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Complementary medicine and the NHS: experiences of integration with UK primary care

Complementary medicine and the NHS: experiences of integration with UK primary care
Complementary medicine and the NHS: experiences of integration with UK primary care

Introduction: Complementary and alternative medicine (CAM), often accessed privately, can be integrated with conventional care. Little is known about current integration in the UK National Health Service (NHS). We provide an overview of integrated CAM services accessed from UK primary care for musculoskeletal and mental health conditions, to identify key features and barriers and facilitators to integration. Methods: Descriptive analysis of integrated services accessed from primary care providing CAM alongside conventional NHS care for musculoskeletal and/or mental health problems. A purposive sample was identified through personal contacts, social media, literature/internet searches, conferences, and patient/professional organisations. Questionnaires, documentary analysis and stakeholder meetings collected data on the service's history, features, integration, success and sustainability. Data was tabulated. Results: From 38 sites identified, twenty sites were selected. Acupuncture and homeopathy were most common, followed by massage, osteopathy and mindfulness. GPs were often instrumental initiating services. NHS staff enthusiasm facilitated integration, as did an NHS setting, patient/public support, and being adjunctive to an NHS service. The main barriers to integration were funding, negative perceptions of CAM from the clinicians, funders and lobby groups, and local NHS staff attitudes/lack of knowledge. Reduced funding was often why services closed. Conclusions: Various models for integrating CAM with UK primary care were identified. Social prescribing and NHS/patient co-funded CAM may be potentially sustainable models for future integration. Lack of funding and negative perceptions of CAM remain the primary challenge to integration. Evaluating effectiveness and cost-effectiveness of integrated services is vital to ensure sustainability.

Comorbidity, Complementary therapies, General practice, Integrative medicine, Primary health care
1876-3820
8-16
Sharp, Deborah
5be021f2-ec75-4317-bf7d-f02328a50107
Lorenc, Ava
08d9d6c2-99d6-4409-9577-c792c7d41751
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Mercer, Stewart W.
66234c9c-400d-4e2d-bf01-151d1a33b762
Hollinghurst, Sandra
e0ec6e20-afca-437a-a2e1-4250ea157811
Feder, Gene
0fba983e-5a70-4280-99af-69811d2d6a56
MacPherson, Hugh
6485cd22-1dc3-4600-9e00-d3187e981663
Sharp, Deborah
5be021f2-ec75-4317-bf7d-f02328a50107
Lorenc, Ava
08d9d6c2-99d6-4409-9577-c792c7d41751
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Mercer, Stewart W.
66234c9c-400d-4e2d-bf01-151d1a33b762
Hollinghurst, Sandra
e0ec6e20-afca-437a-a2e1-4250ea157811
Feder, Gene
0fba983e-5a70-4280-99af-69811d2d6a56
MacPherson, Hugh
6485cd22-1dc3-4600-9e00-d3187e981663

Sharp, Deborah, Lorenc, Ava, Little, Paul, Mercer, Stewart W., Hollinghurst, Sandra, Feder, Gene and MacPherson, Hugh (2018) Complementary medicine and the NHS: experiences of integration with UK primary care. European Journal of Integrative Medicine, 24, 8-16. (doi:10.1016/j.eujim.2018.10.009).

Record type: Article

Abstract

Introduction: Complementary and alternative medicine (CAM), often accessed privately, can be integrated with conventional care. Little is known about current integration in the UK National Health Service (NHS). We provide an overview of integrated CAM services accessed from UK primary care for musculoskeletal and mental health conditions, to identify key features and barriers and facilitators to integration. Methods: Descriptive analysis of integrated services accessed from primary care providing CAM alongside conventional NHS care for musculoskeletal and/or mental health problems. A purposive sample was identified through personal contacts, social media, literature/internet searches, conferences, and patient/professional organisations. Questionnaires, documentary analysis and stakeholder meetings collected data on the service's history, features, integration, success and sustainability. Data was tabulated. Results: From 38 sites identified, twenty sites were selected. Acupuncture and homeopathy were most common, followed by massage, osteopathy and mindfulness. GPs were often instrumental initiating services. NHS staff enthusiasm facilitated integration, as did an NHS setting, patient/public support, and being adjunctive to an NHS service. The main barriers to integration were funding, negative perceptions of CAM from the clinicians, funders and lobby groups, and local NHS staff attitudes/lack of knowledge. Reduced funding was often why services closed. Conclusions: Various models for integrating CAM with UK primary care were identified. Social prescribing and NHS/patient co-funded CAM may be potentially sustainable models for future integration. Lack of funding and negative perceptions of CAM remain the primary challenge to integration. Evaluating effectiveness and cost-effectiveness of integrated services is vital to ensure sustainability.

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More information

Accepted/In Press date: 15 October 2018
e-pub ahead of print date: 17 October 2018
Published date: 1 December 2018
Keywords: Comorbidity, Complementary therapies, General practice, Integrative medicine, Primary health care

Identifiers

Local EPrints ID: 427739
URI: http://eprints.soton.ac.uk/id/eprint/427739
ISSN: 1876-3820
PURE UUID: 9cac2694-0293-45c5-a656-14e67cd12ccb

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Date deposited: 25 Jan 2019 17:30
Last modified: 07 Oct 2020 00:14

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Contributors

Author: Deborah Sharp
Author: Ava Lorenc
Author: Paul Little
Author: Stewart W. Mercer
Author: Sandra Hollinghurst
Author: Gene Feder
Author: Hugh MacPherson

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