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Network News - Volume 3 Number 2


In This Issue:


June Webcast: The importance of engagement in the discussion of competency

The term competency has been used for years by regulators, educators, and employers, yet the multiple - sometimes conflicting - meanings of the term itself have not been fully discussed. In this presentation, Zubin Austin will review the different meanings of the word 'competency' from diverse stakeholders' perspectives, and the implications of these differences for assessment and confidence in decision making.

Live Session: Thursday, June 2, 2016 11 AM ET Washington, DC, United States
Replay: Wednesday, June 8, 2015 8:00 PM ET Washington, DC, United States
Want to attend? Register by emailing info@inptra.org.
Cannot attend? We post our webcasts in the Events section of our website so you can listen to them at your convenience


INPTRA’s 2016 Membership Survey Results

INPTRA is striving to be the leading worldwide resource for physiotherapy regulation to ensure safe and competent physiotherapy practice.

One step to achieving this vision is to gather information from regulators to clarify what resources would be most helpful to you.

A big thank you to the dozens of people from 16 countries who responded to our survey! The winner of the $US 50 Amazon gift certificate for completing the survey went to Brenda McKechnie of the College of Physiotherapists of Manitoba, Canada.

About 25% of respondents had regulatory systems that were not yet well established, being developed or had no regulatory system in place. The rest had well-established regulatory systems.

Top five priorities in order were:

  1. Continuous professional development (70%)
  2. Licensure/registration of international physiotherapists & Accreditation of physiotherapy education (tied at 55%)
  3. Mobility (52%)
  4. Discipline and complaints (50%)
  5. Improving regulatory systems (45%)

Respondents were interested in hearing how other countries deal with those top priorities.

Given your responses, we will continue to seek out information on those top priorities and share them with you through this newsletter, our webcasts and meetings. We also plan on finding ways to provide guidance and resources to those countries that are developing their regulatory systems.

View survey results.


New Feature: How we regulate physiotherapy in…

Each quarter, we will focus on a different country’s model of physiotherapy regulation.

We would be pleased to highlight your country’s model of regulation. We have developed a set of questions to help you describe regulation in your country.

Even if you do not currently regulate physiotherapy or are developing a model of physiotherapy regulation, we’d be interested in how you ensure safe and competent physiotherapy in your country.

Email us at info@inptra.org for more information.


How we regulate physiotherapy in…New Zealand

By Janice Mueller, Chairperson, Physiotherapy Board of New Zealand

Physiotherapy in New Zealand is regulated by the Physiotherapy Board. The Board is governed by the Health Practitioners Competence Assurance Act (2003), the principal purpose of which is to protect the health and safety of the public by ensuring New Zealand’s health practitioners are competent and fit to practise.

The title ‘Physiotherapist’ is protected under law, and New Zealand’s physiotherapists are required to be registered with the Board and hold an Annual Practising Certificate. Currently there are around 4500 practising Physiotherapists in the country; in the last four years new registrations have been split roughly 55:45 between tertiary graduates from New Zealand universities and applicants from overseas. The Board does not regulate ‘physiotherapy assistants’ or ‘technicians.’

Scope of Practise
The work of physiotherapists is defined in the gazetted General Scope of Practice as:

Provid[ing] services to individuals and populations to develop, maintain, restore and optimise health and function throughout the lifespan. This includes providing services to people compromised by ageing, injury, disease or environmental factors. Physiotherapy identifies and maximises quality of life and movement potential by using the principles of promotion, prevention, treatment/intervention, habilitation and rehabilitation. This encompasses physical, psychological, emotional, and social well being.

The Scope also recognises that physiotherapists are ‘educated to practise autonomously by applying scientific knowledge and clinical reasoning to assess, diagnose and manage human function.’ Patients can access physiotherapists directly, i.e. there is no need for a referral from a doctor. Dry needling is allowed, but physios are not able to prescribe medicine. Telepractice is a small but increasingly important part of delivering treatment to remote communities.

Recently the Board has developed a ‘Specialist’ scope of practice for clinicians who demonstrate leadership in consultancy, education and research. Specialists work collaboratively with the physiotherapy profession and wider health sector across a range of health and disability settings. They actively participate and take a leadership role in professional activities, including local and national strategy and policy development.

The standards expected of New Zealand’s physiotherapists are set out in the new Bi-National Australia and Aotearoa New Zealand Physiotherapy practice thresholds document, the Aotearoa New Zealand Code of Ethics and Professional Conduct, and the Board’s Position Statements. The legislative framework for physiotherapists requires continuous professional development, and each year we audit a randomly balloted tranche of practitioners to ensure this is being carried out.

