The future of complementary medicine and the NHS in Scotland
At the start of June, Boo Armstrong (from Get Well UK) facilitated a meeting at Manor Place for people interested in exploring the future of complementary medicine and the NHS in Scotland and potential opportunities for social enterprises to deliver public services on an outreach basis. Boo sends us her report:
A meeting hosted by Senscot (the social entrepreneur network, Scotland) in Edinburgh to explore the future of complementary medicine and the NHS in Scotland. The meeting was held on 2nd June 2006 from 11am – 2.30pm.
Who attended the meeting?
Dr Pauline Stevenson, Stan Gerrard, Maggie McKeen, Les Huckfield, Audrey Hall, Frances Bryce, Neil McLean, Colin Campbell, Viv Reynolds, John Boswell, Pam Anderson, Maggi Scott, Chris Rogan, Pamela Cumming, Heather and Gaving Monteith, Kenny Drysdale, Boo Armstrong, Arun Sharma, Paulo Quadros, Geoff Harker, Licia Claveria, Rosie Grant, Sandra Laird, Gill Batty.
Boo Armstrong, founder of Get Well UK introduced the meeting
Get Well UK was established as a social enterprise working to end inequalities in health care and increase NHS access to complementary medicine in the UK. Work to date has focussed on demonstrating how a service could work, and promoting a musculoskeletal service to NHS commissioners in England.
Audits of Get Well UK’s work can be found at www.getwelluk.com/publications along with public policy research and the Smallwood Enquiry looking at cost-savings for the NHS through complementary medicine provision. Get Well UK is an example project in the report.
Get Well UK aims to increase access to complementary medicine and support practitioners to deliver high quality services in which they are valued; both professionally and financially.
The meeting was organised to assess the mood in Scotland, to bring together interested people and begin to work out a strategy to work together to achieve integration for the benefit of NHS finances and NHS patients.
Participants were asked to share their intention for the meeting and for increasing access to integrated healthcare. All contributions follow:
What do we want to achieve?
Integrated health centres for all – combing the best of western medicine and complementary medicine in a holistic way eg herbs, GPs
Build on the successes of Healthy Living Centres and existing work in hospital settings eg yoga in psychiatric hospitals with referrals from consultant psychiatrists
Practitioners are being trained to very professional standards and are working on placements in hospitals -> what to do with the database of practitioners?
Outreach into communities to ensure everyone can benefit
Political will for social enterprises to deliver public sector services – need to get information to politicians and commissioners of services about who provides services and how they are provided.
Do existing providers need support? What do they need?
Work with Community Health Partnerships
Get mainstream funding
Help people reduce medication (mental health specifically mentioned) – spend the money on complementary medicine instead
Create a network which is stable (past experiences people have agreed to do things and moved away, not done them etc.)
Use NHS E-Library – Scottish Complementary and Integrated Healthcare Forum
Show cost-savings to the NHS
Encourage GPs to avoid medicalising often human/person-centred problems and make more use of counselling, complementary medicine
Develop and work with professional standards eg supervision, clinical governance so that services are well regarded and understood to be safe by colleagues in the NHS
Why have people attended?
Share experience and ideas
Get ideas and find out what other people/groups are doing
Work with the NHS to increase income
Create a collective platform to achieve joint aims
Make the links between creativity/health improvement
Waiting lists – personal experience of how bad NHS lists are – can we intervene?
Platform for new therapies
Engage with the NHS
Learn about complementary therapies, for integrating into Quit and Save programme
Link into public health- improve the health or people in Scotland
Help narrow the health inequalities gap + increase choice for NHS patients
Education of practitioners
Potential for helping people with mental health problems – build on experience
Staff in NHS – help them to stay well
Help people get back into work
Peer-to-peer teaching -> health improvement
Formalise ad-hoc practice
To learn, adopt, adapt, improve
Assist in promoting awareness of and access to complementary medicine in Scotland
Work together to achieve a shared goal
In a democratic country people should be able to choose what kind of therapy they want.
What resources are available?
Enfact – East Neuwk of Fife Accessible Complementary Therapies
Pauline – might want to help create the network?
UnLtd – financial support for social entrepreneurs
Dunoon Link Club
Support from people in the NHS
Best practice to learn from
Evidence about what works
Foundation for Integrated Health
Universities in Scotland offer degrees and research – link in
Political support – health minister, civil servants/health advisors
Patients – share stories and success with NHS. Use patient power.
