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Tuesday, 25 February 2020 12:13

Safe Practice: Protecting our members

By the British Acupuncture Council’s safety officer, Hannah Bowie-Carlin

 

I was appointed by the British Acupuncture Council as its new safety officer in September 2019, replacing Ian Stones who held the position for 13 years.

My primary role is to protect our members and their patients.

I have been a practicing member of the British Acupuncture Council since graduating from The University of Westminster in 2004.

The importance of providing clear and practical help to members on how to reach the BAcC’s high standards cannot be underestimated.

Underpinning everything is the Code and Guide to safe practice.        

This is a hugely important document, which highlights our stringent safety standards and it is vitally important that members regularly consult the Code.

Only British Acupuncture Council members belong to a Professional Standards Authority (PSA) accredited register, providing professional guarantees of safety, education and continuing professional development (professionalstandards.org.uk).

This gives patients, care providers and other healthcare professionals the confidence to use a British Acupuncture Council member when seeking treatment for themselves or on behalf of someone else, safe in the knowledge that they are in good hands.

I spend a great deal of time carrying out research so that I am able to provide members with the best, most up to date, safe practice methods. This, in turn, allows practitioners to provide professional treatments on a par with other medical professions.

Another important part of my role is to answer any safe practice questions from practitioners or patients. If, for example, a practitioner is approached by a patient with a complicated condition and would like advice on whether/how it is safe to treat, I can help guide on this. Patients also call me for advice and reassurance on treatment they have received. On our website we have a search facility which brings up information in our vast library of resources ranging from what to expect in a treatment, what acupuncture is good at treating, to lots of research and current affairs in the acupuncture world.

I am also responsible for managing the British Acupuncture Council’s Adverse Incident reports from BAcC practitioners. I follow these up if required but also provide practitioners with advice and support to help them avoid a similar situation in the future.

Our incidents of adverse events are extremely low. MacPherson 2001 and 2004 found no incidents of blood infections in the thousands of BAcC practitioners and patients.

A mistake or adverse incident can seriously affect the reputation of acupuncture so it is vitally important for practitioners to follow the Code of Safe practice. Anyone receiving a complaint against them will have their treatment assessed against the Code. If they are found to be practising within our guidelines they have much greater protection against complaints being upheld.

I believe the future of traditional acupuncture lies in its full integration into western healthcare, which would mean an exemption from local environmental licensing laws that put us in the same bracket as tattooists and ear piercers. I am currently working with local authorities with a view to achieving this. I am lobbying local government and senior environmental health officers as well as delivering presentations to groups of high level local officials.

I will also be meeting with those developing Welsh legislation. Last year a report from the Royal Society for public health (RSPH) drew attention to this issue in a report entitled ‘Skins and Needles’. The report included some information that alarmed many of our members, who felt that they had been misrepresented. It reported that one in five people who have a tattoo, a body piercing, electrolysis or acupuncture suffer some sort of health setback as a result. 

The BAcC quickly called for this to be retracted as our own adverse incident reporting system reveals that out of two million treatments delivered by members each year, just 20 (0.001%) result in an adverse event.

The vast majority of incidents are minor, such as a small bleed or a bruise when the needle is removed. While there is a risk to any healthcare procedure, the number of adverse events in acupuncture is very similar to the rates of adverse events in hospitals across Europe.

I will continue to work on this matter and hope to meet with RSPH to discuss this further.

Something I would also like to work on with our practitioners is our moxa skills. I am looking forward to the moxa workshops we will be providing this year. I hope to ensure that our collective skills and standards are high so we can provide both the effective treatment using moxa and ensure all the treatment we provide is at the highest safety standards.

By Christine MacFie, MBAcC

British Acupuncture Council member Christine MacFie discusses her role as a volunteer complementary acupuncture practitioner at two cancer support centres.

In early 2017 I became a volunteer complementary therapist, treating cancer patients with acupuncture at two local cancer support centres. I currently spend three hours a week at the busy MacMillan Horizon Centre in Brighton. This offers complementary therapies to people from all over Sussex following a cancer diagnosis.

