Minutes of the Professional Issues
Chairman: Sarah Bazin
Members: Nicole Muzar
General Secretary: David Gorría
Agenda: in Annex 1
Agenda Point No. 1. Welcome and introduction
The Chairman of the Professional Issues (PI) Working Group (WG), Sarah Bazin, welcomed all members to the second meeting of the 2016 – 2018 period in Stockholm, Sweden. She especially welcomed Guus Meerhoff as member of the PI WG. She reported that KNGF informed the Executive Committee of the European Region, prior to the selection process of WG members for the period 2016 – 2018, about its internal organisation restructuration and since at that time it was not sure who would be responsible for guidelines and professional issues at national level, both Guus or Karin, were presented as candidates to the PI WG from the Dutch Association till the end of the restructuration process.
The Chairman particularly thanked Fysioterapeuterna / Swedish Association of Physiotherapists for hosting the Working Group’s meeting and its generous hospitality.
The draft Agenda was agreed and adopted (See Annex 1).
Agenda Point No. 2. Minutes of the last meeting held on 8 – 10 September 2016 in Warwick, UK
The Minutes of the last Professional Issues WG, held in Warwick, UK, on 8 – 10 September 2016, were approved.
They will be sent to the Member Organisations, members of all Working Groups and the Executive Committee of the European Region.
Agenda Point No. 3. Matters arising from the Minutes
It was reported that the General Secretary has contacted ParkinsonNet and Samyra Keus on behalf of the European Region, and especially its 20 Member Organisations, which were involved in the development of the European Physiotherapy Guidelines for Parkinson’s disease, lead by ParkinsonNet and KNGF.
The aim of the contact was to clarify conditions for use, dissemination and implementation of the guideline by those MOs involved on its development, since it is required approval to do those actions.
MOs and WG members understand that if the guideline is adopted or modified a reference should be included. Other requirements are understood as a limitation on the use of the guidelines for which MOs contributed financially and on their development with work and evaluation.
Furthermore the European Region and its MOs would like to know about the statistics of guidelines download per country and type of user (physiotherapist, patient, researcher…)
At the present time no answer has been received.
Guus Meerhoff offered to contact ParkinsoNet with this regards to clarify above issues.
ER-WCPT Congress Liverpool 2016
The Chairman sought feedback from WG members who had attended by facilitating a process evaluation.
No otter matters arising were expressed or recorded.
Agenda Point No. 4. Activities for the period 2016 – 2018 Overview of “projects” and distribution of the activities / responsibilities
The Chairman reported that she 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, prioritising activities and having group discussions for specific actions when necessary.
The WG has to complete the drafts of all its documents and resources/ materials before the 3rd WG meeting and the final draft by the 4th WG meeting at the latest, in order to circulate all documents to the MOs for their revision prior to the 2018 General Meeting.
Active Points (5 – 10)
Agenda Point No. 5. Action of the PI WG related 2016 GM: Network to support MOs and WGs on their various activities or projects
As discussed at the last WG meeting and linked to the motion presented at the 2016 GM to develop/create and keep updated a database that will serve as reference for support for the MOs, it was reported as follows:
- The General Secretary (GS) has contacted WCPT seeking information on how to use WCPT database of experts. At the present time no response has been received. The Chairman will contact WCPT again in order to get back to the MOs and WG.
- Actions to start the development of a European Region network to support MOs and WGs on their various activities or projects.
The GS has prepared a list of key words for which advice and networking can be needed based on the recommended activities of the WGs for the period 2016 – 2018.
The draft list of keywords has been circulated among the WGs members for their comments and was presented at the meeting.
The WG members agreed:
- To review the document removing those terms, which may not be essential and add any possible missing term.
- To discuss about to which extent start the use of the network in order to make sure that those appointed will be consulted.
Above two actions would be taken once a response from WCPT is received or at the next WG meeting. If WCPT network not fulfilling the needs of the Region, MOs will be asked to appoint those to be within the network and an update of the network list will take twice a year.
Agenda Point No. 6. Clinical Guidelines and Multidisciplinary Guidelines (S02):
To invite MO’s to share their Summary of findings in English and present it in the ER-WCPT database.
To explore IT solutions for collaborating in the GRADING process.
For the period 2016 – 2018 and following the recommendations approved at the 2016 GM, the Professional Issues WG agreed the following activities and their respective schedule for each of them:
Strong recommendation for MO’s to update the ER-WCPT Guidelines database (despite of the fact that they are not in English).
To invite MO’s to share their Summary of findings in English and present it in the ER-WCPT database.
Nirit Rotem presented the database updated.
The WG members reviewed the database and agreed the following:
With those additions, the database would be posted on the European Region Website. Then, before the end of March 2017, MOs would be informed about the update and asked to review the content of the database. MOs would be encouraged to include their guidelines, even if they are not in English, if possible with a summary of them describing the findings in English and provide Evidence Based Best practices.
To facilitate the additions from the MOs, a version of the database would be available in Google documents or other similar tool.
The latest updated version of the database would be presented to the 2018 GM.
To explore the possibility of collaboration on making Evidence profiles (GRADE) and tables of findings.
To explore IT solutions for collaborating in the GRADING process.
The WG members agreed to develop a practical document for the MOs informing them about:
A draft document would be prepared by April 2017. Then circulated among the WG members in May 2017. The agreed version by the PI WG would be circulated among the other WG members prior to the Joint meeting in September 2017.
This document would be presented by the PI WG for discussion at the joint meeting of the WGs in Dublin, Ireland 2017.
Guus and Emile would be responsible for preparing the draft document and lead this action.
To consider the further need for holding a 4th conference on Clinical Guidelines.
In order to prepare a 4th Conference on Clinical Guidelines during the second half of 2018, as suggested by the 2016 GM, the WG agreed as follows:
Guus Meerhoff with the support of Emilie Wøjdemann and Charlotte Chruzander will lead this action.
To Maintain involved in GIN and its Allied Health Professionals Group
Emilie Wøjdemann and Guus Meerhoffand attended and represented the European Region at the 13th G-I-N Annual Conference hold in September 27 - 30, 2016 in Philadelphia, Pennsylvania.
The 14th G-I-N Annual would take place in September 2017 and South Africa.
The WG agreed that the objective for 2017 and 2018 G-I-N Annual Conferences should be to coordinate the participation of all physiotherapists attending the conferences and their involvement in the Allied Health Professionals Group.
With this objective a correspondence would be prepared for all WCPT MOs asking them if any of their members is attending.
Other issues on Clinical Guidelines
Finally it was reported that a colleague from Axxon, Prof. dr. Dominique Hansen, has sent a proposal to the European Region for the Development of ER-WCPT physiotherapy clinical guideline compendium.
In order to discuss the feasibility of this project and possible next steps, the General Secretary would introduce him by e-mail to Guus, Emilie and Nirit so they can have a skype conversation or even a face-to-face meeting in Amsterdam when appropriate.
The WG would be informed about the outcome of the discussion with Dominique Hansen.
Agenda Point No. 7 – Promote Physiotherapy: the role of Physiotherapists in the European Region (S02).
Address the role of physiotherapists as first contact practitioners, Direct Access / Self Referral, Independent prescribers and, Advanced Practitioners. Add categories as indicated.
Add date of each document to indicate
Give information if open to non-members or not.
Nicole Muzar has identified issues / topics missing in the database to be addressed with resources, such as First contact practitioners / Direct Access / Self Referral - Independent prescribers - Advanced Practitioners, among others.
Those topics have been added to the database of resources / material from the MOs to be used when Promoting Physiotherapy.
In order to continue with this project the WG agreed the following actions:
Once these changes are included in the database before the end of March 2017, MOs would be requested to review their national information and insert those materials missing.
A blank template would be given to each MO to introduce their information.
MOs would have one month to do it (April 2017)
Once the MOs have provided their information and material, the WG will cluster and review what it is appropriate to stay or not in the database.
An updated database would be presented at the 3rd WG meeting.
Nicole and Jill would introduce the changes in the database and prepare the correspondence for the MOs making clear which kind of material the WG is seeking for.
The request for update of both databases, clinical guidelines and promotional material, would be sent to the MOs together in one e-mail.
The latest updated version of the database would be presented to the 2018 GM.
In a later stage WG will seek feedback on the use of the database by the MOs if possible and discuss which material will be public or just restricted to the MOs.
Finally the WG agreed to follow the update of information on Direct access provided by the MOs on the ER-WCPT website and if possible update the survey from 2011.
Agenda Point No. 8. To update the Briefing paper - Active and Healthy, the role of the Physical Therapist in Physical Activity– To review and update as appropriate all the document references and include new research or supportive material when available
8.1 - Emphasise the value of the physiotherapists’ involvement in health promotion and disease prevention during this term every second two-year period (S01)
8.2 - EU Platform for Physical Activity –Action (1609): Promoting physical activity in children, the role of Physiotherapists, European Region of the World Confederation for Physical Therapy
A) To update the Briefing paper - Active and Healthy, the role of the Physical Therapist in Physical Activity
The WG members agreed the following actions:
The actions on “how MOs promote physical activity/exercise and the Physiotherapist as the specialist” should be kept updated.
As starting point the General Secretary would get in contact with the Swedish association to check the total price for translation.
B) Emphasise the value of the physiotherapists’ involvement in health promotion and disease prevention
The WG agreed to develop Physiotherapy Value Statements aligned with the UN Goals – Ensure healthy lives and promote well-being for all at all ages – and with the recommendation of the 2016 GM to emphasise the value of the physiotherapists’ involvement in health promotion and disease prevention. Jill Long will lead the development of these statements.
C) EU Platform for Physical Activity –Action (1609): Promoting physical activity in children, the role of Physiotherapists, European Region of the World Confederation for Physical Therapy
The General Secretary reported on the actions that ER-WCPT is undertaken to improve its commitment - Action (1609): Promoting physical activity in children, the role of Physiotherapists, for presentation to the EU Platform for Action, Diet, Physical Activity and Health.
First group of actions: (September 2016 – January 2017)
1 - Based on the Active and Healthy Briefing paper, it has been prepared a skeleton for the commitment, including full time plan and list of action to be developed.
2 – Reviewed the current references in that draft document and update those out of date.
3 – Done a literature research for other references, material and publications relevant to be included (such as those you referred from DG Sante, DG EAC, WHO)
Draft submitted to the EU Commission for their comments on 6 February 2017. Waiting for a response.
Second group of actions: (March – May 2017)
4 – Revision of other relevant information to be included from:
4.1 - 4th European Congress of the ER-WCPT on Physiotherapy Education, Practice, Research and Management - Advancing Physiotherapy – Demonstrating Value and Impact – 11 – 12 November 2016, Liverpool – Review the abstracts received related to physical Activity and Children
4.2 – Doc Physiotherapy Works for Obesity from CSP
4.3 – Doc published by the EU Commission - 'Childhood Obesity: Halting the rise
4.4 – ECIP briefing paper – Europe´s Obesity Challenge – Annex 8B of this meeting
4.5 – Content from FYSS 2017 related to obesity
5. Database of ER-WCPT Member Organisation actions to promote and disseminate physical activity/exercise benefits for children.
- The current database should be reviewed and sent to the MOs for update – 2017 April
6. Database of national / Member States guidelines on physical activity/exercise or health promotion actions and campaigns for children.
- The current database should be reviewed and sent to the MOs for update - – 2017 April
Include full title of referenced documents below with a short summary. –April 2017
7. EU actions and EU co-funded projects (DG RTD; Chafea) or other relevant projects
7.1 Key DG SANTE policy documents
7.2 DG EAC relevant documents
7.3 The WHO relevant documents on Physical Activity:
7.4 Database of relevant EU co-funded projects (DG RTD; Chafea) or other relevant projects.
Document to be submitted to the EU Commission for their comments in the final draft
Third group of actions: (September – November 2017)
8 Dissemination and promotion of the results and databases – use our channels and others that the EU Commission can provide
9 Presentation of the results to the Chair of the Platform and in a plenary of the EU Platform, if possible with MS authorities present. 28 – 30 November 21017
Charlotte Chruzander, Jill Long, Nirit Rotem and Sarah Bazin are leading the document development.
Finally it was noted that the Public Health Panorama calls for the submission of papers for a special issue on obesity and unhealthy diets in the WHO European Region.
This will be published in December 2017. The deadline for submission is 31 May 2017.
If the EU Commission – Platform – has not objection, the European Region will submit its above document.
Agenda Point No. 9. To be a point of contact for MOs regarding professional Issues (S01. S02, S03 & S04)
The WG would continue during the next period being a point of contact for MOs regarding professional issues.
Agenda Point No. 10. Quality Assurance Standards – The draft standards presented to the GM are to be reviewed aligning to comments received.
Jill and Victoria reported on the work undertaken to review and update the Quality Assurance Standards of Physiotherapy Practice and Delivery
The revision of the standards have been done using and taking into consideration:
These Standards are what at least should be achieved. – Standards cannot be aspirational, are a minimum.
Actions to follow:
At this point it was reported about the importance of having this document update and accurate since MS authorities have requested them to the secretariat and also due to the actions of CEN - European Committee for Standardization - related to creation of standards for professions and in particular to health professions. European standardization in the healthcare sector has traditionally been limited to medical devices and e-health applications. Nevertheless, in recent years there has been an increasing level of demand from stakeholders in relation to the standardization of healthcare services.
The updated and agreed version of the standards would be provided to CEN.