There is a formal process for handling notifications and complaints under the HCPA Act (2003). The Board’s website has details on how to register a complaint or concern, and a flow-chart of the complaints and notifications procedure.

Qualifications
New Zealand physiotherapy graduates complete a four year undergraduate degree at the University of Otago or Auckland University of Technology. These degrees are recognised by the Physiotherapy Board, and include over 1000 hours of clinical practise and a research project. Successful completion sees students conferred with a Bachelors degree; after graduation students apply for registration and an Annual Practicing Certificate in order to enter the workforce as Physiotherapists.

International applicants have their qualifications compared with the curriculum of New Zealand’s physiotherapy degrees – the application process is fairly quick for physiotherapists who have trained in countries with four year physiotherapy degrees that are a close match to our four year degree programme. Other nations’ applicants need to demonstrate their eligibility to apply for registration in New Zealand – is their physiotherapy qualification sufficiently similar to our tertiary programme, and how might any shortfalls be addressed through CPD, postgraduate qualifications, and so on. There are also requirements for English language proficiency and documentation of good character.

If the applicant is eligible they then send in their completed application pack and a fee is paid. Applicants are assessed on their whole application portfolio. More details are available on the Board’s website.

Current issues
The major regulatory development for 2016 in New Zealand is the implementation of the ‘Bi-National Physiotherapy Thresholds’ – a joint physiotherapy competency framework we share with Australia that sets out the entry-level requirements for initial and continuing registration as a physiotherapist in Australia and New Zealand. They are used as a reference point by the Physiotherapy Board for registration, competence review and the accreditation of physiotherapy undergraduate programmes – so it’s a big regulatory change, but one which reflects contemporary physiotherapy practice.

The new thresholds are recognition of the Trans-Tasman Mutual Recognition Arrangement (1998), a non-treaty agreement between the Australian Government, State and Territory Governments and the Government of New Zealand.


Learn at your Leisure Part 1: Listen to our webcasts

We have posted previous webcasts on our website in the Events|Webinars section of the INPTRA website. Past webcasts include topics such as:

  • Education of the public: a regulator’s responsibility?
  • Scope of practice
  • Telehealth
  • Regulation in New Zealand and the Philippines
  • The Professional Card in Europe
  • Promoting international mobility
  • Physiotherapists prescribing medications
  • Direct access
  • Models for regulating advance practice and recognizing specialization
  • Testing to assure entry level competence
  • The challenge of seeking regulation


Learn at your Leisure Part 2: View INPTRA 2015 Conference Presentations

Another way to learn more is to view the PowerPoint presentations from the INPTRA 2015 conference in Singapore.

If you have questions from a presentation, email info@inptra.org with the name of the presentation and presenter. We will share your question with the presenter and share their response with you.

Topics include:

  • Mobility and Common Standards
  • Continuous Professional Development
  • Ethics, Enforcement and Compliance
  • Emerging Physiotherapy Regulation
  • Multi-professional Regulation – the future for physiotherapy?


Requests for Support

We are pleased to report that organizations are asking for information or support in a number of areas of physiotherapy regulation.

You can view the requests and responses on our website at Regulatory Resources|Requests for Support.

We would be glad to:

  • Research a question regarding some aspect of physiotherapy regulation.
  • Provide a letter to support measures that strengthen safe and competent physiotherapy.


Do you have regulatory resources for INPTRA’s website?

We’re still excited about the new content on the INPTRA website.

Do you have regulatory resources to share with other regulators in the following areas? Send them to us and we will post them to the website.

  • Articles
  • Country Profiles
  • Educational Accreditation Standards
  • Entry to Practice Competencies
  • Standards of Practice
  • Continuing Professional Development
  • Ethics, Enforcement and Compliance
  • Regulation Language
  • Reports and Newsletters


Canada – A study comparing 5 countries’ PT educational accreditation standards

In November 2013, a study was completed for the College of Physical Therapists of Alberta comparing physiotherapy educational accreditation standards of five countries.

The report, Foreign Qualification Recognition: A Review of International Physiotherapy Education Accreditation Systems, can be found on the INPTRA webpage, Regulation Around the Globe | Educational Accreditation Standards.


Kenya - Physiotherapy Council of Kenya (PCK) becomes a reality

By Douglas Kotut, Registrar

Kenya has come of age; finally we have a council to regulate the practice and training of physiotherapy – Physiotherapy Council of Kenya (PCK). It has indeed been a long wait. Our Health Cabinet Secretary gazetted seven council members in September 2015 to oversee the council’s activities. They later appointed me as the Registrar thanks to, among other things, the exposure to regulatory issues from the previous INPTRA meeting in Singapore.

