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Ask an expert - general

163 questions

Q:  My first visit for acupuncture was nearly 2 weeks ago. I wanted to try it for my hot flushes, itching skin(due to a medication I am on) and arthritis. Unfortunately that evening I realized I had a heavy ache in the whole length of my left arm. I can use the arm as usual but I am aware of the dull ache, at nightime it seems to trouble me so much more and I have to take painkillers or use ibroprufen gel.

On my 2nd visit 3 days ago the acupuncturist was obviously concerned that I was still suffering this ache, I did not have needles on that occasion in the arm, but she tried massage etc all to no avail. She said she had never heard of anybody having this ache for this long before.

I did have a fracture of the wrist on this arm before, but this was about 9 years ago; no pins or anything so she presumed it was nothing to do with this.

I would be glad if you could be of any help as this ache is now causing me sleepness nights, (it wakes me when the medication has worn off).

A: This is a most unusual outcome. There are a number of rare short term adverse effects associated with treatment, but most disappear after 24 to 48 hours. There are also a number of normal treatment effects, and a dull aching sensation where the needle has been inserted is relatively frequent, but this again disappears within minutes of treatment, although occasionally lasting a little longer.
 
The only thing we can think may have happened is that there has been a slight bruise created by the treatment adjacent to a nerve, and the impingement is causing the sensation you are experiencing. In any event we think that it would be best to visit your GP and ask for a neurological assessment to see whether there is a specific nerve which is being affected.
 
We also need to emphasise that all of our practitioners are fully insured so that if this problem continues and is a direct result of treatment you would be entitled to make a claim for any disturbance or distress this may have caused.
 
However, we hope that it proves to be a consequence of minor bruising within the underlying tissue, and in our experience where this kind of problem does occur it does resolve within a week or two, gradually diminishing in intensity and discomfort. We are sorry that you have had this happen, and hope that it does not deter you from having further treatment. 
 

A:  We're afraid that this is not something we can answer with an individual recommendation. There are a variety of schools and university courses, all of which are slightly different and offer unique training. The BAcC is closely associated with the British Acupuncture Accreditation Board, and a graduate of any course accredited by them is granted automatic eligibility for entry to the BAcC, so in that sense we endorse all of the accredited colleges.
 
The best thing to do is visit the Board's website www.baab.org and  see the list of accredited colleges, find which ones are close to where you live and see what prospectuses you can obtain or when the next open day is.
 

Q:  What is the VAT status of treatments made by an acupuncturist? Exempt or standard rated?

A: There are no exemptions from VAT for acupuncture treatment because we are a healthcare profession. This only applies to the statutorily regulated professions like osteopathy.  The full list, taken from the HMRC site, is:
 Item 1 of Group 7 of Schedule 9 to the VAT Act 1994 exempts:

 

The supply of services by a person registered or enrolled in any of the following –

(a) the register of medical practitioners or the register of medical practitioners with limited registration;

 

(b) either of the registers of ophthalmic opticians or the register of dispensing opticians kept under the Opticians Act 1989 or either of the lists kept under section 9 of that Act of bodies corporate carrying on business as ophthalmic opticians or as dispensing opticians;

 

(c) the register kept under the Health Professions Order 2001;

 

(ca) the register of osteopaths maintained in accordance with the provisions of the Osteopaths Act 1993;

 

(cb) the register of chiropractors maintained in accordance with the provisions of the Chiropractors Act 1994;

 

(d) the register of qualified nurses and midwives maintained under article 5 of the Nursing and Midwifery Order 2001;

 

(e) the register of dispensers of hearing aids or the register of persons employing such dispensers maintained under section 2 of the Hearing Aid Council Act 1968

 

Health Professions Order 2001

 

Professions which have registers kept under the Health Professions Order 2001 are:

 

arts therapists;

 

podiatrists and chiropodists (Chiropody: the examination, diagnosis, treatment and prevention of diseases and malfunctions of the foot and its related structures);

 

clinical scientists;

 

dieticians (Dietetics: the application of nutritional science to the maintenance or restoration of health);

 

biomedical scientists;

 

occupational therapists (Occupational therapy: treatment aimed at enabling people disabled by physical illness or a serious accident to relearn muscular control and co-ordination, to cope with everyday tasks, such as dressing, and when possible to resume employment);

 

orthoptists (Orthoptics: a technique used to measure and evaluate squint, mainly in children. It includes assessment of monocular and binocular vision, eye exercises and measures to combat lazy eye);

 

paramedics;

 

physiotherapists (Physiotherapy: treatment of disorders or injuries with physical methods or agents);

 

prosthetists and orthoptists;

 

radiographers (Radiography: the use of radiation to obtain images of parts of the body. Radiotherapists are included in this register);

 

speech and language therapists; and

 

operating department practitioners

Q:  I am due to have surgery can I ask for acupunture instead of conventional medicine?

A:  A great deal depends on what you mean. If you are referring to the anaesthetics for the operation, or any of the pre-meds which people may have to take, then we would strongly advise someone not to do this. Although acupuncture has been used for anaesthesia, mainly in mainland China, it has fallen into disuse because on most occasions it is more reliable to use conventional methods, and these have to be in place and ready anyway in case the acupuncture anaesthesia ceases to work. One of our members wrote a fascinating account of being asked by a patient to use acupuncture anaesthesia for nasal surgery, mainly because the patient could not have conventional anaesthetic. The patient bled less and recovered more quickly than the other patients, but he found it too stressful to do it again, even when asked by the consultant.
 
As far as post-surgery is concerned, again this depends on what kind of surgery we are talking about. There are a number of conditions for which acupuncture treatment may be offered as pain relief in place of or in addition to conventional medication, and there is some very well documented and proven research for the use of acupuncture to reduce the nausea from which people suffer after a general anaesthetic. Our factsheets on the main homepage under 'research' give all the references to both of these. However, there are few other areas where we would be comfortable that someone used acupuncture as an alternatibe unless it was with the express permission of the surgeon or consultant and did not increase the operative or post-operative risks.
 
To give clearer advice, though, we would need to know what kind of surgery you are going to have.
 

Q:  I am a Health and Social Care student researching into acupuncture. I am looking for information on regulation of acupuncturist and requirements they must have to be a registered practitioner. I haven't been able to find any information on your website if any practitioner must have any CRB checks, professional indemnity insurance or annual renewal of registration. Is there any in place for practitioners governed by the BAcC

A: All of our practitioners are covered by a bloc professional idemnity policy through Royal Sun Alliance which is a full 'claims occurring' policy with a £5million limit of cover. The only practitioners whom we do not insure are those working full time in the NHS, for whom NHS cover applies.
 
We do not routinely seek CRB checks for practitioners. The vast majority of the membership intake is from accredited teaching institutions, some of whom seek CRB checks when students enrol. The BAcC took advice from the Health Professions Council some years ago when acupuncture was about to be statutorily regulated on whether we should introduce mandatory CRB checks. We were advised that self-declaration was adequate, although we did investigate which of several agencies would be most appropriate for mass checking. The BAcC's Code of Professional Conduct requires that members do not work unsupervised in a number of situations where CRB checks would be essential. However, we do regard ourselves as exempt from the provisons of the Rehabilitation of Offenders Act 1974 insofar as we require members to disclose all convictions, including spent ones, because of the potential for working with vulnerable adults and undertaking  home visits.
 
There is an annual renewal of registration process which requires members to make a number of declarations about their continuing fitness to practise, and any relevant issues to do with criminal or civil actions, or insurance claims. This process is under review and will be upgraded for the 2014 renewal process.
 

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