Formalising standards across Europe a case study on

Formalising standards across Europe: a case study on osteopathy Jonathan Bailey-Teyletche President European Federation of Osteopaths CEN process Healthcare Professionals Crossing Borders 31 October 2013 Gert Jan Goede Chair Forum for Osteopathic Regulation in Europe

Agenda European osteopathic landscape to date Identify challenges of effective regulatory collaboration Explain development of European Standard on Osteopathy (CEN) Next steps … Healthcare Professionals Crossing Borders 31 October 2013

About EFO Ø European Federation of Osteopaths (EFO) recognised by EU as Osteopathic Professional Association Ø It has member organisations from 17 countries Ø Its activity is focussed on EU lobbying, national mediation and representation Ø Member of CEPLIS Ø Worked closely with FORE since 2009 Healthcare Professionals Crossing Borders 31 October 2013

About FORE Ø Seeks to enhance protection of patients in Europe by promoting wider recognition of osteopaths and high standards of osteopathic treatment Ø Members from across Europe, including: v competent authorities, v voluntary registers and v associations Ø Member of Crossing Borders Healthcare Professionals Crossing Borders 31 October 2013

Status of osteopathic regulation in Europe Countries with regulation and EU registration: Finland, Iceland, Lichtenstein, Malta, Switzerland UK Countries with regulation and non EU registration: France, Hungary, Latvia, Portugal Countries with regulated treatment but not regulated profession: Belgium, Bulgaria, Italy, Romania, Slovenia Healthcare Professionals Crossing Borders 31 October 2013

Status of osteopathic regulation in Europe Countries considering regulation: Germany, Ireland, Norway, Spain Countries not recognised/ with no current plans: Austria, Cyprus, Denmark, Greece and Sweden Countries which are unclear: Central and Eastern Europe Healthcare Professionals Crossing Borders 31 October 2013

Barriers to development of regulation Ø No clear identity for osteopathic profession within individual countries Ø Inconsistency of training and qualifications Ø Lack of critical mass of osteopaths Ø Opposition to osteopathy as autonomous profession Ø Lack of political will Healthcare Professionals Crossing Borders 31 October 2013

Freedom of movement: the challenges Ø Lack of osteopathic regulation Ø Lack of consensus on osteopathic education and training across Europe Ø Challenge for competent authorities: v Recognising qualifications v Exchanging information Ø Impact on patient safety Ø Osteopathy = ‘general systems’ profession Ø Little or no employment structure (e. g. language testing) Healthcare Professionals Crossing Borders 31 October 2013

Voluntary European standards Ø Published: v FORE European Frameworks on standards of osteopathic education, training and practice (ratified by European Federation of Osteopaths) v EFO Codex documents v Scope of Osteopathic Practice in Europe Ø No legal basis, but template for national templates Ø Formalisation of European Frameworks with the European Committee of Standardisation Healthcare Professionals Crossing Borders 31 October 2013

Comité Européen de Normalisation Ø CEN = Comité Européen de Normalisation Ø European standardisation organisation, made up of standards bodies from EU and EFTA (31) Ø UK member = British Standards Institute (BSI) Ø Recognised by EC as competent authority for development of standards Healthcare Professionals Crossing Borders 31 October 2013

What is a CEN Standard? Ø Well known in the product and process arena Ø Key part of the Single European Market Ø Moving into services, including healthcare, e. g. v Aesthetic surgeons v Hearing aid professionals v Chiropractors Ø Developed according to a defined process Ø Doesn’t override national legislation, but provides standard in those countries where none exists – ‘soft law’ Healthcare Professionals Crossing Borders 31 October 2013

Purpose of the CEN Standard Ø Improvement on the status quo Ø Become indicative standard across Europe Ø Promote greater consensus in profession Ø ‘Strengthen’ the profession internally and externally Ø Improve standards of patient care across Europe Healthcare Professionals Crossing Borders 31 October 2013

Developing a CEN Standard Ø Proposal to develop a Standard Ø Acceptance of the proposal Ø Drafting Ø CEN Enquiry: public comment at national level Ø Adopting by weighted vote Ø Publication of Standard Ø Review of Standard Healthcare Professionals Crossing Borders 31 October 2013

CEN process for osteopathy Ø Funded by EFO and FORE Ø Name: European Standard on Osteopathic Healthcare Provision Ø Secretariat: Austrian Standards Institute Ø Work conducted by Technical body 414, made up of national delegations from CEN members Ø Drafting group (from members of TC 414) develops drafts to be considered Healthcare Professionals Crossing Borders 31 October 2013

The draft Standard Ø Not public document yet Ø Standards used as reference: v WHO benchmarks v FORE Framework documents v EFO Codex documents Ø Challenges: v terminology v reflect osteopathic practice in Europe v reflect EU higher education policy v consensus on minimum standards Healthcare Professionals Crossing Borders 31 October 2013

The draft Standard Ø Current draft includes: v foreword, v introduction, v scope, v terms and definitions, v description of Osteopathy Ø Clinical Practice: v case history v examination v osteopathic diagnosis v treatment v osteopathic profession v continuing professional development (CPD) v quality management Healthcare Professionals Crossing Borders 31 October 2013

The draft Standard Ø Education and Training v Type 1 training programmes v Type II training programmes v Common features v Essential competencies for osteopathic practice v Core competencies in osteopathic education v Osteopathic teaching, learning and assessment (clinical education) Ø Annexes: Osteopathic structure-function models, Principles of Ethics, Osteopathic techniques Healthcare Professionals Crossing Borders 31 October 2013

How could the CEN Standard be employed? Ø By individual practitioners/clinics Ø Educational institutions Ø Associations in non-regulated countries Ø Help to draw public attention to high standards Ø Develop patient/public information about standards of osteopathic care in Europe Ø Guidance for regulators Ø Lobbying tool at national/EU level Healthcare Professionals Crossing Borders 31 October 2013

CEN Public Inquiry Ø Opportunity for public to input to development of CEN Standard Ø Launch of consultation on European Standard on Osteopathic Healthcare Provision: 7 November 2013 -7 April 2014 Ø Contact National Standardisation Body Healthcare Professionals Crossing Borders 31 October 2013

Next steps … Timeline Activity 7 November 20137 April 2014 Launch of public consultation (CEN Inquiry) Summer 2014 Analysis of responses by TC 414 Autumn 2014 Final version drafted Autumn/Winter 2014 Vote in CEN (weighted vote) Spring 2015 Publication of Standard 2014 -15 Awareness campaign 2015 National implementation (where no regulation exists) Healthcare Professionals Crossing Borders 31 October 2013

Further information Jonathan Bailey. Teyletche Gert-Jan Goede jonathan. teyletche@efo. eu www. efo. eu foresecretariat@osteopathy. org. uk www. forewards. eu Healthcare Professionals Crossing Borders 31 October 2013