Physiotherapy education varies across Europe. Some variation is driven by differences in the professional remit of physiotherapists between jurisdictions, and some by the specific needs of health systems and populations, but one thing we all share is the need to increase our awareness of and action towards planetary health. This, however, is not mentioned in the draft EU common training framework (CTF).
The proposed European Common Training Framework is about much more than mobility. It presents an opportunity to delineate what is common and important to our profession. To ensure its relevance to physiotherapists today and into the future, the CTF should include planetary health and sustainability as integral elements required in the minimum training of physiotherapists.
Climate change, biodiversity loss, and pollution are increasingly recognised as major threats to human health and health system resilience, including across Europe and within physiotherapy practice (Romanello et al, 2023; Forde and Gaynor, 2026). Physiotherapists will increasingly encounter the consequences of environmental change through rising burdens of cardiorespiratory disease, heat-related illness, chronic disease exacerbation, mental health impacts, and disruption to healthcare delivery (Forde and Gaynor, 2026). A modern physiotherapy workforce in Europe (and beyond) must therefore be equipped to understand and respond to these challenges. Planetary health is therefore a fundamental “common training” that all physiotherapy courses should include.
Sustainability is no longer a peripheral educational concern. The European Union has committed to embedding sustainability competencies across education through initiatives such as GreenComp: The European Sustainability Competence Framework and the broader European Education Area agenda for the green transition (European Commission Joint Research Centre, 2022; European Commission, 2025). Excluding sustainability from a new EU-wide professional training framework would place physiotherapy behind wider European educational policy and societal expectations.
Cuisle Ford (PT, PhD)
Associate Professor in Physiotherapy and Education for Sustainability Fellow at Trinity College Dublin
Dr Forde teaches at undergraduate level and helped develop and coordinates the Postgraduate MSc in Clinical Exercise at Trinity College Dublin. She is an academic advisor to the Dublin Midlands Climate and Sustainability Committee under the Irish Health Service Executive.
Provide feedback and call for the inclusion of planetary health and sustainability education in the EU Common Training Framework for Physiotherapy Education
The CTF is open for individual feedback until 23 June 2026. You can download the EPA’s feedback here for inspiration.
In further support of planetary health as a common training need specific to physiotherapy, it should be noted that World Physiotherapy explicitly recognizes the climate change emergency and its significant impact on human health and well-being. World Physiotherapy’s global policy calls for physiotherapists to be aware of the interconnections between climate change, sustainable development, and global health and to collectively take action to reduce the environmental footprint of the profession. Furthermore, the Europe region of the World Physiotherapy has formally endorsed sustainable and environmental responsibility in the face of the climate crisis and its relevance to health, and the European Network of Physiotherapy in Higher Education (ENPHE) held a seminar entitled “The Future of Physiotherapy Education: Trends, Challenges, and Opportunities” during which a Planetary Health working group completed teaching prompts.
In their feedback regarding the CTF, the Europe Region of World Physiotherapy commented that the CTF should “reflect the full scope of contemporary physiotherapy practice” calling for stronger expectations in “sustainable practice”. This is to be commended, and aligns with the region’s progressive work in this area; however, the term “sustainable practice” is unfortunately open to adaptable interpretation and not clear enough with regard to the underlying understanding of sustainability (Maric, Plaisant & Richter, 2025).
Reading the draft CTF, as well as the public feedback on it, has reinforced my belief that we are a dynamic and varied people who care deeply about our profession, but that we do not (yet) consider planetary health a core part of our training. The reasons for this are beyond the scope of this blog, however, if you are reading this and believe, like I do, that we should equip our future physiotherapists with knowledge and competencies relevant to planetary health, then one thing that the CTF process does offer is a platform for such views to be shared, and I would invite you to do just that!
Provide feedback and call for the inclusion of planetary health and sustainability education in the EU Common Training Framework for Physiotherapy Education
The CTF is open for individual feedback until 23 June 2026. You can download the EPA’s feedback here for inspiration.
AI declaration
Artificial intelligence was not used in the creation of this blog.
References
All images by Cuisle Forde (PT, PhD)
European Commission. (updated Feb 2025). Learning for the green transition and sustainable development. European Education Area. https://education.ec.europa.eu/focus-topics/green-education/learning-for-the-green-transition
European Commission Joint Research Centre. (2022). GreenComp: The European sustainability competence framework. Publications Office of the European Union. https://op.europa.eu/en/publication-detail/-/publication/bc83061d-74ec-11ec-9136-01aa75ed71a1/language-en
Forde, C., & Gaynor, O. (2026). Climate change – How does it affect Physiotherapists and what can we do about it? Physiotherapy Practice and Research, 47(1). https://doi.org/1412590
Maric, F., Plaisant, M., & Richter, R. (2025). Advancing the deliberate implementation of the concept of sustainability and its alternatives in physical therapy research, practice, and education. Physiotherapy Theory and Practice, 41(6), 1239–1253. https://doi.org/10.1080/09593985.2024.2395486
Romanello, M., di Napoli, C., Green, C., Kennard, H., Lampard, P., Scamman, D., Walawender, M., Ali, Z., Ameli, N., Ayeb-Karlsson, S., Robinson, E. J., Lowe, R., & Costello, A. (2023). The 2023 report of the Lancet Countdown on health and climate change: The imperative for a health-centred response in a world facing irreversible harms. The Lancet, 402(10419), 2346–2394. https://doi.org/10.1016/s0140-6736(23)01859-7