Memorandum submitted by Dr Hugh J Nielsen HO 29


Evidence for Homeopathy in the NHS

1. Summary

1.1 Each of the homeopathic hospitals on the NHS reported clinical outcomes data from a wide range of medical complaints. 1-5 At each hospital, positive outcomes has been reported by about 70% of follow-up patients overall, pointing out the value of homeopathy to patients and the need for further research initiatives to investigate the positive effects of the homeopathic intervention in particular diagnoses.6,7

2 Background


2.1 The United Kingdom's homeopathic hospitals are located in Bristol, Glasgow, Liverpool, and London. The four have been part of the country's National Health Service (NHS) since its inception in 1948, and are staffed by medically qualified practitioners who possess additional training and certification in homeopathy. All units have outpatient services only, except Glasgow Homoeopathic Hospital (GHH), which has an additional in-patient service.


3 Homeopathic Hospitals outcome surveys and other studies

3.1 An observational study at Bristol Homeopathic Hospital included over 6,500 consecutive patients with over 23,000 attendances in a 6-year period (Spence, Thompson & Barron, 2005) 8. 70% of follow-up patients reported improved health, 50% major improvement. The most common diagnostic groups were Dermatology, Neurology, Rheumatology, Gastroenterology, Psychiatry and Ear, Nose & Throat. The best treatment responses were reported in childhood eczema or asthma, and in inflammatory bowel disease, irritable bowel syndrome, menopausal problems and migraine. The main weakness of this study was the crudeness of the outcome measure; the strength of the work was in its size and comprehensiveness. Further non-randomised research has corroborated such results in childhood eczema (Keil et al., 2008)9 and menopausal syndrome (Bordet et al., 2008)10, for example.


3.2 A 500-patient survey at the RLHH showed that many patients were able to reduce or stop conventional medication following homeopathic treatment (Sharples, van Haselen & Fisher, 2003)11. The size of the effect varied between diagnoses: for skin complaints, for example, 72% of patients reported being able to stop or reduce their conventional medication. The study also showed that many patients seek homeopathy because of their concerns about the safety of conventional treatment.


3.3 In a pilot study published in 2008, data from 1602 follow-up patient appointments at all five NHS homeopathic hospitals were collected together over a one-month period (Thompson et al, 2008)12. Eczema, chronic fatigue syndrome, menopausal disorder, osteoarthritis and depression were the 'top five' most referred conditions. The medical problems referred to the hospitals typically are chronic conditions where available conventional treatments are often not effective. In total, the study identified 235 separate medical complaints treated at the hospitals during one month. Many patients had multiple pathologies. At just their second homeopathic appointment, 34% of follow-up patients overall reported an improvement that affected their daily living. For patients at their sixth appointment, the corresponding improvement rate was 59%. The study showed that reported health benefit may be gained more quickly in some medical conditions than in others. The pilot findings are informing a programme of standard setting for treatment outcomes in the NHS homeopathic hospitals.


3.4 Qualitative research carried out at GHH found that those motivated to seek this form of treatment may achieve an empathy with their homeopathic doctor that can make a positive contribution to the enablement and health change they feel as a result of their appointments (Mercer, Reilly & Watt, 2002; Bikker, Mercer & Reilly, 2005)13,14. Patients attributed key importance to the length of consultations, the whole-person approach, being treated as an individual, and telling and having their 'story' listened to in depth (Mercer & Reilly, 2004)15.


3.5 An outcome survey carried out at the Liverpool department of homeopathic medicine over a 12 month period in 1999-2000.(Richardson, 2001)16 1100 patients were surveyed; 76.6% reported an improvement in their condition since starting homeopathic treatment and 60.3% regarded their improvement as major. 814 patients were taking conventional treatment for their condition and 424[52%] of these were able to reduce or stop conventional medication. The main conditions treated were osteoarthritis, eczema, chronic fatigue syndrome, asthma, anxiety, headaches, inflammatory arthritis and irritable bowel syndrome.


3.6 A further outcome study was conducted at the same department in Liverpool covering the period 2001-2006 (the study is in the final stages of preparation for publication). The study looked at 2495 patients of whom 72.9% reported an improvement in their condition and 57.3% rated their improvement as major. 1648 patients were taking conventional treatment and 771[46.8%] of those were able to reduce or stop it. The main conditions treated in this study were eczema, osteoarthritis, chronic fatigue syndrome, menopausal symptoms, anxiety, asthma and depression.

