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Ask an expert - about acupuncture - NHS & private healthcare

26 questions

We're not quite sure whether you are asking about having sessions of acupuncture with your GP or whether you are considering asking your GP whether it is OK to have acupuncture.

If it is the former, then we suspect you may not get very far. There are quite a few doctors who now incorporate acupuncture within their day to day practice, but generally speaking they are normally only allowed to do so when there is an evidence base for the condition which they are trying to treat. For a variety of complex reasons most of the research into acupuncture doesn't pass muster with the UK regulatory agencies, and chronic lower back pain is one of the few that does. Unfortunately NICE, which used to recommend ten sessions of acupuncture for chronic lower back pain, has recently reversed its ruling, so it is now unlikely that your GP will take advantage of this to refer you on or to treat you themselves.

There is nothing to stop you asking your GP if he or she is happy to give you acupuncture treatment, and most GP practices have at least one partner who uses acupuncture regularly. In terms of getting treatment free at point of delivery, this is perhaps your one and only option.

In terms of safety with the problems which you have, there is nothing in the literature to suggest that any of your health issues might make acupuncture a bad idea. We have experience of treating people with all of these problems. We are always careful with epileptic patients, but that is mainly because many want to get off their medications and we would never make that recommendation, however successful treatment may appear to be. When a condition is well controlled even GPs are reluctant to interfere with the treatment plan. As far as mental health issues are concerned we advise members to be aware of their limitations. Although we take detailed case histories and explore many problems with patients there are some areas where a practitioner needs specific skills in addition to acupuncture training to be able to understand the kinds of problems with which they are dealing. We regard mental health issues as one such area, and we are in the process of exploring standards for expert practice which would define what additional training a practitioner should have.

As far as the back problems are concerned, we feel confident that acupuncture treatment may well be able to help, but you may find it worthwhile to discuss your complex health background with a local practitioner before committing to treatment. Most acupuncturists are happy to give up a little time without charge to discuss with prospective patients whether acupuncture is the best option for them.

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.

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