Additionally, I treat a few of these cancer patients privately on request, to support their health and wellbeing after their free acupuncture treatment has finished.

I generally see three patients weekly at the Horizon Centre. Since 2017 I have given over 450 voluntary and 160 paid acupuncture treatments.

In this month's blog, the British Acupuncture Council's head of research, Mark Bovey, takes an in-depth look at research that came out in December 2019 on the effectiveness of acupuncture for the treatment of chemotherapy induced peripheral neuropathy

On 28 December 2019 The Christie NHS Trust in Manchester reported very positively on their trial of acupuncture for chemotherapy induced peripheral neuropathy (CIPN) https://www.christie.nhs.uk/about-us/news/latest-news-stories/christie-research-shows-acupuncture-helps-chemo-patients . Dr Jacqui Stringer, lead for complementary health and wellbeing described the results as ‘phenomenal’. A patient told how she was now able to drive again and return to embroidery, things she’d had to give up because of the nerve symptoms. CIPN is a common side effect of chemotherapy treatment, and may show both sensory symptoms (e.g. tingling, over-sensitivity, pain), motor symptoms (impaired movements and activities) and overall a reduced quality of life. Chief investigator and consultant oncologist professor Andrew Wardley: ‘We hope this trial will lead to a new standard of care for treating this condition, improving the lives of millions of patients’. Even without this recent endorsement acupuncture is used by many people with CIPN (30% in one survey).

Tuesday, 17 December 2019 09:52

What do you know about candour?

By Jane Debois, Head of Professional Standards

On 21 October 2019, members of the British Acupuncture Council (BAcC) senior leadership team attended the Professional Standards Authority’s (PSA) Accredited Register conference which focused on the duty of candour. This is a very important issue, so in response to learnings from the event we have produced our own Duty of Candour Guidance.

So, what is the duty of candour?

Candour is being honest when something goes wrong. The PSA believes telling patients openly and honestly that something has gone wrong with their care is an essential part of a healthcare professional’s practice. The obligation to do so is known as the professional duty of candour. Issues of openness, transparency and candour were prominent in 2013 in the aftermath of the publication of the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (the Francis Report ) In 2014, in response to the Francis inquiry report, the government published Hard Truths . In that report, it was announced that a statutory duty of candour on all Care Quality Commission (CQC) registered providers in England would be introduced, making it a requirement for them to be open and honest where there had been failings in care. Hard Truths also made clear that issues of candour were applicable to professionals as well as to organisations.

The BAcC understands that sometimes things do go wrong and acknowledges that, although these matters are rare, we want to reassure members that we are here to advise and provide support. In our experience clear communication and an apology may prevent a concern from escalating to a complaint.

The purpose of the guidance is to outline the duty of candour to BAcC members and explain how they may include it within their practice. The guidance provides the following:

  • circumstances in which to say sorry
  • how to say sorry
  • examples of incidents that require an expression of candour
  • how the BAcC can support you.

Imelda Redmond CBE, National Director of Healthwatch England spoke at the PSA’s conference about the patient’s view regarding the duty of candour. She advised that patients require the following:

  • to know something has gone wrong
  • an apology
  • a remedy i.e. support to put matters right
  • to know what will be put in place to ensure it does not happen to someone else (fostering a learning the culture)

The BAcC considers that patients should be told of an adverse incident as soon as practical and if something has gone wrong, apologise. It's the right thing to do, and is not an admission of negligence. BAcC members should not underestimate the importance of listening and kindness.

We encourage all members to exercise this duty and to remind you all that the BAcC is here to support you.

 

[i]https://webarchive.nationalarchives.gov.uk/20150407084231/http://www.midstaffspublicinquiry.com/report

[ii] https://www.gov.uk/government/publications/mid-staffordshire-nhs-ft-public-inquiry-government-response

Researcher Lianne Aquilina, who is also a British Acupuncture Council member, considers the evidence supporting claims that acupuncture can help women manage severe premenstrual syndrome (PMS).

