Constitution & code of ethics and conduct

BRITISH ASSOCIATION OF HIRUDOTHERAPY

Hirudo medicinalis: professional use, protection and promotion

B A H

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CONSTITUTION

This document (10 pg.) was ratified at the British Association of Hirudotherapy (BAH) Partnership meeting of Establishment 01/12/2007, reviewed 17/05/2015 and approved by Council representatives administrative body – the Executive Committee 29/06/2015:

BRITISH ASSOCIATION OF HIRUDOTHERAPY DIRECTOR: NINA BARBORA EVANS

BRITISH ASSOCIATION OF HIRUDOTHERAPY (Hirudo medicinalis: professional use protection and promotion)is not a profit-making limited civil liability public legal person, which combines persons, who have received medical or life-enhancement education, are interested in medical leech specifics, production, professional use, protection and promotion, people’s health improvement and illness prevention, and would like to be qualified as Quadracare in Hirudotherapy specialist or Leech therapy consultant & hirudo practitioner and registered as “Hirudotherapy practitioners” and  “Quadracare in Hirudotherapy specialists” in the UK.

The organization isbased at the address: 4 Brookbank Avenue, London W7 3DW, United Kingdom.

Article 1. Name

The name of the organisation shall be The British Association of Hirudotherapy (Hirudo medicinalis: professional use protection and promotion), herein after referred to as BAH.

Article 2. Aims and Objectives

2.1. The prime purpose of the British Association of Hirudotherapy (Hirudo medicinalis: professional use protection and promotion) is to promote and legalise The Integrative Quadracare: Focus on the Best World Experience Approach in Modern Leech therapy and Hirudopractice” as the most professional way for Hirudotherapy in the UK.
NB. BAH advocates the use of “The Integrative Quadracare: Focus on the Best World Experience Approach in Modern Leech therapy and Hirudopractice” as the most professional way in Hirudotherapy (a short version would be QuadraCare in Hirudotherapy), also secure and safe for our patients, sufficient and based on the successful evidence of good healthy practice, scientifically approved, originated from eminent doctors and scientists from 12 countries, members of International Co-operation Community of Hirudopractitioners –ICCHP–, also suitable for a variety of treatments including sports-related conditions, comprehensive in it’s public presentation and NHS prescriptions friendly.

2.2. To encourage, support and protect the integrity of “Quadracare in Hirudotherapy specialists” and “Leech therapy consultants & hirudo practitioners (further down as hirudotherapy practitioners), to ensure the well being of their clients and the high quality standards with which Hirudotherapy is delivered to the public and included within the health provision of the nation.

2.3. To enable the members and partner organisations to speak with one voice, and, as and when appropriate, to provide that voice especially for setting up a structure to educate and qualify UK hirudotherapy practitioners (using European Union practising instructor experience, either in the UK or in other EU countries).

2.4. To forge links with the British Complementary Medicine Association, The Health Commission, relevant departments of government, Parliament, the media, training organisations, and the public as appropriate to organise accreditation,  monitoring, supervision, further international training and knowledge-sharing seminars.

2.5. To encourage links with European and world associations for the betterment of International legislation.

2.6. To provide and maintain a basic Code of Ethics and Conduct, backed by a disciplinary procedure(Disciplinary Committee), guidance notes on Law and Ethics.

2.7. To be recognized as the representative body in Hirudotherapy for therapists, associations, schools and clinics as well as complementary and alternative medicine organisations etc.

2.8 To protect hirudotherapists’ rights to deliver hirudotherapy discipline with personal autonomy, and practice hirudotherapywith advice from the BAH.

2.9 To provide registered BAH Hirudotherapy practitioners (“Quadracare in Hirudotherapy specialists” and “Leech therapy consultants & hirudo practitioners”) with professional legal indemnity insurance and Hirudo medicinalisofficial supplies from leech factories. To ensure the best price and the possibility for secure use, protection and promotion of Hirudo medicinalis for members of BAH and their clients.

2.10 To ensure professional use of medical leeches Hirudo medicinalis as Biological equipment using the single use only principle. To promote and protect the way of utilisation of Hirudo medicinalis relevant to UK Law requirements.

2.11 To achieve the foregoing objectives in a lawful and positive manner.

Article 3. Mandate

The BAH may promote its objectives through, but not limited to, one or more of the following:

3.1. By encouraging research;

3.2. By providing advice;

3.3. By co-operating with other bodies;

3.4. By setting aside funds for special purposes or as reserves against future expenditure;

3.5. By depositing or investing funds (but to invest only after obtaining advice from a financial expert) if deemed appropriate as a need for diversification;

3.6. By making available self-employed or voluntary personnel for the purpose of administering the BAH;

3.7. By publishing or distributing information;

3.8. By doing anything else within the law, which promotes or helps to promote the Objectives.

Article 4. Membership (Governance of the Constitution)

4.1. Natural and legal persons from UK and foreign countries who have read, understood and accepted the BAH Constitution, but not younger than 18 years of age, can be members of the BAH.

4.2. The members of the BAH are subdivided into those of honour, full and associated. A person can be a member of several associations. A person cannot be an honour, full and associated member of the BAH at the same time.

Full and associated Member organisation

4.3. Only the full member category of membership will form the voting Council body of the BAH. This is open to self-employed practitioners and organisations with members practicing and promoting hirudotherapy, subject to supplying relevant information and adherence to BAH code of ethics and conduct etc., have a Council vote. Each voting member will be entitled to have one representative at a Council Meeting. No member may have more than one representative attend or vote at a Council Meeting at the same time. Attendance of any additional representatives (without voting rights) will be at the discretion of the Executive Committee.

4.4. Natural and legal persons from the UK and foreign countries who have understood and accepted the BAH Constitution, complying with the requirements set in Items 4.1. and 4.2. of this Constitution, who were recommended by the Director or 2 full members as a professional and of good character, have applied for the BAH membership, undertaken the obligation to follow the Constitution of the BAH in writing, submitted a short description of their activity, received a consent from 100% of the Council Meeting, paidthe entrance fee of £1000 can become the full, free entrance is for associated members of the BAH.

4.5. Full members willing to re-new their full membership at the BAH have to pay the membership fee of £20 yearly.

4.6. Associated members have no time limit for their membership and are exempt from the annual payments, therefore they can participate at the General Meeting of the BAH without voting rights.

Honour Member organisation

4.7. Natural and legal persons from the UK and foreign countries who have understood and accepted the BAH Constitution, complying with the requirements set in Items 4.1 and 4.2 of this Constitution, who were recommended by the Director or 2 full members as a professional and of good character, a short description of their activity was submitted, who have received consent from 100% of the Council Meeting of the BAH can become the honour members of the BAH with no time limit. The honour members are exempt from the entrance fee and annual payments and have the right of the advisory vote, therefore they do participate at the General Meeting of the BAH and can participate in the Council Meetings with no voting rights.

4.8. The Administration of the BAH must keep a register of members. Membership is not transferable.

4.9. The documents and other information concerning the activity of the BAH is provided to members following a request to provide the information and submitted to the Council.

4.10. Members of the BAH can withdraw their membership from the BAH by submitting a written application to the Council.

4.11. Members of the BAH can be expelled from the BAH at the General Meeting of the BAH, receiving consent from 100% of the Council body, if:

1) They do not follow this Constitution;

2) They discredit the name of The British Association of Hirudotherapy (Hirudo medicinalis: professional use protection and promotion) by their actions;

3) Following the recommendation of the Director.

Partner organizations of the BAH

Organizations, institutions and self-employed persons who are willing to be partners of the BAH, following the main purpose of this Constitution and promoting hirudotherapy and relevant services at different levels, should apply to the BAH Council in writing and receive consent from 100% of the BAH Executive Committee. Official and recognised partners are welcome to participate at the AGM with no voting rights, but an advisory vote.

Friends of the BAH

Open to all wishing to support the BAH in its work on behalf of Hirudotherapy (Modern leech therapy and Hirudopractice).

No voting rights.

Article 5. Governance

5.1. Governance will be in accordance with the voting rights detailed in the previous Membership Article.

5.2. The Council shall delegate its day-to-day operational function to the Executive Committee.

5.3. A professional complaint made against a member of the BAH will initially be considered by the Executive Committee, then by the Disciplinary Committee.

5.4. Consultants, speakers and others may attend council meetings by the invitation of the Director or any member with the approval of the Executive Committee. Notice of their attendance will be as detailed in the agenda as part of that meeting.

Article 6. Annual General Meeting

6.1. As soon as the number of the BAH members exceed 1000 and BAH registered with the UK Government, an Annual General Meeting of members (AGM) shall be held each year with one month’s notice in writing to all members of the BAH. It shall be the duty of the Executive Committee to fix the date of the AGM so that not more than fifteen months shall elapse between one AGM and the next.

Before above mentioned conditions are in place, AGM role is performed by regular Council or Executive Committee Meetings (before the number of the BAH members exceed 100), which have to be not more than fifteen months elapse between one and the next.

6.2. Resolutions submitted in writing, stating the names of the proposer and seconder and received by the Secretary not less than forty days prior to the date of the meeting shall be added to the agenda, which will be distributed to the members not later than fifteen days before the meeting.

The Annual General Meeting:

1) Amends and supplements the Constitution;

2) Determines the amount of the entrance fee and the membership fee;

3) Receives an independent report of the statement of accounts, or if appropriate, a draft report from the Financial Controller/Hon. Treasurer and confirms the annual financial statement of the BAH;

4) Informs regarding the Council decision concerning the acceptance, cancellation and expulsion of full, associated and honoury members of the BAH;

5) Makes decisions concerning the restructuring and the termination of the activity (reorganization and liquidation) of the BAH;

6) Receives reports from the Council, Director, Secretary, Executive Committee, project administrators or consultants to the BAH regarding the administration, finance and activities of the BAH since the previous AGM.

7) Presents nominations for all officers, which must be received in writing with the names of the proposer(s) and seconder(s) by the Secretary not less than forty days prior to the date of the AGM, then will be added to the agenda.

7) Appoints auditor or independent examiner, if required, for the BAH.

8) Discusses and votes on resolutions, deals with the Executive Committee re-election and any other business put before them.

Extraordinary General Meeting

An Extraordinary General Meeting shall be called upon the written request to the Director of twenty-five percent of the voting member organisations of the BAH or on the decision of the Director for a specific purpose. The Secretary shall be responsible for convening an Extraordinary General Meeting within 14 days of receiving the written request that establishes the required twenty-five percent of the voting membership by giving at least 15 days notice to every member organisation of the date, location and agenda of this EGM.

Article 7. Council Meetings

In addition to Item 11.3. the following will apply:

7.1. The Council of BAH shall be deemed to be in session at any time a meeting has been called and a quorum is present. The regular meetings may be Annual General Meetings, Extraordinary General Meetings or General Council Meetings.

7.2. If a quorum shall not be present within thirty minutes of the scheduled time for starting a meeting the meeting will be cancelled.

7.3. The Director will have one vote plus a casting vote if there shall otherwise be an equal number of votes cast for and against a motion.

7.4. Member organisations not able to send a delegate to attend any meeting may in advance and not less than 15 days prior to the meeting notify the Secretary of the appointment of a proxy to vote on their behalf or deposit with the Secretary their decisive vote. All decisions in all meetings shall be made by the vote of the majority unless specified otherwise (see Items 4.4, 4.7, 4.11, 7.12.3c, 10.3, 11.1).

7.5. The Council shall meet on dates to be agreed by the Council at each AGM.

7.6. The Director will preside over the meeting.

7.7. Items for inclusion in the agenda must be received by the Secretary no later than forty days before the date of the meeting.

7.8. The agenda for a Council meeting will be issued to all members no later than thirty days before the date of the meeting.

7.9 The minutes of the meeting should be issued to all members no later than fourteen days after the meeting.

7.10 In the event that no Executive Committee is present to chair the meeting, then the meeting shall be adjourned to a convenient place one calendar month later and all member organisations shall be so advised by the Secretary.

7.11 The purposes of the meetings are to make recommendations for action by Executive Committee, project administrators, sub-committees or other designated persons and to resolve or ratify certain matters presented by or to the Executive Committee.

7.12 The Minutes of the previous meeting will, with any amendments, be signed by the Executive Committee.

The COUNCIL – gathering once a year or more (depending on demand) with the fifteen days notice in writing to full and honour members of the BAH:

1) Makes decisions concerning the acceptance and cancellation of the members of honour, full and associated members of the BAH;

2) Makes decisions concerning the establishment of other legal persons or to become a participant of other legal persons;

3) Has the right to elect the Executive Committee and appoints the Disciplinary Committee. This operational body shall be the officers of the BAH ratified by the Council. They must be full members (but cannot be paid persons) of the BAH.

4) Makes decisions about the next GM, also the term of the AGM can be renewed or extended subject to approval by the Council.

The Administrative operational body of the COUNCIL and its competence. The Executive Committee of the BAH (In addition to Item 11.2):

1) Provides the power of the Council with its day-to-day operational function;

2) Shall have the authority to function in all designated matters provided a majority of members are present and agree a course of action. The term “present” includes live electronic conversation where all participants can communicate at the time of the meeting with all other participants;

3) Member automatically ceases to be a member of the operational body of the Council if he or she:

a) Ceases to be a member of the BAH (reversible if all remaining Council members agree upon resumption of that person’s membership);

b) Is absent from 3 consecutive Council meetings;

c) Is removed by a resolution passed by the Council resolution where two thirds of the attending Council Members support the resolution at a Council Meeting.

