Will we ever achieve a level playing field for complementary therapist volunteers in the NHS? Marc Leverton asks in the Summer Opinion article.
The changing face of the NHS
Society’s attitudes to medicine and healing are changing, and let’s face it, our trust in the NHS isn’t what it was. Take the example of complementary therapists, once considered a wacky fringe element even the Royal family are now known to be keen supporters.
But how does this effect volunteers I hear you ask. Well most hospital clinics offer some form of complementary therapy, such as acupuncture or chiropractics nowadays. Which is great of course, it gives us more choice in our treatment. But like so many things with the NHS things aren’t so straightforward.
Obviously the NHS is still largely based on what we will call traditional medicine. But here is the crazy part, support for complementary therapies depends on such variables as to where you live, what your GP thinks about complementary medicine and as always what funding available.
So for complementary therapists there is a situation where their services may be paid for by one PCT but only offered free of charge on a voluntary basis in another area. Imagine working in one practice but only being able to get a voluntary position in a similar place a few miles down the road.
The traditional camp
Homeopathy is one therapy that’s reputation has taken a real kicking in the media. The therapy favoured by the Royals seems constantly under attack. In 2006 The Times printed a letter by an eminent group of doctors including James Black, who won the Nobel prize for medicine in 1998 and Keith Peters, president of the Royal Academy of Medical Science.
"At a time when the NHS is under intense pressure, patients, the public and the NHS are best served by using the available funds for treatments that are based on solid evidence."
Ouch. The doctors went on to say that they are "sensitive" to the needs of patients for complementary care to enhance their well-being.
But they insist that this, and the need for emotional support when dealing with a critical illness, "can be supported through services already available within the NHS without resorting to false claims".
Ok, so you wouldn’t exactly expect doctors to welcome in something which challenges their existence but I think most rational people would feel that there is room for both traditional medicines and complementary therapies and that both have their place. You wouldn’t want a complementary therapist helping you if you were in A&E I suspect.
Acupuncture – joining the mainstream.
Acupuncturist Deborah used to volunteer for an NHS-run drug treatment centre: "To be honest, I think they saw volunteers as a way of providing an additional service at no extra cost to themselves. There weren’t any paid positions to move onto, but our work was always used in all the PR for the centre which was a bit annoying."
Deborah left the position and now runs her own practice. Ironically she is getting referrals from the NHS now, work that she says she could have been offered as paid work when she was a volunteer. "I think the NHS is so big that managers can’t see the bigger picture’ is her assessment."
Charlotte McNeil is the Marketing Manager for the British Acupuncture Council. She told me: “At present, getting acupuncture on the NHS can be a bit of a postcode lottery. There are, as yet, no national arrangements in place”.
The number of traditional acupuncturists working in the NHS is slowly increasing, which is positive given the serious budgetary constraints in the NHS. Roughly 10% of British Acupuncture Council members now work in NHS funded operations.
However as McNeil goes on to explain: “The BAcC is aware of variations in the terms and conditions under which work is offered, these can happen even within the same PCT or hospital depending on the funds available”.
The BAcC hopes that impending statutory regulation of acupuncture will create more opportunities for a wider section of the population to benefit from traditional acupuncture on the NHS.
It will also make it easier for their members to become volunteers for the NHS if they so choose because the Register will solve the uncertainties which some NHS commissioning staff experience in identifying properly qualified and skilled practitioners.
Reflexology – funding depends on charitable trusts
The challenges that acupuncturists face are echoed in other therapies. Doreen Baker is the Chief Executive of the Association of Reflexologists, "Discussions and feedback from members leads us to believe that there is an expectation within the NHS that reflexologists will undertake treatments initially on a voluntary basis and occasionally this then becomes funded," she says.
"We believe that a good proportion of reflexologists working in hospitals and hospices do so as a volunteer. Financial backing for the services of reflexologists may well depend on whether the hospital or hospice is supported by charitable funds although there are a few NHS employed reflexologists. Those reflexologists are very often already nurse trained as well."
Supported by charitable funds? No wonder the service is so ad hoc. I am obviously completely naive in thinking that my National Insurance and Income Tax go into the NHS then.
UCLH – NHS Culture
Looking at wider reasons that volunteers face these inconsistencies Angie Buxton-King, the Complementary Therapies Manager at University College London Hospitals (UCLH), describes the culture that volunteers and therapists must fit in to.
"Now the health service is becoming more integrated, we have to have the same level of professionalism across the board. This means volunteers need to follow the same protocol and policies as paid staff."
"It is a bit of a chicken and egg situation." she adds: "I was interviewing for a paid Reflexology position recently and having NHS experience is vital, but getting it without volunteering is very difficult."
Familiar Story
I am sure many volunteers are familiar with this situation. There is no easy answer, every therapy will have to fight its own battle to become accepted.
We are going through a time of change, medicine is a undergoing a 21st century makeover and the NHS is, as usual, the battleground. Unfortunately, the pawns in the middle of this battle are volunteers.
