Friday 24th November 2023
Alan Longcroft (he/him) MBAcC MRCHM
To download a copy of the policy as a PDF, click here.
If you are considering gifting a course of herbal medicine, acupuncture or tuina manual therapy treatment to a friend, family member or loved on, please familiarise yourself with the policy below.
To find out more about gift certificates, click here.
Background
1.1 In response to enquiries around the appropriateness of paying for courses of treatment on behalf of friends, family or loved ones, I aim to clarify my position and processes around this.
1.2 I run a multi-modal healthcare service using acupuncture, herbal medicine and manual therapy. As such, I cater for a broad range of health needs for a diverse group of service users, and I aim to ensure that my processes are sufficiently flexible for the full range of individuals I serve.
1.3 I aim to ensure the policy offers sufficient transparency to anybody seeking to understand my processes on third-party payment.
Scope
2.1 This policy applies to fees which are paid by another person on behalf of a current or prospective patient.
2.2 This may include either direct payment for a course of treatment, or gift certificates purchased for a prospective patient.
Therapeutic obligations
3.1 I am committed to delivering best ethical practice for all of my patients.
3.2 With reference to the framework for healthcare ethics from Beachamp and Childress (1985), anyone seeking treatment is entitled to be treated with beneficence, non-maleficence, autonomy, and justice. Put simply, I’ll act in your interests (beneficence), I’ll avoid harm (non-maleficence), I’ll help you steer your treatment (autonomy), and I’ll maintain an appropriate balance between each person’s needs in my patient base (justice). Typically, practices in healthcare involve a balance between these principles which may often conflict.
3.3 Further to this, I am obligated to meet certain statutory duties such as the duty of confidentiality (I will not disclose any details of your care without explicit consent), the duty of candour (I will be honest and transparent about anything which may have gone wrong in your care), safeguarding of vulnerable people and protection of personal data.
3.4 More widely, I am accountable to two regulators in all matters concerning safe and ethical practice:
3.4.1 I am bound to the Code of Professional Conduct of the British Acupuncture Council. If you feel something has gone wrong in your care or in the handling of third-party payment, a complaint can be made to the British Acupuncture Council.
3.4.2 I am bound to the Code of Ethics and Practice of the RCHM. If you feel something has gone wrong in your care or in the handling of third-party payment, a complaint can be made to the Register of Chinese Herbal Medicine.
3.5 It is important to be aware that these therapeutic obligations apply to the service user (the person seeking to undergo treatment) rather than the person who is offering to fund that treatment (hereafter referred to as the funder).
3.6 It is likely to arise that a funder may also be a patient of my practice. In such cases, I aim to be clear that each person will be treated as the service user where relevant to their own care, however in respect to the care of another person that respective service user’s needs must not be impinged on by the funder.
3.7 Further, I aim to avoid the administration of third-party payment from impinging on the delivery of any person’s care.
3.7.1 Where a current service user enquires about referring a friend, family member or loved one, I will aim to avoid that the administration detracts from their own care. This will normally be organised outside of scheduled treatments or consultations.
3.7.2 Where a funder is providing limited funds, I will make my recommendations to the service user on the basis of best practice and work constructively with the service user to operate within the constraints of limited third-party funding.
Conflict of interest
4.1 There are potential issues which may arise in relation to third-party funding. In all cases, I am committed to meeting my therapeutic obligations to the service user, and I aim to protect the money of the funder.
4.2 In the event where these interests may conflict, my obligations to the service user take priority.
4.3 My obligations to the service user include the right to confidentiality. As such, details of the service user’s care cannot be discussed with the funder, including whether they have proceeded to undergo the funded treatment.
4.4 Conflicts of interest are not disregarded where the funder is a family member or spouse.
Receipt of third-party payment for a course of treatment
5.1 It is not expected that a service user would notify me in advance that their payment would be made by a third party.
5.2 Between appointments scheduled online and in-clinic, payment may be received by a variety of methods. As such, it is not usually immediately apparent that payment has been made by a third party, but can be confirmed upon inspecting financial records.
5.3 Where a course of treatment is pre-paid by a third party, administration regarding appointments will be resolved with the service user. Requests for refunds must be made by the service user. Refunds will be sent to the funder.
5.4 Courses of treatment which have been pre-paid must be scheduled within seven years.
5.4.1 I am obligated not to retain personal data beyond a period of time reasonable to its purposes. With reference to the Code of Professional Conduct of the British Acupuncture Council, and as stated in my privacy notice, all personal data is erased after a period of seven years has elapsed following the latest point of delivery of care.
5.4.2 In the care of minors, this period is seven years following the majority of the service user (i.e. their eighteenth birthday).
5.4.3 Requests for refunds therefore cannot be honoured after this time period has elapsed.
Purchase of gift certificates
6.1 A gift certificate should be purchased with the details of the funder, including the name, email address and contact telephone number.
6.2 The funder will receive a confirmation of purchase to the email address provided, containing a reference code unique to the purchased gift certificate and a web link to register the name and contact information of the intended recipient. This registration is in place to establish the service user and funder regarding each person’s care. This is important to facilitate the resolution of potential issues which may arise in the process.