Link into specific patient groups eg people with MS, back pain, mental health problems, addiction, stroke
Professional organisations eg hypnotherapy body, herbalists etc
Service level agreements from community health partnerships
Social enterprise – one model could be providing services to some clients eg insurance companies and using profits to pay for community services
Link into social workers and health promotion days
Raise awareness of safety of herbal medicine and the financial savings that could be made for the NHS
Strength in numbers
Therapies that work with groups rather than individuals are cheaper
Lots of practitioners graduating every year
The emerging themes seemed to be: networks, standards and politics. Three groups explored these issues with the following results:
Levels of evidence
Social enterprise networks eg cultural
Potential network (from this meeting)
Website – access to databases
Scottish Complementary and Integrated Healthcare Forum (SCHIF) – can be used for sharing best practice and examples shared at the meeting
What are the barriers for referral?
Alternative routes for patients and GPs
Research Council for Complementary Medicine
One network to pull these strands together, different for different people, would be very helpful.
What therapies are available in Scotland and who provides them? Some therapies have registers of practitioners, but there is not one central resource. Why not?
College to offer training to complementary practitioners in additional skills eg NHS speak, clinical supervision, evaluation, measuring outcomes etc. New and emerging practitioners need new tools to work with/in the NHS.
GP information – need to preach to the unconverted. How do we do this?
BBC news website is registering interest in complementary therapies – vote now!
Within the NHS – could there be a body to deal with complementary therapies information. GPs would then have a single point of contact.
GPs need to be able to make informed decisions to refer their patients to a complementary therapist. They need to understand issues such as regulation.
Therapists need to be accountable for their work and understand their role.
Public health. Is this the natural ally for complementary medicine due to the preventative, whole person, hard to measure outcomes and impact.
Scottish Forum for Public Health has scholarships for public health work available and is linked into the Faculty of Public Health. www.sfph.org.uk to apply.
In Scotland there are 15 health boards and 40ish Community Health Partnerships, formed as part of Scottish health reform. Each Health Board has a public health strategy which sets the agenda for health improvement.
Would be most effective if complementary therapies had one consistent voice/message to the government. There needs to be room for individuality though.
Find allies, remember that many people at all levels of the NHS use complementary therapies.
Translate complementary medicine speak into a language that other health professionals and commissioners will understand.
Due to the centralised NHS in Scotland the most effective route is to get ministerial framework with funding to implement it.
Build on existing networks eg healthy living centres.
Work with regeneration areas. Budgets are agreed until 2009 but start lobbying for the next 3 year round. Find out who the decision makers are. Many practitioners have worked in the NHS before or do now – who are they and what skills, experience, networks do they have?
Develop the economic arguments eg supporting staff reduces absenteeism and increasing productivity; reducing medication; reducing hospital visits.
Are there enough practitioners ready to provide services?
Where does new NHS money go and who decides that? Currently goes towards staff increases and medication.
Scottish Intercollegiate Guidance Network (medical colleges who decide what new treatments to make available) and Quality NHS Scotland (evaluate treatments and decide on new drugs and treatments).
Can we work with these two groups and demonstrate effectiveness?
How to bring money into the sector – social enterprise (politically public sector services delivered by social enterprises are flavour of the month).
Some social enterprises have been successful in delivering services, generating money and changing public policy eg Salus in health and safety.
Private opportunities eg private companies, insurance, charitable donations.
Would a quality mark help? Would it make it easier for GPs to know who to buy services from?
Conclusion. commitments and Resources
There is a commitment to move these issues forward – but who and how is not clear. The first step is for everyone to join up to the SCHIF network (see attached), to share what they are working on, so that duplication can be avoided and the community becomes less fragmented.
There could be a role for a social enterprise to take this work forward? If anyone is interested start by talking to Senscot/Boo/UnLtd.
A contact list of people who attended and others who are interested is attached.
Join the SenScot mailing list for updates on social enterprise and politics etc. http://www.senscot.net/forms/bsubscribe.php
The participants said: Enthuse about today. Work ongoing to develop good practice. Measure client evaluation before and after treatment to see effect of therapy. Mull things over. Just do it Promote complementary medicine in Scotland. Promotion. Raise profile. Make the case to NHS funders (not easy!). Look at social enterprise and insurance companies.
Good luck and see you online at SCHIF…
Contact: Boo Armstrong, firstname.lastname@example.org