Abstract
BackgroundProvision of complementary therapy services within the NHS is scarce and contested. However, their adoption may be more likely in a service model that is designed to the specifications of clinicians and Primary Care Trust (PCT) managers. Our objective was to identify the features of a 'NHS friendly' service to inform service designers who wish to develop NHS complementary therapy services.MethodsUsing a case study approach, two sites offering complementary therapies on NHS premises were studied using interview and documentary data. We conducted interviews with 20 NHS professionals, including PCT managers and clinicians. We used descriptive content analysis to analyse interview data. We collected and analysed documentation, such as referral data, funding bids and evaluations, to compare reported and documented behaviour.ResultsIdeally, a 'NHS friendly' complementary therapy service should offer a limited number of therapies for a specific condition for high priority patient populations (e.g. acupuncture for addictions). In this service model, the therapies should be perceived to have 'good' evidence for conditions where there are 'effectiveness gaps' (i.e. current treatments are limited). The service should be evaluated and regularly promoted. Inter-professional relationships would flourish through opportunities for informal contact and formal interactions, such as observations of consultations. However, the service should include gatekeeper mechanisms to control demand and avoid picking up 'unmet need' (i.e. individuals currently not accessing NHS services). The complementary therapy service should pay for itself and reduce NHS costs elsewhere, such as hospital admissions.ConclusionThe service design model identified in this study is problematic. For example, it is contradictory to provide specific interventions for specific conditions within a holistic healthcare framework. It is difficult to avoid providing for 'unmet need' while concurrently filling 'effectiveness gaps'. In addition, demonstrating the impact of a community service on reducing hospital admissions is challenging. Those seeking to establish a NHS complementary therapy service might be well-advised to meet as many of the criteria of a 'NHS friendly' model as possible, recognising that its full realisation may be impossible. However, during periods of innovation and financial security, some relaxation of expectations may occur.
Highlights
Provision of complementary therapy services within the NHS is scarce and contested
Current provision of complementary therapy services in the NHS is patchy, sporadic and under threat [1,2]. Their adoption may be more likely with a service model that is designed to the specifications of clinicians and Primary Care Trust (PCT) managers
The NHS professionals we interviewed were either influential in decisions about funding the complementary therapy service (PCT managers), provided administrative support to the service or were eligible to refer into the service
Summary
Provision of complementary therapy services within the NHS is scarce and contested Their adoption may be more likely in a service model that is designed to the specifications of clinicians and Primary Care Trust (PCT) managers. Current provision of complementary therapy services in the NHS is patchy, sporadic and under threat [1,2] Their adoption may be more likely with a service model that is designed to the specifications of clinicians and Primary Care Trust (PCT) managers. Research on healthcare professionals' attitudes and referral behaviours regarding complementary therapies should offer some guidance on the design features of state funded complementary therapy services These studies are abundant, for doctors and nurses [14,15,16,17,18,19,20,21,22,23]. This might only partially explain the absence of complementary therapy services in the NHS, as complementary therapy treatments such as spinal manipulation (osteopathy and chiropracty) for mechanical neck disorders [29], acupuncture for headaches [30,31] and herbal remedies for benign prostate hypoplasia [32,33] are not widely available in the NHS, despite having relatively robust evidence of clinical, and in some cases, cost effectiveness
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
