Frequently Asked Questions

Please refer to the below Frequently Asked Questions before emailing "Contact Us" with any queries as you may find some of your answers here. 

Covid-19 related FAQs

Our pool has been shut through the Covid pandemic - do you have any information on what we need to do differently ?

See ATACP Recommendations for safe aquatic physiotherapy practice in relation to the Covid-19 pandemic

How do I disinfect equipment during Covid-19 ?

Initially PWTAG stated pool equipment needed to be disinfected between individual patient use, when the guidance was reviewed earlier this year it was relaxed to after sessional use. Currently PWTAG state ‘periodically disinfected with 1000mg/l chlorinated water solution or impermeable, non-porous surfaces could be wiped down with 60% v/v ethanol or 70% v/v isopropanol’. Pre covid the ATACP stance was all equipment needed to be cleaned and disinfected at least weekly. We are aware departments used pool water to disinfect equipment, but pool water chlorine levels are too low (1-3ppm equivalent to 1-3mg/l) versus WHO recommended 1,000mg/l. Individual risk assessments will determine your view on ‘periodically’ disinfected. Note that most noodles and kickboards are closed cell with impermeable surfaces which can be wiped down using the medical disinfectant wipes. 

What Personal Protective Equipment (PPE) should be used during Covid-19 ?

In accordance with Covid-19: Guidance for maintaining Services within Health and Care Settings clinical PPE recommendations include the wearing of type IIR surgical face masks for low or medium risk patients, for both the therapist and patient (if feasible), where the therapist is providing hands on treatment within 2m.

If either the patient or therapist are required to submerge in the water, then wearing a face mask is not possible. The mask should be removed for the submersion and stored on the poolside in a disposable bag. The face mask must be replaced for exiting the pool.If the face mask becomes wet, it will be ineffective and needs to be changed. A full-face shield or visor could be used to prevent the mask becoming wet through water splashing onto it. On poolside full PPE (mask, apron and gloves) is required when within 2m of a patient.

It is a personal choice if you wish to wear higher protection face masks. Local policies may have further PPE stipulations.

Other FAQs

How long can Physiotherapists / Assistants spend in the water each day?

Daily immersion time for staff should be individually risk assessed, especially in circumstances such as return to work or pregnancy. Service user treatment time recommendations vary considerably based on the individual risk assessment and screening for example level of irritability, fatigue, and temperature control.

I have recently discovered that I am pregnant, is it still ok to work in the pool?

  • Individual risk assessment with consideration to history of miscarriages, low-lying placenta, foetal growth retardation, incompetent cervix, multiple or IVF pregnancy, any bleeding or discharge, scan results, pre-eclampsia, and gestational diabetes. 
  • If any concerns, liaise with the medical MDT. 
  • Pool water temperature not to exceed 350 C, if so aquatic physiotherapy becomes a contra-indication. 
  • For pregnant staff, the immersion time, fatigue and ability to perform the medical emergency evacuation procedure should also be risk assessed. 

How do I write or update our Pool Safety Operating Plan ?

All pools will need their own specific Pool Safety Operating Plan including a Normal Operating procedure as well as an Emergency Action Plan.

The PSOP should include:-

  • Statement of policy
  • Description of the hydrotherapy pool including size, depth, steps or gradient, any hoists, bather load, turnover period, filtration and disinfection
  • Responsibilities of those involved in the running of the pool
  • Pool user screening
  • Staff training and competency requirements
  • Referrals
  • Risk assessment
  • Pool Water Normal Operating Procedures (NOP) and Emergency Action Plan (EAP)
  • Emergency evacuation procedures
  • Procedure in case of water chemistry readings out of recommended parameters
  • Procedure in the case of a positive microbiology sample result
  • Procedures in the case of pool water contamination
  • Cleaning schedules

Please refer to Guidance on Good Practice in Aquatic Physiotherapy

I am wanting to provide Physiotherapy in a client's own pool or leisure pool, what risk assessments do I need to have in place?

The risk assessment is similar whether working within a trust or someone's domestic pool. Ensure safety for all emergency situations. See Risk Assessment Appendix in Guidance on Good Practice in Aquatic Physiotherapy for a template.

I need help or advice for a hydrotherapy pool build.

See Hydrotherapy Pools - Expert Clinical Considerations in Planning and Design

What are the water monitoring and recording requirements for a hydrotherapy pool?

