• ESCO is the multilingual classification of European Skills,
Competences, Qualifications and Occupations relevant for the
EU labour market and education and training.
• ESCO is part of the Europe 2020 strategy.
• To help job matching
• Enabling mobility
• Facilitate dialogue between the labour market and
• Linked to relevant international classifications and frameworks,
such as NACE, ISCO and EQF
1st Pillar
The list of occupations in this diagram started by using ISCO
08 and was then amended based on the expertise of the group
However, because of the evolution of healthcare it
may be updated and new occupations added in future
ENPHE working group
22nd of March 2014
 Suggestions for the definition of physiotherapy
 Suggestions for the decriptions of physiotherapy related
 Physiotherapy Assistant
 Physiotherapist
 Advanced Physiotherapist
ENPHE WG suggestions 3/2014:
Physiotherapy Assistant
 First of all: most of European countries nowadays do not have
assistant in physiotherapy in their health care and education system.
 We would like to call ‘physiotherapy assistant’ as ‘assistant in
 Our recommendations for describing the level of assistant in
physiotherapy are:
 at least the level of Associate degree
 at least on EQF level 5 (or 4) depending of the description of the
 Our recommendation for the role of assistant in physiotherapy:
Assistant helps to provide physiotherapy services that achieve and
optimise client outcomes (Canadian Alliance of Physiotherapy
Regulators, 2012).
Physiotherapist Assistant
Definition by European Region of the World Confederation
for Physiotherapy:
A Physiotherapist Assistant assists and works under the
sole direction and supervision of the Physiotherapist who
delegates specific aspects of interventions. A
physiotherapist assistant only works within defined
contexts using agreed treatment protocols and
procedures. A Physiotherapist assistant is responsible to
the Physiotherapist.
ENPHE WG suggestions 3/2014:
 Registered physiotherapist (as well as Advanced Physiotherapist) should be
first contact autonomous practitioner.
 Registered Physiotherapists are educated at least on EQF 6 level.
 Evidence based concept should be explicitly mentioned in the description of
registered physiotherapist.
 Our suggestion for describing the levels is to look at ‘ENPHE Focus Groups’
paper (2012)
 Physiotherapy process and Physiotherapy Diagnosis should be explicitly
written in the description of registered physiotherapist.
 It should be mentioned in the description that the registered physiotherapist
is also able to supervise students, other professionals, colleagues etc…
Definition by European Region of the World Confederation
for Physiotherapy:
A Physiotherapist is an autonomous health care professional
who assesses, diagnoses, plans, treats and evaluates
clients/patients and is responsible for his/her own actions.
A Physiotherapist has their own caseload of clients/patients
with complex needs and practices within complex and
increasingly unpredictable contexts. A Physiotherapist
practices according to professional codes of practice and
conduct. A Physiotherapist has completed a minimum of
Bachelor of Science Physiotherapy education programme, or
equivalent, which is recognised by the state to practice
ENPHE WG suggestions 3/2014:
Physiotherapy advanced practitioner
 The description of advanced physiotherapist should be
written on EQF 7 level. Our suggestion for describing
the level is to look at ‘ENPHE Focus Groups’ paper
Advanced Physiotherapist
Definition by European Region of the World Confederation for
An Advanced Physiotherapist is a Physiotherapist who has formally
demonstrated an ability to apply advanced competence
(knowledge, skills and attitudes) in a defined area, within the
scope of practice recognised as physiotherapy. An Advanced
Physiotherapist has highly specialised skills to address complex
decision-making and manage risk in unpredictable contexts, which
demands innovation. An Advanced Physiotherapist has completed
an advanced programme or can demonstrate he/she can work at
an advanced level, focusing on a specific area of clinical practice,
education, research, or professional management among others.
2nd Pillar
Skills/Competences/Knowledge & Scope
• To identify the essential
skills/competences and knowledge for
each occupation listed and provide
also a scope note for each skill,
competence and knowledge provided.