6.3 Upon registration, a physical certificate will be issued to the funder via postal information if supplied (optional). Certificates are typically received within three working days. Alternatively, a digital certificate can be issued for home printing.
6.4 Prior to registration of the intended recipient, administration regarding the gift certificate will be resolved with the funder.
6.5 Following registration of the intended recipient, administration regarding the gift certificate will be resolved with the service user. Requests for refunds must be made by the service user. Refunds will be sent to the funder.
6.6 Gift certificates are assigned an expiration date of seven years.
6.6.1 While gift certificates are not intended to expire, I am obligated not to retain personal data beyond a period of time reasonable to its purposes. With reference to the Code of Professional Conduct of the British Acupuncture Council, and as stated in my privacy notice, all personal data is erased after a period of seven years has elapsed following the latest point of delivery of care.
6.6.2 In the care of minors, this period is seven years following the majority of the service user (i.e. their eighteenth birthday).
6.6.3 Requests for refunds therefore cannot be honoured after this time period has elapsed.
Resolution of specific potential issues
7.1 Where the intended service user chooses not to undergo treatment:
7.1.1 It is important that third-party payment not introduce potential coercion around consent to treatment. It will be emphasised that any service user has the right to refuse any part of treatment at any time.
7.1.2 It is appropriate that the funder be refunded in such cases. Requests for refunds must be made by the service user. Refunds will be sent to the funder. Alternatively, at the discretion of the funder, the pre-payment or gift certificate may be transferred to another person.
7.2 Where pre-payment is received or a gift certificate is purchased but the service user does not schedule an appointment or does not confirm whether they choose to either undergo treatment or refuse treatment:
7.2.1 It is appropriate that the funder should be refunded in such cases.
7.2.2 The funder will be reminded at the point of purchase that the right to confidentiality of the service user will be upheld. Therefore I am not able to confirm or deny whether an intended recipient of a pre-paid course of treatment or gift certificate has proceeded to schedule an appointment.
7.2.3 As such, the funder cannot be notified that a pre-paid course of treatment or gift certificate has not been used. The service user will be contacted, prompted to schedule their pre-paid appointment and reminded that they may also refuse treatment. They will be reminded that a refund can only be processed at their own request.
7.2.4 Gift certificates have an explicit expiration date of seven years. For reasons around my obligation to erase personal data after seven years, this expiry date is also applied to pre-payment. Therefore the service user has a period of seven years to confirm whether they intend to schedule a course of treatment or to refuse care.
7.3 Where a funder enquires into details of the care of the service user:
7.3.1 My therapeutic obligations to the service user must not be infringed by factors such as third-party payment.
7.3.2 As such, I am unable to provide any details of the care of the service user. Further, the service user’s right to confidentiality precludes me from confirming or denying that the service user has undertaken any treatment.
7.3.3 In such cases, I will endeavour to recommend that the funder make this enquiry with the service user directly.
7.4 Where a funder requests to terminate treatment:
7.4.1 My therapeutic obligations pertain to the service user. Although the service user may be dependent on third-party funding, requests to terminate treatment can only be made by the service user.
7.4.2 I will always act in the interests of the service user. I will make my recommendations to the service user on the basis of best practice and work constructively with the service user where limited funds are available.
7.5 Where a service user requests a refund directly to themselves:
7.5.1 It is important that third-party payment not introduce potential coercion around consent to treatment. It will be emphasised that any service user has the right to refuse any part of treatment at any time. In such cases, pre-payment is refunded.
7.5.2 The funder’s money should be protected. A refund will only be made to the funder. Instances where the funder cannot be refunded apply only where my obligations to the service user would be infringed.
7.5.3 It is inappropriate for a potential service user to accept payment for a service they do not intend to receive, and seeking a refund to themselves may be considered theft.
7.5.4 The transfer of funds between the funder and the service user for any reason is a matter between these two individuals. Upon refund to the funder, I will not be able to remain further involved with such matters.
Conclusion
8.1 The policy for accepting third-party payment is not intended to deter third-party funding. Rather, I aim to ensure transparency around my processes to enable this.
8.2 It is important to acknowledge potential risks to service users which may arise where third-party funding is abused, however likelihood is very low. Where I become aware of potential for any further risk, I will update this policy.
8.3 The processes described within this policy aim to mitigate these risks.
8.4 These are weighed against the benefits to accepting third-party funding for prospective service users. This is essential for those who otherwise wouldn’t be able to access these services by their own means, and offers an opportunity for new people to be introduced to acupuncture and Chinese medicine treatment which they otherwise might not have considered. For these reasons, I believe the low likelihood of potential risks is strongly outweighed by its advantages.
8.5 I will endeavour to be reactive to emerging issues to ensure that potential service users can benefit from third-party funding to access my treatments in a safe and ethical context.
Gifting a course of treatment
I am frequently asked if a course of treatment can be “bought” for a friend or family member. Yes, and I feel it’s important that this is facilitate for anybody who otherwise wouldn’t have access to treatment. However there are ethical considerations around this, and so I’ve laid these out in a Policy for Accepting Third-Party Payments. If you are considering gifting a course of treatment to a loved one, please read this first - this is readable online or downloaded as a PDF.
Gift certificates are available for herbal medicine, acupuncture and tuina manual therapy treatments. See details below: