Approved Minutes EU Matters Working Group, 19 ­ 21 January 2017, Haapsalu, Estonia ­ Pages 12

 

 

Approved Minutes

 

 

Approved Minutes of the EU Matters

Working Group Meeting

19 – 21 January 2017,

Haapsalu, Estonia

 

 

Present:

Chairman: Roland Craps

 

Members: Kadri Englas

Karl Spiteri

Silvia Meriaux-Kratochvila

Natalie Beswetherick

Elisa Pelosin

 

General Secretary: David Gorría

 

Apologies: Tim Németh

 

 

Minutes

Agenda Point No. 1. Welcome and introduction

 

The Chairman of the EU Matters WG, Roland Craps, welcomed all members to the second meeting for the period 2016 - 2018 being held in Haapsalu, Estonia. He noted that Tim Németh has sent his apologies for absence due to personal reasons.

 

The Chairman particularly thanked the Estonian Association of Physiotherapists (EAP) and the Haapsalu Neurological Rehabilitation Centre for hosting the working group’s meeting and its generous hospitality. It was noted that the WG meeting took place in Estonia in order to offer the support of the WG members by participate with presentations in a meeting at the Social Ministry to present reasons for Regulation of the Physiotherapy Profession in the country. Other topics such as title protection, education levels, patient safety, and registration to practice were also discussed. A report of the meeting will be prepared and circulated among all the participants including the authorities. The Estonian Association with the support of the European Region will continue doing actions to regulate the profession in Estonia for patient safety and to ensure high standards.

 

Agenda Point No. 2. Approval of the minutes of the last Working Group Meeting held 15 - 18 September 2016 in Sofia, Bulgaria

 

The Minutes of the EU Matters WG meeting, held in Sofia, Bulgaria, on 15 – 18 September 2017, were approved and would be sent to the members of all working groups, the Executive Committee and Member Organisations.

 

Agenda Point No. 3. Matters arising from the Minutes

 

No other matters arising were expressed.

 

Agenda Point No. 4. Approval of the agenda


 

The draft Agenda was agreed and adopted

 

Agenda Point No. 5. Activities for the period 2016 – 2018 Overview of “projects”, distribution of responsibilities, activities and next steps

 

The Chairman of the EU Matters Working Group reported that he had presented the planned timetable of future activities 2016 – 2018 to the Executive Committee who had agreed the plan in general terms.

 

The Members agreed to update and review the draft time plan under each agenda point as appropriate, fixing deadlines, prioritizing activities and having group discussion for specific actions when necessary.

 

The EU Matters WG has to finish the first draft of all its documents and resources / material by the third WG’s meeting and the final draft at the latest by the 2018 January’s meeting in order to circulate them among the MOs for their revision prior to the 2018 General Meeting.

 

Active Points (6 – 9)

 

Agenda Point No. 6. Action of the EU WG for the 2018 GM: Draft document: Terms and definitions to support the discussion of the documents

 

 

As discussed at the last WG meeting and seeking to facilitate the engagement of the delegates in the GM discussions, a draft short list of essential terms with their definitions was presented to the meeting for comments. This list (terms and definitions) is important to ensure common understanding of the documents´ content and to support the discussion at the GM prior to the vote and approval of them. It was clearly noted that this document it is not a dictionary or an activity overlapping with the WCPT glossary.

 

Kadri Englas and Karl Spiteri presented the first draft of the document, which was developed from a selection of the available terms on the WCPT and ER-WCPT Glossaries.

 

The WG members reviewed the document removing those terms, which were not essential or related to documents to be discussed at the GM and added those terms missing.

 

Based on the meeting agreement a second draft would be prepared by the end of March 2017 by Kadri Englas with the support of Karl Spiteri and Tim Németh. The draft would be circulated among the other WGs members for comments prior the end of June to reach a consensus. The agreed version by the EU Matters WG would be circulated among the other European Region WG members for their possible comments and additions between the third and forth WG meeting, so the document would be ready to be circulated with all the 2018 GM documents.

 

Furthermore it was agreed that the Chairman of the European Region would contact the WCPT CEO Jonathon Kruger to discuss the update of the WCPT Glossary and its European Region annex.

 

Agenda Point No. 7. Review and respond to EU developments related to the Physiotherapy profession in Europe. (S01 & S04)

 

 

Monitor the legislative developments at EU level, and their implications for the profession, and cooperate with all relevant entities and partners.

