An NHS centre for integrated medicine, part of University College NHS Foundation Trust

The Royal London Hospital for Integrated Medicine (RLHIM) is the largest and, as part of University College London Hospitals NHS Foundation Trust (UCLH), the most integrated public sector provider of Integrated Complementary Medicine (ICM) in Europe.

UCLH is one of the UK’s leading academic medical centres. Integrated care is offered in collaboration with several UCLH Hospitals and departments, including the University College Hospital Macmillan Cancer Centre, The National Hospital for Neurology and Neurosurgery, the Eastman Dental Hospital, the Elizabeth Garrett Anderson Hospital (women’s and children’s services), the gastroenterology and rheumatology departments of UCH. Models of integration vary according to patient need.

The RLHIM is an NHS centre, operating on the normal NHS terms and conditions, including that patients must be referred by their GP. All clinical staff are members of statutorily registered health professions with additional training and qualifications in ICM. Treatment options include (in alphabetical order) Autogenic Training, Acupuncture, CBT, Diet and Nutritional advice, Phytotherapy, Homeopathy, Medical and Clinical Hypnosis, Occupational therapy, Physiotherapy, Podiatry and Reflexology alongside conventional medicine.

We constantly strive to improve our services and have several programmes of service improvement and research to develop and improve services to our patients as well as providing information to both commissioners and patients. These are detailed below.

Shortlisted for our Innovations Award 2011.

The RLHIM’s programme of research and service development aims to establish the hospital as delivering evidence based integrated medicine. All research emphasises the importance of patient experience; both in terms of understanding the treatment experience from the perspective of patients receiving treatment at the RLHIM, and evaluating treatments using methods which prioritise patient wellbeing and incorporate outcomes patients feel are important to them.

The design is an innovative, using iPads and encouraging patients to enter long term follow up data online, even after they have been discharged from the hospital.

The project will gather essential information and every patient referred for 3 years. It will evaluate patient improvement, cost effectiveness of the treatment and patient experience of treatment using the EQ-5D-5L measure of health related quality of life at specific time points. This will be used to calculate Quality Adjusted Life Years (QALYs).

A nested qualitative study with a sub-sample of patie
nts will additionally explore patients’ experiences of receiving treatment at RLHIM. This project has received full Charitable funding.

3. A pragmatic observational cohort study of integrated treatment for musculoskeletal disorders This project is under way, it uses a mixed methods approach to assess the impact of ICM treatment as offered at the RLHIM for patients with a variety of musculoskeletal disorders over one year. The Research Fellow is a PhD candidate at London South Bank University, co-supervised at the RLHIM

4. Exploring patients’ perceptions of self-care: The daily practice of RLHIM clinicians promotes pateint self-care. However, advice and support on self-car ids formalised and generally not included in information provided to patients and commissioners, nor in leaflets or on the website. The project aims and develop the RLHIM’s self-help and self-care approaches, informed by patient perceptions and views.

A qualitative study will be undertaken with patients to explore their perceptions of self-care. Once analysed, the results will influence RLHIM self-care policy and service provision. This project has received some Charitable funding.

5. A feasibility study evaluating a course of Tai Chi training, in conjunction with standard care, for patients with Parkinson’s disease (PD).

This study, a collaboration with the National Hospital for Neurology and Neurosurgery will provide preliminary data on effectiveness in terms of function and mood of Tai Chi training It will inform the design of a subsequent randomised controlled trial.

6. A pragmatic observational study on the clinical effectiveness of rosehip capsules for patients with chronic knee pain. All participating patients will receive a 3 month course of rosehip capsules.

Outcome measures will be completed at baseline and 3 months. All patients will also participate in a nested qualitative study to explore their experiences of this treatment for chronic knee pain.

7. A service evaluation study of self-acupuncture for patients with tension-type headaches. This is a service evaluation of a newly-introduced treatment. All patients will receive an administered course of acupuncture congruent with NICE guidelines. Subsequently they will be offered training in self-acupuncture. The study will evaluate the effectiveness of the self-acupuncture, compared to no additional treatment. Patients will also participate in a nested qualitative study to explore their experience of self-acupuncture.

8. RLHIM is supervising or co-supervising several health professionals undertaking higher degrees in ICM, including

• A Professional Doctorate in Clinical Psychology for a qualitative study exploring fibromyalgia patients’ experiences of receiving Autogenic Training
• A Professional Doctorate in Health Psychology. The research is a pilot study evaluating the impact of mode of delivery of Cognitive Behavioural Therapy (CBT) for Insomnia.
• An MSc research project exploring the effect on patients with fibromyalgia and their ability to cope with on-going pain, when cognitively processing their key metaphorical pain-related cognitions using CBT-based techniques.