4) Has the authority to act in the name of and on behalf of the Council of the BAH in a manner consistent with this Constitution. In particular: –

a) To initiate and regulate meetings and proceedings.

b) They are appointed persons and shall be empowered to control the administration of the BAH and to operate the banking account(s) of the BAH. The authorization of cheques above the threshold detailed in Item 11.2 will require two signatures of Executive Committee members. One of those signatures will be the Director, the person responsible for the running and control of the account(s), the second will be the Secretary.

c) To provide rulings on the interpretation of this document and on any other matter pertaining to the BAH which shall be conclusive and binding unless revoked when presented for ratification at the next available Council meeting and AGM. Even so, until the ratification or otherwise of the Council Executive Committee, decisions will stand and be supported in the interests of continuance of the smooth running of the BAH;

d) To control paper work at the BAH to ensure a high professional level and smooth hirudotherapy procedures at members’ places of employment (assessment, memo and consent forms), using the single use only of Hirudo medicinalis principle to promote and protect the method of disposal of leech (regarding current requirements), and protect doctors and patients from stress;

e) To promote and recognize qualifications in Hirudotherapy for UK practitioners, also to set up yearly indemnity insurance for the BAH members;

f) To set the financial year end;

g) To appoint persons, project administrators or subcommittees as appropriate, for the purpose of achieving a specific task or objective. Such appointments may be discontinued at any time.

Article 8. Termination of membership

The full membership shall be terminated:-

8.1. Upon receipt by the Secretary of a written notice of resignation. (No subscriptions or fees already paid to the BAH for such membership will be returnable either in whole or in part.)

8.2. If the annual subscription to BAH has not been paid by the last day of the third calendar month following the due date in the relevant year, unless previously agreed by the Executive Committee.

8.3. If the Executive Committee, recommends that a member organisation or an individual should be required to resign. In such a case the Secretary will advise the member of the Executive’s decision and invite the member to attend the Council Meeting at which the proposed termination will be considered, or submit a written reply. The agenda will include the proposed termination. The matter must then be put before the Council at a Council Meeting. If the Council votes to agree the termination then the Secretary will advise the member accordingly.

Article 9. Patron

The Executive Committee may recommend to the Council at the AGM the appointment of persons whose services to Hirudotherapy will assist in the achievement of the aims of the BAH. Persons appointed as Patron of the BAH shall serve in that capacity for two years from the date of appointment and shall at the end of that period be eligible for re-appointment, being re-appointed at the Annual General Meeting for a further term of two years or until prior resignation in writing.

Article 10. Dissolution

10.1. The BAH may be dissolved at a Council Meeting or an Extraordinary General Meeting convened for that purpose.

10.2. The date of the EGM or Council Meeting must be conveyed to the members no less than 40 (forty) days before the date of the meeting to dissolve the BAH.

10.3. Two thirds of the voting members present must support the proposed dissolution. Any assets remaining after satisfying outstanding debts and other liabilities shall be distributed wholly to charitable organisations (preferably having similar objectives) as decided at the dissolution meeting. A copy of the final account after distribution of the assets of the BAH will be distributed to the membership of the BAH at that time. The cost of that distribution will be included in the winding up of the BAH.

Article 11. Amendments

11.1. The Council may propose an amendment to the Constitution providing two-thirds of the voting members present agree. Such amendments will only be effected if two-thirds of the total voting membership who vote in respect of the amendment(s) support the changes proposed at the meeting. The Secretary will be responsible for administering the counting of the received votes. Members will have four weeks to submit their vote from the date the minutes are issued.

11.2. The threshold at which cheques will require two signatures is any sum above £2,500 (two thousands and five hundred pounds).

11.3. MEETINGS

11.3aThe duration of the activity of the BAH is not limited.

11.3b A quorum is deemed present where at least 10% of voting members and both Executive Committee members are present.

11.3c The number of annual Council Meetings can only be revised if agreed by two-thirds of the voting members present at any meeting deemed in session.

REFERENCES:

  • The British Complementary Medicine Association (BCMA) Code of Conduct;
  • The British Medicine Acupuncture Society (BMAS) Code of Ethics;
  • Biopharm Leeches UK brochure;
  • The Constitution of Lithuanian Hirudologist Society;
  • Duremar Therapy, UK. The Consent form and Memo;
  • J.B. Kamenev “Leech treatment”, Moscow, 2006

Hirudo medicinalis: professional use, protection and promotion

B A H 

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CODE OF ETHICS AND CONDUCT

INITIAL AGREEMENT

 

All staff, tutors and members of the BAH agree to:

  • Always conduct themselves to the highest levels of ethics, integrity, accountability and responsibility.
  • Treat all clients and potential clients with absolute dignity, confidentiality and respect as free and equal individuals.
  • Respect the commercial confidentiality of the BAH by not divulging business information to any third parties.
  • Maintain the good reputation of the hirudotherapy profession in general and the BAH in particular.
  • Comply with both the spirit and the letter of any commercial agreements made with clients, potential clients, professional colleagues and the BAH.
  • Make commercial agreements with clients and potential clients that are fair and will respect all parties to such agreements.
  • Represent true levels of status, title, competence and experience in order not to mislead, misrepresent or defraud.
  • Clearly state to clients and potential clients the terms of any commercial agreement including the expectations of both parties.
  • Make no claims or implications of outcomes that cannot be demonstrated or guaranteed.
  • Obtain written permission from any client or potential client before releasing their names as referees.
  • Respect the absolute rights of the client’s confidentiality except as expressly permitted by the client or potential client in writing or as required by law.
  • Recommend different resources when these will be more appropriate to the client’s needs.
  • Avoid all conflicts of interest and give notice of such potential conflicts to the BAH. Advise both the BAH and the client on the risk of conflict if a relationship moves beyond a hirudotherapist/client situation (For example a personal or business relationship).
  • Refrain from offering professional information or advice that you know to be confidential, misleading or where the accuracy is beyond your competence to assess.
  • Endeavour to enhance public understanding and acceptance of professional hirudotherapy.
  • Share skills and experience with fellow members the BAH to further increase the body of knowledge, skills and competencies of such parties.
  • Respect all copyrights, agreements, work, intellectual property and trademarks and comply with all laws covering such areas.
  • Use the tuition, definitions and works provided by the BAH as the basis for all hirudotherapy procedures, practices and objectives.
  • Avoid treating minors (people who have not yet had their 18th birthday) without the express written consent of parent, guardian or teacher as appropriate.
  • Contact the BAH immediately if you find yourself in a situation which may create conflict, litigation or bad publicity.
  • Comply with all laws and by-laws of the UK and, if hirudotherapy clients are based abroad, with the laws of the clients’ country.
  • Ensure that all advertisements and promotional materials, whether verbal or written, are legal, decent, truthful, honest and in compliance with the requirements of the UK Advertising Standards Authority.
  • Make a copy of this Code freely available to clients if they request it.

 

PART ONE

1. General Information

THE DEFINITION OF THE THERAPY, THE FIRST CLINICAL USE AND Prolonged Localised Bleeding

Leech therapy can be traced back several thousand years to traditional Ayurvedic texts, is also known to have been used by the pharaohs of Egypt, and was very popular in Europe in the 19th Century (especially in England, France and Russia). However, since these times, many things have changed.

In the 20th Century three main things happened, which significantly influenced the use of leech therapy.

Firstly Western medicine became the major treatment for human medical care, with chemical drugs producing rapid relief in severe cases, and has been supported with scientific proof as well as evidence based studies. Since this has been introduced and accepted as the traditional approach, this factor has pushed all alternative and complementary approaches (including leech therapy) into the background.

Secondly it was discovered that a leech’s saliva consists of more than a 100 biologically active ingredients which produce anti-inflammatory, anti-stress, thrombolytic, anti-bacterial and immune stimulating effects in a patient’s body. Therefore leech therapy and Hirudopractice has had a great chance to survive in the modern world, changing its status from ‘traditional’ or ‘ancient’ medicine to Complementary medicine. Now it could be treated only as a supporting method built into the main scheme of different therapies.

NB. The term “Leech therapy” refers to a live medical leech application performed by medically trained staff only, where a leech is used in the same way as a biological ‘single use’ needle. The term “Hirudopractice” means the use of leech products (capsules, suppositories, pills, and creams) as well as new technologies and innovations combined in a very particular way with applications of a live leech or other complementary medicine methods for self-healing and health care purposes. It could be performed by complementary medicine specialists, as well as medically trained practitioners. To keep it simple we will refer to “hirudotherapy” to describe both these methods.

IMPORTANT NOTE: There is a great difference between Doctor of Medicine-neurologist professionally using leeches for patients after Cerebral Strokes, Cerebral Haemorrhage, MS, Cerebral Palsy with Paracephaletic cyst in the brain, epileptic seizures or trigeminal neuralgia and Complementary Medicine specialist, who is applying leeches for health care purpose. Also there is a huge difference between doctor-gynaecologist using leeches for medical infertility treatment and home based hirudopractitioner applying leeches for self-healing only.

BAH clearly defers these two approaches and offers separate levels for a training system.

Thirdly, because not every health issue can be fixed with chemical drugs (nor with leech therapy) and at the very beginning of the 20th century leech therapy was applied still in the old fashioned way (as in the 19th century or previously), so live leeches were often applied next to chemical drugs without a proper scheme of understanding of the combining factors and risks, resulting in a confusing situation. This happened because in combination the expected results did not occur. It was not clear why sometimes leech therapy appeared to be a not so powerful method anymore, or why a set dose of a chemical drug appeared stronger or weaker next to a live leech application. Also there were no universal methods publicly introduced or formulated of how it would work for the majority of patients, as everyone could react in slightly different way depending on their condition or an individual reaction to the live leech bite.

In the 21st Century the situation has changed again.

Many prominent Western medical doctors and scientists have started using Complementary/Alternative methods (and leech therapy in particular) making many great discoveries by combining both chemical drugs with live leech and their products.

BAH is aware of good empirical practice for different uses of life leech. They could be provided using ancient technique of local applications (above the painful area) or systemic approach (using knowledge about biologically active points and energy channels-meridians).

BAH is constantly working with the most prominent scientists in that area from the USA, Russia, Poland, Lithuania, Israel, Germany and other countries within the International Co-operation Community of Hirudopractitioners –ICCHP- in order to establish National and European Union Leech Registers, mutual Standards and Education system for Modern Leech therapy and Hirudopractice. For those Western medicine doctors who prefer to stay removed from this comprehensive approach, the newly developed Integrative Method of Medicine (which is very well represented and introduced in the “WHO Traditional Medicine Strategy 2014-2023” document) should be the best encouragement to get back on track and start using more natural (for human) methods along with their progressive colleagues.

This strategy document is available here:

http://apps.who.int/iris/bitstream/10665/92455/1/9789241506090_eng.pdf?ua=1

It is important to make very clear from the very beginning that Leech therapy and Hirudopractice are not alternatives, but Complementary old and well known medicine, which works well together with Western medicine and is extremely helpful for patients who need the above mentioned positive effects without undesirable side effects (which usually accompany regular use of chemical drugs). Applying Leech therapy and Hirudopractice, in a modern and correct NHS friendly way (according to conditions presented more specifically below), increases the level of natural hormones (including serotonin and endorphins) and the patient will feel happy, relaxed and comfortable during and after the treatment. Leeches applied correctly will treat diseases caused by insufficient micro-circulation, which will in turn help patients who suffer from blood defects, joint disorders, neuroses, boils, haemorrhoids, varicose veins and many other ailments (e.g. hypertension, bronchitis, asthma, heart attack, stroke, depression, infertility, memory disorders, diabetes, peptic and duodenal ulcers, arthritis, obesity, chronic fatigue syndrome etc.) These total more than 400 diseases please refer to the BAH website for more indications and contraindications:

http://www.bah.today/wp-content/uploads/2014/06/Uses-of-Hirudotherapy.pdf

The application of a live leech will not build your muscles or help you get rid of bad habits but, if applied correctly using a modern professional evidence-based and scientifically proven approach, it will help GPs in their everyday duty, minimising the quantity of home visits and specialists’ consultations. Also the number of hospital beds needed could be reduced because it will improve patients’ health significantly, them being at home and receiving leech therapy there.

We advocate the use of “Integrative Quadracare: Focus on the Best World Experience Approach in Modern Leech Therapy and Hirudopractice”as the most professional way in Hirudotherapy(a short version would beQuadraCare in Hirudotherapy or just (QC)). We view this as secure and safe for our patients, sufficient and based on the successful evidence of good healthy practice, scientifically approved, originated from eminent doctors and scientists from 12 countries (members of International Co-operation Community of Hirudopractitioners –ICCHP–, please see the testimonials at www.quadracare.co.uk), also suitable for a variety of treatments including for sports-related conditions, comprehensive in its public presentation and NHS prescription friendly.

For specialist cases we have access to supervision from the aforementioned developers and experts in this field, as they perfectly well represent the process for scientifically substantiating Leech therapy and Hirudopractice to improve modern healthcare by using QuadraCare in Hirudotherapy (QC).

