This piece has just come out about my award winning local health project BLOSSOM!

1. 24 PrimaryCare TODAY November/December 2011
Complementary Therapy Clinical Focus Incorporating Complementary Therapy HIV Asthma Nutrition Diabetes
When commissioning complementary
By Maggy Wallace The report concluded by making it explicit that regulation in general, including both statutory and
more regulation was needed for this sector. And from voluntary regulation.
Much is currently being written about commissioning – but it appears not this report and subsequent associated activity arose CNHC now registers a range of practitioners qual-
everyone is entirely clear what it all entails. the CNHC, established with DH funding, as the
voluntary regulator for complementary healthcare
ified in a number of complementary disciplines. So
what does this mean as far as commissioning com-
W
ander around the net and definitions complementary healthcare? We would describe it practitioners in the UK. plementary healthcare is concerned? A very recent
abound: take your pick: the NHSACE as a collective approach to healthcare, that sits
example will help to illustrate quickly what CNHC
website (1) offers both narrow definitions: alongside allopathy, in offering choice and options The current picture
‘the cumulative effect of GP referral and prescribing for people with some healthcare problems. Often The HoL Report was published over 10 years ago. registration can mean in practice, with application
decisions’; and wider ones: ‘more about the decisions referred to as complementary therapies (and some- Table 1 shows the current picture for healthcare for commissioners.
made by the holders of public budgets whether and times as alternative), The House of Lords Science and
when to make or buy healthcare’. Doug Forbes of Technology Sixth Report in 2000 (4) classified what
The Institute of Commissioning Professionals puts was available then as follows:
it very simply, it is about ‘what to acquire’ (2). Group 1: Professionally organised alternative ther-
Another level of commissioning describes it is as apies ‘Principal disciplines which claim to have an
‘understanding how to achieve successful prevention, individual diagnostic approach and are considered
and working with patients in community settings the ‘big 5’ by most of the CAM world’. This includes
on the ongoing management of their long-term acupuncture, chiropractic, herbal medicine, home-
conditions’ (3). But there always appears to be a opathy and osteopathy.
caveat, neatly summed up by Julie Wood, National Group 2: Complementary therapies ‘Therapies
Lead for Clinical Commissioning, who talks about which are most often used to complement con-
‘fingers being crossed behind the system’s back’ in ventional medicine and do not purport to embrace
promising to deliver the Promised Land for the NHS. diagnostic skills’. This includes: Alexander Technique,
Certainly all seem to agree that it’s hard, including the aromatherapy, Bach and other flower remedies,
King’s Fund’s CEO Professor Chris Ham. body work therapies, including massage, counselling
stress therapies, hypnotherapy, meditation, reflexol-
How can CNHC help to simplify the com- ogy, shiatsu, healing, Maharishi Ayurvedic Medicine,
missioning of complementary healthcare? nutritional medicine, yoga.
The Complementary & Natural Healthcare Council Group 3: Alternative disciplines ‘Those which
(CNHC) was set up with Department of Health sup- purport to offer diagnostic information as well as
port to provide a national register of complementary treatments…which are indifferent to the scientific
healthcare practitioners. As such, we can help by principles of conventional medicine.’
giving commisioners accurate, timely and useful Group 3a: includes long established and tradi-
information on which to base their decisions in rela- tional systems of healthcare: eg: anthroposophi-
tion to commissioning complementary healthcare. To cal medicine, Ayuvedic medicine, Chinese herbal
find out how can we do that, read on. medicine, Eastern medicine, naturopathy, Traditional
It is clear that the complementary healthcare sec- Chinese Medicine.
tor is confusing. What is complementary healthcare? Group 3b: Other alternative disciplines ‘Other
Who does it? Who actually has an accurate picture alternative disciplines which lack any credible evi-
and how do I commission it? dence base’ eg: crystal therapy, dowsing, iridology,
Let’s start with a definitition of sorts.What is kinesiology, radionics.