Collaborate – Internal (11 – 14)
Agenda Point No. 11. With the Education Matters WG
(Identify trends in Physiotherapy research and common research topics across MOs) (S03)
For these points in collaboration with the Education Matters WG it was reported as follows:
To follow up and support MOs implementation of CPD at national level and monitor EU developments. (SO2, SO3 & S04).
It was reported that the Education Matters WG (Taking into account the work under development by the Education WG on issues such as specialisation, etc), has agreed to defer discussion on this item until the 3rd WG meeting.
Nicole Muzar is the PI WG member responsible for collaborating with the Education Matters WG during the period 2016 – 2018 on the actions related to CPD.
To support the MOs in the process of recognising Physiotherapy specialisation within their countries, including collaboration with WCPT subgroups (SO2, SO3 & S04).
It was reported that the Education WG Members discussed during its last meeting the following points about specialisation:
After the discussion, the Education WG agreed:
Time plan agreed by the Education WG:
Nicole Muzar, with the support of Charlotte Chruzander, are the PI WG members responsible for collaborating with the Education Matters WG during the period 2016 – 2018 on the actions related to specialisation and will contact Education WG colleagues responsible: Helen French, Silke Gruber and Carmen Suarez.
To review and update, if needed, the Briefing Paper Promoting Research and Research careers within Physiotherapy in Europe
The Education WG discussed how to work on this recommendation from the GM and agreed to start by:
(Refer also to agreed points in the Minutes of the last meeting)
Agreed actions of the Education WG:
Agenda Point No. 12. With the EU Matters WGs
For this point, in collaboration with the EU Matters WG, it was reported that they are trying to identify Trends and Drivers affecting the Physiotherapy workforce within the European Region.
To elaborate a document on those trends, The EU WG has decided to ask MOs 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?
B – What are the most critical factors that according to you will reduce demand for Physiotherapist workforce in your country under the following fields?
A draft of the questionnaire, including the specific identified choices under each heading would be prepared by middle of March 2017 for the Education WG members’ revision. Once agreed, the questionnaire would be circulated among the MOs before the end of March 2017 with a deadline of response by the end of April 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 May – June prior to the 3rd WG meeting.
PI WG members, Sarah Bazin and Victoria Massalha, agreed the actions of the EU Matters WG.
Agenda Point No. 13. To keep the information about Professional Issues on the webpage of the ER-WCPT updated and accurate (SO3).
The Secretariat reported that he has sent in December 2016 a correspondence to the MOs asking them to update their national information about Physiotherapy in their countries (education, practice, work conditions and mobility procedure).
A gentle reminder to those MOs who has not yet updated their information has been sent on 7th February 2017. This information requested from the MOs is needed, among other purposes, for the work of the WGs and if not received then questionnaires would be circulated among the MOs to complete the current projects.
WG members agreed on the need of having accurate information on the responses provided by the MOs and also agreed to review the Education button content.
Furthermore it was reported that in order to investigate the visitors of the European Region website, and see if any measure are needed about its content orientation, a pop up appears when accessing the European Region website asking:
We are conducting a survey to improve our website.
Are you here as:
It will run till the 3rd WG meeting and based on the results further steps would be decided.
Next step to improve the European Region website would be to add “google translate” as it has been included in WCPT website.
Agenda Point No. 14. To contribute to the ERWCPT Congress (SO1, SO2, SO3 & S04)
Based on the information from the Executive Committee (EC) 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 Congress of the European Region have been reviewed and revised by the EC.
The final versions of both documents with an invitation for Member Organisations to consider making a bid to host the 5th European Region Congress on Physiotherapy in 2020, has been sent on 7 February 2017.
The deadline for this call for proposals is 2nd May 2017.
The MOs have already been informed about the EC decision on the Congress scope, which will be in place until the next evaluation after the 2024 Congress. The scope of 2020 congress will be "Physiotherapy Education linked to Professional Activity and Research”.
The UK Report on the 4th Congress strongly recommended that all three WGs would collaborate and contribute to the ER Congress in 2020.
Collaborate – External (15)
Agenda Point No. 15. To collaborate on activities with relevant health related organisations (S04)
Sixty-sixth session of the WHO Regional Committee for Europe
The European Region through its Executive Committee member, Roland Paillex, participated in the 66th session of the WHO Regional Committee for Europe that took place in Copenhagen, Denmark, on 12-15 September 2016.
Health Ministers and high-level representatives of the 53 Member States of the WHO European Region, partner organisations and civil society participated in the session.
The European Region submitted a statement on the Action plan for the prevention and control of Non-Communicable Diseases in the WHO European Region.