QuadraCare in Hirudotherapy (QC) has an integral approach to medicine and combines four areas of healing to improve micro-circulation in the human body:

  1. Lifestyle coaching and solutions
  2.  Modern Leech therapy and new technologies in Hirudopractice
  3.  Health enhancement supplements & apparel
  4.  Modern physiotherapy and osteopathy

 

It is important to note that each of these areas has been used separately by practitioners working alongside Western medicine for many years, specifically in coaching, osteopathy, physiotherapy and food supplements. Only Leech therapy was used for many centuries as the most ancient approach on its own. Nevertheless, each of these can assist in the treatment of a wide range of illnesses offering significant long term relief from pain.

To explain how the QuadraCare in Hirudotherapy (QC) works, here is a brief description of each area:

  1. Lifestyle coaching and solutions – are needed to change long term bad habits and develop life-long skills to improve patient health.
  2. Modern Leech therapy and new technologies in Hirudopractice – developed by prominent scientists, professors, doctors and practitioners are important when live leeches and leech product will be prescribed.
  3. Health enhancement supplements & apparel – the food supplement products and other effective natural ingredients produced, supervised by medical advisers and       doctors of Medicine ensure much better blood formula and are important as a part of wellbeing.
  4. Modern physiotherapy and osteopathy – applied using specially designed equipment, a unique exercise programme and a particular style of massage, is extremely useful, because provides better condition of muscular system, therefore micro-circulation will be improved dramatically.

Let’s start with the fact that systematic thought (area 1) helps to create healthy habits and can establish a healthier lifestyle. To this we add a rational healthy diet with the help of modern technologies in Leech therapy and Hirudopractice (area 2), a complex of modern physiotherapy and osteopathy (area 4), with a useful set of nutritional supplements and functional accessories (area 3), resulting in a clearly optimised mode of life. Using these methods you will see quite dramatic changes, orientated to restore human micro-circulation and resulting in good health and quality of life.

Summarising, QuadraCare in Hirudotherapy (QC) represents the very latest developments in modern technologies and scientific discoveries within complementary and holistic medicine. It incorporates a modern complex of complementary medicine diagnosis, a homeopathic approach, food supplements, a particular set of workouts for capillary system action, and the Chinese ‘meridian’ method using biologically active points for leech applications. This unique package effectively helps improve the micro-circulation in the human body, reducing post-treatment reactions (and other issues) and creating particular conditions in our body to re-balance, re-build and even enhance most of its functions. If a patient is still considered to have to be using some chemical drugs, they would work quicker and better, providing more positive results and less damage for general human health (possibly with a lower dosage).Nevertheless recovery of health by using live medicinal leech on its own differs from the traditional way of treatment with drugs, as the leech is an animal having a natural biological structure.

Live leech application as an important part of QuadraCare in Hirudotherapy (QC): Medicines dull symptoms of illness, whereas remedy/health recovery using leech therapy eliminates the cause of the illness itself. The leech, by biting the skin, injects into the body of the patient over 100 bioactive substances; however it selectively directs just those substances which are necessary to uniquely cure the person’s ailments.The leech bite irritates receptors in the skin, triggering activity of the internal organs. At the point of the leech bite a very light painful sensation may occur which passes in some minutes. Visible signs at the point of the leech bite are a small trace on the skin for a short time.

The leech’s saliva contains anti-inflammatory/anaesthetic/antiseptic substances and prevents blood from clotting, but all of these substances can also activate chronic illnesses or inflammatory processes. After the second or third session of treatment the state of the patient’s health very frequently worsens, however this is a normal part of the natural process, does not represent any health danger and hence should not be a worry. Healers call this process ‘a response reaction of the organism’ to the action of secretions of the leeches’ salivary glands. The state of health usually improves only after the fourth or fifth session of treatment. By the leeches ‘blood letting’ from a human body, microbes, toxins, salts and ballast substances are eliminated, thus the organism is cleared in natural way. In addition it promotes the improvement of the person’s blood circulation, and (most importantly) leads to the normalisation and improvement of capillary circulation, which cannot be achieved using chemical reactions.

When proper blood circulation is restored, connections are re-established between the separate organs and the correct activation of local and general immune reactions can proceed. Because of the difference in osmotic pressure due to the leech secretions, organism fluids start to move from the internal organs to the surface of the skin, thus the property of the leech bite wound to continue bleeding encourages the movement of even previously immobile fluids. This also continues after the leech has detached.

When the leech drops off the skin, the wound continues to bleed plentifully and patients should not be afraid of this part of the natural process. Conversely only slight and/or short–term bleeding indicates impaired blood circulation (to restore this circulation leeches can be applied at exactly the same place). Bleeding lasts for some hours (about 12-24) and the patient loses approximately 20-30 ml of blood and lymph mixture. It is very important to understand that this is not a pure blood loss, but blood and lymph mixture which is a healthy process, not dangerous to the patient.

The course of treatment, the number of leeches used, and their application is determined by a qualified (QC) specialist or Leech therapy consultant & hirudo practitioner. Such a person should have a certificate of completion of a course (and/or membership approval) with the British Association of Hirudotherapy [BAH] which has covered practical and theoretical hirudotherapy knowledge.

The leech has a local and a general influence on a person’s organism:
Local influence is accompanied by bleeding at the point of  the bite, itchiness and reddening of the skin, and possible inflammation of the lymph nodes. Application and lubrication with leech products (such as ‘Hiruda’ ointment) provides rapid relief of itchiness. If the itch persists lubrication with the ointment should be applied 2-3 times per day. The general reaction is accompanied by improvement or deterioration in mood and the general state of health. The person usually becomes calmer, sleeps better, and adequately reacts to life’s problems. In some cases after a procedure trembling, drowsiness, weakness, and an increase in body temperature can occur.

IMPORTANT NOTE there is a small potential risk in the transmission of human specific Aeromonas bacteria found in the leech’s gut. To minimise this risk we recommend (and ourselves use) a procedure of natural staging of the leeches’ application, allowing time for the leeches to be fully saturated and then self-detach. This, not forcing premature withdrawal, is because of the “antiseptic effect” which happens at the very last moment before leech detaches itself. Naturally the antiseptic component is sprayed into the human’s blood system with leech saliva. In rare cases of an excessive reaction from the Aeromonas bacteria (manifested by extreme redness, itching and swelling), one should be immediately be prescribed a course of antibiotics.

Leeches usually stay attached at a truly congested site for between 15 and 90 minutes, depending on the health problems of a patient. Individual leeches can only be used once (as they are “single use only biological needles”). The used leech is then disposed of in a container with special disinfectant solution and subsequently destroyed by cremation, undertaken by the specially approved the UK Medical Waste Company (as a BAH contractor). The leech is never used twice, in accordance with epidemiological hygienic sanitary requirements.

Once the leech has detached, the bite wound should be covered with a sterile bandage and an absorbent dressing pack. When the pack is impregnated with blood, another may be applied or replaced by a new dry one. The sterile dressing could remain on for 24 hours, or less if bleeding ceases, after which a sterile plaster should be applied to the wound for one more day. Following the procedure it is not advised for the patient to take a bath, wash the application area or go to the swimming pool for two days. During this remedy using medicinal leeches the effect of some medicines is increased, thus it is important to inform the leech therapy consultant & hirudo practitioner of any medical conditions and medication in use. During the leech treatment alcohol abuse, drug use, taking herbaceous or biologically active preparations is not recommended. If the patient does not feel any health improvement following the completed course of treatment, it is an indication that too few leeches were used; in which case the treatment should be repeated within 1-3 months with a larger amount of leeches (possibly also including leech products).

IMPORTANT NOTE: In an effort to prevent infectious disease, do not experiment or try to use any other species of leech not offered by representatives of the British Association of Hirudotherapy [BAH], or indeed under any doubtful circumstances. A cheap price does not guarantee the quality of leeches, and especially does not guarantee adequate professional execution of the procedure. Therefore we are extremely concerned about leech quality and always confirm with our suppliers two main conditions:

  1. When the leech was born and what was given as food, especially for the very last feeding? Also for how long and at what temperature the leech was on a forced starvation?
  2. Whether they could provide identical weight/size leeches?

Leech allergies arise very rarely. In the case of a patient’s concern of their susceptibility to allergy, a biological test can be performed prior to any treatment. This test consists of a single leech application at the lower back area. If the person is allergic to the substances contained in the leech saliva, it will appear obvious within 2-3 minutes (at which time the leech would be detached immediately). A later allergic reaction, which could appear after about 12 hours, usually passes by itself and does not cause serious health problems. Any unclear questions about health changes should be addressed directly to the leech therapy consultant & hirudo practitioner, as only the healer possessing specialist knowledge of (QC) can adequately assess patient’s condition and advise how patient should proceed according to the condition.

Leeches should be applied only by the leech therapy consultant & hirudo practitioner nursing staff. Before applying leeches a leech therapy consultant & hirudo practitioner should be able to evaluate three main conditions:

  1. the condition of the leech: leech therapy consultant & hirudo practitioner should be aware of medical leech type – medicinalis, verbana, officinalis or other -, the leech birth date and last breeding date
  2. The content of the leech: for how long was leech forcibly on starvation and what temperature regime was applied
  3. The condition of the patient: diagnosis and current condition, also noting if there are any contra-indications for leech therapy.

Also when leech therapy consultant & hirudo practitioner is qualified as a “QuadraCare in Hirudotherapy (QC) specialist” they are trained to the highest level of professionalism. They should be able to provide for the patient: coaching, correct breathing techniques, a set of modern physiotherapy exercises, and (even more important) supervision and advice from BAH. Thus, being able to pass to the patient a specific combination of leech products and other food supplements, necessary to ensure the patient’s health improvement and the best preparation or post treatment care for live leech applications. This is what we mean by “The Integrative Quadracare: Focus on the Best World Experience Approach in Modern Leech therapy and Hirudopractice” or “QuadraCare in Hirudotherapy (QC)”, as a modern method, professional, safe and secure for our patients, sufficient and based on the evidence of good health practice and scientifically approved, comprehensive in its public presentation and being NHS prescriptions friendly.

We do not suggest applying directly on painful areas, nor do we suggest using more leeches during one session than absolutely necessary. We prefer our patients to know the truth before they agree to the treatment. There are proven scientific facts and discoveries introduced to BAH by ICCHP international experts, such as Prof. Albert Krashenyuk, Dr. Oleg Kamenev, Biologist Magdalene Westerndorff and others (who have investigated the neurological wave and sound effects of leeches, and also the use of leech capsules, creams and suppositories); following on from the discoveries of the British scientist Dr John B Haycraft, made around 1884. There are a lot of good healthy practice examples in Modern Leech therapy and Hirudopractice, but there still too few discoveries to prove most of the positive effects of using leeches and their products in the modern times. That’s why it’s so important to get supervision and the second opinion from medical practitioners, advisors, and other sources (conferences, knowledge sharing seminars, CPD training, etc.). BAH is able to ensure and provide the most benefits for clients and trainees.

There are no negative side effects to leech therapy so long as we use QuadraCare in Hirudotherapy (QC): a sufficient and comprehensive scheme for appropriate leech products, necessary food supplements and other above mentioned practices. In summary “as few high quality leeches as possible equals a more positive effect for the patient!”

THE MAIN BENEFITS OF “QUADRACARE IN HIRUDOTHERAPY (QC)

A) COMPREHENSIVE WORLD WIDE BEST EXPERIENCE READY TO USE FOR ALL

1. The British Association of Hirudotherapy [BAH] works under “umbrella” of International good practice, experience, empirical evidence, ethical conduct, and the latest scientific discoveries and innovations in Leech therapy and Hirudopractice, focusing on what is useful for the British public and the NHS. Though not too much scientific research and practical experience in this field happens in the UK currently, however it is important to note that BAH is involved in the UK expert contribution, e.g. Dr. Ashley Croft, known by his bulletins within the group of international colleagues, is a BAH honorary member.

2. There are still not enough scientific discoveries to be able to explain all positive effects on the human body and its systems using leeches. Most old-fashioned leech therapy practitioners just know that it works well, but they cannot explain why. BAH uses the most prominent leech therapy practitioners’ experience globally and not following only one school or method. Therefore BAH is free to choose any supervisor or advice suitable for our clients and trainees, empowering them with high standard professional information, ready to use practically with no limitations of geo-political, cultural, religious or other conditions.

3. Our modern society suffers from stress, drugs, overuse of chemical medicine and its bad side effects, pollution, GM food, bad habits and ecology. Similar problems can exist with leeches. They should also be free of these factors, only then can we expect good results. BAH works only in partnership with reliable approved leech farms.

B) CLARITY AND TRANSPARANCY AT ALL STAGES

This creates a unique connection between BAH members, trainer and trainee, also patient and practitioner, which we can describe as trust, rapport, teamwork, respect, support and empathy. That positive base works on both sides: the patient experiences less stress and depression; the treatment process is much smooth and quicker; a practitioner feels more content and appreciated (because of the power of the method they are using and the supervision they consistently receive).

C) THE NEWEST TECHNOLOGIES INTRODUCED & EXPLAINED ACCORDING TO THE CONDITION OF THE PATIENT AT ANY TREATMENT STAGE

1. Everyone is made aware from the very first intake-session of the 3 effects which live leech produce during each professionally performed application: anaesthesia in the first place; an injection directly into the blood system of more than 100 biologically active ingredients secondly; antiseptic at the last stage, just before the leech detaches from the body.