ENPHE WG suggestions 9/2014
On basis of:
 Physiotherapy expert
 Communicator
 Collaborator
 Manager
 Health care promotor
 Reflective practitioner
 Professional
Key competencies /
Physiotherapy Expert
Physiotherapists are experts in function, movement and mobility
using ICF-descriptions (physiotherapy process)
 Consults with the client to obtain information about his/her health,associated
history, previous health interventions, and associated outcomes.
 Collects assessment data relevant to the client’s needs and physiotherapy
 Analyzes assessment findings.
 Establishes and a physiotherapy diagnosis and prognosis.
 Develops and recommends an physiotherapy intervention strategy.
 Implements physiotherapy intervention.
 Evaluates the effectiveness of physiotherapy interventions.
 Completes physiotherapy services.
 Documents the whole physiotherapy process
Key competencies /
Physiotherapist use effective communication to develop
professional relationships with clients, families, care
providers and other stakeholders in a patient centered way.
 Develops, builds,and maintains rapport, trust, and
ethical professional relationships through effective
 Elicits, analyzes,records, applies, conveys and shares
 Employs effective and appropriate verbal, nonverbal,
written, and electronic communications.
Key competencies /
Physiotherapist work collaboratively and effectively to
promote interprofessional practice and achieve optimal
client care
 Establishes and maintains interprofessional
relationships, which foster effective client-centered
 Collaborates with others to prevent, manage and solve
problems and conflict.
 Is able to collaborate at intercultural and intersectional
Key competencies /
Physiotherapist manage time, resources and priorities at all
levels for individual practice and ensure sustainable
physiotherapy practice overall
 Manages individual physiotherapy practice effectively.
 Manages and supervises personnel involved in the
delivery of physiotherapy services.
 Participates in activities that contribute to safe and
effective physiotherapy practice.
Key competencies /
Health care promotor
Physiotherapist responsibly use their knowledge and expertise to
teatch, guide as well as promote and prevent health and wellbeeing of individual clients, communities, populations and profession
 Works collaboratively to identify, respond to and
promote the health needs and concerns of individual
clients, populations, and communities.
 Works for prevention of diseases and movement
impairments to optimise health
Key competencies /
Reflective practitioner
Physiotherapist are commited to ongoing learning for the purpose of
improving client outcomes to seeking, creating, applying,
disseminating and translating knowledge to physiotherapy practice
 Uses a reflective approach to physiotherapy practice.
 Incorporates lifelong learning and experiences into best,
evidence based physiotherapy practice.
 Is willing and capable of critical reflection
 Is voluntary and selfmotivated in continuous professional
Key competencies /
Physiotherapist are commited to the best interests of clients
society to ethical practice, support of professionled regulation,
and high personal standards of behaviour
 Conducts self within legal and ethical health care
 Respects the individuality and autonomy of the client.
 Contributes to the development of the physiotherapy
 Owes scientific attitude
ENPHE WG suggestions 3/2014
Definition of physiotherapy -1/2
 Movement is the main concept in physiotherapy. It should be written clearly in
the definition.
 Movement as a concept should be integral in the concepts function, activity
and participation (See ICF, International Classification of Functioning, Disability
and Health). We would like the definition to be person centred work and take
into account the person’s environment.
 Person centeredness and goal orientation should be clear in the definition. It
should stress on evidence based physiotherapy (see
 We would talk about reasoning skills instead of thinking skills in the coming
Definition of physiotherapy- 2/2
 Physiotherapy process and physiotherapy diagnosis should be
explicitly written in the definition.
 Physiotherapy definition should include prevention, health
promotion and education as well as physiotherapy in individual,
group and society level.
 Interprofessional and multidisciplinary collaboration should be
added into the definition.
 Physiotherapy as part of rehabilitation would be important to
mention in the definition.
 We would talk about optimizing individuals resources instead of
maximizing them.
 Education, guidance, management and research belong to
physiotherapy and should also be mentioned in the definition.
Mara Kulsa, Latvia
Bjorg Gujonsdottir, Iceland
Marietta Handgraaf, Germany
Erna Rosenlund Meyer, Denmark
Maija Kangasperko, Marja-Leena Lähteenmäki, Finland
Andre an Haack, Rob Tijssen and Jasmin Pekaric, The Netherlands;

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