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Ask the Expert
Ask an expert - about acupuncture - NHS & private healthcare
Provision of acupuncture on the NHS is fairly limited. There are about 2000 doctors and 6000 physios who belong to special interest groups within their professions, but most use acupuncture only as another tool in the toolbox. They are also severely limited by only being able to offer treatment for conditions which have an accepted evidence base. These are few, not because there aren't any but because the standard test applied, the randomised control trial, was designed for drugs, not therapies like acupuncture, and the practice of acupuncture does not lend itself to such a design. There are hundreds of thousands of studies, mainly from China, which underpin the World Health Organisation's list of conditions which acupuncture can treat.
A small number of BAcC members have managed to secure funding to provide acupuncture within the NHS, but these projects are few and far between. In theory GPs are allowed to use their practice funds as they wish, and could refer patients for treatment within their budgets, but in practice this does not happen. There is immense pressure on funding right now, especially with the Commissioning Groups taking over from the Primary Care Trusts, and with savings being sought everywhere possible, there is less chance of either individual provision or the funding of units or projects.
The BAcC is keenly aware that with the average cost of a treatment being between £30 and £50, depending where you live, this puts treatment beyond the reach of many people. However, there are a growing number of innovative ways in which BAcC members are trying to reach people who otherwise could not afford acupuncture, and most members are willing to discuss reductions in fees if a small discount enables someone to have treatment. Ask your local BAcC members for advice.
Q: How can I find out if my PCT will fund acupuncture?
A: As you probably already know, there are some important variations to both the diagnosis and in the treatment and outcomes when you see NHS practitioners who provide acupuncture to when you see a qualified traditional acupuncturist.
GPs and physios working within the NHS are allowed to use acupuncture within their existing scope of practice, and there are one or two conditions, such as chronic low back pain, where the NICE guidelines allow doctors to make referrals for a number of sessions of acupuncture as a primary treatment. Although the guidelines do not specify who can administer the treatment, our experience is that this is invariably offered by existing NHS staff, who are often not members of the British Acupuncture Council, unfortunately. A small number of PCTs fund specialist acupuncture clinics, but these are few and far between.
In order to make a pitch for providing acupuncture services practitioners have to organise themselves as groups, satsify an immense number of requirements and then bid against all other providers for what has become a shrinking pot of funds, so there are likely to be less rather than more PCT-funded acupuncture services for the short term future until the new commissioning arrangements have settled down. Your starting point should be your local GP office or the GP who may be able to refer you onwards.
Q: Is the BAcC affiliated to the Health Professions Council? I am advised by the NHS Blood & Transplant people that I can't give blood for 4 months after acupuncture treatment unless you are.
A: The acupuncture profession is not statutorily regulated, and as such BAcC members are not registered with the Health Professions Council. This means, as we replied to an earlier enquirer,
that as the rules currently stand there is always a deferral period of four months before blood can be donated after acupuncture unless it has been delivered by a statorily regulated practitioner.
The BAcC fought long and hard to avoid this position after the previous certification scheme was dropped in an EU harmonisation programme. We pointed out at length that this meant that BAcC members, who receive years of training in safe practice, were deemed unsafe but an art therapist or anyone else on a statutory register could pick up needles and use them with no training, and their patients could give blood. However, SR means that someone's livlihood is at stake if they do not ensure they are properly trained, and this is seen as the best possible incentive to best practice. SR draws a very sharp line in the sand about who is and who isn't 'in.'
We estimate that this decision cost the National Blood Service about 10,000/15,000 regular donors at a time when they were appealing nationally because blood stocks were low.
Needless to say this has caused a vast amount of irritation to our members, and we continue to take a very assertive stance against what we believe to be a judgement which sacrifices common sense in the interests of simplicity. The BAcC is one of a small number of organisations which have been taken on as 'early adopters' in the pilot phase of the CHRE's new scheme for accrediting voluntary registers. We have been very clear that we would hope that this new form of organisational kitemarking may persuade the National Blood Service to add the BAcC to its current list of statutory registers.
Q: I found a brilliant acupunturist in leicester (Abbey Park Health Care) they do the low cost multibed £15-£25 set up. However it's quite a distance and difficult to get to and from my address DE11 8BZ, could you please let me know the closest low cost multi bed clinic to my home address.
A: Although many BAcC members organise or work in multi-bed clinics we do not keep lists ourselves. There is, however, a well-organised special interest group which has been set up by BAcC members, the Association of Community and Multibed Acupuncture Clinics (ACMAC), whose details and membership lists can be found at acmac.net. You might try to search their site to see if there are providers closer to you, although when we undertook a search there was in fact no-one closer to you than the Leicester clinic.
Most people choose to use multi-bed clinics because they make acupuncture treatment affordable, although there are some people who like the open plan setting and the ethos behind them. It is only fair to point out that most BAcC members are happy to make concessions on fees where someone may struggle to meet their 'headline' costs, and it is possible that once you take into account the travel costs and time to get to Leicester a local practitioner may be able to arrange something with you which reduces the amount of inconvenience and is equally cost effective.
However, if it is this particular style of treatment that you wish to experience then the ACMAC site is your best bet to obtain information.
Q: How much does acupuncture normally cost, and how many treatments do you normally have to have.
A: Prices for acupuncture treatment vary considerably across the country. In London, the cost of a first treatment, which can take anywhere between an hour and an hour and a half, can range from £50-£70, with ordinary appointments of between half an hour and an hour between £35-£50. In the rest of the country the ranges are sometimes about £10 lower. Most BAcC members are willing to give concessions if someone finds treatment beyobnd their purse, but it is not something one can easily advertise - local colleagues often take umbrage at what might be construed as a price war and in our experience it is often those who most need to seek concessions who tend not to.
The answer to how many sessions is the 'how long is a piece of string?' question. A great deal depends not only of the seriousness of the problems someone has in combination with the length of time they have had them, but also on the constitutional strength of the person. A healthy person can have a serious illness and recover quickly whereas an unhealthy person can have a relatively minor condition that can last for years. All that we ask our members to do is communicate clearly with the patient what their own expectations are, and ensure that there are sufficient review periods set aside to look at progress. It helps considerably if there are measurable outcomes too; 'feeling a bit better' is less helpful than 'able to walk half a mile further.'
What we like to avoid wherever possible is a situation where someone has treatment for an extended period and then complains because there has been no change. It should always be the case that a patient is entirely clear why they are continuing to have treatment and that continuing consent has been given.