2. Every patient and trainee is explained the latest discovery of the Phenomenon of Biological Adaptation for the leech bite and its saliva. This usually happens after 10 applications and means that post-application bleeding will be over a shorter and more consistent time. This then allows us to apply more leeches, losing much less blood. Also it means that we are in full control of the process of leech therapy and the prescribed scheme for live leech applications, instilling in the patient more confidence in their treatment.

3. Each patient and trainee is introduced to the “Wave effect during a live leech application”, the scientific discovery of Prof. Albert Krashenyuk. Meaning they have an understanding of what is happening in the human brain during the leech application and how well the hormonal system is performing during the session (even up to 15 minutes after the leech detaches), clarifying why during each leech application there should not be any disturbing factors (phone calls, computer, TV, discussions, etc.)

D) TRIPLE IMPACT USEFUL AT ANY LEVEL OF THE NHS SYSTEM

  1. Good prevention and preparation before any treatment as the body’s microcirculation is improved significantly
  2. Perfect drainage during and after any surgery or treatment for the lymphatic and blood system
  3. Sufficient cleaning for the human body’s organs (liver, kidney, lungs, etc.) and systems after chemical treatment, including chemotherapy and cancer removal operations.

E) STRESS-FREE RELAXING APPROACH

BAH uses a gentle approach for gradually building new good habits into the daily routine, providing life coaching in order to:

  1. Exclude some of the worst habits
  2. Exchange some of bad habits for better ones
  3. Add some useful and healthier habits

F) STRONG EVIDENCE BASED AND SCIENTIFICALLY PROVED TREATMENT

1. In some cases following the natural detachment of leeches many of them die, indicating the residual levels of previously used chemical drugs and other toxins long retained in the patient’s body. Diagnostically it means that we can control the moment when the body intensifies self-cleansing and is able to extract (by dramatically improved micro-circulation) most of these undesired substances from the blood and lymphatic system. Therefore by the percentage of dead leeches at each stage of treatment, we can deduce how well the cleansing process is proceeding.

2. After treatment the human body is much better balanced from an energy perspective (we refer to that as energological balance) and demonstrates a great response to QuadraCare in Hirudotherapy. A person feels much more energised, stronger, more positive, and encouraged for more good results by following a prescribed treatment scheme that can guarantee general health enhancement and a stronger immune system.

3. Knowing about Prof. Albert Krashenyuk’s “Wave Effect” and how these high frequency signals interacts with human brain activity, we can assume an increased level of naturally produced neurone-mediators or natural hormones during a live leech application. To quote extreme cases, our supervisors have performed case studies and have experience of the dramatically increased level of cleansing and neutralising the impact of nuclear radiation and ultra-magnetic waves by leech therapy e.g. workers at nuclear power stations, the consequences after explosions, mobile phones, computers, etc. A very good example of this was discussed at the 2008 Roundtable with the Chernobyl Rescue Team at the Lithuanian Parliament, where doctors/scientists together with their patients presented the beneficial effects after applications of a whole complex of (QC), including live leech applications.

G) A COMPLEX METHOD FOR GENERAL HEALTH IMPROVEMENT PROVIDES:

  1. Cleansing
  2. Regulation
  3. Re-building

Therefore in conclusion, complementary medicine treatment, a homeopathic approach, food supplements, physical workouts and Chinese ‘meridian’ methods (used separately by other healers and doctors) are quite acceptable in the UK, but invasive and radical live leech applications and leech product therapy as yet requires a different approach.

It is therefore called “The Integrative Quadracare: Focus on the Best World Experience Approach in Modern Leech therapy and HirudopracticeorQuadraCare in Hirudotherapy (QC)” and explained in a particular way that is designed to be attractive to the British public and media i.e. much in the same way as in Indian cuisine, where the “Balti” and “Tikka Masala” dishes were introduced for the British palette many years ago. Bearing in mind that a leech bite could sound horrifying to most British people, we should be extremely careful and flexible when applying Hirudotherapy. We are therefore very dependent upon the reputation and experience of the British Association of Hirudotherapy [BAH] and each individual leech therapy consultant & hirudo practitioner, especially a QuadraCare in Hirudotherapy (QC)specialist, is trained and/or approved by BAH.

CORE CURRICULUM (MINIMUM/BASELINE EDUCATIONAL REQUIREMENT FOR SAFE PRACTICE)

For today the ancient approach of Hirudotherapy is enriched with many scientific discoveries, such as the addition of the Homeopathic approach (“Great power but using small doses”) and knowledge of food supplements, osteopathy, modern physiotherapy and the biological active points from Chinese Medicine. We advocate the use of “The Integrative Quadracare: Focus on the Best World Experience Approach in Modern Leech therapy and Hirudopractice” (the short version: QuadraCare in Hirudotherapy or QC) as the most professional, secure and safe for our patients, comprehensively based on the evidence of healthy practice and approved science originated from eminent doctors and scientists. This changes and elevates the status of the “Leech therapy consultant & hirudo practitioner” to, under our tutelage and approval, who we refer to as the “QuadraCare in Hirudotherapy specialist”.

Such a person should have a certificate of completion of a recognised course (and/or membership approval) with the British Association of Hirudotherapy [BAH], having covered practical and theoretical knowledge in QuadraCare in Hirudotherapy and should be able to evaluate three main conditions:

  1. The condition of leech: the medical leech type – medicinalis, verbana, orientalis, officinalis, and also the leech birth date and last breeding date.
  2. The content of leech: for how long was the leech forcibly starved and what temperature regime was applied.
  3. The condition of the patient: diagnosis and current condition, also if there are any contra-indications for leech therapy.

For prevention, early diagnosis and self-healing you do not have to be a western medicine trained doctor, because every human being in the 21st century interested in high quality health (especially its enhancement) is intelligent and smart enough to learn and apply leech according to BAH recommendations. Nevertheless to be able apply the complex scheme for QuadraCare in Hirudotherapy you have to acquire sufficient knowledge from many areas, as leech therapy on its own is just a good tool to create the necessary conditions for a human body’s recovery, but does not give such a good result alongside serious medical treatment these days. This is because, if a patient is being treated with chemical drugs, their impact could deter the action of a live leech application, having serious consequences in being able to predict what may happen and how the patient could react. Therefore the prescribed scheme of the use of live leech is very important, and it could be crucial to decide in certain circumstances NOT TO PRESCRIBE ANY LIVE LEECHES.

Please find below the described structure of our training system in Hirudotherapy as a part of The Integrative Quadracare: Focus on the Best World Experience Approach in Modern Leech therapy and Hirudopractice:

1st level – Hirudotherapy for self healing purposes only 

To start with, we offer the “First Instruction in Hirudotherapy” fundamental course.

It deals with the basics of hirudotherapy, care of leech and how to apply them in a safe and professional manner. Some medical knowledge helps but is not essential. The theoretical and background information is provided online (for this part of the training BAH estimates 7 hours self-study); then in addition a practical 3-day (at least 15 hours) training is provided, initiated by a one-to-one session. After completion of the practical part, appropriate publications are provided online for further development (for this part of the training BAH recommends 28 hours at least self-study).

The trainee would then receive a certificate of attendance and be an associate member of the BAH and also of the British Complementary Medicine Association for an unlimited period of time. This gives trainees the possibility to receive free supervision and advice from the these organisations. Also BAH further offers to develop practical skills and theoretical knowledge during CPD seminars (50 hours per year at least) and public knowledge sharing meetings (3 hour sessions plus, once a month).

For this level BAH encourages a total of 50 hours of practical experience in Hirudotherapy.

2nd level – for Hirudotherapy practitioners

If a trainee wishes to then work with fee paying clients, they would be required to perform a number of practical applications on themselves and/or family and friends for a period of at least 3-4 months. Each of these applications would need to be documented and reported to BAH as proof of experience and professional competence, and also a specific BAH questionnaire successfully completed. After being approved at this stage (BAH suggest it should take at least 100 practical sessions with full documentation for 150 hours, including self-study of material provided directly online and via internet links), they will receive a Hirudotherapy Practitioner Certificate as confirmation of readiness to begin practical sessions with the fee paying clients.

Alternatively we offer an online knowledge check (equivalent to answering the above mentioned BAH questionnaire) for membership for practitioners trained with other reliable training providers. BAH is aware of most of training centre activities and their reputations in the world via the International Co-operation Community of Hirudotherapy Practitioners [ICCHP] and also the World Hirudotherapy Association [WHA] (as Director of the BAH has been the secretary of ICCHP since 2012 and a full member of the WHA Organisers Committee since 2013).

For this level BAH credits a total of 200 hours of practical performance in Hirudotherapy.

3d level – for Quadracare in Hirudotherapy specialists

The next step, possible after 6 months from the previous training stage, is designed for only medically trained applicants interested in advanced live leech applications. It is a one day Accelerator Training (of not less than 6 hours) for the Fundamental Integral Course in Hirudotherapy, designed for experienced Hirudotherapy practitioners who would like to be able to introduce a wider range of complementary treatments necessary to ensure a patient’s health improvement and provide the best preparation/aftercare treatment for live leech applications e.g. techniques for correct breathing, a set of modern physiotherapy exercises. Even more importantly they are able to get supervision and advice from BAH’s experts and pass it directly to the patient on a particular schemes of leech product and food supplement combinations for their specific case.

The trainee is then asked to present documentary evidence of his practical activities for at least 300 hours and least 50 + 24 = 74 hours for Continual Professional Development and/or knowledge sharing seminars with BAH or other reliable training provider. After the completion of all requirements the trainee can receive their certificate of “Advanced Applications and Modern Technologies in Leech Therapy & Hirudopractice” and in addition a certificate of “The Integrative Quadracare: Focus on the Best World Experience Approach in Modern Leech therapy and Hirudopractice“.

For this level BAH credits a total of 580 hours of practical performance (200 for 1st and 2nd levels and 300 + 50 + 24 + 6 = 380 for the 3d level).

4th level – for advanced QuadraCare in Hirudotherapy practitioners

In order to be approved to spread the QuadraCare in Hirudotherapy around the world, possible only for people with all 3 levels of BAH training system completed (or alternatively the 1st and 2nd levels accepted via our knowledge check from reliable training providers and the 3rd provided by BAH) and also after practical performance in Hirudotherapy for at least 24 months. BAH then asks for documentary evidence of experience, at least 50 hours per year Continual Professional Development and 20 hours per year participation in knowledge sharing seminars with BAH or other reliable training providers to achieve the 4th Level, “Advanced Quadracare in Hirudotherapy Practitioner” status.

In this case BAH then offers, following a further Accelerator Day (6 hours) of “Personal Presentation in the Integrative Quadracare”, the trainee a “The Licensed Trainer in Integrative Quadracare for the British Association of Hirudotherapy” certificate with the possibility of opening new approved training centres outside the UK.

For this level BAH estimates not less than total of 1400 hours of practical performance in Hirudotherapy (9 months to pass initial three levels and 15 months to prepare for the 4th level, up to a total of 24 months). BAH expects that within 15 months there would be 750 hours of practical performance plus 580 hours (previously counted for initial 3 levels of the training) plus 70 hours for CPD and/or knowledge sharing seminars – all documentary evidence required.

We can help our trainee at every step of this process (or as far as they wish to take it), provide leech products & food supplements from reliable partners, also high quality leeches, business paperwork and the supervision of our experts; all these being the benefits received by a BAH member. Also the trainee would be informed of any future courses, conferences and events.

To reiterate, after completing 3rd  and 4th levels”, the BAH trainee should be able to introduce a wide range of complementary treatments necessary to ensure a patient’s health improvement and provide the best preparation/aftercare treatment for live leech applications e.g. techniques for correct breathing, a set of modern physiotherapy exercises. Even more importantly they are able to get supervision and advice from BAH’s experts and pass it directly to the patient on a particular schemes of leech product and food supplement combinations for their specific case. This is what we mean by “The Integrative Quadracare: Focus on the Best World Experience Approach in Modern Leech therapy and Hirudopractice” or “QuadraCare in Hirudotherapy” as a modern method used in a professional, safe and secure manner for our patients, sufficient and based on the evidence of good healthy practice and scientific approval, comprehensive in its public presentation and provided in an NHS prescription friendly way.

Patient Acceptability

As with most health enhancing and medical procedures, a patient’s attitude towards the use of leeches depends largely on the physician’s skill in clearly explaining the process. It may help to mention that this age-old procedure is quite painless mainly because the area to be treated is usually enervated; the leech produces its own anaesthetic. In most cases patient receptiveness is excellent.

The leech has local and general influence on a person’s organism:

–          Local influence is accompanied by bleeding at the point of bite, the itchiness and reddening of the skin, and possible inflammation of the lymph nodes. Application and lubrication with ‘Hiruda’ ointment provides rapid relief of itchiness. If the itch persists, lubrication with the ointment should be applied 2-3 times per day.

–          The general reaction is accompanied by improvement or deterioration in mood and the general state of health. The person usually becomes calmer, sleeps better, and adequately reacts to life’s problems.In some cases after a procedure trembling, drowsiness, weakness, and an increase in body temperature can appear.

