Health and Social Care Bill

Memorandum submitted by the British Acupuncture Council (HS 120)

1. The British Acupuncture Council (BAcC) is the largest body for the regulation of traditional acupuncture in the UK. With over 3,000 members and a track record of delivering robust self-regulation (recognised in the Secretary of State’s announcement on herbal medicine on 16 February 2011), the BAcC believes that it has a significant and expanding contribution to make to national healthcare delivery. BAcC members offer over 3 million patient treatments a year and wish to expand this service work within the NHS. The inclusion of acupuncture in the NICE guidelines on the treatment of low back pain is a demonstration of hose BAcC members can significantly benefit the nation’s health.

2. The BAcC believes that the bill offers opportunities for GP consortia to allocate funds specifically for services which their patients request, such as acupuncture. The BAcC believes that one of the great advantages in placing the commissioning arrangements closer to patient needs is that small providers will now have a much greater opportunity to become an ‘any willing provider’. The BAcC hopes that the commissioning arrangements will permitting individual acupuncturists and consortia of acupuncture to compete effectively without undue burden.

3. The BAcC has welcomed the extension of regulatory arrangements for herbal and traditional Chinese medicine practitioners. The BAcC remains committed to the statutory regulation of acupuncture alongside herbal medicine and traditional TCM in order to minimise potential public confusion caused by splitting these closely intertwined strands. However, it believes that the extension of the function of the CHRE into the accreditation of voluntary self-regulation presents an opportunity to generate innovative forms of regulation and would welcome the chance to participate in the process of developing these systems.

4. The BAcC particularly welcomes the emphasis on outcomes in the Bill, with effectiveness, safety and quality for patients being highlighted. The BAcC has an exemplary record in promoting safe practice in its field, and has always demonstrated high levels of patient satisfaction with the services provided by its members. Like many small bodies with a predominance of self-employed or small group members, however, it has proved difficult to find the funding necessary to demonstrate by well conducted research the cost-effectiveness of acupuncture.

5. The BAcC hopes that the explicit provisions in the Bill promoting research will extend to encouraging the funding of studies which compare the cost effectiveness of acupuncture treatment alongside conventional care. Where these have been conducted already, as, for example, in Ratcliffe J, Thomas KJ, MacPherson H, Brazier J. A randomised controlled trial of acupuncture care for lower back pain: cost effectiveness analysis. British Medical Journal, 2006; 333: 626-628, acupuncture treatment has been shown to significantly reduce the overall cost of care. The large-scale GREAT trials in Germany demonstrated similar outcomes and have encouraged the use of acupuncture in mainstream provision.

6. The BAcC is mindful that the extended consultation time, -integral to best traditional acupuncture practice - is now considered in conventional medicine to contribute significant reductions in the provision of care (and therefore costs) for chronically ill, repeat patients. The BAcC would be happy to work in partnership with statutory bodies to enable research into this or other aspects of its work.

7. In particular the BAcC believes that the period of transition presents an ideal opportunity to set aside or earmark funding for a small number of innovative pilot projects or studies involving the use of complementary therapies. A relatively small investment at this stage could generate results which could be rolled out on a national scale if they clearly demonstrate that a number of complementary therapies can offer a high level of patient satisfaction, cost effectively.

8. The BAcC welcomes the focus on patient needs and choice throughout the Bill, and does so from a perspective which recognises that the service offered by its members is often beyond the means of those who could most benefit from the intervention – the NHS patient. It hopes that the provisions of the Bill will allow easier access to these treatments to this group.

9. The BAcC also hopes that the commissioning consortia allow flexibility to individual GPs in making choices about what they want to fund within their practices. There have been examples within the current structure where choices have been delegated to PCTs, which have then issued blanket refusals to any funding within their areas.

10. The BAcC is also encouraged by the creation of the Health and Wellbeing Boards which appear to offer possibilities for ensuring that local communities have a direct say in the integrated services which are proposed for them. Through its Regional Group network, it is developing a network of traditional acupuncturists who would be able to offer acupuncture provision on a scale which warrants consideration by commissioners seeking cost effective provision within their area.

11. In conclusion, the BAcC is a model of self-regulatory excellence in the healthcare sector. It believes that the current healthcare reforms, while they target problems of a major and infrastructural nature, nonetheless offer exciting possibilities to extend and improve care.

12. It has long been the aspiration of the BAcC to have its members contributing to a ‘free at point of delivery’ system, and the reforms proposed in the Health and Social Care Bill bring that aspiration a little closer to realisation.

March 2011