SIST EN 16224:2012+A1:2014

Healthcare provision by chiropractors

This European Standard specifies requirements and recommendations for healthcare services provided by chiropractors.

Bereitstellung von Gesundheitsleistungen durch Chiropraktoren

Die vorliegende Europäische Norm legt Anforderungen und Empfehlungen an die durch Chiropraktoren angebotenen Gesundheitsdienstleistungen fest.

Prestation de soins de santé par les chiropracteurs

La présente Norme européenne spécifie les exigences et les recommandations relatives aux prestations de
soins de santé par les chiropracteurs.

Zdravstvene storitve, ki jih zagotavljajo kiropraktiki

General Information

• Status: Published
• Publication Date: 09-Mar-2014
• ICS: 11.020.10 - Health care services in general
• Technical Committee: I13 - Imaginarni 13
• Current Stage: 6060 - National Implementation/Publication (Adopted Project)
• Start Date: 10-Feb-2014
• Due Date: 17-Apr-2014
• Completion Date: 10-Mar-2014
• Ref Project: EN 16224:2012+A1:2014 - Healthcare provision by chiropractors

Relations

• Replaces: SIST EN 16224:2012 - Health care provision by chiropractors
• Effective Date: 01-Apr-2014
• Consolidates: SIST EN 16224:2012 - Health care provision by chiropractors
• Effective Date: 18-Jan-2023

Overview

EN 16224:2012+A1:2014 - Healthcare provision by chiropractors is a CEN European Standard that specifies requirements and recommendations for chiropractic healthcare services. It defines expected levels of clinical practice, education, organisation and professional conduct to promote patient safety, reproducible quality and evidence‑based care across chiropractic services in Europe. The standard incorporates Amendment 1 (2013) and is intended for adoption by national standards bodies; it does not supersede national legislation.

Key topics and technical requirements

• Clinical practice and patient management
  • Requirements for case history, patient examination, clinical records, diagnostic imaging, clinical decision‑making, plan of care and referrals.
  • Emphasis on documentation, informed decisions and continuity of care.
• Core competencies
  • Defines professional competencies necessary for safe chiropractic practice (assessment, treatment and communication).
• Education and training
  • Guidance on undergraduate, graduate programmes and continuing professional development (CPD).
  • Annex B provides a recommended curriculum model, subjects (biomedical, behavioural, clinical sciences) and clinical training guidance.
• Code of ethics
  • Professional conduct, confidentiality, consent, equality & diversity, and responsibilities towards patients and colleagues (Annex C).
• Clinic organisation and facility requirements
  • Practical requirements for clinic layout, hygiene, access, reception, consultation/treatment rooms and toilets.
  • Equipment requirements and maintenance expectations.
• Quality, safety and governance
  • Incident reporting, audit, quality assurance and clinical governance mechanisms to monitor and improve care.
• Professional infrastructure
  • Insurance, professional association membership and reporting standards.
• Supporting annexes
  • Annex A: patient records guidance; Annex D: noted deviations; Bibliography for further reading.

Practical applications - who uses this standard

• Chiropractors and clinic managers: adopt clinical record formats, infection control, equipment maintenance, referral pathways and quality assurance processes.
• Education providers: align curricula and assessment methods with the recommended programme content and clinical training expectations.
• Regulators and professional bodies: set licensure/registration criteria, codes of ethics, and CPD requirements consistent with the standard.
• Insurers and auditors: use the standard as a benchmark for clinical governance, risk management and service audits.
• Healthcare commissioners and multidisciplinary teams: reference the standard when integrating chiropractic services into primary and secondary care pathways.

Related information

• Published by CEN/TC 394 and approved for national adoption across CEN member countries.
• The standard references the WHO definition of chiropractic and encourages evidence‑based review of services.
• Note: EN 16224:2012+A1:2014 complements national legislation and local clinical guidelines rather than replacing them.

Keywords: EN 16224:2012+A1:2014, healthcare provision by chiropractors, chiropractic services, clinical governance, patient records, chiropractic education, code of ethics, CEN standard.

Standards Content (Sample)

2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.Zdravstvene storitve, ki jih zagotavljajo kiropraktikiBereitstellung von Gesundheitsleistungen durch ChiropraktorenPrestation de soins de santé par les chiropracteursHealthcare provision by chiropractors11.020.10Zdravstvene storitve na splošnoHealth care services in generalICS:Ta slovenski standard je istoveten z:EN 16224:2012+A1:2014SIST EN 16224:2012+A1:2014en,fr,de01-april-2014SIST EN 16224:2012+A1:2014SLOVENSKI
STANDARDSIST EN 16224:20121DGRPHãþD

EUROPEAN STANDARD NORME EUROPÉENNE EUROPÄISCHE NORM
EN 16224:2012+A1
January 2014 ICS 03.120.10; 11.020 Supersedes EN 16224:2012English Version
Healthcare provision by chiropractors
Prestation de soins de santé par les chiropracteurs
Bereitstellung von Gesundheitsleistungen durch Chiropraktoren This European Standard was approved by CEN on 10 May 2012 and includes Amendment 1 approved by CEN on 12 December 2013.
CEN members are bound to comply with the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this European Standard the status of a national standard without any alteration. Up-to-date lists and bibliographical references concerning such national standards may be obtained on application to the CEN-CENELEC Management Centre or to any CEN member.
This European Standard exists in three official versions (English, French, German). A version in any other language made by translation under the responsibility of a CEN member into its own language and notified to the CEN-CENELEC Management Centre has the same status as the official versions.
CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, Former Yugoslav Republic of Macedonia, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland, Turkey and United Kingdom.
EUROPEAN COMMITTEE FOR STANDARDIZATION
COMITÉ EUROPÉEN DE NORMALISATION EUROPÄISCHES KOMITEE FÜR NORMUNG
CEN-CENELEC Management Centre:
Avenue Marnix 17,
B-1000 Brussels © 2014 CEN All rights of exploitation in any form and by any means reserved worldwide for CEN national Members. Ref. No. EN 16224:2012+A1:2014 ESIST EN 16224:2012+A1:2014