Bowen Therapy: allowing chronic pain to roll off your back
• According to a report* out in September 2010 there are eight million chronic pain sufferers in Britain alone.
Most problems involve the back, which costs the nation £12.3billion annually, in health bills and lost productivity.
• Bowen Therapy is an alternative, natural, drug-free, non-invasive complementary therapy.
• A national study, carried out by The Bowen Therapy Professional Association (BTPA) in the summer of 2006, showed
that 95 per cent of back pain sufferers experienced either complete relief or a marked improvement, after a series of no
more than three Bowen treatments.
• The technique involves the therapist using only thumbs and fingers, to make gentle rolling movements over
muscles and tendons at precise points. It is believed that the moves send impulses to the brain to
trigger the body’s own healing systems. A gap of 5 to 10 days is recommended between Bowen sessions;
so that the body can process the subtle information it has been given.
• Short-term (acute) injury may be resolved in 1 – 3 Bowen treatments, while
• long-standing (chronic) conditions may require longer.
• As well as chronic back pain, Bowen Therapy can also help with a host of other health
• issues such as: frozen shoulders, sports injuries,whiplash, migraine, hay fever,
• asthma, IBS, fertility matters to name but a few.
• The Bowen Therapy Professional Association (BTPA) is the largest UK professional
association for qualified Bowen Therapists.
• For further information on Bowen Therapy, registered BTPA members in your area,
• how to become a BTPA member and/or testimonials visit www.bowen-therapy.co
• or call 0844 561 7173.
*The September 2010 report was sponsored by drugs giant, Pfizer

2. November/December 2011 PrimaryCare TODAY 25
Clinical Focus Incorporating Complementary Therapy HIV Asthma Nutrition Diabetes Complementary Therapy
healthcare – prepare for challenges
a Case Study meet this need and if these therapies are offered to recruit a ninth: “As a team we aim to provide
CNHC registrant Jane McGrath has gained sup- then practitioners must be properly registered. I feel evidence based high quality care and ensure patient
port from her local Primary Care Trust (PCT), that McGrath’s CNHC registration is really impor- safety. Within the recruitment we ask for CNHC
Mind and Enabled4Growth, which is run by tant in providing the service, as it gives the user a registration as this is assurance and safeguard of the
Leonard Cheshire Disability, to set up an innova- guarantee of quality.” professional qualification of the practitioner. We
tive new social enterprise in the London Borough James Coke, fundraiser for Hammersmith &
Fulham Action on Disability (HAFAD) agreed: “Jane work in tertiary care and also in the community
of Hammersmith & Fulham. Called ‘Blossom’, the
organisation provides what McGrath describes as worked with HAFAD on our summer fayre offering setting. It’s important for us to model best practice
registration can offer to commissioners: viz: assur-
‘high end’ complementary therapies to those who complementary therapy which went down a storm to the complementary therapy community and also
ance that registrants:
can afford to pay and uses the profit to deliver ther- with our members. The fact she is CNHC registered within the health and social care setting. CNHC
gave peace of mind and incentivised members to a) have met national occupational standards (ie registration ensures that the team comply with Trust
apy services at substantially reduced cost to patients
explore her therapies as they knew they would be achieved occupational competence) for their
in the Borough’s deprived areas. Blossom was policy on recruitment of therapists and also the
launched in August 2011 and McGrath has received in safe hands.” discipline;
National Cancer Peer Review Programme, Manual
an award from UnLtd to develop her marketing. In terms of the service itself, McGrath says the full b) meet requirements for staying up-to-date with for Cancer Services 2008 Complementary Therapy
The reduced cost therapy services are only paying clients are really happy with the approach. the new CPD requirements; (Safeguarding Practice ) Measures.”
