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Ask an expert - about acupuncture - NHS & private healthcare

25 questions

We are not quite sure from your question whether you are not paying for your treatment because it is being paid for by a health insurance company or whether it is being provided free at point of delivery within an NHS Pain Management Unit or perhaps delivered by an NHS physiotherapist. However, we are pretty sure that you would know if you were covered by private insurance so you must be one of the fortunate ones who has managed to find treatment inside the NHS. This is not as common as it was, say, a decade ago, although more prevalent in Pain Management facilities.

Generally speaking, we have always heard that people referred to Pain Clinics are offered a fixed number of sessions in order to ensure that everyone can have access to the service. The NHS Choices website says that up to ten sessions of acupuncture may be available in a course of treatment, but this can vary greatly with supply and demand. Your doctor, through whom you presumably were referred, can both let you know and make a case for you if you feel that the sessions are of benefit and need to be carried on.

While NHS provision is the only treatment free at point of delivery you will find that many acupuncture practitioners are prepared to discount treatment fees if someone is in need of help but not able to pay the standard fee. There has to be an element of professional judgement in this; not everyone shares the same sense of poverty. This 'expert' was asked for reduced fees through poverty by a patient who revealed during the session that his brand new BMW had broken down but it was under warranty so he was happy.

There are also a growing number of community acupuncture clinics which offer treatment in a group setting for a lower fee, partly to ensure that all income groups can have access to treatment. A national listing of clinics in this scheme can be found here http://acmac.net/. This might provide another option if your NHS funding ceases.

We hope that you manage to get your MRI within the limit of treatments you've been offered, but if that doesn't work we hope that we've given you other useful options.

 

 

Q: Can I get Acupuncture free on the NHS in the Chester area?

A: We're very sorry to say that unless by chance there is a GP or physiotherapist inside the NHS to whom you can get a referral there is very little chance of obtaining acupuncture treatment within the NHS, in the UK as a whole and not just within the Chester area. There used to be a number of projects and facilities within the NHS which provided treatment free at the point of delivery, but as we are sure you are more than clearly aware, the current funding strictures inside the NHS have seen a great many of what have been perceived as 'luxury' services cancelled or closed down.

The only realistic chance of getting treatment within the NHS will be if someone working within it has added it to their repertoire. With over 7000 physios and 2500 doctors having done so there is a small chance, but the acupuncture you receive will be decidedly medical, not traditional. This means that it is likely to be directed at the symptoms from which you suffer, and be based on a western medical diagnosis. We don't knock this; many of the people trained in this style do a great job. They are limited really to those things which have an evidence base, and for many technical reasons the thousands of acupuncture studies are not really accepted as sufficient proof to offer a wider range of treatments.

If it is the cost which is the determining factor you could do worse than talk to some of our members in your area (whose details you can find by entering your postcode in the database search on our home page). Many are prepared to offer reduced fees for cases of financial hardship but we never advise people to advertise this because it sometimes encourages people who can well afford treatment to start bartering. There are also a number of community acupuncture clinics which aim to offer treatment in a multi-bed environment, but we have checked their website (acmac.net) and there are no clinics near you. The nearest is in Manchester, the fares to which might well outweigh the cost savings on treatment.

We suspect you might find this an impossible task, but we send every good wish to succeed and if you do manage to get into the system we would love to hear how you did it!

Q:  I would like to know what I have to do to become a registered NHS Acupuncturist.  I am a qualified acupuncturist. I studied with the CNM college.

We are not sure that there is such a thing as a registered NHS acupuncturist. Our members have sought for years to achieve some form of recognition, either by way of statutory regulation or by way of recommendation from statutory bodies, and the best that we have managed to achieve at a national level is the use by NHS Choices of the BAcC's register as the 'go to' place to find a traditional acupuncturist. This was very much premised on the fact that the BAcC has been accredited by the Professional Standards Authority under its Assured Voluntary Register scheme.

 Other than that we have many individual members who have managed over the years who have managed to gain contracts for services with specific NHS departments or consultants in their area, but the recession has seen a significant fall in the number of these. Where NICE guidelines have made room for the use of acupuncture, as in the currently hotly challenged NICE Guideline for Back Pain, what little take up there has been has been through work being offered to practitioners like physiotherapists who are already employed within the system.

 And more than that, we are afraid, we cannot say. 

Q:   I live in the south west of London area, and I am just trying to find out if there is a acupuncturist treatment on the NHS. I am unemployed at the moment, but I can get a referral from my GP.

A: We are sorry to say that there is not a great deal of acupuncture provision on the NHS. Some doctors and physiotherapists inside the NHS use acupuncture but this tends to be restricted to their normal scope of practice and generally is only allowed for specific treatments for which there is a good evidence base. This tends to rule out the use of acupuncture for general well-being and for those areas which are our stock trade, where there is substantial lower grade evidence but not a great deal of gold standard trials. We, of course, are not happy with using an inappropriate standard as a yardstick, for reasons which are too complex to cover here, but that is the situation. 

There are also a number of Pain Clinics which routinely offer acupuncture treatment, and your GP could refer you to these if your problems fell within their general scope.

We are assuming that your circumstances are such that you need treatment to be free at point of delivery. We doubt that you will find many of our members who are able to offer treatment for nothing, but all of us have at various times taken on patients at highly reduced fees because we want to ensure that treatment does not become a kind of middle-class preserve because those on low incomes or the unwaged cannot afford it. This is a matter of personal choice, and if you ask around there may well be practitioners within relatively easy reach who could off some kind of deal - we have over 500 members in Greater London.

Some members have also started to set up what are called multibed clinics to try to provide acupuncture at relatively low cost, often £10 - £15. A list of such clinics can be found at http://acmac.net/acu/clinics, and the ACMAC website makes for interesting reading. The standard of treatment remains high, but obviously being treated in a community setting does not quite offer the same levels of individual care or privacy that one to one work offers. However, it does mean that acupuncture becomes more widely available.

We hope that you manage to track down someone who can help you.

Q:  I've had treatment for my neck,shoulders,and back.  After the treatments I feel great but when I wake up the next day I feel achy and tired.

A:  This is not an unusual reaction after treatment. We often alert patients especially after the first and second session, that they may experience a resurgence of the pains they have had to an even greater extent. This is not a bad thing, and if nothing else shows that the treatment is having an effect. Since lasting adverse effects are very unusual after treatment it is usually a good sign. We only get concerned if an episode of tiredness and achiness lasts for a great deal longer or if the pattern continues without any discernible improvement in the problems for which someone came to treatment.

The mechanism for this is not clearly understood. Since Chinese medicine is premised on a flow of energy, called qi, there are explanations which borrow the analogy of chilblains which can be very painful when they are warmed up after a walk in the cold. Not a very positive analogy but gets across the idea of a circulation being restored not always being a comfortable process. More plausible is the fact that treatment is aimed at restoring proper function in the body, and ultimately this will impact on structure. If the body starts to realign then various muscle groups are going to rearrange themselves. Treatment is also aimed at expelling pathogens, and we often find that the outward travel of these can make someone feel like they are on the edge of a cold.

However, whatever the explanation in either system of medicine, we can reassure you that this is not uncommon, and while we would not want to state as a general principle that things sometimes get worse to get better, it is a frequent enough event to be predictable in cases of muscular problems in the neck and back.

The only other factor which we would explore is whether someone is cashing in their 'feeling good' after treatment by over-doing it a little. The mild euphoria and relaxation after treatment Is quite common, and we do find that people can sometimes take this sense of well-being down the gym or into the park for a run. We usually advise our patients to take it easy after treatment while the system is in flux, and leave it time to settle.


 

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