By John Kapp,
The legal infrastructure is in place to allow certain complementary treatments to be provided free on the NHS by GP referral.
Here are four of the treatments recommended by the National Institute for Clinical Excellence (NICE);
- The Mindfulness Based Cognitive Therapy (MBCT) 8 week course for depression and Irritable Bowel Syndrome (IBS) and
- Spinal manipulation,
- Acupuncture and
- Alexander Technique for low back pain.
Depression, IBS and low back pain comprise two thirds of case load in primary care, and patients have the statutory right to these treatments under the NHS Constitution (since it came into law on 21st January 2010), if their doctor says it is clinically appropriate.
They are provided free on the NHS so that commissioners can tick the box: ‘complies with NICE guidelines.’ However, the amount commissioned is so small that the waiting time is thousands of years.
Commissioners should honour patients rights within a reasonable wait (less than 18 weeks) by opening up the market to private providers, as was done in 2008 for hip and knee replacements.
Complementary therapists who provide these treatments for paying clients should be invited to bid for contracts to provide these treatments free at the point of use to patients referred by their GP.
They should be paid in arrears from the public purse by commissioners, as GPs, dentists, opticians, and chemists are now paid. Alternatively, the prescription form for these treatments could be issued in the form of a voucher, which is valued at the tariff price of the treatment, and which the patient trades in exchange for the treatment.
The implementation of such a scheme will have to be campaigned for locally by patients and complementary therapists. Their Clinical Commissioning Groups (CCGs) are legally obliged to consult the public under Patient and Public Involvement legislation (Local Government Act 2007).
Therapists should be asked to be allowed to bid to provide these NICE-recommended complementary treatments, to become Any Willing Qualified Providers of them.
The issues are described on www.sectco.org, particularly on section 5e titled: 'Model contract for Payment by Results commissioning for patients rather than providers.'