A global movement for change: take-homes from Tokyo

Before heading to the World Physiotherapy Congress in Tokyo, I wrote about the value of learning from our international colleagues. 

Now, having experienced it first-hand, I find myself inspired and more energised than ever. This was more than just a congress — it was a powerful reminder that physiotherapy sits at a pivotal moment in its evolution.

Across every session I attended and each panel I participated in — whether on the future of our workforce, the economics and funding of physiotherapy, or our role in global sustainability — one message rang clear: physiotherapy must adapt boldly and collaborate deeply if we are to meet the moment.

We are entering an era shaped by major global shifts. Populations are ageing. People are living longer, often with more complex, chronic, and multiple conditions. Technology is advancing at breakneck speed — with artificial intelligence, digital health platforms, and data-driven insights increasingly shaping healthcare delivery. 

Meanwhile, health inequalities are widening, exposing deep-rooted disparities in access, outcomes, and trust. And within our own profession, we face serious workforce capacity challenges, alongside a rise in international mobility that is reshaping the makeup of our global workforce.

And yet, in this challenge lies immense opportunity.

                  Collaboration: Our Strongest Asset

This congress reaffirmed for me that physiotherapy’s strength lies in collaboration. We must work not only across borders but across disciplines. No single profession can address the scale of what is coming. We must partner more intentionally — with medicine, nursing, public health, occupational therapy, social work, community health advocates and exercise professionals — to co-create systems that work for people, not just patients.

As physiotherapists, we bring unique strengths to this collaboration: our whole-person approach, our skill in movement, our ability to listen and connect, and our deep training across all body systems. These generalist foundations are not something to grow out of — they are something to protect, to champion, and to adapt to new settings, especially in managing complexity in underserved and ageing populations.

With increasing global mobility of physiotherapists we should have a mission to raise standards around the world. To work with other clinicians, regulators, universities, researchers and leaders to ensure that every physiotherapist has the opportunity to thrive, what ever environment they are in.

A Shift in Philosophy

We must also rethink where and how physiotherapy is delivered. The future must lie in shifting care closer to home and into communities — especially for those who are least able to access it. The congress was filled with powerful, humbling examples of this. I listened to stories of physiotherapists painstakingly creating custom burn masks for survivors in Syria and Haiti, delivering rehabilitative care on foot in some of the most rural areas of Africa, and designing safe, inclusive environments in New Zealand to ensure that Indigenous communities feel culturally respected and physically safe when receiving care. In Poland, we heard how physiotherapists are now actively shaping national workforce planning strategies, influencing system-wide reform from the ground up. And in Canada, physiotherapists are taking on leadership roles in oncology pathways, designing and delivering complex, evidence-based care in a field where our contribution is increasingly critical.

These are not outliers — they are beacons. They show us what is possible when we combine skill, compassion, cultural sensitivity and professional autonomy.

We must try to align education, commissioning and service design, policy and workforce strategies. Retaining and developing the right skills will only be maximised with service design shifting away from traditional silos (MSK, neuro, respiratory etc.), towards personalised, person centred care pathways. We can lead this charge!

Releasing Capacity: What Can We Let Go?

To rise to these challenges, we need to create space and time for ourselves. That means asking difficult, provocative questions: What can we give up? What can other professions take on? What can technology, including AI, do better or faster so that we can focus on what only we can do?

This is not about surrendering roles — it’s about elevating our contribution. About focusing our efforts where they matter most. In the UK we have a complex, multicultural, diverse population. Understanding the complexity of this takes time and time we often don’t have in a stretched system with a stretched workforce. Building trust takes time, and delivering care that respects different cultures, religions, and experiences of health and illness across communities is something we must get right.

Letting go of things we have traditionally delivered may give us a shot at managing the rising complexity and comorbidity we see in the UK and around the world. This is however, a luxury for me to talk about. In the the UK, physiotherapy is well established, its scope well defined and its position in the healthcare system well respected. This isn’t the case everywhere, so letting go of things may not be an option right now.

A Call to Global Leadership

If there’s one message I’m taking home from Tokyo, it’s this: we must lead. Not with ego, but with empathy, evidence, and a shared global ambition to raise the standard of physiotherapy worldwide. That includes leading in research, in education, in clinical practice and in service transformation.

As the UK, I truly believe we can demonstrate excellent leadership in this movement — but it was also clear that we have so much to learn from colleagues across the globe. Whether it’s innovations in rural health delivery, the integration of physiotherapists into public health systems, or new models of community-based rehabilitation, other countries are advancing in ways that should both inspire and challenge us.

The physiotherapists I met — from every corner of the world — showed me how life-changing our work can be. We are problem-solvers, advocates, innovators and healers. Whatever challenges lie ahead, I am confident that physiotherapy has the heart, skill and global unity to face them — and to thrive.

Let’s not wait to be invited to the table. Let’s build it, together.