3.7 A patient satisfaction survey carried out at the Liverpool department in November 2008 showed that of 132 patients questioned, 115 were very satisfied and 15 were satisfied with the service provided. 98 patients said that they thought homeopathy was helping their condition, 27 were unsure and 2 said it wasn't helping.



4 Recommendations


4.1 Given the patient outcomes and satisfaction it would be of immense benefit to the NHS and to patients to engage in research in homeopathy and cost effectiveness of homeopathy in the NHS.


4.2 The outcome studies demonstrate that there are specific conditions where homeopathy is particularly useful and is an important element in improving patients' lives.




1 Sharples F, van Haselen R, Fisher P. NHS patients' perspective on complementary medicine. Complement Ther Med 2003; 11: 243-248.

2 Spence D, Thompson EA, Barron SJ. Homeopathic treatment for chronic disease: a 6-year university-hospital outpatient observational study. J Altern Complement Med 2005; 5: 793-798.

3 Clover A. Patient benefit survey: Tunbridge Wells Homoeopathic Hospital. Br Homeopath J 2000; 89: 68-72.

4 Richardson WR. Patient benefit survey: Liverpool Regional Department of Homoeopathic Medicine. Br Homeopath J 2001; 90: 158-162.

5 Reilly D, Mercer SW, Bikker AP, Harrison T. Outcome related to impact on daily living: preliminary validation of the ORIDL instrument. BMC Health Serv Res 2007; 7: 139.

6 White A, Ernst E. The case for uncontrolled clinical trials: a starting point for the evidence base for CAM. Complement Ther Med 2001; 9: 111-115.

7 Walach H, Jonas WB, Lewith GT. The role of outcomes research in evaluating complementary and alternative medicine. Altern Ther Health Med 2002; 8: 88-95.

8 Spence DS, Thompson EA, Barron SJ (2005). Homeopathic treatment for chronic disease: a 6-year university-hospital outpatient observational study. Journal of Alternative and Complementary Medicine, 11:793-798.

9 Keil T, Witt CM, Roll S, Vance W, Weber K, Wegscheider K, Willich SN (2008). Homoeopathic versus conventional treatment of children with eczema: A comparative cohort study. Complementary Therapies in Medicine, 16:15-21.

10 Bordet MF, Colas A, Marijnen P, Masson J, Trichard M (2008). Treating hot flushes in menopausal women with homeopathic treatment - results of an observational study. Homeopathy, 97:10-15.


11 Sharples F, van Haselen R, Fisher P (2003).  NHS patients' perspective on complementary medicine: a survey. Complementary Therapies in Medicine, 11:243-248.

12 Thompson EA, Mathie RT, Baitson ES, Barron SJ, Berkovitz SR, Brands M, Fisher P, Kirby TM, Leckridge RW, Mercer SW, Nielsen HJ, Ratsey DHK, Reilly D, Roniger H, Whitmarsh TE (2008). Towards standard setting for patient-reported outcomes in the NHS homeopathic hospitals. Homeopathy, 97:114-121.

13 Mercer SW, Reilly D (2004). A qualitative study of patient's views on the consultation at the Glasgow Homoeopathic Hospital, an NHS integrative complementary and orthodox medical care unit. Patient Education and Counselling, 53:13-18.

14 Bikker AP, Mercer SW, Reilly D (2005). A pilot prospective study on the consultation and relational empathy, patient enablement, and health changes over 12 months in patients going to the Glasgow Homoeopathic Hospital. Journal of Alternative and Complementary Medicine, 11:591-600.

15 Mercer SW, Reilly D, Watt GC (2002). The importance of empathy in the enablement of patients attending the Glasgow Homoeopathic Hospital. British Journal of General Practice, 52:901-905.


16 Richardson WR.(2001) Patient benefit survey: Liverpool Regional Department of Homeopathic medicine. British Homeopathic Journal 90 158-162.


Dr Hugh Nielsen

Department of Homeopathic Medicine

Old Swan Health Centre



November 2009