 

The General Secretary reported on the involvement of the European Region with comments on a study tasked by the European Commission; DG for Health and Food Safety (DG SANTE) and the Consumers, Health, Agriculture, and Food Executive Agency (CHAFEA), to a consortium composed by Ecorys Nederland B.V., Erasmus University Rotterdam and Spark Legal Network and Consultancy Ltd.

 

In 2015 the European Region challenged the quality of the questionnaire for the study when it was conducted and also noted the overlap with other EU Commission actions.

 

In November 2016 the European Region commented on the draft study entitled: Cross-border health services: potential obstacles for healthcare providers since the study did not give sufficient pre-eminence to the three following main principles for health professional’s mobility:

 

1 – The various level of education in the Member States (MS) leading to a regulated profession, as it is the case for a Physiotherapist. A regulated profession implies that access to a profession is subject to a person holding a specific qualification according to national laws or regulations

Training requirements for obtaining such professional qualifications differ from country to country and may, therefore, make the practice of a profession in another Member State (MS) quite difficult.

2 – The different scopes of practice in each of the MS for the same (regulated) profession. The study pays insufficient account to the differing nature of scope of practice for professions in different EU countries, and the variation in approaches to continuing professional development [CPD].

3 – Protection of the public, upholding patient safety and minimising risk over facilitating professional mobility within the EU.

 

The European Region also presented concerns about the lack / gap of linking this study with other EU Commission official actions or initiatives, namely:

1 - Mutual evaluation of regulated professions - Overview of the regulatory framework in the health sector on the example of physiotherapists – DG GROW/E5;

2 – Definition for physiotherapist used in the document. – ESCO reference to be used; and

3 – ANNEX V of the Study & YOUR EUROPE + temporal or permanent mobility.

 

Other specific and detailed remarks were also presented by the European Region.

 

In December 2016 the European Region received a letter confirming the acceptance on the above and specific remarks to be included in the final study.

 

The final version of the study report will be given to the European Commission, Directorate on health systems, medical products and innovation in 2017.

 

David Gorría, the General Secretary, also reported on the current situation of the other main issues / topics that the European Region is following. He noted that most of them are related to Directive 2013/55/EU on Professional Qualifications Recognition – DG Internal Market.

 

Those are:

  • European Professional Card

  • Partial access to a regulated profession

  • Common training framework & tests

  • European Commission Actions related to evaluate national regulations on access to professions. (Art 59) & Proportionality test & Guidance on reforms needs for Member States in regulation of professions

 

The EU WG agreed to continue working as an observatory on any relevant EU developments affecting the Physiotherapy profession in Europe, reporting to the MOs and reacting as appropriate providing accurate information and supporting documents. All WG members will be responsible under the EU WG Chairmans’ lead.

 

Agenda Point No. 8. Inform and seek expert opinion from the MOs to EU developments and consultations. (S04)

 

 

The WG would continue providing responses to the EU Commission consultations affecting the physiotherapy profession or public health as appropriate during the next period. The MOs would be informed on the WG actions.

All WG members will be responsible under the EU WG Chairman’s lead.

 

Agenda Point No. 9. Horizon scanning and assess the impact of demographic, economics, technology and mobility challenges on the future physiotherapy workforce. (S04)

 

 

The WG agreed to develop a document identifying Trends and Drivers affecting the Physiotherapy workforce within the European Region.

 

To elaborate the document, the MOs will be asked to identify:

 

A – What are the most critical factors that according to you will create demand for more Physiotherapist workforce in your country under the following fields?

  • Demographic

  • Population ageing

  • Multi-morbidity

  • Workforce to population ratio

  • Changing disease patterns

  • Changing lifestyle (NCDs)

  • Public demands and expectations

  • Immigration

  • Technological

  • Medical advancements

  • Physiotherapy technology

  • eHealth

  • Genomics

  • Economic

  • Government priorities

  • Health care systems reforms

  • Health care demand

  • Physiotherapy pay

  • Physiotherapy unemployment

  • Private health care

  • Public health care spending

  • Physiotherapy / professional

  • Physiotherapy migration/mobility

  • Physiotherapists’ retirement

  • Physiotherapy scope permitted

  • Physiotherapy education

  • Physiotherapist assistants

  • Physiotherapy regulation

  • Number of new PT graduates

  • Other – please state

  • Unions

  • Culture

  • Research

  • Geography

  • Other health professionals

 

B – What are the most critical factors that according to you will reduce demand for Physiotherapist workforce in your country under the following fields?