Any unclear questions about health changes should be addressed directly to the Quadracare in Hirudotherapy consultant and/or referred to BAH, as only the healer possessing specialist knowledge of hirudotherapy. The Consultant can adequately assess the condition and advise how one should proceed according to the condition. Leeches should be applied only by a hirudotherapy consultant or leech-practitioner nursing staff.

Applying Leeches

1. Clean the patient’s skin thoroughly with soap and water to remove all substances with a strong odour or taste, such as traces of operative prep fluids or saline. Rinse cleaned areas with plain water.

2. Dampen a square of gauze with water and cut a 1cm hole in the middle. Place the gauze on the patient with the hole in close contact with the area to be treated. This will form a barrier to prevent the leech from wandering.

3. Steer the head of the leech to the hole in the gauze. Attachment generally occurs quickly. However, if the leech is reluctant to bite, try:

1) Warm water compress;

 2) A few drops of soft alcohol (7-13%) in a dish with the leech for not more than 40 seconds;

3) If above mentioned approaches did not work, make a small needle prick on the skin to produce a tiny droplet of blood (which should result in enthusiastic attachment eventually).

4. Once the leech is attached, it will likely remain safely in place until fully distended. The gauze square can be removed and used elsewhere without disturbing the animal. However, it is important that the site be checked continuously to ensure the leech hasn’t moved.

5. Leeches usually stay attached at a truly congested site for 30 to 90 minutes. If the blood supply is poor (in which case the diagnosis of venous congestion is probably wrong), they may detach prematurely and attempt to wander to another site, for example, normal skin. Leech movement can be prevented by simple physical persuasion, but the best way to avoid wandering is to pre-cut holes in a sheet of the “Op Site” dressing, and to apply this to the treatment area.

6. Leeches may simply drop off the skin when satisfied and will not attempt to bite again. They should then be placed in a jar and labelled with the patient’s name. This will avoid confusion between used and unused animal and to prevent use on another patient.

7. Leech allergies arise very rarely. In the case of a patient’s concern of their susceptibility to allergy, a biological test will be performed prior to any treatment. This test consists of a two leeches applied to the sacral vertebra area. If the person is allergic to the substances contained in the leech saliva, it will appear obvious within 2-3 minutes (the leech will be detached immediately at any reaction or after this time). A later allergic reaction, which could appear after about 12 hours, usually passes by itself and does not cause serious health problems.

8. Such a person should have a certificate of completion of a course which covers the practical and theoretical hirudotherapy knowledge.

9. The animals should be applied in adequate numbers to the general area of maximal congestion. The head (or biting end) of the animal can be recognised by its searching movements, while the tail end is used mostly as a sucker for fixation. It is best to use the hungriest (normally the smallest) leeches first. Do not use forceps forcibly on the leech.

10. Leeches usually stay attached at a truly congested site for between 15 and 90 minutes, depending on the health problems of a patient. Individual leeches can only be used once; the used leech is disposed of.During this remedy & by using medicinal leeches, the effect of some medicines is increased. It is important to inform the hirudotherapy consultant of any medical conditions and medication in use. During the leech treatment: alcohol abuse, drug use, taking herbaceous or biologically active preparations is not recommended. If the patient does not feel any health improvement after the completed course of treatment, it means that too few leeches were used; in that case the treatment should be continued or repeated in 1-3 months time.

In an effort to prevent infectious disease, do not experiment or try to use other species of leech not offered by representatives of the BAH, or indeed under doubtful circumstances. Cheap prices do not guarantee the quality of leeches, and especially does not guarantee adequate professional execution of the procedure.

Dealing With Leeches After Use

1. Once the leech is detached, the bite wound should be covered with a sterile bandage and an absorbent dressing pack. When the pack is impregnated with blood, another may be applied or replaced by a new dry one. The sterile dressing could remain on for 24 hours, or less if bleeding ceases; after which a sterile plaster should be applied to the wound for one more day. After the procedure it is not advised for the patient to take a bath, wash the application area or go to the swimming pool for two days.

2. Leeches which have been used on a patient should be disposed of by initially narcotizing them with 8% alcohol and then placing them in 70% alcohol in a galley-pot for 5 minutes and then discarding them via a sluice or incinerator. Individual leeches can only be used once (as they are “single use only biological needles”), the used leech is disposed of in a container with special disinfectant solution and then destroyed with a very low temperature and cremation with the specially approved the UK Medical Waste Company as a BAH contractor. The leech is never used twice, in accordance with epidemiological hygienic sanitary requirements.

3.  Return the Sharp Box with used frozen leeches and all unused leeches in sterile water to the representatives of the BAH. The BAH attitude is that each leech is very similar to that of a “Live needle with single use only”. In the near future, it is BAH intention is to establish The National Medical Leech Register for The United Kingdom, which will help to control the use of all leeches in the country.

Important Warning

  • NEVER re-use a leech on a second patient and ALWAYS return a used leech to the representatives of the BAH.

LEECH STORAGE CONDITIONS

The two most important things to avoid are heat and chlorinated tap water. Leeches can live for months on a blood meal so feeding is unnecessary.

  • TEMPERATURE: The leeches will survive quite happily in a refrigerator or in a cool place, provided thetemperature does not exceed 25°C. Special care and attention should be taken if theleeches are to be used in a heated hospital ward. Keep them as cool as possible until theyare needed. Never put leeches into direct sunlight.
  • WATER: Distilled water plus HIRUDOSALT™ is recommended. HIRUDOSALT™ is a speciallyformulated recipe for making up water ideally suited for maintenance of the medical leechHirudo medicinalis. Distilled water with HIRUDOSALT™ added is far superior todechlorinated tap water which contains unwelcome additives and the condition can vary throughout the year.Do not use distilled water alone as it will deplete the animals “ions”. Simply stir 0.5g ofHIRUDOSALT™ into each litre of distilled water. The water is now ready for use. Aerationis unnecessary.
  • CONTAINER: A lid is essential. Leeches are amphibious and like to crawl about. Perforations are advisedbut they must be very small indeed, as the leech body is elastic and capable of goingthrough remarkably small openings. A cloth cover secured tightly with string, rubber bandor tape is useful. Do not overcrowd. The greater the amount of water, the less it needschanging. No more than 50 leeches should go into a 2.5 litre container (The BAH recommends 3 litres volume glass jars as a Leech Containers).Whether you prefer to maintainthe leeches in water (or Hirudo/Mix gel), store them at the room temperature or in exceptional warm weather conditions inthe refrigerator (for the short time only as leech needs the oxygen) in the sterile or distilled water which has had 0.5g per litre of Hirudosalt™ added.

 

Indicators For Therapeutic Use Of Leeches

  • Cardio- vascular diseases:

              ischemic heart disease

             – hypertension/high blood pressure

             – myocardial infarction

             poor blood circulation

             – myocarditis

             – pre-strokeorpost-strokecondition

             – lower extremity arterial disease

             – arterial and vein thrombosis

             trophic ulcers

  • Proctology:

              haemorrhoids

  • Neurology:

              vessel disease of brain and spinal cord

              spine osteochondrosis

              radicalistic

              neuropathiesofskull, brain and cranial nerves

              neuritis, neurosis, neuralgia, insomnia

  • Urology:

              kidney stones

              kidney disease

              chronic prostate

              varicose veins in testicals, etc.

  • Skin diseases:

             – carbuncles and furuncles

              age spots

              scleroderma

              hair lose

              eczema, psoriasis

  • Dental Surgery:

              disease of the parodontium, disease of the oral cavity

  • Breach of metabolism:

              obesity, podagra, diathesis

  • Different injuries:

              contusions, broken skin, haematomas, oedema

  • Ear/Nose/Throat diseases:

              vestibular neuritis

              оtitis

              nose and sinus diseases

              chronic tonsillitis

              tinnitus

  • Оphtolmology:

              keratoconus, conjunctivitis

              detached retina

              inflammatory eye disease

              eye injuries

              glaucoma

  • Gastroenterology:

              chronic gastritis

              peptic ulcer disease

              cholecystitis

              gallstone disease

              colitis, pancreatitis

  • Endocrinology:

              diabetes

              cyst of thyroid gland

              goitre

  • Rheumatology:

              rheumatism

              rheumatoid arthritis

              scleroderma

  • Breathing system:

              bronchial asthma

              pneumonia

  • Genecology:

              mastitis, myoma, cysts

              fections and inflammatory diseases

              chronic uterine and appendage diseases

  •   Cosmetology:

              cellulite

              wrinkles

              bad skin colour

CONTRA-Indicators For Therapeutic Use Of Leeches

  1. Anaemia (C)
  2. Haemophilia (C)
  3. Pregnancy (C)
  4. Very low blood pressure (for a long time) (C)
  5. Exhaustion ( C )
  6. Strongly pronounced allergic reaction to insect bites (C)
  7. Any type of cancer (C)

 

2. HEALTH AND SAFETY REQUIREMENTS

All practitioners must comply with the provisions of the Health and Safety at Work Act 1974 and appropriate supporting regulations to ensure a safe and hygienic place of work for themselves, their colleagues and their clients.  The following are the basic standards required to comply with the above Act and are considered the minimum standards expected by the BAH for all its members’ practices. 

Workplace Floors, passages and stairways must be of sound construction, properly maintained and free from obstruction.  Electrical equipment will be maintained in an efficient and safe condition and suitable for use. The provision and maintenance of a comprehensive first aid kit is required in all workplaces. All workplaces shall have suitable and sufficient lighting, heating and ventilation provided and maintained as appropriate.

Fire Appropriate fire precautions shall be maintained at all times. Means of escape in case of fire shall be maintained and shall be kept free from obstruction at all times.

Storage Adequate provision for storage shall be provided for all equipment and items required for treatment. All storage must be suitably clean and in such a place so as to avoid any risk of contamination.

Sanitary Accommodation The sanitary accommodation shall be provided and maintained in a clean and hygienic condition. The accommodation must be supplied with a conveniently accessible washing facility which includes the provision of hot and cold water (or water at suitably controlled temperature), soap, and towels.

Waste Disposal All waste material and other litter shall be placed in a suitable covered leak proof receptacle and arrangements shall be made with a commercial waste disposal company for removal as and when necessary. Arrangements for clinical waste disposal shall be arranged as appropriate individually and for used leeches ONLY via BAH.

Clinical Hygiene All parts of the premises used in connection with Quadracare in hirudotherapy treatments must be kept clean and in such good repair as to enable them to be effectively cleaned. All tables, couches and seats used for the treatment of clients shall have smooth impervious surfaces, thoroughly cleaned using a suitable disinfectant at the end of each working day and after any spillage on the surface.

Where appropriate the skin in the area of the leech application site must be appropriately cleansed. Prior to conducting hirudotherapy the practitioner will wash his/her hands and forearms with soap and hot water, drying with a clean disposable towel. A wash hand basin with continuous supplies of hot and cold water (or water at suitably controlled temperature), with adequate supplies of soap, towels and nailbrushes must be provided in each treatment room.

Treatment Couches Treatment couches should be at waist height with a wash-down vinyl surface, an open face hole, removable headrest and vinyl covered pillows. Surfaces are to be kept clean and free from blood residue and a disposable paper towel roll must be used. To sterilise the couch and other surfaces dilution of Sodium Hypochlorite is recommended.

Gowns and Towels These should be changed and cleaned after each use and free from stains as appropriate. A disposable paper towel roll must be used as opposed to cloth towels.

Other Trays, Cups and instruments Hirudo Medicinalis (and other types of medical leeches appointed in the BAH constitution and Code as single use only biological instruments) and other disposable instruments must be pre-packed and pre-sterilised and only used once before proper disposal in a puncture and leak-proof box that is clearly marked ‘sharps’. The box and its contents must be disposed of in a manner approved for clinical waste via BAH.

Personal Hygiene Hands and Finger nails must be scrubbed clean with antibacterial soaps between each patient. Paper masks must be used when in close contact with patients. Use sterilised plastic disposable gloves during leech application and withdrawal, or a sterilised cotton wool technique as appropriate. Disposable hand towels are recommended. Plastic gloves must be worn when examining skin disease. Refrain from smoking or consuming food in the treatment area.

INSURANCE Registered members of the BAH must not practice without adequate professional Indemnity, public liability and product cover insurance. The BAH and BCMA are responsible to produce evidence of insurance cover annually.

PROHIBITED TREATMENTS:  Abortion; Pregnancy related symptoms against the advice of a midwife or a medical doctor; Controlled infectious disease, which require hospitalisation in isolation; Treatment for cancer and other serious diseases should not be offered as a replacement to conventional medical treatment.

PRACTICE MANAGEMENT/COMMERCIAL ACTIVITIES Members should keep proper business records and conduct their affairs in a legal and responsible manner. Self-employed practitioners must submit annual accounts to the Tax Office.

PROVISION OF TRAINING Members will be required from time to time to attend further teaching seminars and lectures in order to keep up to date with current professional standards. Members are expected to keep up to date with new research and developments within the profession.

 

PART TWO

A. RELATIONSHIPS

A.1. RELATIONSHIPS WITH CLIENTS

NOTE: In order to make these statements more personal and clear BAH refers to every Quadracare in Hirudotherapy practitioner “YOU”.

A.1.1 GENERAL

A.1.1.1. You are free to choose whom you accept as a client. Having accepted a client you develop a relationship of trust with him/her. When a client consults you, his/her needs come first. You must never abuse that relationship.

