You have just had a letter

A complaint, concern or fitness to practise investigation has been raised and you need to respond. Start here, and start now — evidence built early always reads better than evidence assembled the week before a deadline.

You are preparing your response

You are writing to the GOsC, or working with your professional body or insurer, and need documented CPD and written reflection to put behind what you say.

Your case is going further

The matter is heading towards the Investigating Committee or a Professional Conduct Committee hearing, and you need to show sustained change rather than good intentions.

You are applying for restoration

You are off the Register and working towards going back on it. Evidence of what you have done in the meantime is the heart of a restoration application, and you do not need to be registered to take this.

Nothing has been raised

You want your practice to stand up to scrutiny, and verifiable CPD in your record at the same time.

Professional boundaries

Boundary concerns in hands-on practice, dual relationships, and the prohibition on romantic or sexual relationships with patients. The GOsC calls a failure here the most serious abuse of professional standing.

Consent and communication

Consent for examination and treatment, chaperones, explaining risk, and communication that patients later say they did not understand.

Record keeping and documentation

Clinical notes, what they must contain, and why poor records so often turn a defensible complaint into an indefensible one.

Probity, honesty and dishonesty

Integrity in advertising, claims about treatment, invoicing and insurance, and allegations of dishonesty — the category regulators treat most seriously.

Social media and digital conduct

What you post, how you respond to reviews, patient contact through personal accounts, and the blurring of professional and personal online.

Duty of candour and adverse events

Being open when something goes wrong, apologising properly, and the difference between explaining and defending.

Overview of professionalism

What professionalism means in osteopathic practice, why it matters, and the GOsC’s role in setting and upholding standards.

Core principles

Patient-centred care, integrity and honesty, accountability, confidentiality, communication, dignity, teamwork, record-keeping and reflective practice.

The Osteopathic Practice Standards

All four themes in practice: communication and patient partnership; knowledge, skills and performance; safety and quality in practice; and professionalism.

Professional boundaries

Boundaries in practice, the prohibition on romantic or sexual relationships with patients, commercial pressures, digital and social media conduct, and managing inappropriate behaviour.

Breaches and consequences

What a breach looks like, its effect on patients and public trust, the GOsC fitness to practise process, and what remediation actually involves.

Professionalism and fitness to practise

Early warning signs, insight and regulatory decision-making, conduct during a fitness to practise investigation, restoring trust, and professional resilience.

Conclusion and assessment

Key takeaways, followed by a post-course assessment. Your certificate is issued on completion.

Osteopathic Practice Standards

The GOsC’s standards for osteopaths, arranged under four themes: A, communication and patient partnership; B, knowledge, skills and performance; C, safety and quality in practice; and D, professionalism.

Theme D: Professionalism

The theme most conduct concerns engage. It requires osteopaths to act with honesty and integrity and to uphold high standards of professional and personal conduct so as to maintain public trust, and it covers professional boundaries, the duty of candour and the confidential management of patient information.

Professional boundaries

The GOsC describes failure to establish and maintain appropriate boundaries as likely to be the most serious abuse of professional standing. Boundaries can be physical, emotional or sexual, and a failure of sexual boundaries can bring the profession into disrepute and lead to removal from the Register.

Abuse of professional standing

The GOsC’s own phrase for what boundary failures amount to. Not every crossing of a boundary is an abuse of standing, which is why what happened, why, and what you did next all matter to how a concern is assessed.

Duty to inform the GOsC (D12)

The separate obligation to tell the GOsC as soon as is practicable about regulatory proceedings anywhere in the world, a criminal charge anywhere in the world, a police caution, or suspension or a practice restriction imposed by an employer over conduct or competence — and to cooperate with any request for information.

Record retention

D5 sets the minimum: eight years after the last consultation, or, where the patient is a child, until their twenty-fifth birthday. You should also have a written policy on retention, transfer and disposal, and arrangements for records to be kept safely after you finish practising.

Restoration to the register

The route back for an osteopath who has been removed or has come off the Register. Evidence of what you have done in the meantime sits at the heart of the application, which is why registration is not a prerequisite for this course.

Verifiable CPD

CPD with evidence of completion that you can keep with your CPD record. This course is certified and self-directed, which is a different category from learning undertaken with others — check the GOsC’s current CPD requirements for what your own cycle needs to contain.

Insight

Understanding what went wrong, why it happened, and the effect it had on patients, colleagues and public confidence in the profession. The element most often described as lacking.

Remediation

The concrete steps taken so the same thing does not happen again — training, supervision, changes to how you work — together with evidence that they happened and have been sustained.

Communication and patient partnership

Communication, effective patient partnerships and consent — the information a patient needs to
make an informed choice about their care.

Knowledge, skills and performance

Having the knowledge and skills to practise as a primary healthcare professional, maintaining them,
and working within the limits of your skills and experience.

