Complementary and Alternative Medical practices: Osteopathy
Complementary and Alternative Medical Practices
A new national register of Complementary and Alternative Medicines (CAMs) has been developed for GPs, CCG board members and private healthcare practitioners, who refer patients to CAM treatments. A national study completed in 2007 concluded that: "More and more people are turning to CAM therapies, like osteopaths, in point of fact 51% of the population are expected to use one or more CAM therapies during their lifetime".
The General Medical Council, the body which licenses doctors to practise medicine in the UK, states in its guidance for the profession, Tomorrow’s Doctors, that doctors should be able to: "Demonstrate awareness that many patients use complementary medicine, and awareness of the existence and range of these therapies, why patients use them, and how this might affect other types of treatment that patients are receiving."
The National Institute for Health and Care Excellence (NICE), the statutory body responsible for providing national guidance and advice to improve health and social care, states that: "…the use of CAM is widespread and increasing across the developed world. There is a clear need for more effective guidance for health professionals, so that they can give evidence-based advice to patients about what does and does not work and what is and is not safe, and for the public."
The medical profession is attempting to respond to the rapidly growing public demand for CAMs − over 50% of GPs are now providing access to a range of treatments and therapies that are outside conventional medicine − and the British Medical Journal, the official publication of the British Medical Association, has made calls for GPs to receive better instruction in the use of CAMs.
However, despite the aim of successive governments of giving patients freedom to choose medical treatments, including CAMs, the Department of Health has struggled to find any meaningful and practical way of widening provision or encouraging the development of these treatments on the NHS.
The DoH website, Supply2Health, is intended to be a national register of Any Qualified Providers, including CAMs. The Government states that: "Any Qualified Provider (AQP) is an important tool available to commissioners to ensure patients are offered the highest quality community services in a setting that suits them… When a service is commissioned using choice of Any Qualified Provider, any provider which meets the strict NHS standard qualification process can provide a service locally. An AQP can be from the NHS, charity or independent sector. Patients go to the provider of their choice, based on quality and individual preferences. Competition will be on quality, not price".
A cursory glance at Supply2Health, however, shows that the website is completely unfit for purpose. The range of treatments and therapies listed as available is extremely limited: acupuncture, for example, which NICE actually recommends as a treatment option for lower back pain on the basis of scientific evidence is not listed. In fact, Supply2Health lists only one provider who actually offers a CAM.
The rationale behind any complementary, alternative or integrative/holistic treatment is exactly the same as conventional medicine: improving the health of the patient. In terms of a National Health Service, this imperative is increasingly allied to that of expense: as the cost of promoting the nation’s good health and treating its ill health increases, so the need grows for more cost-effective treatments than the NHS traditionally has been capable of supplying.
The Health and Social Care Act 2012 is the most extensive reorganisation of the NHS in its history. The Act abolishes Primary Care Trusts and Strategic Health Authorities and transfers up to £80 billion of commissioning funds to 211 clinical commissioning groups (CCGs), which will be controlled by a strong GP presence. It is critical to the success of the new Act, and the Government’s wider ambitions for its health reforms, that GPs are able to refer patients to selected CAM therapies where appropriate. However, while the new CCGs are extremely unlikely to fund any treatment which is not available on the NHS at this time, given the current state of economy, we hope that our National Register together with constant lobbying will make NHS funding for CAM therapies a reality in the near future.
The ultimate aim of the register of Complementary and Alternative Medicines is therefore no less than to encourage GPs and clinical commissioners to refer patients to the providers of CAM treatments. This will be done by providing an authoritative, reliable and comprehensive source of information on the integrative/holistic treatments available, including the rationale behind each treatment; a guide to its claims and usage; and a geographical listing of qualified practitioners for each discipline.
The first phase of the directory will include the therapies listed below:
The directory will be limited initially to fully licensed professionals who accept GP referrals on a private-patient basis. Although many of those listed within this directory would qualify for AQP status, Commissioning.GP is not preparing such a directory at this time.
All practices that participate in the CAM directory will be charged a registration fee which will cover the creation of a Micro Site. This allows the viewer to search, evaluate and compare each practice before choosing a preferred practitioner.
All choices and decisions to use a particular practice are strictly between the patient and the practice. Commissioning.GP makes no recommendations and gives no undertaking with respect to any treatment received, nor does it endorse any individual treatment or practitioner.
For further information please visit Dynamic Osteopaths