The National Institute of Health and Care Excellence (NICE) have published the Guideline on Low Back Pain and Sciatica that had been produced in draft form in April 2016 as NICE guideline [NG59].
We note with concern the final recommendations published today.
The exclusion of acupuncture from its place in the 2009 guideline we believe to be both a mistake and a retrogressive step.
The British Acupuncture Council wishes to make three clear statements regarding this decision.
The British Acupuncture Council believes that NICE have made a mistake in the science thus making the guideline change inappropriate.
The mistake relates to the fact that the acupuncture provided by a BAcC regulated traditional acupuncturist is based on the eastern tradition of medicine and healing and therefore does not fit easily into the western methods employed to ‘measure’ treatments.
The British Acupuncture Council can provide a full explanation of the scientific methodology and the way that the mistake has happened.
Secondly the British Acupuncture Council believes that in the current health and care context of an increasingly frail population creating an ever greater burden upon a system that is already failing, the decision to reduce patient choice and to potentially limit a recognised therapeutic intervention is inappropriate at best.
Back pain is a major presenting condition in primary care. Regulated traditional acupuncturists providing traditional acupuncture based on the eastern medical system could offer the sort of innovation in primary care service requested in the NHS England 5 Year Forward View but currently only being delivered by tinkering with the current structures, workforce and service provision.
In reality we believe that this guideline will have little effect upon the delivery of care and support given by a BAcC regulated traditional acupuncturist to his or her patients.
Clinical decision-making has always been between the patient and the clinician made at the point of care. There is a three way blend of expertise and opinion between published information, the clinician and the patient.
In traditional acupuncture based upon the eastern system of medicine this decision-making considers the whole person and provides a holistic approach to what might be the presenting symptom of low back pain. Thus a guideline based upon a single intervention approach is of less validity.
The huge body of evidence that shows the effectiveness of acupuncture is still valid.
Clinician and patient can remain confident that traditional acupuncture is an appropriate method to help manage low back pain.
There will be a continuing information campaign around this topic.
For members there are specific materials available to communicate locally as required.
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