  • Demographic

  • Population ageing

  • Multi-morbidity

  • Workforce to population ratio

  • Changing disease patterns

  • Changing lifestyle (NCDs)

  • Public demands and expectations

  • Immigration

  • Technological

  • Medical advancements

  • Physiotherapy technology

  • eHealth

  • Genomics

  • Economic

  • Government priorities

  • Health care systems reforms

  • Health care demand

  • Physiotherapy pay

  • Physiotherapy unemployment

  • Private health care

  • Public health care spending

  • Physiotherapy / professional

  • Physiotherapy migration/mobility

  • Physiotherapists’ retirement

  • Physiotherapy scope permitted

  • Physiotherapy education

  • Physiotherapist assistants

  • Physiotherapy regulation

  • Number of new PT graduates

  • Other – please state

  • Unions

  • Culture

  • Research

  • Geography

  • Other health professionals

 

A draft of the questionnaire, including the specific identified choices under each heading would be prepared by 17 February for the WG members’ revision. Once agreed, the questionnaire would be circulated among the MOs by the 1st week of March 2017 with a deadline of response by the end of March 2017.

 

With the information collected a draft document would be prepared showing trends and factors affecting the Physiotherapist workforce – creating or reducing demand.

The draft document with the results would be circulated among all WGs members in April – June prior to the 3rd WG meeting.

 

Karl Spiteri with the support of Tim Németh, Kadri Englas, and Silvia Meriaux-Kratochvila will lead this task.

 

Collaborate – Internal (10 – 13)

 

Agenda Point No. 10. To keep the information about EU on the webpage of the ER-WCPT updated and accurate (SO3).

 

 

As agreed at the last WG meeting, Karl Spiteri presented a draft proposal on how to facilitate finding the information available on the ER-WCPT website taking into consideration the type of user accessing to the web (MO, Physiotherapist or General Public).

The proposal showed how to allocate the current information for each of the three types of users.

 

The WG members discussed in the proposal and agreed that since the website is for the MOs and its members and that such a change have cost implications, prior to take a decision a survey on the number and kind of website visitors must be explored.

 

In order to do it, the WG agreed to create a pop up to appear when accessing the European Region website asking:

 

We are conducting a survey to improve our website.

Are you here as:

  • A physiotherapist member of Member Organisation

  • A physiotherapist not a member of Member Organisation

  • Other health professional

  • Public

  • Authority

 

The pop up will run till the 3rd WG meeting and based on the results, the WG will decide further steps.

 

Tim Németh and Karl Spiteri with the support of Kadri Englas and Elisa Pelosin will lead this action.

 

The General Secretary would take the necessary actions to include the pop up and data collection.

 

Agenda Point No. 11. To contribute to the ER-WCPT Congress (SO1, SO2, SO3 & S04)

 

 

It was reported that based on the information from the Executive Committee presented at the last WG meeting, MOs comments, experience from previous congresses, and the evaluation report of the 4th European Region Congress, the documents entitled: Guidance for hosting a Congress of the European Region and Guidance to apply for hosting a Congresses of the European Region have been reviewed by the members of the Executive Committee.

 

The final versions of both documents with an invitation for bids to host the 5th Congress of the European Region in 2020 will be sent to the MOs in January/February 2017.

 

The MOs have already been informed about the decision of the EC on the congress scope till next European Region Congresses evaluation planned after 2024 congress.

 

All WG members will collaborate and contribute to the ER-WCPT congress in 2020.

 

Agenda Point No. 12. European Region Strategic Plan

  1. To align the Strategic Plan of ER-WCPT with the Strategic Plan of WCPT

  • Include Comments expressed by MOs at the 2016 GM

  • SMART revision of the 4 Strategic Objectives

  • Align duration as WCPT - 2021

  1. To evaluate to which extent we have achieved the strategic objectives - 2018

  2. To agree the baseline data and targets on the KPI’s

 

 

As agreed at the first WG meeting, Natalie Beswetherick presented to the meeting how to align the European Region Strategic Plan with the WCPT Strategic Plan (2017 – 2021), including references to WCPT vision and WCPT Strategic Outcomes.