A.1.1.2. Once you have accepted somebody as your client, you have a duty to provide him/her with an appropriate treatment or, if necessary, referral while he/she is under your care.

A.1.1.3. Members’ obligations to their patients are usually governed by the contractual relationship between them. There may be certain circumstances where there is no contractual relationship, e.g. in an emergency, but nonetheless members owe their patients a duty to act with reasonable care in accordance with the standards of professional skill expected of a member.

A.1.1.4. If you have good reason (possibly including the safeguarding of your own wellbeing) to terminate a series of treatments before their completion, where the client is requesting further sessions, you should negotiate this in person with the client, and where appropriate arrange for the care of the client to be assumed by another practitioner or other health professional via BAH.

A.1.1.5. The client under your care will rightly expect you, within reasonable limits, to make yourself available to them. You should ensure that your clients have clear information about your practice arrangements and how to communicate with them. Communication skills, underpinned by professional attitudes are essential to your competence as a practitioner. Where communication fails, good practice often fails. (It must be stressed, that one of the major faults with professionals of all kinds is a breakdown in communication and you must be aware of the possibility of disciplinary proceedings, where normally the burden may fall upon you to establish whether you have properly expressed yourself and communicated with the client. Therefore you should take special care in this area).

A.1.1.6. The relationship of a member of the Association and his/her patient is that of a professional with a client. The patient puts complete trust in a member’s integrity and it is the duty of members not to abuse this trust in any way. Proper moral conduct must always be paramount in members’ relations with patients.

A.1.1.7. The client can expect to find you sensitive, caring, understanding and non-judgemental. They should have your undivided and uninterrupted attention, and should know that you are making sufficient time available in which to deal properly with their needs. If you consider that the client is making unreasonable demands, you should explain politely that you have to balance the needs of more than one client and divide your time fairly between them. You should however be most courteous throughout.

A.1.1.8. Members must take care when explaining the procedures and treatment which they propose to administer, and should recognise the client’s right to refuse treatment or ignore advice. Treatment of a client is legally permitted only with his or her express or implied consent; the law regards an assault as the touching of one person by another without the former consent. It is unacceptable to solicit a client by any means to accept treatment when he or she has not specifically requested it.

A.1.1.9. You must ensure that what you and your client discuss with each other is heard and understood accurately on both sides. This may well be difficult in certain cases, but ultimately it is up to you. In deciding what information to give, you should use non-technical language, encouraging the client to ask questions and play a full part in the decision that has to be taken. If you feel after this that there is still doubt as to what the client understands, it is advisable to record this in the case notes. It is your prerogative to decide not to progress with a treatment if you are concerned about this possible lack of understanding.

A.1.1.10. For the purposes of ‘medical treatment’ the consent of a minor who is 16 to 18 years of age is effective in the absence of the consent of the parent or guardian by virtue of section 8 of the Family Law Act 1969. However, members should note that it is by no means certain that this extends to the therapies represented by the Association, and therefore they should obtain the consent of the parent or guardian of all clients under the age of 18 whenever this is possible. When the consent of the parent or guardian cannot be obtained, members are warned that they may, in legal terms, be committing an assault on the patient if they continue or commence treatment.

A.1.1.11. Members should ensure that they themselves are medically, physically, and psychologically fit to practice.

A.1.1.12. All members must be adequately insured to practice. Normally this will be through the BAH also via BCMA (British Complementary Medicine Association), only with a specialist insurance company. Private insurance is not recommended. The insurance policy must state provision for public and employee (if personnel are employed) liability and indemnity as well as the provision for professional treatments.

A.1.2. PROFESSIONAL PRACTICE

A.1.2.1. All members shall ensure with the BAH that their working conditions are suitable for the practice of their therapy.

A.1.2.2. Members must take care to see that their practices are managed with due diligence. (Due diligence is the level of judgment, care, prudence, determination, and activity that a person would reasonably be expected to do under particular circumstances). In particular, delegation of professional duties should be made only in favour of those qualified to accept them.

A.1.2.3. You should never allow a treatment to be prejudiced by your views about a client’s gender, ethnicity, disability, culture, beliefs, sexuality, lifestyle, age, social status or language difficulty. Your own beliefs and attitude must not come before the overriding interest of the client consulting you.

A.1.2.4. Members have an implicit duty, within the law, to keep all information concerning, and views formed about, patients entirely confidential between the member and the patient concerned. This same level of confidence must be maintained by assistants and receptionists when these are employed. Even the fact of a patient’s attendance at a member’s practice should be considered confidential, and should not be disclosed to a third party without the patient’s consent, including disclosure to their GP,  unless it is a matter of life and death, or the law requires the information to be divulged. When in doubt concerning matters that have legal implications a member would be wise to consult the Executive Committee. In particular members must ensure that they comply with applicable Data Protection legislation.

A.1.2.5. Members have to get necessary injections annually (T.B., Hepatitis B/Jaundice and Flu) provided by partners of the BAH, also be updated with HIV current cases (http://www.ukcoalition.org/epf/images01/hiv_is_your_business.pdf).

A.1.2.6. Members must ensure that they keep accurate, clear and comprehensive records of the treatment they administer to patients. It is important that this information can be easily understood as these are legal documents and may have to be produced in the case of any dispute.

A.1.2.7. In any case where you discover that the client is suffering from a condition which is outside your scope of practice, you must provide the client with details of another practitioner or other competent health professional and, with the client’s consent, you should make available to such a person all relevant information.

A.1.2.8. Practitioners working alone in their own homes or other premises should be aware of the need for caution, particularly when they are seeing a client they have not met before. It may be necessary sometimes to take sensible precautions, such as asking another person to be on the premises during a first session.

A.1.2.9. Practitioners can take up physical contact with the genitalia area during hirudotherapy treatment after discussion that the practitioner should do so for good clinical  reasons, and only if the client agrees. A specific consent form always has to be signed. This should be carefully recorded in the case notes.

A.1.2.10. There is always the possibility that some clients may experience any contact as invasive and intimate. You are therefore advised to ensure that before taking up any contact on your client’s body you have explained fully what you wish to do, and have obtained full consent.

A.1.3. YOUR CONTRACT WITH THE CLIENT

A.1.3.1. Whilst you may not have a document in writing, by agreeing to see the client you are entering into a legally binding contractual relationshipwith your client, the terms of which must be understood and accepted by both you and the client. It is your duty to ensure, during and after consultation, that the client understands what you can and cannot offer. Your side of the contract is to take reasonable care and use your professional knowledge and skill to advise or treat clients.

A.1.3.2. You must also ensure that anyone assisting you at your place of work is competent, bears their responsibilities, and is properly trained and supervised where necessary. You must not enter into any business relationship to provide care with anyone who is not a practitioner and does not carry professional indemnity insurance to cover him.

A.1.4. BOUNDARIES IN CLIENT RELATIONS

A.1.4.1. Clients may become your friends; you may find yourself called upon to treat professionally someone who is already a friend. There is no harm in this provided you keep a clear line, understood on both sides, between the social and the professional relationship. At no time must a past, present or anticipated personal relationship interferes with the impartial professional position you must maintain as a practitioner.A contractual relationship describes a relationship bound by an agreement or contract. It may range from a verbal agreement to a signed statement on a consultation form or a signed formal contract, which sets out in detail the services to be provided, and under what circumstances.

A.1.4.2. Serious difficulties will occur if you abuse your professional position to pursue an emotional (in a personal sense) or sexual relationship with a client or their close relative::this is bound to disturb the crucial relationship between practitioner and client. It is your professional duty not only to avoid putting yourself in such a position, but also to avoid any form of behaviour which might be misconstrued in this way.

A.1.4.3. You must be on your guard against inappropriately crossing the boundaries between your role as a practitioner and some other role. It is not possible to list every eventuality but you should develop an awareness of areas in which these problems may arise and act appropriately.

A.1.5. UNDUE INFLUENCE ON CLIENTS

A.1.5.1. Undue influence is a concept recognised by law where one in a potentially superior position by way of age, status or profession could influence a more vulnerable person. You, as a practitioner, meet clients who are thereby vulnerable and open to persuasive influences from you. You cannot exploit that position to your advantage as this would lead to a breach of trust.

Examples include:

  • • Pressurising clients to continue to have treatments;
  • • Subjecting clients to treatment that is unnecessary, or not in their best interests;
  • • Prolonging treatment beyond that which is appropriate;
  • • Deliberately withholding necessary treatment or referral to an expert;
  • • Imposing one’s beliefs on a client;
  • • Soliciting a client to give or lend you money or other benefits;
  • • Charging unreasonable fees or withholding information about fees and associated costs until they have been incurred;
  • • Putting pressure on a client to purchase a product which will bring to you financial reward.

A.2. RELATIONSHIPS WITH COLLEAGUES AND OTHER HEALTH PROFESSIONALS

A.2.1. You should work in co-operation with other practitioners and healthcare professionals to obtain the best result for each individual client and ensure that any other professional you delegate to, complies with your requirements.

A.2.2. You must refer clients to another practitioner where necessary, ensuring that the person to whom you have referred them is competent to carry out the treatment involved. When referring a client or when a client is transferred to another therapy you must provide the other practitioner with the relevant information about the client, ensuring that you have first obtained the client’s consent.

A.2.3. If something comes to light during a treatment, which you believe it is in the interests of the client’s health for the G.P. to know, you should advise your client to consult his G.P. or ask the client’s consent to inform the G.P. If in doubt, seek advice from the BAH.

A.2.4. You may comment on the ability of your professional colleagues when providing a reference or in other circumstances, provided that your comments are honest and sustainable. Similarly, you may use professional journals to advocate your way of doing things, so long as you avoid criticism of named colleagues and do not claim superiority for yourself.

A.2.5. However if you believe a colleague’s conduct, health or professional performance poses a threat to clients, you have a number of responsibilities. First, you should find out facts then, if appropriate, you must take action designed to protect clients. If necessary you should in confidence inform an employer, the BAH, or somebody else in authority. Any such comment must be honest and sustainable. If in doubt, take advice from an experienced colleague before doing anything.

A.2.6. A practitioner shall not undertake the treatment of a client known to be under the care of a fellow practitioner without the consent of that practitioner, except in an emergency or if satisfied that the former practitioner has been duly informed of the transfer.

A.2.7. If a client chooses for personal reasons to transfer to another practitioner or member without the knowledge or recommendation of the original practitioner or member, it would be advisable as a matter of courtesy for the transferee practitioner or member to inform the original practitioner or member before making any further arrangements, so that any relevant information may be exchanged.

A.2.8. No matter how justified a member may feel in holding critical views of a colleague’s or other practitioner’s competence or behaviour, it is unprofessional and would be considered unethical that he or she should communicate such an opinion to a third party.

A.2.9. If any dispute arises between members regarding their professional practice, the matter should be referred to the Executive Committee. If a satisfactory outcome is not reached swiftly, the Executive Committee may refer to the BAH for final arbitration. If they were unable to adjudge the matter to the satisfaction of both parties, then the most likely outcome would be that both parties would be considered at fault and that only a civil action could resolve it.

A.2.10. Members must not countermand instructions or prescriptions given by a doctor.

A.2.11. Members must not advise a particular course of medical treatment, such as to undergo an operation or to take specific drugs. It must be left to the client to make his own decision in the light of medical advice.

A.2.12. Members must never give a medical diagnosis to a client in any circumstances; this is the responsibility of a registered medical practitioner. However, many members have a ‘gift’ of diagnosis and of discovering dysfunctions in the physical, emotional, mental and spiritual aspects. In this case the member may make a mention of any believed disorder which he may discover and advise the client to see the doctor for a medical diagnosis and record this action.

A.2.13. Where acting as an assistant or locum, a practitioner may not procure for the benefit of another practice any client of the principal’s practice, neither for the duration nor within six months of the termination of the agreement, without the written consent of the principal.

B CONSENT

B.1. NEED FOR INFORMED CONSENT

B.1.1. To ensure professional use of medical leeches Hirudo medicinalis, Verbana and Officinalis as Biological  equipment using the single use only principle, and to promote and protect the official method of disposal of medical leeches relevant to UK Law requirements before instituting any hirudotherapy treatment. You should ensure that informed consent to such treatment has been given to everyone client before each treatment. Failure to obtain informed consent could lead to civil proceedings and complaints to the BAH against you.

B.2. MEANING OF INFORMED CONSENT

B.2.1. Informed Consent means consent that is given by a person who has been supplied with all the necessary relevant information about the treatment.

B.2.2. The person by whom the treatment is sought must possess the necessary intellectual capacity to give such consent. (You are referred to the sections B3 and B4 relating to children and those lacking intellectual capacity.) A person in the normal course of events has the intellectual capacity to give consent if he is able to:

  • • Understand in simple language what the treatment is, its purposes and why it is being
  • • Understand its principal benefits, possible consequences and alternatives.
  • • Retain the information for long enough to make an effective decision.
  • • Make a free choice.

B.2.3. A person will have legal capacity to give consent to a treatment if that person is within the age of the relevant law for giving such consent. As noted in section B5 below, the relevant age for the giving of such consent does differ and therefore it is up to you to ensure that you are aware of the particular law pertaining to the country you are in.

B.3. CHILDREN AND THOSE WITH A DISABILITY IN GENERAL

B.3.1. If a parent or guardian is present during a treatment then consent is implicit.