Patient records . 17 A.1 Duty to keep patient records . 17 A.2 Content of patient records . 17 A.3 Correction of patient records . 17 Annex B (informative)
Recommended programme curriculum
.................................................................. 18 B.1 General ................................................................................................................................................. 18 B.2 Curriculum model and educational methods .................................................................................. 18 B.3 Basic biomedical sciences ................................................................................................................ 19 SIST EN 16224:2012+A1:2014

Code of ethics . 23 C.1 Working with patients . 23 C.1.1 Good clinical care . 23 C.1.2 Health promotion and self care . 23 C.1.3 Raising concerns about patient safety . 23 C.1.4 Equality and diversity . 24 C.1.5 Keeping up to date . 24 C.1.6 Teaching, training, appraising and assessing . 24 C.1.7 The chiropractor-patient partnership . 24 C.1.8 Communicating with patients . 24 C.1.9 Communicating with other health professionals . 25 C.1.10 Preparing reports for third parties . 25 C.1.11 Children and young people . 26 C.1.12 Vulnerable adults . 26 C.1.13 Dealing with relatives, carers and partners . 26 C.2 Openness and honesty . 26 C.2.1 General . 26 C.2.2 Maintaining trust in the profession . 27 C.2.3 Consent . 27 C.2.4 Providing access to patient health records . 28 C.2.5 Confidentiality . 28 C.2.6 Discharging patients . 28 C.3 Working with colleagues . 29 C.3.1 General . 29 C.3.2 Colleagues’ conduct and performance . 29 C.3.3 Respect for colleagues . 29 C.3.4 Sharing information with colleagues . 29 C.3.5 Delegation and referral . 29 C.3.6 Honesty and trustworthiness . 30 C.3.7 Providing and publishing information about chiropractic services . 30 C.3.8 Writing reports and giving evidence . 30 C.3.9 Research. 30 C.3.10 Financial dealings . 31 C.3.11 Conflicts of interest . 31 SIST EN 16224:2012+A1:2014

A-deviations" . 32 Bibliography . 35
identify when further investigations are needed and act on this need in the patient’s best interests; b) use further investigations when the information gained from such investigations will benefit the management of the patient; c) undertake and/or interpret the results or, if this is not possible, refer the patient for appropriate further investigations; d) record the outcomes of the investigations in the patient record. 3.1.5 Clinical decision making and diagnosis The chiropractor shall: a) evaluate the patient’s health status and health needs from the information gained during the case history, physical examination and further investigations; b) formulate and document a working diagnosis and/or differential diagnosis and a rationale for care, based on the evaluation of this information. The diagnosis, or rationale for care, shall be kept under review while caring for the patient; c) interpret all of the information available about a patient and then make and record decisions about the patient’s health and health needs and how these change over time; d) consider the natural history and prognosis of any presenting complaint, or emergency situation that might need immediate action, and the likelihood of preventing recurrences or managing any long-term healthcare needs. SIST EN 16224:2012+A1:2014

Patient records A.1 Duty to keep patient records a) The chiropractor should record information in a patient record for each patient. b) Patient records should be written in an official language of the country. c) Patient records should be stored by either paper or electronic means and the security maintained such that they are only accessible to authorised personnel. d) The chiropractor should ensure that provision is made for the safe-keeping and secure storage of patient records upon ceasing work at their practice address or in the event of their death. A.2 Content of patient records Patient records should contain the following information: 1) patient’s name, address, date of birth, contact details, marital status, gender, occupation; 2) if the patient is not competent to give consent, the name and status of the person giving consent; 3) notification if treatment or advice is given in contradiction with clinical guidelines; 4) advice given to the patient; 5) reason a patient has required access to records or required corrections of records; 6) information given to or received from other healthcare providers, institutions, laboratories, insurance companies, police, child welfare, etc.; 7) patient’s general medical practitioner; 8) notes on sick leave, reports. Patient records should be an accurate reflection of each clinical encounter and should include any factors relevant to the patient’s ongoing care, including their general health. All records should be understandable to another chiropractor who may be called upon to assume the care of the patient. Records should be stored securely in accordance with local legislation. A.3 Correction of patient records Any errors within a patient record should be corrected by the addition of the correct information without deletion of any previously entered information and noting the source of the correction. SIST EN 16224:2012+A1:2014

Recommended programme curriculum 1) B.1 General A programme curriculum should include: 1) curriculum model and educational methods; 2) basic biomedical sciences; 3) behavioural and social sciences, ethics and jurisprudence; 4) clinical sciences and skills; 5) clinical training; 6) assessment methods and regulations; 7) curriculum level, structure and composition. B.2 Curriculum model and educational methods The chiropractic institution should define a curriculum model and educational (teaching and learning) methods consistent with the objectives of the curriculum. The curriculum and educational methods should ensure the students have responsibilit
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