Firstly, an introduction to the current qualifications and their knowledge and practical competencies:

Level 3 qualifications (from around 2010) are based upon working with non-pathological tissue, in other words, the training does not include information about assessing and treating injuries.  Aches and pains of a postural source may be helped by a treatment, but it is outside of scope of practise to work on tissue that is damaged. Massage techniques included are effleurage, petrissage, simple frictions, tapotement, vibrations, compressions and passive stretching. Treatments are based on pre, inter/intra and post event massage.  Level 3 qualifications, on the whole tend to be knowledge based.

Level 4 qualifications contain knowledge and practical skills working with pathological tissue but only of a muscular, bone or tendinous source. You will have been taught assessment techniques and orthopaedic tests to make a judgement about the source of injury and treatment techniques. Massage techniques included are soft tissue release, connective tissue techniques, corrective frictions, trigger points and myofascial release. Level 4 qualifications tend to assess the application of knowledge, in other words, taking the knowledge and applying it in different situations.

Level 5 qualifications again is working with pathological tissue and includes ligament and neural injuries. Assessment, and treatment of these injuries are included in the qualification. Massage techniques included are further myofascial techniques, positional release, active isolated stretching and proprioceptive neuromuscular facilitation (PNF). Level 5 qualifications ask the student to take the knowledge, apply it in various situations and be able to justify or analyse what they have done.  As you can see, there are increasing levels of understanding and application of knowledge as the levels increase.

We are completely aware that there are many different qualifications available and some qualifications were gained many years ago. The qualifications gained prior to 2010 may have content from level 4 or 5 so we look at these separately. We also recognise that experience and CPD can extend the skills and knowledge of a therapist considerably, but formal qualifications are assessed during the process and the student is deemed to have an adequate level of knowledge and can demonstrate competence in practical skills.  CPD courses are rarely assessed for competence and experience is difficult to quantify so the only definite measure of skill is the qualification you have.

Level 5 qualifications form the basis of a foundation degree and a bachelor’s degree is level 6.  Most regulated qualifications are based upon degree level education. Please be aware that a regulated profession is not just a matter of listing the approved therapists but also has a high educational standard attached to it.

We receive many queries around regulation, specifically… why can’t our industry be statutorily regulated?

There is a sense that regulation by statute will be a panacea solving all problems of credibility and recognition. What has to be remembered is that regulation is designed primarily to protect the public. Regulation in the UK is on a spectrum based on perceived risk. Statutory regulation is not the badge of honour it once was and is largely reserved for professions regarded as high risk. At the other end of the spectrum is voluntary and self-regulation for low risk professions such as our own.

The Professional Standards Authority described UK regulation in these words: 

‘The regulatory framework for health and care is rapidly becoming unfit for purpose. The people who run regulation struggle to provide coordinated or coherent oversight of the delivery of care, despite their valiant efforts, because its parts are not designed to work together well.’

Our current belief is that with the vast majority of Therapists belonging to a Professional Association the industry does a reasonable job of protecting the public, and until there is a better regulatory model in the UK self regulation through the PAs and Voluntary regulation through bodies such as CNHC is the best option. The bigger issue is around providing a coherent voice for the industry particularly when talking to Government and this is where we should direct our endeavours in the future.

If you are interested in the detail of regulation in the UK we would refer you to the Professional Standards Authority website