B.3.2. You must bear in mind that a child has a right to participate at any age in decisions about his or her treatment. Part of the therapist’s skill should be in knowing when a child is consenting to treatment or any aspect of a treatment. If this consent is not forthcoming, then you should not proceed with that treatment.

B.3.3. On parental consent, because of the practical difficulties involved in determining how the relevant law applies in any particular case, you are advised to act as follows:

B.3.4. If the client is under the age of 16, you are advised not to carry out a treatment unless you are satisfied that the client’s parents or other legal guardian have given their consent. Whilst the terms of the consent can be subject to circumstances, in the event that the parent or guardian is not present at the treatment, you are warned that there could be serious repercussions if it is later established that such consent did not exist. If for some reason the parent or guardian is not present, the consent should be obtained in writing for the particular treatment. A practitioner could find himself facing disciplinary proceedings if a complaint is made and it is established that no such consent was ever given.

B.3.5. There might be extremely rare circumstances where you believe that you should treat a child under the age of 16 without parental consent. If this situation arises you should on no account treat the child without seeking advice from the BAH and/or a solicitor.

B.3.6. It will be noted that you are committed to being able to demonstrate in your particular hirudotherapy treatment or care of a child that you will safeguard the child from harm and have a positive and safe environment for the child or children concerned.

You must bear in mind the following:

  • • Recognise when the child might be at risk or harm from any circumstance, either connected with your treatment or otherwise.
  • • That the need may arise for working with and referring to other agencies.
  • • Confidentiality and when it may be necessary to break it.
  • • Record keeping.

B.4. CLIENTS OVER THE AGE OF 16 WHO DO NOT HAVE INTELLECTUAL CAPACITY

B.4.1. Where a client is over 16 and does not have the intellectual capacity to give informed consent (see paragraph B.2.2.), then before carrying out any treatment you should obtain the consent of the parent, guardian or other person with the care of the client. In doubt, you should seek advice from the BAH.

B.5. CLIENTS OVER THE AGE OF 16 BUT UNDER 18 WHO DO HAVE INTELLECTUAL CAPACITY

B.5.1 In the case of clients over the age of 16 but below the age of 18 who do have intellectual capacity, you are advised not to carry out any treatment unless you are satisfied that:

  • • The client has been given sufficient and relevant information allowing the form of consent to be given;
  • • The client has given informed consent;
  • • The client is actually not below the age of 16 – in other words check from the date of Birth;
  • • Generally it is safer, if possible, to obtain the informed consent of the parent or guardian but this is not mandatory. It is a matter of your informed or considered opinion that you must note on your records in any event.

(You should note that the age of consent is different in different parts of the United Kingdom. You must therefore ensure that you are aware of the law relating to the area. Consent to the treatment of a person over the age of 16, but under the age of 18 may be given by the client or the client’s parent or other legal guardian. All of these people have an equal right to give consent but it is not necessary to obtain consent from more than one of them. In the event of a conflict between a client and the parent or guardian or between parents, you should seek legal advice)

 

C. CLIENTS’ RECORDS AND CONFIDENTIALITY

C.1. GENERAL RULE OF CONFIDENTIALITY

C.1.1. Confidentiality underpins your relationship with your clients.

C.1.2. You should keep to yourself any personal information you learn or record, and the opinions you form in the course of your professional work. This duty extends to your staff.

C.1.3. You must ensure that confidential information which you are responsible for is securely protected and that you store it or dispose of it when no longer required. You must keep any records on any clients properly secured to protect them as well as possible against any theft, fire or any other disaster, and to ensure that if such an event should occur they are covered by insurance.

C.1.4. When you decide to disclose confidential information you must be prepared to explain and justify your decision.

C.1.5. You may need to allow your Inspector of Taxes to see your practice’s financial records but, to protect the client’s confidentiality in such circumstances; financial information should be kept separate from clinical notes.

C.1.5. Subject to the matters set out below, you shall not disclose to a third party any information about a client, including the identity of the client, either during or after the lifetime of the client, without the consent of the client or the client’s legal representative. You are responsible for taking all reasonable steps to ensure that this general principle is adhered to by any employee or agent, and any information relating to the client is protected from improper use when it is received, stored, transmitted or disposed of. If in doubt, you should take legal advice on the question of disclosure of any information.

C.2. EXCEPTIONS TO THE GENERAL RULES OF CONFIDENTIALITY

C.2.1. Exceptions to the rules of confidentiality are that you may disclose to third party information relating to the client:

  • • If the client has requested this;
  • • If you believe it to be in the client’s interest to disclose information to another health professional and the client has given his consent;
  • • If you believe that disclosure to someone other than a health professional is essential for the sake of the client’s health and the client has given his consent;
  • • If disclosure is required by Statute i.e. an Act of Parliament this will be concerned with issues such as Drug Trafficking and Terrorism;
  • • If you have been directed to disclose information by any official having a legal power ordering disclosure. These are officers appointed by Act of Parliament (Serious Fraud Office or Inland Revenue) or a court which can summons you as a witness. In all these cases written evidence of their powers to request the information should be provided;
  • • If upon seeking advice from the BAH or consulting your solicitor you have been advised that disclosure should be made in the public interest;
  • • If there is risk of harm to self or others;
  • • If, following an ethical process of decision making and acting in good faith, you decide that disclosure is for the greater good and is more important than privacy of the individual.

C.2.2. In each case, where disclosure is considered appropriate you shall:

  • • Inform the client before disclosure takes place unless it is advisable, or legally required, not to do so;
  • • So far as is reasonably practical, make clear to the client the extent of the information to be disclosed, the reason for the disclosure and the likely consequence of disclosure where to do so is appropriate;
  • • Disclose any such information as is relevant;
  • • Ensure as far as possible that the person to whom disclosure is made undertakes to hold information on the same terms as those to which you are subject;
  • • Record in writing the reasons for such disclosure clearly on any record for future use.

You are strongly advised to consult a solicitor if you are placed in a situation where the appropriate legal, ethical or moral path is not immediately apparent.

 

C.3. CONTENTS OF RECORDS

C.3.1. You must keep accurate, comprehensive, easily understood, contemporaneous signed and dated case notes including the following details:

  • • The person’s details: names, address, date of birth, telephone numbers;
  • • G.P.’s details if the client agrees;
  • • Any problems and symptoms reported by the client;
  • • Relevant medical and family history;
  • • The information or advice you give on the initial and any further treatment;
  • • The decisions made by you;
  • • Treatment you gave and any observations;

 

C.4. OWNERSHIP OF AND RESPONSIBILITY FOR RECORDS AS BETWEEN THERAPISTS

C.4.1. Where you work together with other therapists in any capacity, in the same practice or premises, whether as employer or employee or otherwise, you are advised to enter into a specific written agreement as to ownership of, and hence, responsibility for the records of clients whom you treat in that practice or those premises.

C.4.2. In the absence of any legal rule or such specific agreement as is mentioned immediately above to the contrary, clients’ records, correspondence and other records of a similar nature shall be deemed for the purposes of the provisions of this Code to be the property and responsibility of the therapist (if any) to whom the practice belongs. Ultimately however, it is for the client to choose if he or she wishes the records to be transferred elsewhere to another therapist and those records must be in their original form and forwarded immediately, subject to the payment of any reasonable administrative charges according to the limitations of current statutory policy.

C.4.3. In the case of a therapist working with other therapists, where there is any possibility of doubt on the part of a client, you have a responsibility for ensuring that each client has written confirmation of the name and status of the person who is responsible for the client’s day-to-day care, supervising the client’s overall treatment, responsible for their records, and the person to approach in the event of any problem with any treatment.

C.5. RETENTION OF CLIENTS’ RECORDS

C.5.1. Such records shall be retained in your custody for a period of 7 years from the date of the last visit the client made, except in the case of clients under the age of 21;

C.5.2. Where records should be so retained until the client reaches the age of 21 plus 7 years. In the event of the client suffering from a mental or physical disability, so as to

preclude the client from being able to make his own decisions, the records should be kept for a period of 80 years (at least 15 years) and thereafter you should take legal guidance on the retention of such notes in particular circumstances.

C.5.3. You should make prior arrangements that on the closure of a practice for whatever reason, including death, the records of the clients should be deposited for safe keeping for not less than the period stated above, and notification of the deposit shall be given to the BAH and inserted as an advert in a newspaper circulated in the district in which the practice is located. Such records will be released from safe deposit upon instruction or a written authority of the client to whom they relate or such client’s legal representative.

 

C.6. DISPOSAL OF RECORDS

C.6.1. Destruction of records must be done securely, usually by shredding.

 

C.7. ACCESS TO RECORDS BY CLIENTS

C.7.1. The Data Protection Act 1998 gives clients the right of access to information held in their health care records by professionals such as you. This right extends also to people appointed on behalf of a client, and to the representatives of any deceased clients. The Act sets out the method of disclosure and your right to object, particularly if you feel this would not be in the client’s best interest. If necessary, you should seek advice from your own solicitor before disclosing records.

C.7.2. Subject to the last paragraph, and if so requested by a client in writing, you shall make available to the client, without delay, copies of any records or comments in accordance with the statutory provisions. Where you release original records for any reason to a client, for a purpose other than the transmission to another health professional, you are advised to obtain from the client an undertaking for their return, and to keep a copy for yourself. You are entitled to charge a reasonable administrative charge or fee in respect of such disclosure up to the current amount under the Data Protection Act 1998.

C.7.3. Any clinical records you keep on computer are subject to the provision of the Data Protection Act 1998 under which you may be required to “notify” the Information Commissioners office. To establish whether or not you are required to do so visit

www.informationcommissioner.gov.uk/eventual.aspx?id=2662)

People whose clinical records are kept on computer have the right to inspect them.

C.8. PROVISION OF INFORMATION CONTAINED IN HEALTH RECORDS TO LEGAL BODIES

C.8.1. If you are required or requested to give evidence or information to a Court or other

Tribunal you should do so with care. Whatever evidence is given you must be independent or impartial.

D.1. NO MEMBER MAY ADVERTISE, ALLOW HIS OR HER NAME TO BE ADVERTISED IN ANY WAY, OR BE INVOLVED IN ANY PUBLICITY, EXCEPT IN THE FORM LAID DOWN BY THE BAH.

D.1.1. Members are permitted to advertise providing that the advertisements do not make claims to cure any condition or illness.

D.1.2. Members are permitted to show the Association logo in an advertisement or on their headed notepaper, but it must not be used to advertise courses, which would give the impression that the member was acting as a representative of, or under the direction of the Association. Schools may use the BAH logo, whilst they hold current affiliated or accredited status.

D.1.3. Door plates, signs, etc., must not be considered a form of advertisement for the member and therefore must not appear to be such. Nothing more than the normal professional plate customary in the member’s area of practice is permitted.

D.1.4 (a) Letter headings, business cards and other stationery used in ‘private practice’ must be in a strictly professional style and may show only the business partners’ company name if used, member’s names, the designated letters BAH, contact details and if desired the Hirudotherapy Practitioner (also Quadracare in Hirudotherapy Specialist and Trainer-Consultant) provided this is accurate and not protected by statute. No deviation from this is allowed.

D.1.4 (b) Members are reminded that whether or not they practise under a recognised (by the BAH) business partners’ company name, it is a legal requirement that all names must be and included on all business stationery and at the premises of the practice.

Special rules apply to partnerships of more than 20 persons. Changes in partnerships should be noted as soon as they occur. Members involved in any such business should make themselves aware of the legal procedures relating to the running of same.

D.1.5. Members are advised to consult the BAH before participating in any form of publicity in the press, on television or radio because:

D.1.6. (a) There may be difficulties that can be avoided only by means of expert advice. When asked for comment by a newspaper, especially a national newspaper, members should realise that they have little or no control over the published form and content, nor is there any certainty that they will be quoted in full, or in the context they intend. Similar dangers exist in edited television or radio programmes.

D.1.6. (b) If not properly informed on the subject matter, a contributor could be responsible for the publication of incorrect information and thus be the cause of misleading information reaching the public.

D.1.6. (c) The Executive Committee and every member must take all steps to ensure that publicity originating from them is seemly and proper and does not in any way damage the public image of their profession or the BAH interests.

D.1.7. The circulation of literature intended to educate and inform the public about the work of the member, the scope of his or her services, etc. is perfectly acceptable.

D.1.8. Any reference to an individual member must be confined to his or her name, designated letters, BAH contact details.

D.1.9. The literature offered should be of a strictly professional style and format.

D.1.10. The literature should be distributed to members of the public only at their express wish, e.g. leaflets may be made available at exhibitions or seminars or in the reception area of the practice or posted at the request of an interested individual.

D.1.11. The use of such literature in mail shots or mass leafleting is not permitted. Included in this form of advertising would be ‘telephone sales’.

D.1.12. Members may publish books, pamphlets and articles of an informative nature about the therapies and other subjects relevant to them. Such publications must, however, be of scientific or educational value and must avoid matters that might be considered to be in the nature of personal advertising and should be limited to the author’s name, address, credentials and profession.

E. MEMBERS ARE PERMITTED TO ENGAGE IN THE TEACHING AT ANY SCHOOL OF HIRUDOTHERAPY IN WHICH THEY ARE QUALIFIED (AS RECOGNISED BY THE BAH), PROVIDED THAT:

E.1. Teaching is in the form of a workshop only.