available for people with clinical need who are “People who can afford to pay have said they are c) can be called to account for poor practice Lamont continued: “The Belfast Health and
receiving support for recovery of long term medical really pleased to be able to put something back through the robust Fitness to Practice processes;
conditions and mental illness. Due to the nature of into their local community. I’m thrilled because Social Care Trust with funding from our local cancer
the client group, McGrath’s CNHC registration was this model gives me the opportunity to deliver d) are properly insured; charity, Friends of the Cancer Centre, has recently
crucial. “The first question the PCT practice man- high-quality services to patients who would not e) have access through the web site to relevant appointed two therapists, Tracy McAloney and Patsy
ager asked me was ‘Are you CNHC registered?”, otherwise be able to afford these kind of therapies.” information on a range of healthcare issues relat- McDaniel, as complementary therapist facilitators
McGrath said. “He told me they are approached But perhaps most importantly, McGrath talks ing to regulation. to develop outreach services to cancer patients and
by a lot of therapists wanting to work with these about the difference it makes to her patients: “I their carers throughout Northern Ireland. This role
work with some very vulnerable people, particularly CNHC is finding that increasing numbers of com-
patients but they will only recommend CNHC reg- will be working in partnership with NHS providers,
those who are in recovery from mental health prob- missioners and employers are requiring their com-
istered practitioners.” charities and private practitioners and although
CNHC registration was also a key factor for lems. They always ask me where I’ve trained and plementary healthcare practitioners to be CNHC
registered to ensure public safety. Many view CNHC registration with CNHC is voluntary we will be
Blossom’s partner organisations. Enabled4Growth want to know that I am properly registered. They
want to know that I am credible and that they can registration as a demonstration of best practice for promoting registration so that service commissioners
supports disabled people to make choices which
are right for them and is working with McGrath on trust me. My CNHC registration provides this reas- practitioners as well as the profession itself. can ensure best practice.” McAloney said: “CNHC
the project. Enabled4Growth’s Business Adviser, surance and that’s very important.” Jan Wilkinson, Complementary Therapies promotes the professionalism of complementary
Leonore Lord, said: “As Blossom provides com- McGrath (right) is aiming to do research on the Co-ordinator for Guys and St Thomas’s NHS therapy and reassures patients and clients that
plementary services for people with all types of impact of the service and Foundation Trust said: “CNHC registration is essen- therapists meet the required occupational standards
Photo: Karen Lois Whiteread
disabilities – it is absolutely essential that any com- if the business model is tial for any complementary practitioners who wish before they can be added to the register.”
plementary service we are working with has been successful hopes to work to work for us. This is in line with guidance from
with Leonard Cheshire the National Cancer Action Team and demonstrates Maggy Wallace is Chair of CNHC, the voluntary
vetted and approved. The CNHC quality mark gives
both us and our service users peace of mind.” Disability to roll the service our commitment to meeting national occupational regulatory body for complementary healthcare.
Similarly, Alex Tambourides, Chief Executive of out nationally. standards.”
(1) 2011 ACE web site home page October 2011
Hammersmith and Fulham Mind commented: “The Lyn Lamont, Complementary Therapies
(2) Forbes, Doug ‘Achieving Commissioning Excellence’ available on www.
standard suite of interventions for people with The value of CNHC Co-ordinator for the Cancer Centre, Belfast Health commisioning.org.uk
mental health is not enough so there is a big need registration and Social Care Trust agrees. Lamont said the Trust (3 )Forbes, Doug, ‘Achieving Commissioning Excellence.’
for complementary therapies, as different things This case study helps to currently employs a team of eight CNHC regis- (4) 2000 House of Lords Science and Technology Select Committee 6th Report
work for different people. Blossom is helping to demonstrate what CNHC tered practitioners within cancer care and is due Complementary and Alternative Medicine
Western Medical Acupuncture BRITISH MEDIAL
ACUPUNCTURE SOCIETY
– ancient and modern FOUNDATION COURSES IN WESTERN
MEDICAL ACUPUNCTURE
by Allyson Brown, British Medical Acupuncture Society
The BMAS runs Foundation Courses for healthcare professionals who are subject to
A
cupuncture has been around for centuries, from account of a number of large studies carried out mostly statutory regulation, registered in the UK, or the country in which they practice, and for
the telltale tattoo marks on Ötzi the Iceman in Germany, and a subsequent Cochrane review. whom acupuncture is within the scope of their professional practice.
