcare professionals). If you update a record, you must not erase information that was previously there, or make that information difficult to read. Instead, you must mark it in some way (for example, by drawing a line through the old information).
11. You must be aware of and manage effectively and safely the risks of infection
You must take appropriate precautions to protect your clients, their carers and families, your staff (where applicable) and yourself from infection.
You must also take precautions against the risks that you might infect someone else. This is especially important if you suspect or know that you have an infection that could harm others, particularly clients. If you believe or know that you may have such an infection, you must get medical advice and act on it. This may include the need for you to stop practising altogether, or to change your practice in some way in the best interests of protecting your clients.
You must keep to the rules of confidentiality when dealing with people who have infections. For some infections, such as sexually transmitted infections, these rules may be more restrictive than the rules of confidentiality for clients in other circumstances
12. You must limit your work or stop practising if your performance or judgement is affected by your physical, emotional or mental health
You have a duty to take action if your physical, emotional or mental health could be affecting your fitness to practise. You should get advice from a consultant in occupational health or another suitably qualified medical practitioner and act on that advice. This advice should consider whether, and in what ways, you might need to change your practice, including stopping practising if this is necessary. You also have a duty to report any other SMTO therapist if you believe they are failing to meet this requirement
13. You must carry out your duties in a professional and ethical way
You must carry out your duties and responsibilities in a professional and ethical way. Clients are entitled to receive good and safe standards of practice and care. The SMTO seeks to protect the public from unprofessional and unethical behaviour, and to make sure that SMTO members know the standards expected of them.
14. You must behave with integrity and honesty.
You must make sure that you behave with integrity and honesty and keep to high standards of personal and professional conduct at all times.
15. You must follow SMTO guidelines in relation to advertising your services
Any advertising you undertake in relation to your professional activities must be accurate. Advertisements must not be misleading, false, unfair or exaggerated. You must not claim that your personal skills, equipment or facilities are better than anyone else’s.
If you are involved in advertising or promoting any other product or service, you must make sure that you use your knowledge, healthcare skills, qualifications and experience in an accurate and professionally responsible way. You must not make or support unjustifiable statements relating to particular products or services. Any potential financial rewards to you should be made explicit and play no part at all in your advice or recommendations of products and services that you give to clients.
Nothing may be published in the name of the SMTO without the prior agreement of the Committee, or sub-committee or Member acting with the full authority of the Committee.
16. You must not be involved in any behaviour or activity that is likely to damage your profession’s reputation or undermine public confidence in your profession
As a registered professional your behaviour will potentially be under scrutiny at all times by members of the public and you should ensure you do nothing to bring your profession into disrepute. Appropriate professional boundaries must be maintained between therapists and the client. Development of a personal relationship must result in the cessation of the therapeutic relationship.
D. Discipline / Enquiries into allegations against SMTO members
The Committee of the SMTO may, on investigation and using its own discretion, de-register any student or practising therapist contravening the spirit or letter of the Organisation’s Code of Ethics and/or Code of Practice or on the grounds of any other act which they may consider to reflect adversely on the good name and reputation of the Organisation. Each case will be reviewed on its own merit and will not set a precedent.
The Complaint Investigating Panel will investigate any allegations against a member or training body of any conduct that falls short of the standard required.
The Professional Conduct Panel will consider allegations of professional misconduct, referred to it by the Complaint Investigating Panel.
The Professional Conduct Panel will investigate allegations of serious impairment due to ill health of a Registered Massage Therapist referred to it by the Complaint Investigating Panel
Complaints should be put in writing in the first instance to the Secretary who will acknowledge receipt within ten working days. The Secretary will write to the Member concerned giving details of the complaint lodged and requesting full and detailed information. If no reply is received within 28 working days, a second request for information is sent out to the Member. Failure to bring any response would instigate automatic suspension until the next renewal date. The Member concerned will be requested to explain the situation in writing or in person. The Complaint Investigating Panel will decide if there is a case to answer. Any Member subject to investigation shall be entitled to make representation to the Complaint Investigating Panel either in person or through a representative, before any decision is taken as to whether there is a case to answer or not. Clients should be advised accordingly, if they wish to make a complaint, of the complaints procedure. Appeals may also be lodged with the Scottish Massage Therapists’ Organisation. If the complaint is about the SMTO, the General Council for Massage Therapy (GCMT) or Complementary and Natural Healthcare Council (CNHC) should be contacted.
E. Comments and review
The SMTO would be pleased to receive any comments on this Code and how therapists use it in practice. Such comments will be fed into the next review of the Code.