 

Furthermore she also presented, as agreed to be prepared during the first WG meeting, how the European Region will act to achieve each of the 4 European Region Strategic objectives (SO). The WG discussed them and agreed as follows:

 

SO1. Demonstrate the value and impact of physiotherapy – To achieve this we will:

  • Present the evidence through collaboration with WHO Europe, Bone & Joint Decade, Fit for Work Europe Coalition & European Forum for Primary Care

  • To review and update “Active & Healthy: the role of Physical Therapist in Physical Activity” briefing paper

  • Responding to EU developments and consultations

 

SO2. Physiotherapy is recognised as an autonomous profession – To achieve this we will:

  • Advocate for and support MOs so that practitioners make their own clinical judgements and treatment choices

  • Advocate for and support MOs to gain recognition as first contact practitioner professionals and have direct access in their country

  • Advocate and support MOs to achieve recognition of advanced practice and specialisation

 

SO3. Promote excellence in physiotherapy led research, education, and practice – To achieve this we will:

 

  • Disseminate the professions research and evidence base through its’ quadrennial scientific congress

  • Review and update its’ European specific policy statements, briefing papers, and standards in line with WCPT

  • To maintain and develop links with ENPHE

 

SO4. Lead and engage with EU and national health policy development – To achieve this we will:

  • Collaborate with European Health Workforce so that physiotherapy is recognised as a key health care profession in all countries.

  • European Forum for Primary Care, Make the case for a physiotherapy role in primary care developments.

  • EU plans for action on diet, physical activity and health – to demonstrate that physiotherapists are the profession to provide physical activity interventions

 

To agree the baseline data and targets on the KPI’s

2018 evaluation

 

Based on the above additions on how to achieve the 4 European Region Strategic Objectives, the WG members discussed and agreed the below Key Performance Indicators (KPIs) for each strategic objective.

 

SO1. Demonstrate the value and impact of physiotherapy

1.1 Number of meetings with international institutions and alliances where evidence of Physiotherapy was presented

1.1 Number of platform presentations where evidence of Physiotherapy is demonstrated

1.3 Number of international initiatives that we have provided evidence for e.g. Written responses, media briefings

 

SO2. Physiotherapy is recognised as an autonomous profession

2.1 Number of MOs with 

- Protection of title

- Ability to accept self-referrals

- Physiotherapists are recognised as first contact practitioners, recognised as advanced practitioners and specialisation

 

SO3. Promote excellence in physiotherapy led research, education, and practice

3.1 Number of abstracts submitted

3.1 Number of abstracts accepted for presentation

3.1 Number of registered delegates

 

SO4. Lead and engage with EU and national health policy development

4.1 Number of institutions/EU groups that invite Physiotherapy to participate in their boards

4.1 Number of specific initiatives that identifies the role of Physiotherapy in its actions

4.1 Number of requests to participate in EU activities/ initiatives

 

 

Natalie Beswetherick will prepare a presentation and a new version of the Strategic Plan to be circulated among all European Region WGs for comments on both how to achieve the strategic objectives and KPIs.

 

To evaluate to which extent we have achieved the strategic objectives.

 

 

As mentioned in agenda point 12, the WG agreed to align the ER-WCPT Strategic Plan with the WCPT Strategic Plan also in duration. Since the WCPT plan runs till 2021, the European Region Plan as above modified will run from 2018 to 2022 after the approval by the 2018 GM. A first evaluation of achievement and performance according to the identified KPI would take place prior to the 2020 GM in order to present to the MOs performance results and agree activities till 2022. In the GM 2022 a second performance evaluation will be presented and accordingly, it will be decided to change or not the Strategic Plan objectives and how, which will be aligned with the new WCPT Strategic Plan.

 

Agenda Point No. 13. With the PI WG:

  1. Rising unemployment issues across Europe

  2. To look at changing disease patterns

 

 

For this point, in collaboration with the PI Matters WG, it was reported that it is linked to the content of agenda point 9 Trends and Drivers affecting Physiotherapy workforce within the European Region and these drivers – changing disease patterns and unemployment issues – will be covered within the survey and document to be elaborated.

 

PI WG members, Sarah Bazin and Victoria Massalha, would be informed about this decision.