Q: Can you describe the symptoms of severe PMS?

A: Generally, PMS refers to physical, emotional and behavioural symptoms that occur in the two weeks prior to the onset of menstruation. This condition affects a woman’s quality of life and the term applies when the symptoms occur for two or more consecutive menstrual cycles. A woman is asked to subjectively record her symptoms in a diary before a diagnosis is made. Diagnosis is made based on the timing of and also severity of her symptoms.

Severe PMS is possibly currently underdiagnosed, with different estimates of prevalence. A differential diagnosis may need to be made. Women with severe PMS can benefit from management by a multidisciplinary specialist team of health professionals, which could include a professional acupuncturist.

Clinical head of service at the Gateway Clinic, Dominique Joire, extols the virtues of an acupuncture service that is fully integrated into the NHS.

The Gateway Clinic, which is part of Guy’s and St Thomas’ NHS Foundation Trust, has been fully integrated into the NHS since 1992, treating about 300 patients per week. GPs from Lambeth, Southwark and Lewisham can freely refer their patients with long-term chronic pain, migraine, cancer pain, fibromyalgia and also for HIV support.

The clinic offers patients a course of 6 to 12 weekly acupuncture treatments but also dietary and lifestyle advice with daily drop-in sessions of auricular acupuncture, Qi Gong, Pilates classes and mindfulness meditation sessions.

Our aim is to empower long-term chronic patients to get control back with their health.

Thursday, 12 September 2019 09:14

Lessons from the American opioid crisis

By Mark Bovey, Research Manager

There’s been a so called ‘opioid crisis’ in the US for some years now, with tens of thousands of opioid related deaths annually. In the UK, where the mortality rates are much lower, there has not been the same recognition of a crisis but the scale of the problem has now burst into prominence with the news that more than half a million people have been on opioid pain killers for over three years. Part of the US response has been to push forward non-pharmacological options for pain control, to doctors and also health insurers. Many university hospitals and health centres have established integrative care programmes combining the best of orthodox and complementary treatments.

In the UK this sense of urgency and innovation has not yet surfaced. NICE is content to recommend more of the same. ‘Integrative’ healthcare in the UK may mean various things but incorporating complementary treatments is not one of them and NICE’s default position is to remove these therapies from the scope of any new guideline they are developing. In the US acupuncture stands as the most evidence based, immediately available choice to fulfil the calls for non-drug pain control. It is an effective, safe and cost-effective treatment for numerous types of acute and chronic pain.

By Natalie Chandra Saunders

“Education is the most powerful weapon you can use to change the world” (Nelson Mandela).

In December 2018, The Times published an article with the headline Professors sound alarm over rise of acupuncture for children. The article questioned not only the efficacy, but also the ethical implications of treating children with acupuncture.

Perhaps unsurprisingly, one of the first professors to step forward and criticise paediatric acupuncture was Edzard Ernst. In the article, Ernst is quoted as saying:

“I am not aware of sound evidence showing that acupuncture is effective for any childhood conditions.”

He goes on to state that children are more likely to be injured by acupuncture than adults, and could even have their lives put at risk if acupuncture is used in lieu of ‘effective treatment.’ Later in the article, pharmacologist David Colquhoun rubs salt into the wound by describing paediatric acupuncture as a “rather unpleasant form of health fraud.”

By Olga Fedina (BAcC member, Spain)

Last autumn the Spanish coalition government, led by the Socialist PSOE Party, launched a concerted attack on natural therapies, including acupuncture. Since then there have been some developments.

Our hopes that this situation would make everyone involved in complimentary therapies forget their differences and unite in the face of common danger were fulfilled. In January, several important organisations, including the two biggest acupuncture professional bodies, the SAC (The Society of Acupuncturists of Catalonia) and the FEMTC (European Chinese Medicine Foundation), as well as other natural therapists’ associations, educational institutions and natural products suppliers, united to form the Natural Therapies Foundation (Fundación de Terapias Naturales - FTN). The aim of the Foundation is to defend the scientific evidence relating to the efficacy of the natural therapies.

