You must only perform acupuncture in premises suitable for professional therapy work.
The premises should be setup for safe clinical practice of acupuncture or other therapeutic interventions. When working from home the treatment room(s) must not be used for any ordinary domestic purposes.
You must ensure that both you and any premises in which you work are properly registered or licensed for the practice of acupuncture
If you practise outside Greater London you must be registered under the Local Government Miscellaneous Provisions Act 1982 for all of the practices in which you work. Under the terms of this Act registration applies to each person for every practice unless a recognised and specific group practice arrangement is in place.
If you practise within Greater London (with the exception of the City of London for which special licensing arrangements apply) you must contact your local environmental health department to advise them of your presence and to inform them of your exemption from licensing under the London Local Authorities Act 1991.
You must have suitable hand washing and sanitary facilities
You must ensure that there are hand washing facilities with supply of clean hot and cold running water located in the treatment room or in the near vicinity.
You must ensure the provision of antibacterial liquid soap in a suitable dispenser, disposable paper towels and an adequately sized bin which should be foot pedal operated if lidded and placed close to the basin.
You must keep the treatment room clean
You must ensure that table tops, shelves and all working surfaces including couches and chairs are smooth and easily cleanable.
Flooring must be smooth or short pile (not looped) commercial carpeting.
You must avoid possible cross-infection from treatment surfaces
You must ensure the couch surface is clean for each patient by one of the following three methods:
- cleaning the couch surface before treating each new patient
- covering the couch surface with paper couch roll, fresh for each patient and disposed of immediately after the treatment
- covering the couch surface with towels or sheets alone, fresh for each patient and boiled or machine-washed on a 40-60 degrees setting before reuse.
You should regularly clean all surfaces with an appropriate detergent or disinfectant, and you must always do so at the beginning and end of every working day.
You must only use equipment which is CE-marked and conforms to current legislation
You must use, single-use, pre-sterilised disposable needles packed in a box marked with a lot number, CE mark, method of sterilisation, the word ‘sterile’, an expiry date.
You must dispose of any needles beyond their expiry date immediately.
Unused needles from open multipacks must not be used if there is any risk that they have been contaminated once the seal on the package has been broken.
Unused needles from open multipacks must not be stored overnight for later use.
Any needle(s) in an unopened package with a damaged seal must not be used.
Guide tubes must be pre-sterilised and come packaged with each individual needle or set of needles; they must not be used or stored for use after the session in which the seal on the package is broken. If using a needle injector, stainless steel re-usable guide tube or similar you need to sterilise between treatments.
Your duty of care
You must ensure the health and safety of your patient
You must take a thorough medical history of each new patient and ensure that acupuncture is an appropriate treatment for them.
If a patient has, or is suspected of having, a notifiable infectious disease or has a serious pre-existing medical condition, you should ensure that it is safe to treat them, if necessary by contacting their GP with the clients written consent.
You must ensure that any part of the body treated is clean, free from wounds and cuts, and clear of any clothing.
If you leave a patient unattended: you must first obtain their consent; you must advise them not to move in any way which might bend or damage a needle and cause them injury; you must make them aware of how to call for your immediate attention at any time.
You must not leave a patient unattended when using moxa, cupping or any other form of treatment where a patient may suffer from physical injury.
You should be recognise adverse reactions to acupuncture treatment and know what action to take, including referral to another acupuncturist or other health professional if appropriate.
You must ensure that your own health and personal hygiene do not put the patient at risk
You must cover any cuts and wounds with a waterproof dressing.
You must keep your nails short and clean. You must not wear artificial nails or use nail polish that could compromise hand hygiene.
You should dress in a professional appropriate and clean manner which befits the professional/medical nature of your role and have closed footwear.
You should avoid giving treatment when suffering from an infectious or contagious condition which may be transmitted to the patient.
You should inform your GP as soon as possible if you suspect that you are suffering from, or have been in contact with someone suffering from, a notifiable infectious disease.
You should not treat a patient if your performance may be affected by prescribed or over-the-counter medication.
You should make changes to your practice or cease practising if your physical or mental health could adversely affect your performance or judgement or otherwise put patients at risk.
