29 Nov 2023
Updated and strengthened guidance to ensure safer practice by chiropractors who treat children under the age of 12 years has been published today.
The new Statement on paediatric care has been published by the Chiropractic Board of Australia (the Board) after considering the recommendations made by the Safer Care Victoria independent review into chiropractic spinal manipulation of children under 12 years. The Board also considered community needs and expectations, and specifically the strong support for consumer choice voiced in the public consultation of the independent review.
The Board examined how common themes in the independent review’s recommendations align with its existing regulatory guidance, and used these insights to inform a risk-based approach to updating its Statement on paediatric care. This includes updated advice reinforcing the need to ensure that parents or guardians fully understand their rights and the evidence before treatment is provided to children.
‘Public safety is our priority, and especially so when we consider the care of children’, Board Chair Dr Wayne Minter said.
The revised statement takes effect from today. It provides strengthened guidance on best practice and evidence-based care; proper informed consent; practice that is within a chiropractor’s skills, competence and expertise; advertising that is in accordance with the National Law; communication; and good practice with vulnerable communities, including children and young people.
‘Chiropractors have an obligation to practise within their skills, competence and expertise, have a duty to ensure patients are fully informed of the risks, benefits and the evidence base of treatment, and ensure informed consent is given.
‘By strengthening the guidance, the Board has more clearly outlined its expectations,’ said Dr Minter.
Significantly, the Board noted that no examples or experiences of serious harm were reported through the independent review consultation, by either the public or health practitioners, and that no risk of harm has been identified among concerns raised with Ahpra.
The Board has ensured its guidance is based on contemporary information. A systematic review of the effectiveness and safety of spinal manipulation in children under 12 years was conducted for the independent review in 2019, and in 2022 the Board commissioned Cochrane Australia to update this review. Both reviews were consistent in finding that it is difficult to draw conclusions about the safety and effectiveness of spinal manipulation in children.
Dr Minter reaffirmed that it is crucial to inform patients and their guardians of the risks, benefits and evidence base of treatments before obtaining informed consent for any treatment.
‘This is why the Board has carefully outlined its expectations in the revised Statement on paediatric care and within the existing regulatory framework. This allows the Board to continue to protect the public by being responsive to emerging issues related to evidence-based practice while ensuring the public has access to and receives safe, ethical and competent care from chiropractors,’ he said.
The revised statement replaces the Interim policy on spinal manipulation for infants and young children, which has been in place since 2019.
If anyone has concerns that the care provided by a registered chiropractor is below the standard expected, we want to know. Notifications are part of the system for keeping patients and the public safe. We will act when the public is at risk.