By Merete Linden Dahle

Many men struggle with lack of sex drive, ability to have sexual intercourse and premature ejaculation. Erectile dysfunction is defined as the "inability to achieve or maintain an erection adequate for sexual satisfaction,” and can be classified as psychogenic, vasculogenic, neurologic, and endocrinologic. More than 40% of men over the age of 40 experience various forms of potency problems, and the causes can be anything from illness, lifestyle, stress, obesity, emotional or relationship problems. Erectile dysfunction is associated with age but also with chronic diseases such as diabetes, multiple sclerosis, hypertension, high cholesterol levels, cardiovascular disease and depression. Many are not aware that medication can cause erection failure as a side-effect. Both prescription and non-prescription medications can increase the risk of potency problems and affect both desire and ability to have sexual intercourse. The most common medications that may cause erectile dysfunction are: blood pressure medication, antidepressants, antihistamines, Parkinson's medicine, chemotherapy, opiates, but also one of our most commonly used drugs NSAIDS.

Studies have demonstrated that a higher number of men under 40 years, than previously appreciated, suffers from erectile dysfunction caused by a physical, not psychological problem. ED may be the first sign of more serious disease, which make it important for men to understand and recognise that they need to seek help.

By Kevin Durjun, head of events and PR

On my first day in the British Acupuncture Council office seven years ago, I was asked for my passport details so that my flight to Rothenburg could be booked. I remember having absolutely no clue where this exotic sounding place was, nor did I have any understanding of why it was important for me to travel there. Since then I have had the pleasure of visiting Rothenburg several times, and I am now very well acquainted with this far away land and have a very clear understanding as to why it is such an essential feature of the acupuncture landscape.

The Rothenburg TCM Kongress, or Rothenburg as it is fondly known to its friends, is held in an ancient Bavarian walled city that is host to the largest conference for acupuncture practitioners in Europe. For 50 years now, more than 1,000 practitioners of acupuncture and oriental medicine are drawn here each year to learn from lecturers, to break bread with friends and colleagues and to enjoy the fresh air and wonderful conversations that you can only get when you make the time in your crammed schedules. Unless you happen to live in Bavaria, you need to make a lot of time to experience Rothenburg. Just getting there requires dedication. It took me around nine hours to travel there from London. And as soon as I arrived I just had time to drop off my bags in my hotel (inexpensive, basic and lovely) and then rush through the cobbled streets to get to my first engagement of the trip - the International Meeting held in the glamorous sounding Roccocosalle.

The International meeting is where all the big cheeses, the famous speakers, the writers, the policy makers, the people who are working hard to open up the frontiers of acupuncture and Chinese medicine go to meet up at the start of the Kongress so that they can sort out their diaries for the rest of the week. Walking up the corridor to the Roccocosalle you are accosted by the buzz of new connections being made, of old friendships being rekindled, and this wonderful fizzing energy that is generated by people who are passionate about their work. And it is very important to emphasise this - to get the most out of Rothenburg you need to work hard - lots of networking, lots of meetings, lots of focus and lots and lots of walking. The Kongress is held in different venues across the city, which itself is located on many different levels, so you need to allow plenty of time between engagements and be prepared for a work out in between meetings!

By Beverley de Valois, Research Acupuncturist at the Mount Vernon Cancer Centre

People receiving a diagnosis of cancer are routinely offered a cocktail of treatment options with curative or life-prolonging intent.  What is not intended is the assortment of distressing and unpleasant side effects that may accompany these treatments, and which may continue for years after treatment ends.

Acupuncture can play an important role in addressing these troublesome symptoms, offering people a safe, non-pharmacological option for managing wellbeing.  Additionally, it can support recovery after treatment, facilitate a return to active living, and enhance quality of life.