Physiotherapy Council of Kenya joins the list of professions in Kenya having their own regulatory body.

At the beginning of 2016, we certainly hit the road; putting up a house from scratch is not an easy task. Our first assignment was to conduct a baseline survey of all our physiotherapists, training institutions offering physiotherapy and private clinics/hospitals. This has enabled us identify existing gaps and how the situation can be remedied.

We are currently in the final stages of developing rules for registration and licensure, private practice, accreditation of training institutions, professional conduct, curriculum and course content, among others.

This will forever change the landscape of the provision of physiotherapy services in our country.

One of the greatest areas of emphasis is to ensure all our members are fit to practice. We want to regain public trust and improve the quality of service to the public. Some of the strategies towards this goal are prescribing a minimum number of Continuous Professional Development hours (CPDs) one needs before being registered or to renew practice licensure; to have properly laid down human resource and infrastructure norms; to determine the core units for physiotherapy training, etc.

Being a young professional body, we look forwards to learning from other established regulatory bodies both locally and abroad, including INPTRA.

Our government is developing a law (Health Bill 2015) that will have all the regulatory bodies work under one umbrella body- Health Professionals Oversight Authority. Its main responsibility will be to coordinate and synchronize activities of the regulatory bodies.

This include organizing joint inspections to health facilities and training institutions; maintaining a master register of all health workers; arbitrating disputes between statutory regulatory bodies, including conflict and dispute resolution; ensuring standards are not compromised by the regulatory bodies; etc. The existing regulatory bodies (including PCK) will remain semi-independent but will each have a member sit in the board of the oversight authority.

We feel this is a step in the right direction and will help sanitize the health sector in Kenya which over the years hasn’t enjoyed the most favourable ratings from the public.


New Zealand – Bi-national Australia and Aotearoa New Zealand physiotherapy practice thresholds implemented

On May 31, 2016 the Physiotherapy Board of New Zealand implemented the Bi-national Australia and Aotearoa New Zealand physiotherapy practice thresholds – replacing the previous ‘Physiotherapy Competencies’ (2009) document.

The Bi-national Thresholds set out the entry-level requirements for initial and continuing registration as a physiotherapist in both Australia and New Zealand – so they’re a new reference point for the profession in both countries. One of the roles of the Physiotherapy Board is to set the required standards of competence for physiotherapists, under the Health Practitioners Competence Assurance Act (2003).

Nearly all of the competencies from the 2009 framework are included within the new Thresholds document, but the new practice thresholds represent a shift in emphasis in how physiotherapists treat patients when compared to the old competencies framework.

Key differences include:

  • The thresholds are more inclusive of the different types of physiotherapy practitioner, such as managers and leaders (Role 7).
  • They emphasise the ‘professional and ethical practitioner’ (Role 2) – one of the requirements is for practitioners to look after their ‘physical and mental health’ (2.3).
  • The thresholds include advocacy for patients and their rights to healthcare, as well as advocacy for the profession.
  • There is greater emphasis on the collaborative practitioner (Role 5) such as working inter-professionally in a culturally responsive, client centred model of practice.
  • One of the biggest changes, particularly for overseas applicants, is the acknowledgement that physiotherapists usually focus on particular areas of expertise during their careers. There’s been a shift away from demonstrating recent clinical practice in musculoskeletal, cardiopulmonary / respiratory and neurology to a focus on the person. Knowledge and understanding of the three core areas and other body systems is still included in the underlying foundational abilities, however the requirement to demonstrate autonomous practice in all these areas (as was the case in the old Competency 9.4) has been removed.
  • Other areas of greater emphasis include risk management, recognising inappropriate or unethical practice, and ensuring physiotherapists work within their scope of practice and expertise.

You can find out more and download the new Thresholds document at the Physiotherapy Board’s website.


United Kingdom – News from HCPC Issues Brief

These articles are from the Health & Care Professions Council’s weekly Issues Brief.


Subscribe and view previous editions here.

Google given access to London patient records for research
Google has been given access to an estimated 1.6 million NHS patient records in a new data-sharing agreement. Google says it will use the data to develop an early warning system for patients at risk of developing acute kidney injuries. Under the data-sharing agreement, Google's artificial intelligence division DeepMind will have access to all of the data of patients from the Royal Free, Barnet and Chase Farm hospitals in London going back over the past five years and continuing until 2017.

Read more.

