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Complementary Medicine Roundup – February 2019

A NEW HORIZON FOR CAM

In his speech at the Federation of Holistic Therapies Conference 2018 on 29.11.18, Dr Michael Dixon, who is a practising GP (College Surgery, Culm Valley Integrated Centre For Health) and the Chairman of The College of Medicine, spoke of a “New Horizon” for complementary and alternative medicine (CAM) and integrated health and of its increasing acceptance by younger members of the (conventional) medical profession.

This “New Horizon” is not limited to the UK.

The research paper published in Cambridge Core (May 2015, Volume 16, Issue 3, pp. 246-253) titled General practitioners’ beliefs about the clinical utility of complementary and alternative medicine confirms that the researched GPs see a role for CAM within clinical practice.

The BMJ Open blog posted by Emma Grayon 19.03.18 and titled Surgeries employing GPs with additional training in complementary medicine appear less likely to prescribe antibiotics referred to the outcome of research by UK, German and Dutch researchers, led by the University of Bristol, using prescribing data from 7,274 GP surgeries and comparing the differences in the prescription of antibiotics between conventional GP surgeries and those with GPs trained in integrative medicine. See also the BMJ Open research paperDo NHS GP surgeries employing GPs additionally trained in integrative or complementary medicine have lower antibiotic prescribing rates? Retrospective cross-sectional analysis of national primary care prescribing data in England in 2016 (Esther T van der Werf, Lorna J Duncan, Paschen von Flotow, Erik W Baars; BMJ Volume 8, Issue 3).

The research article Changes in the use practitioner-based complementary and alternative medicine over time in Canada: Cohort and period effects by Mayilee Canizares, Sheilah Hogg-Johmson, Monique A. M. Gignac, Richard H. Glazier and Elizabeth M. Badley (published online on 11.05.17 and edited by Russell Jude de Souza) (PLoS One. 2017; 12(5): e0177307), concludes that recent generations are expanding their healthcare needs by including CAM in their conventional care. The research also identifies the importance of doctors discussing the use of CAM with their patients.

Evidence of the increasing acceptance of CAM in the USA, Switzerland, Germany, France, Australia, India, the Netherlands and in many other jurisdictions has frequently been the subject of past issues of the College of Medicine ‘Complementary’ blog.

The World Health organisation Traditional Medicine Strategy 2014 to 2023: Strategy Document states (at page 19):

‘…As the uptake of T&CM (Traditional and Complementary medicineincreases, there is a need for its closer integration into health systems…’

(please refer to my November 2016 blog for more information).

It has been reported, in Medicine News on 21.09.15 and also by Natural News on 26.01.10, that medical students want conventional medicine to include alternative therapies.

Nevertheless, there is a continuing reluctance on the part of UK Health and Social Care organisations and institutions, including within the NHS and by Government and Parliamentary Select Committees, to recognise or even to ‘name’ the contribution and potential of CAM, notwithstanding its increasing use as evidenced by patient choice. For an explanation of the reason for this, see the abstract Patient choice and evidence based decisions: The case of complementary therapies authored by Wye L, Shaw A, shaw D; September 2009.

Promoting the “New Horizon” for CAM expounded by Dr Michael Dixon should surely be one of the aspirations of UK Government Ministers, health and social care managers and policy-makers and (both CAM and conventional medicine) clinicians together with their professional organisations and regulators.

THE ALL-PARTY PARLIAMENTARY GROUP FOR INTEGRATED HEALTHCARE (PGIH) REPORT: DECEMBER 2018

Aspiring to a New Horizon is the aim of this impressive and important Report (31 pages) published by the PGIH titled Integrated Healthcare: Putting the Pieces Together and written by Matthew Williams on behalf of the PGIH. 

Based on an extensive consultation undertaken between 6th February and 31st March 2017 and the submissions received from one hundred and thirteen organisations and other stakeholders, the Report opens with the following statement:

‘…The future of healthcare lies in our health system recognising that physical, emotional and mental health are intrinsically linked, and that only by treating a patient as a whole person can we tackle the root cause of illness and deal with the problem of patients presenting with multiple and complex conditions…’

The Report calls on the NHS to embrace complementary, traditional and natural medicine with the aim of easing the cost and burden of NHS service delivery, especially where there are Effectiveness Gaps. The purpose of the Report is expressed as follows:

‘…To provide a forum for discussion on issues related to integrated healthcare; to stimulate well-informed debate among politicians and stakeholders; and to contribute towards the development of knowledge and policies on the subject…’

A summary of the Report’s diverse, concise and timely recommendations may be read on pages 6 and 7. These are followed by thoroughly researched (see the References on page 31) and detailed text.