Safety and quality in practice

Delivery of care: evaluation and management approaches, record keeping, safeguarding patients, and
public health.

Professionalism

Honesty, integrity and high standards of professional and personal conduct, so that public trust and
confidence in the profession are maintained. Where a concern is about conduct, this is the theme your
response should be written against.

D1 — Honesty and integrity

Not putting your own interest above your duty to the patient, and not subjecting anyone to unnecessary investigation or treatment, prolonging treatment, pressuring a patient into buying a product, recommending a service solely for financial gain, or borrowing money from patients. D1 also carries advertising that must be legal, decent, honest and truthful under the CAP Code, accuracy about your qualifications, the use of the title ‘doctor’, and the requirement to hold professional indemnity insurance.

D2 — Professional boundaries

The GOsC states that the most serious abuse of your professional standing is likely to be a failure to establish and maintain appropriate boundaries, sexual or otherwise, and that a failure of sexual boundaries could lead to removal from the Register. D2 covers physical, emotional and sexual boundaries, social and commercial relationships with patients, patient dependency, and relationships with former patients — and says plainly that you must not end a professional relationship solely to pursue a personal one.

D3 — Duty of candour

Where something goes wrong with a patient’s care which causes, or could cause, harm or distress, you must tell the patient, explain what happened and its effects, apologise where appropriate, and offer a suitable remedy or support. D3 also requires you to be open with colleagues and employers and to take part in reviews and investigations when asked.

D4 — Complaints

You must have a policy for managing patient complaints and respond quickly and appropriately. That includes telling patients how to comment or complain, making sure staff know where to direct a complaint, informing your indemnity insurers immediately if you receive one, and making sure the complainant knows they can refer the matter to the GOsC.

D5 — Privacy, confidentiality and records

Confidentiality survives the death of a patient, and it covers your staff and anyone attending your clinic in a professional capacity. D5 also sets record retention: a minimum of eight years after the last consultation, or, for a child, until their twenty-fifth birthday — with a written policy on retention, transfer and disposal, and arrangements for records after you stop practising.

D6 — Fairness and equality

Treating patients fairly, recognising diversity and individual values, and complying with equality and anti-discrimination law. Refusing a service on the grounds of a protected characteristic is unlawful.

D7 — The reputation of the profession

Conduct in and out of the workplace. D7 names acting within the law, behaving honestly in personal and professional dealings, maintaining the same standard of conduct online as anywhere else, not abusing alcohol or drugs, not behaving aggressively, and not falsifying records, data or other documents. It also says criminal convictions could be evidence that an osteopath is unfit to practise.

D8 — Financial dealings

Charging responsibly and in a way that avoids bringing the profession into disrepute, keeping clear and visible information on fees and charging policies, not pressuring a patient into unjustified treatment, recommending a product only where it benefits them, and declaring any financial or other benefit you receive for introducing a patient to another professional or organisation.

D9 — Colleagues and staff

Supporting colleagues, effective handovers, and responsibility for everyone you employ — including administrative staff — and for the guidance they give patients. If you are responsible for an associate or assistant, you must not put them under undue pressure or expect them to treat beyond their competence.

D10 — Other health and care professionals

Treating other professionals with respect, keeping any comment you make about them honest, valid and accurate, following proper referral procedures, and working collaboratively where that is appropriate and available.

D11 — Your own health

If you know or suspect your physical or mental health is impaired in a way that might affect patient care, you must seek and follow medical advice, stop practising if necessary until you are found fit again, and inform the GOsC. You must not rely on your own assessment of the risk.

D12 — Telling the GOsC

You must inform the GOsC as soon as is practicable of significant information about your conduct and competence, and cooperate with any request for information or investigation. That expressly includes regulatory proceedings by a professional body anywhere in the world, being charged with a criminal offence anywhere in the world, accepting a police caution, and being suspended or placed under a practice restriction by an employer over concerns about conduct or competence.

Insight

Understanding what went wrong, why it happened, and the effect it had on patients, colleagues and
public confidence in the profession. It is the element most often described as lacking.

Reflection

Setting that understanding down honestly and in your own words, including what you would do differently
and what you have already changed. Reflection is the written record of insight.

Remediation

The concrete steps taken so the same thing does not happen again — training, supervision, changes
to how you work — together with evidence that they happened.

The ethics pair to this course: how a decision was reached, where this one covers how you conducted yourself.

The element assessed in almost every case, whatever the allegation, and the one most often described as lacking.

How to write reflection that reads as understanding rather than regret, in your own words.

Turning insight into concrete, evidenced change that a committee can see actually happened.

The forward-looking half of remediation: what you have put in place so it cannot happen again.

What fitness to practise means, how the process works, and what is being assessed at each stage.

Restoring confidence after a concern — with patients, with colleagues and with the regulator.