Your responsibility to perform acupuncture safely
You must establish and maintain a clean field at all times
You must establish a clean field area on a flat, smooth, cleanable surface in the treatment room.
All treatment equipment must be placed on the clean field, including trays/dishes, packets of needles, packets of clean cotton wool or cotton buds designed for external use on skin and sterile alcohol swabs.
You must not place on the clean field any container used for disposal of needles and/or contaminated waste.
You must maintain high levels of hand hygiene
You must wash your hands thoroughly with antibacterial soap if they are visibly soiled or physically dirty.
You must wash your hands with antibacterial soap before and after every treatment.
You must sanitise your hands with alcohol gel before removing any needles.
You must sanitise your hands with alcohol gel before touching the patient if your hands have become contaminated by handling anything which could transfer infection from patient to patient.
You must wash your hands after dealing with blood and body fluids regardless of whether you wear gloves.
You must insert and remove needles hygienically and safely
You must ensure that the skin at the needle site is clean and clear of any clothing.
You must clean any areas of the body where moisture or exudates may collect with an alcohol swab and allow to dry before needling.
You must wash any dirty skin with soap and water before swabbing and needling.
You must thoroughly clean any skin that has been previously treated with creams or oils with 70 per cent alcohol and allow to dry before needling.
You should open all single-use pre-sterilised needles and instruments in the presence of the patient and immediately before use.
You must use a fresh needle for every point needled during a treatment and you must never reinsert a needle that you have already used.
When inserting the needle, you should avoid touching the shaft unless necessary and if supporting the shaft of the needle is required your hands must be sterile or an alternative sterile material used to hold the needle.
You must not place a needle on an intermediate surface before or after use.
You must ensure that you note the location and the number of needles you insert during treatment.
You must place each needle used in a sharps box or medical tray emptied into a sharps box immediately on removal.
If you draw blood when removing needles, you should apply light pressure using clean cotton wool or a cotton bud designed for external use on skin, avoiding contact with the patient’s body fluids. You must dispose of the cotton wool immediately, in a sharps container or clinical waste bag.
Once you have needled a point, you must not re-palpate the point with your bare finger during that treatment session unless the fingertips have been cleaned by hand washing or alcohol based hand rub gel.
You must use well-fitting single-use disposable surgical gloves for blood or body fluid spills
If the patient is bleeding profusely.
If blood or body fluid is spilled; and you must ensure that any spillage is cleaned up promptly using appropriate cleaning agents.
If the patient has open lesions.
If the patient has a contagious disease.
If you have cuts or wounds on your hands which cannot be covered adequately with a waterproof dressing.
If you have a skin infection.
When handling any blood-soiled items, body fluids, excretions or secretions, or touching any contaminated surfaces, materials, or objects.
Your safe disposal of equipment and clinical waste
You must dispose of used equipment and clinical waste legally, safely and in accordance with current legislation.
You must place all sharps – needles, plum blossom needles (seven star hammers) and dermal needles (press studs), etc. – immediately after use into a sharps disposal bin.
You must dispose of sealed sharps containers via a licensed agent.
You must place all clinical waste contaminated with spillage of body fluids – blood, etc. – into a clinical sharps bin or yellow clinical waste bags for collection by a licensed agent.
You must retain all contracts and receipts for clinical waste collection for two years.
You should dispose of any waste which has not come into contact with body fluids or spillages – needle wrappings, single-use guide tubes, etc. – via commercial or domestic waste, provided that it is carefully bagged.
Your sharps box must conform to BS EN ISO 23907:2012 requirements and be clearly marked with the words ‘danger – contaminated needles – incinerated’.
Your commitment to health and safety
You must comply with the requirements and provisions of current health and safety at work legislation, especially hazardous waste and fire regulations
You should be aware that your duty of care extends not only to patients and employees but also to any member visiting your premises.
You must ensure that your premises are safe and that all equipment and machinery on the premises is regularly inspected and maintained.
You must ensure that all electrical and gas appliances are subject to regular examination and certification.
You must carry out an audit in line with current fire safety regulations and legislation.
You should assess your premises for disability access in line with the Equality Act.
You must ensure that you have appropriate equipment and procedures in place in the event of an emergency.