Pool water chemistry, microbiological testing and environmental factors should be monitored, recorded and maintained in accordance with PWTAG Code of Practice. Required tests, frequency and levels expected are outlined in the Guidance on Good Practice in Aquatic Physiotherapy

Aquatic Therapy and Tracheostomies

See Aquatic Therapy for Clients with Tracheostomy

Do I need formal training in Aquatic Therapy to treat patients in the pool?

  • It is the responsibility of the individual to ensure Aquatic Physiotherapy is within their scope of practice.
  • Guidance given in the document entitled “ATACP Guidance on Aquatic Physiotherapy Practice 2021” will need to be considered in the light of the needs of the local service, patients and of the individual physiotherapist.
  • ATACP accreditation is the gold standard framework to prove competency. It is a structured course with examination.
  • A physiotherapist who has not yet undertaken learning and development in line with this document should be directly supervised by a physiotherapist who has done so.
  • The recommended level of competency in aquatic physiotherapy to work unsupervised is to complete the ATACP accreditation process, or equivalent, taking into account the frameworks outlined in the “Developing and maintaining an individual’s competence to practise Aquatic Physiotherapy” in the Guidance.
  • Training and development shouldbe evidenced.

Refer to ATACP Guidance on Good Practice 

See ATACP Course listings

How can I arrange an ATACP Aquatic Therapy Course?

Please contact our Membership Secretary Leila Brown info.aquatictherapy@gmail.com who will forward your enquiry to our ATACP Accredited Tutors.

What is the ATACP Foundation Physiotherapy Programme and what does it involve?

 The Foundation Aquatic Physiotherapy Programme is designed as a starting point for post-qualifying aquatic physiotherapy education and the full programme equates to 86 hours of learning. The programme is in 2 parts and funded separately.

Part 1. The taught element of this programme is facilitated by a tutor accredited by the ATACP and would total 13 hours of theoretical and practical tuition. Of this, students should spend 6 hours in the pool.

Part 2. For recognition and accreditation in Aquatic Physiotherapy, physiotherapists must undertake the foundation assessment process. This includes the submission of a case study of 1800 words, a written and practical assessment of skills and reasoning, as well as submission of a portfolio relating to Aquatic Physiotherapy.

Completion of the taught element component should provide the therapist with the fundamental knowledge and tools to work within their scope of practice in a hydrotherapy pool.  The ATACP recommend ongoing reflection and further learning following attendance of a course in accordance with Healthcare and Professions Council (HCPC) standards of proficiency. The ATACP recommends completion of the full accreditation programme to evidence competency in Aquatic Physiotherapy.

Refer to Accreditation Process

Are ATACP Foundation Courses only suitable for Chartered Physiotherapists?

The ATACP Accredited Foundation programme is aimed primarily, but not exclusively at Chartered Physiotherapists, who work and treat patients in an aquatic therapy setting.  Many people working in aquatic therapy such as Assistants, Occupational Therapists, Osteopaths and Sports Therapists have attended our courses and have found them very useful but at present only HCPC Registered Physiotherapists can undergo the formal assessment and accreditation process. 

Can I apply directly to do the Accreditation assessment?

The Foundation accreditation assessment is currently only open to HCPC registered Physiotherapists.  Candidates are required to attend a 2 day ATACP Foundation Course Study Block delivered by a recognised ATACP Tutor. Alternatively, they need to be able to demonstrate an equivalent level of knowledge & skills required, in line with the Foundation course content prior to application (refer to the ATACP Guidance on Good Practice in Aquatic Therapy (2021) for the Foundation course outline).  Please email ATACPAccreditation@gmail.com to apply or for further details.

Do I need to attend a Foundation course before an Intermediate course?

It is recommended that you attend the Foundation course prior to any intermediate courses to ensure that you have a sufficient knowledge base of the underlying principles and practical skills in aquatic therapy.  However, if you have had extensive experience in aquatic therapy practice and can demonstrate a level of knowledge that is equivalent to that of Foundation level, it may not be necessary to attend the Foundation course first (refer to ATACP Guidance on Good Practice in Aquatic Therapy for the course outline).

How can I get hold of ATACP Guidance on Good Practice in Aquatic Therapy?

The ATACP Guidance on Good Practice in Aquatic Physiotherapy is currently being updated and the new version is expected to be published late Summer 2021.

ATACP members will be able to access the Guidance for free and non-members can purchase an online version for £25. 

What are the benefits of joining the ATACP?

 See here for benefits and details of how to join.

How can I access previous editions of Aqualines?

ATACP members can download previous editions of Aqualines journal (1999 onwards), for free via our website.  Non members can purchase previous editions of Aqualines in PDF format for £5 each (see here for details).  Aqualines is also available at the CSP Library & British Library.