General Medical Council (GMC) strengthens tests for overseas doctors
The GMC is making improvements to the Professional and Linguistic Assessments Board (PLAB) test following recommendations from an independent review commissioned by the GMC. The PLAB test is taken by international medical graduates to assess whether they have the knowledge and skills to practise in the UK. It consists of a written knowledge test at various locations around the world and a practical assessment of clinical skills at the GMC’s Clinical Assessment Centre in Manchester. In future, doctors will be required to undergo a broader knowledge test and a more thorough practical assessment, which reflect real life consultations in the UK health system.

Read more.

Physios can help give GPs five extra minutes with patients, says Chartered Society of Physiotherapy (CSP)
According to new figures published by the CSP, GPs could spend on average five extra minutes with patients if they made physiotherapy available at their surgery. The Physiotherapy Cost Calculator developed by the CSP shows the additional time that could be freed up if patients with back pain and other musculoskeletal conditions, who would normally visit their GP as the first port of call, are offered the option of seeing a physiotherapist instead. The CSP report on a three month pilot in Cheshire where over 700 patients accessed the service who would otherwise have seen a GP.

Read more.

New measures set to support whistleblowers in primary care
NHS England has taken steps to make it easier for primary care staff to raise their concerns so that action can be taken and improvements made. New whistleblowing guidance has been drawn up which will now be consulted on for the next five weeks. The guidance comes after Sir Robert Francis recommended that the principles outlined in his Freedom to Speak Up report be adapted for primary care, where smaller work settings can present challenges around anonymity and conflicts with employers. Proposals include each provider naming an individual, independent of the line management chain, to act as the Freedom to Speak Up Guardian.

Read more.
Read the draft guidance.


United States – Wisconsin law allows PTs to order x-rays

From the American Physical Therapy Association’s PT in Motion News:

“Physical therapists (PTs) in Wisconsin now have a big addition to their licensing law: the ability to order x-rays. The change, signed into law by Gov Scott Walker on April 25, marks the first time any state has specifically authorized PTs to make the decision.

“Under the new law, to be able to order x-ray imaging, the PT must hold a clinical doctorate degree or a specialist certification, or have completed a board-approved residency or fellowship, or a formal X-ray ordering training "with demonstrated physician involvement.

“The law also requires the PT to communicate the x-ray order to the patient's primary care physician ‘or an appropriate health care practitioner’ to ensure coordination of care. That communication is not required if the patient doesn't have a primary care physician or was not referred to the PT by another practitioner, or if the radiologist doesn't identify a significant finding.

“According to Angela Shuman, APTA's director of state government affairs, the Wisconsin law is historic because it's the first time a state PT licensing law has specifically listed ordering x-rays as within a PT's scope of practice.”

View article.


Mark Your Calendar: INPTRA 2017 Conference

The INPTRA 2017 Conference will be held June 30 - July 1, 2017 in conjunction with the World Confederation for Physical Therapy Congress 2017 in Cape Town, South Africa. We will share more details as we get closer to the meeting


Would you like to share your country’s regulatory news?

We would be pleased to include news about healthcare regulation in your country in this quarterly newsletter.

Please send a short article or a link to a news article to info@inptra.org.


INPTRA Regulatory Guiding Principles

These principles on physiotherapy regulation have been developed to provide guidance both to already-established regulatory authorities and, in particular, to those countries where physiotherapy regulation is developing or has not yet been developed. This version is based on feedback from attendees of the INPTRA 2015 conference in Singapore.

The principles provide specific areas that should be addressed in a regulatory model for physiotherapy.

While not all the principles may be feasible at the current time within a particular jurisdiction, they should provide guidance for future change.

The principles also provide the foundation for the collection of data, evidence and resources related to each of the principles.

View the Regulatory Guiding Principles.


INPTRA Board of Directors Report

The INPTRA board of directors approved the following motions at their May 17-18, 2016 meeting.

To approve the February 11, 2016 minutes.

To approve the 2016 INPTRA Policies.

To reimburse the Deputy Chair for hotel expenses for the INPTRA meeting.

Rationale: The Deputy Chair's organization did not fund his travel. INPTRA committed to pay for his flight, but this will allow INPTRA to pay for his hotel expenses as well


Are you a regulator?

Click Agencies under Regulatory Resources on the INPTRA website to view country information.

  • Have we included your country?
  • Is your country’s regulatory agency information correct?
  • Is some information missing?
Be sure to send updates to info@inptra.org.


Submit your country’s regulatory profile

If you would like to submit a profile of your country's physiotherapy regulation, please send the following information (in English and MS Word, please) to info@inptra.org.

  • Country: The name of your country.
  • Point of Contact: Your name, position and email address. This is for INPTRA's information only and will not be posted on the website.
  • Regulatory Model: Provide a brief one-paragraph summary.
  • Website: The website of the organization that represents physiotherapy regulators in your country.

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