WHO Europe - Mental Health
The European Region, with the support and collaboration of the WCPT subgroup International Organisation of Physical Therapy in Mental Health (IOPTMH) has started collaboration and participation in the meetings of WHO Europe Staff groups active in mental health in the European Region.
A third meeting of this group took place on 19 December 2016 in Copenhagen and Executive Committee member Roland Craps attended. At that meeting it was agreed a Consensus Statement - Working together towards an effective and influential mental health workforce in Europe –supported by the European Region. As soon as the lay out of the document is finalised by WHO Europe the statement would be circulated among MOs and WG members.
It was reported that the Global Alliance for Musculoskeletal (formerly Bone and Joint Decade) - Annual Meeting in 2017 would take place on 16 – 17 October 2017 in Dubai.
Nirit offered to attend on behalf of the European Region. The WG agreed.
Jill Long reported about her participation on behalf of the European Region in the Fit for Work Global Alliance Summit, which took place on 9 November 2016 in Bratislava. Slovakia.
At the summit there were launched the “Fit for Work Global Early Intervention Framework”, which provide tools to support health professionals in promoting early prevention, diagnosis, treatment and care for people living with Musculoskeletal and other Chronic Conditions.
She also reported that now Fit for Work is supported financially by a Pharmaceutical company.
As agreed at the last PI WG meeting, the Chairman confirmed to the WG members the European Region full membership to European Forum for Primary Care (EFPC) and the introduction of Jill Long as the PI WG member representative to put forward actions between EFPC and ER-WCPT
Due to the importance of the role of Physiotherapists in Primary care the ER-WCPT will continue with the following actions:
1 – To have an ER-WCPT representative in the EFPC Advisory Board.
A candidate would be presented for the September 2017 Elections
2 – Get involvement in the following EFPC Working Groups on sub-themes relevant to Primary Care:
3 – Develop a position Paper “Physiotherapist and Primary Care”
The ER-WCPT has been in contact with the World Obesity Forum and will advocate for the World Obesity's Action Initiative.
It was reported that ProFouND (Prevention on Falls Network for Dissemination) is organising a meeting; EU Falls Festival on 8 – 9 May 2017 in AMC, Amsterdam.
Since Nicole is not able to attend, it was agreed Guus to attend and also, if two seats available, Emilie.
The General Secretary would do the registration and forward to both of them further information on previous meetings and ER-WCPT involvement with ProFouND.
According to the recommendation approved at the 2016 GM the WG agreed to continue working on the effect of the role of insurance companies on ER-WCPT MOs and the provision of Physiotherapy services.
There is a need to look at the standing of physiotherapy related to insurance companies having different rules of engagement, depending on the country that they are working in so that they may be happy to take self-referral in one country but require the signature of a medical practitioner in another. Discussion about autonomy would also take place with Umbrella Insurances Associations.
The contact with the European Insurance companies will be also used to promote to them the benefit of direct access. (The sooner the access to a physiotherapist, the better for recovery. Sooner in, sooner out)
Sarah Bazin will be in charge of the contacts.
The WG agreed to contact the Societal Impact of Pain (SIP) Pain Alliance Europe to explore membership and collaboration options of the ER-WCPT with the alliance. The General Secretary was tasked to do it.
Furthermore it was also added that Victoria will attend on behalf the European Region the SIP 2017 symposium taking place in Malta on 7 – 9 June 2017.
Agenda Point No. 16. Any other business
No other business were expressed or recorded.
Agenda Point No. 17. Date and Place of Next Meetings
The dates of the 3rd meeting for the period 2016 – 2018, all ER-WCPT WGs joint meeting in Limassol, Cyprus, were confirmed as:
22 September 2017 Joint WGs meetings Dublin, IrelandALL
23 September 2017 WGs separate meetings* Dublin, IrelandALL
Arrival planned for 21 September 2017.
*The Chairman advised members that as the 3rd WG meeting would only be one day (due to the joint meeting of all WGs being on the first day) it would have to be a full working day and it would concentrate on working through the latest drafts of the PI WG documents.
.The 4th meeting of the PI WG meeting would take place on 19 – 20 January 2018 in Malta. The arrival date was planned for the 18 January 2017.
Agenda Point No.18. Closing
The Chairman thanked all the members of the Working Group for their contributions. She also reiterated her thanks to Fysioterapeuterna / Swedish Association of Physiotherapists for hosting the meeting, generous hospitality and especial thanks to Charlotte Chruzander for organising the meeting. She thanked David Gorría for his support to the meeting and on-going work between meetings.