E.2. No certification is issued other than a certificate of attendance.

E.3. If a member wishes to teach a formal course leading to a certificate of proficiency or a diploma, such courses must first be approved by the Executive Committee, and conform to the requirements laid down for affiliated training establishments.

 

F. MEMBERS OF THE BAH MAY BELONG TO OTHER ORGANISATIONS OR ASSOCIATIONS PROVIDED THAT THEY ACCEPT THEIR DUAL MEMBERSHIP DOES NOT GIVE THEM IMMUNITY FROM THIS CODE OF ETHICS.

F.1 Equal Opportunities Policy

This policy applies to the BAH full and associated members, it’s honourary members, officers from the Executive Committee and staff.

All references to the workplace are taken to mean the workplace of:

i) The BAH;

ii) A Training Establishment;

iii) The member – in this case it includes all places in which Hirudotherapy is practised.

F.2 The BAH is committed to a positive and pro-active approach to equal opportunities, which encourages, supports and values diversity. To this end it will fulfil its legal obligations under all relevant legislation whether current or introduced at a future date.

F.3 The BAH requires all members to whom this policy applies to behave in a non-discriminatory manner and expects their full support in changing institutional practices that deny or limit equality. All members have a duty whether or not contractual to comply with this policy statement and any breach of this will be regarded as serious misconduct and will be dealt with accordingly.

 

PART THREE

G. COMPLAINTS AND STATUTORY REQUIREMENTS

G.1. ACTION TO BE TAKEN

G.1.1. You may be an excellent practitioner but inevitably, from time to time, things may go wrong. You must act promptly and appropriately if you become aware of any error on your part or if a client complains of any aspect of your professional practice. In this event you are advised to promptly inform and seek guidance from your insurers or legal adviser first before consulting your client, but you must act promptly. You are also advised to seek advice and guidance from the Official BAH Complaint Journal.

G.1.2. You must ensure that clients have clear information as to how to make a complaint. When handling a complaint, you must act promptly and constructively, putting the interests of clients first and cooperating fully with any external investigation.

G.1.3. If someone complains about your apparent failure in care, they are entitled to a proper investigation and an explanation as to what has happened. You should take the initiative when putting things right. Because questions of compensation may arise, you should ensure that any apology is only given with the consent of your insurer. Any such apology should assure the client that you have taken full steps to prevent a recurrence.

H.1 DUTY OF CARE

H.1.2. Even if you have not charged a fee or do not believe that you entered into a contractual relationship, if you offer to treat a client you owe what is called in law a duty of care to that client. Accordingly, a client suffering injury or loss because you have not used reasonable skill and care in accordance with your profession and the norms for all hirudotherapy practitioners may result in a case against you for damages for negligence in the Civil Courts. In such a case the Court will not only judge whether the standard of care was reasonable, but whether the damage suffered was a direct result of a breach of your duty of care. You should therefore always maintain high professional standards to minimise any risk.

H.1.3. Errors of judgement or wrong decisions do not necessarily amount to negligence. The finding of the Court or Tribunal will depend on whether, on the balance of probability, the care you provided was reasonable. It therefore follows that you will minimise any risk if you:

  • • Maintain your professional standards;
  • • Keep abreast of developments in Complementary Care and general health issues;
  • • Stay within the limits of your personal and professional competence.

I. LEGAL LIMITATIONS

I.1. LEGAL LIMITATIONS ON WHAT YOU CAN DO

I.1.2. The law prohibits you from doing a number of specific things. Whilst this is not an exhaustive list, they include:

  • • Advertising treatments to cure cancer and carrying them out. But this does not preclude the palliative care of those suffering from this disease;
  • • Advertising yourself using a title protected by Statute, unless you are qualified to use said title;
  • • Diagnosing or performing tests on animals in any way, or giving advice following diagnosis by a registered veterinary surgeon where you countermand their instructions, unless you are yourself a registered veterinary surgeon;
  • • Attending women in childbirth, or attending for treatment for ten days thereafter without the jurisdiction and knowledge of the attending midwife, unless you hold an appropriate qualification in midwifery;
  • • Treating venereal disease as defined in the 1917 Venereal Diseases Act unless you are a medical practitioner;
  • • Using manipulation or vigorous massage unless you possess an appropriate qualification to do so;
  • • Prescribing remedies, herbs, supplements, oils etc unless your training qualifies you to do so;
  • • Signing certificates which require the signature of a registered medical practitioner.

 

J. DISEASES

J.1 NOTIFIABLE DISEASES

J.1.1. It is a statutory requirement that certain infectious diseases are notified to the Medical Officer of Health of the district in which your client resides or in which he is living when the disease is diagnosed. The person responsible for so notifying is the G.P. in charge of the case. If therefore, you suspect that you have discovered a notifiable disease, which clinically is identifiable as such, you should insist that a doctor is called in. Each Local Authority decides which diseases shall be notified in its area. There may be therefore local variations. The list includes:

  • • Acute encephalitis;
  • • Acute meningitis;
  • • Anthrax;
  • • Acute poliomyelitis;
  • • Cholera;
  • • Diphtheria;
  • • Dysentery;
  • • Food poisoning;
  • • Infective jaundice;
  • • Leprosy;
  • • Leptospirosis;
  • • Malaria;
  • • Measles;
  • • Ophthalmia neopatorum;
  • • Paratyphoid fever;
  • • Plague;
  • • Relapsing fever;
  • • Scarlet fever;
  • • Tetanus;
  • • Tuberculosis;
  • • Typhoid fever;
  • • Whooping cough;
  • • Yellow fever.

 

PART FOUR

K. DISCIPLINARY ACTION

K.1. BREACH OF THE ETHICAL CODE RENDERS MEMBERS LIABLE TO DISCIPLINARY ACTION WITH SUBSEQUENT LOSS OF MEMBERSHIP, PRIVILEGES AND BENEFITS OF THE ASSOCIATION

K.1.1. Members may be assured that all professional complaints and allegations, written or verbal, made against them, will receive an initial careful examination by the Executive Committee. The Executive Committee acts impartially and its decisions depend solely on  the facts and circumstances of each case. If it is deemed by the Executive Committee that there is a case to hear, then a Disciplinary Committee will be formed which will have the power to make recommendations and decisions concerning the member.

K.1.2. If any member requires advice on a professional or ethical problem, he or she may consult the Executive Committee. If the Executive Committee considers that giving advice may compromise the legal position of the Association, it may refer him or her to an independent adviser.

K.1.3. Members should be aware that the Executive Committee is obliged to accept the findings of a court of law, and is not able to re-open the investigation of facts that led to a finding. The Executive Committee will consider only the seriousness of the finding and any surrounding circumstances in mitigation.

K.1.4. The Disciplinary Committee will consist of no less than 3 people. It will include two members of the Executive Committee and one registered therapist.

K.1.5. The Disciplinary Committee can, after an initial pre-hearing discussion, choose to reject a complaint without a hearing. It cannot, however, choose to find in favour of the complainant without a hearing.

L. DISCIPLINARY PROCEDURES

L.1 Disciplinary Procedures – Breach of the Code of Ethics

L.1.2. A professional complaint or allegation made against a member will initially beconsidered by the Executive Committee.

L.1.3. If, upon such consideration, the Executive Committee find that the complaint or allegation is of such substance or seriousness as requires further investigation, the complaint or allegation can then be referred to a Disciplinary Committee.

L.1.4. If the complaint or allegation is deemed by the Executive Committee to be of a serious nature, the Executive Committee has the power to suspend the respondent’s membership of the Association until such times as the matter has been fully considered by the Disciplinary Committee.

L.1.5. Other than in exceptional circumstances, any complaint or allegation referred to the Disciplinary Committee which has been made orally, shall be required to be made in writing by the complainant for the consideration of the Disciplinary Committee. If a finding of the Court of Law is to be referred to, pre-Disciplinary Committee, then documentary evidence of the findings of the court shall be obtained.

L.1.6 The Disciplinary Committee shall fix a Disciplinary Hearing to consider the complaint or allegation. The complainant shall be invited to attend the hearing to give evidence. The complainant may call witnesses to give evidence if he or she so wishes; such witnesses should normally file written statements in advance. Any witness giving evidence, other than the respondent or complainant, may not be present during the hearing other than at the time when they give evidence.

L.1.7. The respondent member should attend the hearing. The respondent shall be invited to attend the hearing to give evidence. The respondent may call witnesses to give evidence if he or she so wishes; such witnesses should normally file written statements in advance.

L.1.8. The complainant and respondent may both be legally represented and will have the opportunity to ask questions of each other and of the witnesses; subject to the power of the Disciplinary Committee to regulate the hearing in order to ensure that it is conducted fairly.

L.1.9. The membership of the Disciplinary Committee in any individual case will be  notified in advance to both the complainant and the respondent. If any objection to members of the committee is taken, it shall be put in writing in advance of the hearing to the Executive Committee.

L.1.10. If a complainant or respondent wishes to have a supporter with them throughout the hearing, they should notify the Disciplinary Committee in advance. Such a supporter would not normally speak on behalf of the party they were supporting, nor represent them without the specific consent of the Disciplinary Committee.

L.1.11. At any stage before making a final decision the Disciplinary Committee may request additional information or seek professional advice.

L.1.12. The hearing may proceed in the absence of the respondent provided the Disciplinary Committee is satisfied that the notice of the hearing has been sent to the respondent by registered post to the last address they provided to the association.

L.1.13. Having heard and considered the evidence, and any submissions made, the Disciplinary Committee shall decide whether or not the professional complaint or allegation has been proved. The Disciplinary Committee may only find the complaint or allegation proved if they are satisfied, on the balance of probabilities, that the evidence has proved the professional complaint or allegation.

L.1.14. The decision of the Disciplinary Committee may be either unanimous or by majority. All members must vote with no abstentions permitted.

L.1.15. The Disciplinary Committee may either decide to announce their decision orally at the end of the hearing, or to reserve their decision and give it in writing within 7 days. In either event the reasons for the decision will be put in writing by the Disciplinary Committee and provided to both the complainant and the respondent.

L.1.16. If the Disciplinary Committee finds against the respondent, and then disciplinary action may take the following forms:

i) Written warning – this will be appropriate for minor breaches and will notify the respondent that if their standard of behaviour has not improved sufficiently or if further breaches which are of a similar nature have occurred within a specified time scale then a final written warning may be issued. Details of the required change in standard of behaviour will be made explicit in the written warning. The length of time for which this warning will remain on record will also be included within the letter.

ii) Final written warning – this can be given in the case of very serious breaches, or where the required improvement in an initial written warning has not been achieved, and it has been necessary to move to this stage. If a final written warning is necessary the member will be informed that if his/her conduct does not improve within a specified time, or further infringements occur, he/she will have his/her membership of the Association terminated.

iii) In the case of either i) or ii) above, the Disciplinary Committee may make certain requirements as to supervision or retraining. In the event that these are not adhered to, the Disciplinary Committee may reconsider the matter.

iv) Immediate termination of membership of the Association – this will occur in cases of gross misconduct or if the required improvement has not been made following either i) ii) or iii)

L.1.17. Where a member is expelled from the BAH as a result of disciplinary action, all previously awarded Association qualifications must be returned to the BAH, confirming that the contents of the letter are understood and will be abided by. The respondent’s name must also be removed from the list of members in accordance with the decision. A record of the decision and removal will be maintained by the Executive Committee of the BAH with no limit of time.

L.1.18. If the Executive Committee is, or becomes, aware of a therapist they have expelled being a member of any other professional or occupational body, then they will notify that body of the decisions made by the BAH and the reasons for those decisions.

L.1.19. No appeal lies to the BAH against the decision of the Disciplinary Committee. Any appeal against such a decision may only be made to the BAH.

L.1.20. All proceedings of the Disciplinary Committee should be conducted in private. When the hearing is complete and decisions made and acknowledged, all the paperwork should be filed in a secure place and retained by the Executive Committee with no limit of time.

L.1.21. It should be noted that the Disciplinary Committee has no power to make any orders relating to costs of the Disciplinary Hearing.

L.1.22. Registered Therapists are advised to keep the Executive Committee updated with any changes in their professional qualifications, about other annual (Health & Safety/Infection Control, Basic Life Support, Emergency First Aid) courses attended, also of any changes in personal/employment contact details.

L.1.23. Registered therapists are advised to seek appropriate support, advice and representation in the event of a complaint or concern being received about their practice by the Executive Committee.

L.1.24. A registered therapist who becomes aware of circumstances which might result in a complaint being made regarding his/her conduct can contact the Executive Committee and make a statement. The making of such a statement may be a consideration taken into account by the Disciplinary Committee when considering a case.

REFERENCES:

  • The British Complementary Medicine Association (BCMA) Code of Conduct;
  • The British Medicine Acupuncture Society (BMAS) Code of Ethics;
  • The Coaching Academy Code of Ethics;
  • Biopharm Leeches UK brochure;
  • The Constitution of Lithuanian Hirudologist Society;
  • Duremar Therapy, UK. The Consent form and Memo;
  • J.B. Kamenev “Leech treatment”, Moscow, 2006.

IN CONCLUSION:

The Code of Ethics and Conduct of the BAH may be updated from time to time.
It is finally reiterated that no document can cover all eventualities, and it is yet again emphasised that if in doubt the Executive Committee should be consulted.

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