The Supportive Oncology Research Team (SORT), operating within Mount Vernon Cancer Centre (part of the East and North Hertfordshire NHS Trust) has a long-standing focus on researching acupuncture’s potential to improve the wellbeing of people living with and beyond cancer. This research is led by Dr Beverley de Valois PhD, a traditional Licensed Acupuncturist and Fellow of the British Acupuncture Council.  During her 20 years as Research Acupuncturist, she has investigated a number of key areas:

By Julian Scott

I saw my first autistic child nearly 40 years ago, and quite honestly, I did not know what to do. There was nothing in either the western or the Chinese literature to give any guidance. I tried one or two things, without avail, and it upsets me to this day that I was unable to help.

Since that time, I have seen many, many more; particularly recently as there has been a huge increase in the number of children diagnosed as autistic. This is partly due to greater awareness of the condition, but it is mainly because there really are many more autistic children.

It can be heartbreaking for the parents to feel so alienated from their own child, and it is very rewarding when you can help parent and child to reconnect. I still get a slight lump in my throat when I think of a time 25 years ago when the mother came in with her four-year-old boy. He had had five or six treatments by then, but he was still pretty hyperactive. This time he was obviously different. There had been a shift in his energy. The mother had a beam on her face as she said: “I had lost my little boy, and now I have got him back.”

Ian Stones
Safe Practice Officer

 

Well for the last three years it has meant rewriting the Code and Guide to Safe Practice for Acupuncture… although actually, that’s not part of the day-to-day job. I just happened to take on this role at a time when a review was long overdue. I do however think that was a perfect start as I now know the Code and Guide inside out!

Essentially, I see that I am here to support members in their day-to-day practice and I think that’s a really important point to get across. I speak to a lot of members in this role and it is often about offering reassurance and help when it comes to the more difficult and challenging situations we face in clinic. A really important aspect of the BAcC’s work is providing professional support to members in all areas of their practice and support around safe practice is essential. Safe practice covers a huge breadth including safety implications of treating certain patient groups, licensing, clinical waste, insurance, blood donation and adverse reactions to treatment.

Just before Christmas an article appeared in the Times with the headline ‘Professors raise alarm over rise of acupuncture for children’. There has been little or nothing in the mainstream press relating to paediatric acupuncture. So, in a sense, and in the spirit of ‘all press is good press’, this felt like progress. The article quoted myself and Julian Scott, and mentioned several childhood conditions for which children seek treatment. It also mentioned some of the reasons that parents choose acupuncture for their children. 

However, it included some negative quotes from our old friends Ernst and Colquhoun. The first was Ernst stating that he was ‘not aware of any sound evidence showing that acupuncture is effective for any childhood conditions’. Colquhoun went further to state that there simply is not ‘the slightest bit of evidence to suggest that acupuncture helps anything in children’. Whilst they may not be aware of it, good evidence does exist, albeit for a limited number of conditions. For example, a 2016 meta-analysis and systematic review of the use of acupuncture for post-operative nausea and vomiting (PONV) concluded that children who received acupuncture had a significantly lower risk of PONV than those in the control group or those who received conventional drug therapy.[i]

Ernst went on to mention the hypothetical risk of puncturing a child’s internal organs but he failed to provide evidence of any actual harm. A 2011 systematic review analysing decades of acupuncture in children aged 0 to 17 years prompted investigators to conclude that acupuncture can be characterised as ‘safe’ for children.[ii]

Ernst also mentioned what he perceived is a far greater risk. He expressed concern that children would miss out on ‘effective’ treatment because they are having acupuncture. In my experience running a paediatric acupuncture clinic in Oxford, this is not the case. Children almost invariably come already having received a diagnosis from either their GP or a paediatric specialist. They are seeking treatment, such as in the case of bedwetting or chronic fatigue syndrome, because orthodox medicine is unable to effectively treat or even manage their condition. Alternatively, their condition is being managed by medication which may be causing side effects.