 

 

Collaborate – External (14 – 15)

 

 

Agenda Point No. 14. To engage with and contribute to organisations and networks at EU level such as: (S04)

  1. Others including health professionals and patients organisations.

  2. EPHA European Public Health Alliance http://epha.org/

  3. EU Commission: DG Sanco (EU Health Forum, EU Health Work force) DG Education, DG Employment, DG Growth.

 

 

The General Secretary reported about the latest news from the EU WGs / networks in which the ER-WCPT is engaged or has a membership such as:

  • EU Platform for Action on Diet, Physical Activity and Health

  • EU health Forum

  • EU Health Workforce

  • EIP AHA – European Innovation Partnership on Active and Healthy Ageing

 

International associations:

  • WHO Europe Regional Office and WHO Europe Mental health group

  • The Global Alliance for Musculoskeletal (formerly Bone and Joint Decade)

 

He also reported about the stakeholders groups in which the ER-WCPT is involved such as:

  • European Public Health Alliance (EPHA)

  • Fit for Work Foundation (formerly) Fit for Work of Europe Coalition – PI WG in charge

  • World Obesity Federation – PI WG in charge

  • European Forum for Primary Care – PI WG in charge

  • HOPE – Hospitals

  • ProFouND, (regarding implementation) – PI WG in charge

  • European Umbrella Association of health Professionals

    • CPME – Doctors

    • EFN – Nurses

    • PGEU - Pharmacist

    • COTEC – Occupational Therapist

 

The EU WG members thanked the General Secretary for the information presented.

 

The General Secretary and Roland Craps would follow up and attend the meetings of these partners and also explore other possible organisations at EU level to be involved with. The WG members would be informed about upcoming meetings to attend and travel cost reimbursement options, if any, from the meeting organiser.

 

Agenda Point No. 15.

To propose to WCPT and engage with external stakeholders to produce a briefing paper on eHealth and patient care.

&

To raise awareness of and involvement with new technologies and evaluate their impact on practice.

  • Keep the document presented at the 2016 GM updated

  • Create a new specific document on how e-health affects directly physiotherapy practice and physiotherapist covering

  • Apply for membership of the EU eHealth Network

 

 

As agreed at the first WG meeting for the period 2016 - 2018, Natalie Beswetherick has been in contact with the WCPT CEO Jonathon Kruger to ask if as suggested at the 2016 ER GM in the presence of the WCPT President, the European Region can draft a paper (either a briefing paper or position statement) on behalf of the WCPT on the positive use of e-health technologies in the delivery of Physiotherapy services. The WCPT CEO has agreed on this initiative and the WG agreed to draft a WCPT Policy Statement. A first draft would be prepared by the end of February 2017 and circulated among the WG members for comments in March 2017.

 

The WG also agreed to review, keep updated and improve the European Region document on eHealth as asked at the 2016 GM. In detail the WG members agreed:

  • To remove the “branded” examples in meeting annex 9

  • To merge both documents, leading to an improvement of meeting annex 10 and

  • To use the title of meeting annex 9.

The resulting document would then serve as European reference for the WCPT Policy Statement.

A revision would be prepared by the end of March 2017 and circulated among the WG members for comments in April 2017.

 

The WG also agreed to do a collection of good examples of eHealth use for physiotherapy to be posted on the European Region website. An eHealth button / section will be created that enables the information sharing about good practices and/or case-studies in order to find possible references and co-operators within Europe (or wider).

 

Tim Németh with the support of Kadri Englas, Elisa Pelosin and Karl Spiteri would coordinate these actions.

 

Finally, it was also noted that the secretariat has sent a letter of expression of interest for European Region membership of the EU eHealth Network. At the moment no response has been received. Even if the network membership has mandates from 3 years and the current one is from January 2016 to December 2018, the secretariat will contact the EU Commission again to ask if at least an observer status is possible.

 

Agenda Point No. 16. EU WG topic for the Joint WGs meeting in Dublin, Ireland - 22nd September 2017

 

The WG agreed the topic Trends and Drivers affecting Physiotherapy workforce within the European Region for discussion at the joint meeting of the WGs in Dublin, Ireland 2017.

 

Agenda Point No. 17. Any other business

 

No other business were expressed or recorded.

 

Agenda Point No. 18. Data and place of the Next Meeting

 

The 3rd meeting for the period 2016 - 2018, all ER-WCPT WGs joint meeting, would take place on 22 - 23 September 2017, in Dublin, Ireland. The arrival date was planned for the 21 September 2017.

 

  • There would be a separate meeting of the WGs on 23 September 2017.

  • The joint meeting would take place on 22 September 2017. .

 

The dates of the fourth meeting were suggested as 26 - 27January 2018 in Malta. The arrival date was planned for the 25 January 2018.

 

Agenda Point No. 19. Closing

 

The Chairman thanked all the members of the Working Group for their contributions. He also expressed his thanks to the Estonian Association of Physiotherapists (EAP) and the Haapsalu Neurological Rehabilitation Centre for hosting the meeting and its hospitality.