preserved in an alpine glacier to the traditional Cochrane reviews also concluded that ‘available
concepts from ancient China. So what’s new? studies suggest that acupuncture is at least as effective FOUNDATION COURSE VENUES
Western medical acupuncture takes a fresh look as, or possibly more effective than, a prophylactic drug YORK, BRISTOL, LONDON, MANCHESTER,
at needling as a therapeutic modality, using current treatment, and has fewer adverse effects’ for migraine, GLASGOW, BIRMINGHAM, NEWCASTLE
knowledge of anatomy, physiology and pathology, and and that it is ‘a valuable non-pharmacological tool in
the principles of evidence based medicine. We know
SUPPLEMENTARY COURSES
patients with frequent episodic or chronic tension type
now that acupuncture acts principally by stimulating headaches’.
the nervous system; its known modes of action include Acupuncture for nausea and vomiting was the first * BACK PAIN * ELECTROACUPUNCTURE * (free machine)
local andtidomitic axon reflexes, segmental and area with a positive systematic review, and the latest LUMBOGLUTEAL / SHOULDER & ARM / HEAD & NECK POINTS
extrasegmental modulation, and other central nervous
Cochrane review on the subject concluded that there
system effects. Simply put, it modifies the way that
pain signals are received by the brain.
was ‘no reliable evidence for differences in risks of
JOIN THE BMAS
postoperative nausea or vomiting after P6 acupoint
Acupuncture is frequently incorporated into pain
stimulation compared to antiemetic drugs’. * Discounted course fees * Recognition by health insurers (subject to accreditation)
management programmes within pain clinics, and is * Free online Points resource – video demonstrations of examination & techniques
So one of the most ancient therapies used by
probably used most often to treat musculoskeletal and (Cross over package available for experienced acupuncture practitioners)
myofascial trigger point pain. But there are proven man is finding a new place in current contemporary
healthcare as a safe, cost efficient and demonstrably
effects of muscle tone, hormone outputs, circulation,
effective therapy. WEBCASTS NOW AVAILABLE
antibody production and allergic responses. It is also
effective for post-operative pain and nausea. The British Medical Acupuncture Society was Online presentations of the BMAS Spring/Autumn meetings
established in 1982 to promote the use and scientific CPD hours available on completion of quizzes
An increasing number of GPs and hospital doctors
provide acupuncture for their patients, with it being understanding of acupuncture within medicine for
of particular value to those who are unwilling or the public benefit. It seeks to enhance the education Book online at: www.medical-acupuncture.co.uk
unable to rely on a pharmaceutical intervention, such and training of suitably qualified practitioners, and
as pregnant women, those already on medication to promote high standards of working practices in Tel: 01606 786782 Fax: 01606 786783
for chronic diseases, or patients in palliative care. acupuncture.
Nurses and midwives are also learning to incorporate The Society offers four-day foundation courses in Email: admin@medical-acupuncture.org.uk
acupuncture into their practice in these scenarios, and medical acupuncture, designed to build on the existing
physiotherapists are among a group of allied health medical training of regulated health professionals, BMAS House, 3 Winnington Court
professionals adding medical acupuncture to their giving them the skills they need to incorporate medical Northwich CW8 1AQ
portfolio of therapies. Audits are starting to show that acupuncture into their existing practice.
acupuncture is both safe and cost effective, and patient
demand for this treatment seems to be growing. To find out more about the British
NICE guidelines for the early management of non- Medical Acupuncture Society visit
specific low back pain (six months to one year) include www.medical-acupuncture.co.uk
consideration of 12 sessions of acupuncture over Material for this article was drawn from the document ‘The latest
three months. These guidelines were drawn up taking evidence for acupuncture’ on the BMAS website.