The Fountain Centre (FC) is a local cancer charity based in the Royal Surrey hospital in Guildford which offers complementary therapies and emotional support to patients (and their loved ones) living with and beyond cancer. In this blog, research and development coordinator, Natalie Silverdale, talks about the benefits of group acupuncture in a hospital oncology setting.

All our patients are having, or have had, their cancer treatment at St Luke’s Cancer Centre. Our service is provided by volunteers and we have around 35 complementary therapists who give three hours of their time each week. Safe to say, our service would not run without the amazing service they provide!

In the spring of 1984 the First Nanjing Seminars were held in London.

Professor Qiu Mao-Lian and Doctor Su Xin-MIng of the Jiangsu Province Hospital of Traditional Chinese Medicine met with the UK’s Parliamentary Under-Secretary of State for Health with special responsibility for ‘alternative medicine’.

They vigorously and repeatedly stressed two points. First, the wide-ranging effectiveness of acupuncture, not just to treat pain, but for a great range of internal diseases. Secondly, that traditional Chinese medicine (TCM) only survives and flourishes in China because of strong and positive support from the government.

Audley Burnett, British Acupuncture Council member from acupuncturewestwales.co.uk, was fortunate to gain a place on a two-week trip to China recently. The trip, sponsored by the British Acupuncture Council, London’s Confucius Institute and Heilongjiang University in Harbin, north-east China, aimed to help participants widen their knowledge of TCM and witness first hand how it is practised in China.

In this blog, Audley brings to life some of his experiences:

To mark National Fertility Awareness Week, which runs from 30th October to 5th November 2018 British Acupuncture Council member Lisa Collins MBAcC of Lisa Collins Acupuncture in Shrewsbury a blog about how she has supported dozens of couples struggling to start a family.

I understand that 3.5 million people in the UK are affected by infertility. In 11 years of working as an acupuncturist I have witnessed the impact that fertility issues have on couples trying to create their dream family. I’ve seen dreams dashed but on many occasions I have also seen dreams come true. Totting up my files, there are over 120 babies who have arrived in Shropshire after their parents have seen an acupuncturist.

Friday, 26 October 2018 16:20

No Brexit for acupuncture!

By Katie Osborne

Last weekend, 700,000 people took to the streets of London to protest against Brexit, former UKIP leader Nigel Farage called for more support for his Leave means Leave campaign and a beleaguered UK prime minister issued a plea for time to deliver “the Brexit the people voted for.”

Meanwhile, in the beautiful, historic Italian city of Bologna, another international event was taking place where the atmosphere was decidedly more amicable.

In stark contrast to the deadlock between British and European politicians negotiating Brexit, the 2nd International Symposium on Research in Acupuncture was the perfect environment for open and productive dialogue between leading acupuncturists from around the world.

Hosted jointly by Bologna’s Association of Medical Acupuncturists and the city’s Italian – Chinese School of Acupuncture, the event showcased key research and explored some of the main issues currently affecting the profession.

By Kevin Durjun, Head of Events at The British Acupuncture Council

When people think about acupuncture, one of the main images that comes to mind is needles. But there is a whole raft of other treatments including massage, cupping, gua sha, herbal medicine and moxibustion that are also offered by acupuncturists, either alongside traditional acupuncture or instead of it. And some don’t use needles to stimulate points at all. Read on to discover more.

Acupuncture is well known as a safe and effective treatment that uses needles to gently encourage the body’s ability to heal itself. However needles are just one aspect of an acupuncture treatment.

When you come for an acupuncture treatment your acupuncture practitioner may spend up to two hours on an initial diagnosis session before they even think about picking up their needles. During this session you can be asked many questions relating to your physical health, your lifestyle, and your medical history. Your practitioner may also ask you questions relating to your personal life - relating to your work, your relationships and also your family history. They ask these questions to help build up a complete picture about who you are and to understand more about why a particular health condition may have arisen.

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