David Tredinnick MP, Chair of the PGIH, is reported (http://icamhub.com/news: search news pages for the page relating to the Report) as commenting:

‘…Despite positive signs that ministers are proving open to change, words must translate into reality. For some time our treasured NHS has faced threats to its financial sustainability and to common trust in the system…’

‘…Multimorbidity is more apparent now in the UK than at any time in our recent history. As a trend it threatens to swamp a struggling NHS, but the good news is that many self-limiting conditions can be treated at home with the most minimal of expert intervention…’

‘…Other European governments facing similar challenges have considered the benefits of exploring complementary, traditional and natural medicines. If we are to hand on our most invaluable institution to future generations, so should we…’

After reading the Report, readers may wish to refer to the sections of my December 2017 blog headed A HEALTHCARE WORKFORCE IS READY AND WAITING and NHS ALLIED HEALTH PROFESSIONS SHOULD INCLUDE CAM PROFESSIONS.

THE ALLIANCE FOR NATURAL HEALTH INTERNATIONAL (ANH-Intl): A BLUEPRINT FOR HEALTH SYSTEM SUSTAINABILITY IN THE UK

Another impressive initiative towards a New Horizon, that includes an analysis of the potential of CAM, is A Blueprint for Health System Sustainability in the UK – A Consensus Position Paper (130 pages) published by the Alliance for Natural Health International (2018) and authored by Dr Rob Verkerk (Principal Author) and Meleni Aldridge, Melissa Smith and Jerome Burne (Contributing Authors).

The College of Medicine is just one of many organisations and individuals that have endorsed the Blueprint.

A press release issued by Dr Verkerk, on the 12th December 2018, reads as follows:

A major report published today, the result of over 2 years of research and consultation with health professionals, researchers and citizens, argues that many of the NHS’ woes could be remedied by changing the way the UK population manages its health.

The report, A blueprint for health system sustainability in the UK, was delivered today to the Rt Hon Matt Hancock MP, the Secretary of State for Health and Social Care.

“The Government’s planned £20 billion funding increase over the next 5 years will inevitably plug some of the shortfalls in healthcare delivery,” says lead author of the report, Robert Verkerk PhD, founder and executive director of the non-profit, Alliance for Natural Health (ANH) International.

Dr Verkerk continued, “But the greatest challenge facing the NHS is not just about money – it’s the sheer burden caused by preventable, chronic diseases. The solution is less about finding new ways of treating these complex diseases, and more about finding better ways of allowing us to stay healthy for longer. We need a unified language so that the public can communicate effectively and meaningfully with health and fitness professionals and be empowered in the process.”

To this end, the project team responsible for developing the ‘blueprint’ has used both the principles of sustainability and the science of ecology as key lenses through which to look at how individuals can participate more fully in optimising their health within their unique, varied and dynamic ecosystems. Focusing the greater part of healthcare inputs on complex chronic disease states is both expensive and rarely effective. Instead, a bottom-up approach is needed with much more effort expended in the community, before irreversible diseases have manifested. At the same time, health and fitness professionals need to be able to collaborate more effectively to guide individuals.

The ‘blueprint’, a 130-page, heavily referenced consensus paper endorsed by a diverse range of organisations, individuals and companies, sets out new ways in which individuals can manage multiple domains of their health. This can be done with varying levels of support or guidance from health professionals, depending on need or capacity to pay. The report also identifies 10 hallmarks of health system sustainability, including reduced reliance on pharmaceuticals and a greater focus on parameters that optimise health rather than those that simply aim to prevent disease.

In early 2019, the ANH, along with the specialist sustainability non-profit, Forum for the Future, aims to begin deliberations with the Department of Health and other parties to investigate the feasibility of evaluating the proposed approach in different community settings.

The ANH is already working alongside clinics and governments in other parts of the world to evaluate its new model of health system sustainability.

The sections of this comprehensive and most welcome Consensus Paper that are especially relevant to CAM may be found at page 86 and pages 99 to 112.

The aims of the Paper should be adopted within health and social care policy proposals by the NHS, The Department of Health and Social Care, Government Select Committees and also in policy papers produced by The King’s Fund and other health and social care organisations. Some of these organisations are listed in my March 2018 blog under the section headed ENCOURAGING HEALTHCARE ORGANISATIONS TO ENGAGE WITH CAM.