You may recall a few months ago that I posted a link to a blog post by Green councillor Jason Kitcat back in 2010 about the complete lack of osteopathy provision by the NHS in Brighton & Hove and East Sussex, whilst NHS West Sussex referred over 1800 patients for osteopathic treatment in the same year.
The National Institute for Health and Clinical Excellence (NICE) guideline on non-specific low back pain (i.e. that which is musculoskeletal in origin, involving the muscles, joints, discs, bones and ligaments) states that a course of manual therapy, which includes spinal manipulation, should be offered. For a summary of their recommendations, read the following press release from NICE.
With this in mind I did some research and found that the NHS Brighton & Hove City Primary Care Trust last updated their policy on the provision of osteopathy in 2008, in which NHS funding for osteopathy was deemed inappropriate in their opinion. However, this policy has not changed since the NICE guidelines were issued.
Will this position change?
I recently contacted NHS Brighton & Hove City Primary Care Trust to query this and to ask whether they thought the position might change following the planned NHS reforms. The answer I got was a categorical "no". Apparently, they currently commission Brighton and Sussex University Hospitals NHS Trust (BSUH) alone to provide musculoskeletal services to the city and only in the form of physiotherapy at this point in time. Presumably some of these physios have undergone some training in spinal manipulation to meet the NICE guidelines but osteopaths (and chiropractors) spend a good deal of their four-to-five-year degree courses learning a wide variety of techniques for manipulating the spine and other joints safely, effectively and specifically. I must emphasise here that I'm not having a go at physiotherapists - they do an excellent job treating and rehabilitating a wide variety of injuries and conditions - but just like any other profession, they can't specialise in every aspect of musculoskeletal care. Osteopaths are specialists in treating back pain with techniques such as spinal manipulation and in my view should be utilised as such by the NHS.
The skills, specialisms and approaches vary widely between osteopaths, chiropractors and physiotherapists, and between individuals within these professions. Patients are all individuals and should be offered the best choice of treatment for THEM. As I understand it, the planned NHS reforms seek to offer patients greater choice in their own healthcare by offering a wider variety of skilled practitioners the chance to bid for NHS contracts that would provide a range of high quality, cost-effective alternatives to which GPs can refer their patients. To not offer patients this variety of options is surely denying them control over their own healthcare, yet NHS Brighton & Hove PCT have told me there is no plan to change their position on this currently or indeed when the new Clinical Comissioning Group (CCG) is set up following the NHS reforms.
Why would I like osteopathy to be available to all?
During my training I worked in a busy NHS GP surgery in London, treating patients with a variety of conditions of musculoskeletal origin and feedback from patients was very positive. I also spent some time in a hospital environment, working in the British School of Osteopathy HIV clinic at the Royal Free Hospital, managing musculoskeletal conditions in patients with HIV. Both were very rewarding places to work and I would really love to be able to provide NHS osteopathy to my local community here in Brighton & Hove but it seems that, for the foreseeable future at least, there is no chance of this.
Discounted treatment for NHS patients
Okay, so Brighton & Hove residents can't expect to have osteopathy provided free of charge on the NHS but surely there must be a way for those patients without the financial means to pay the full cost of private treatment to get access to osteopathic care? I wrote to each individual NHS GP based near my clinics in Wilbury Road and Preston Park, proposing a discounted rate for any NHS patients referred to my practice; I even offered to provide free treatment to a proportion of those patients whom their GPs considered to be most in need but least able to afford treatment. That was two months ago: there has been no response.
I will keep an eye on developments and report any changes in attitude towards provision of NHS osteopathy in the city. In the meantime I would like to offer discounted osteopathic care to any patients who come to me with a referral letter from their NHS GP. I am currently working on the fine points of this scheme and will provide further information in due course. If this is something you feel you would be interested in taking advantage of, please email me or leave me a message on my contact form for more information. Alternatively, you can leave any comments/questions below.
The National Institute for Health and Clinical Excellence (NICE) guideline on non-specific low back pain (i.e. that which is musculoskeletal in origin, involving the muscles, joints, discs, bones and ligaments) states that a course of manual therapy, which includes spinal manipulation, should be offered. For a summary of their recommendations, read the following press release from NICE.
With this in mind I did some research and found that the NHS Brighton & Hove City Primary Care Trust last updated their policy on the provision of osteopathy in 2008, in which NHS funding for osteopathy was deemed inappropriate in their opinion. However, this policy has not changed since the NICE guidelines were issued.
Will this position change?
I recently contacted NHS Brighton & Hove City Primary Care Trust to query this and to ask whether they thought the position might change following the planned NHS reforms. The answer I got was a categorical "no". Apparently, they currently commission Brighton and Sussex University Hospitals NHS Trust (BSUH) alone to provide musculoskeletal services to the city and only in the form of physiotherapy at this point in time. Presumably some of these physios have undergone some training in spinal manipulation to meet the NICE guidelines but osteopaths (and chiropractors) spend a good deal of their four-to-five-year degree courses learning a wide variety of techniques for manipulating the spine and other joints safely, effectively and specifically. I must emphasise here that I'm not having a go at physiotherapists - they do an excellent job treating and rehabilitating a wide variety of injuries and conditions - but just like any other profession, they can't specialise in every aspect of musculoskeletal care. Osteopaths are specialists in treating back pain with techniques such as spinal manipulation and in my view should be utilised as such by the NHS.
The skills, specialisms and approaches vary widely between osteopaths, chiropractors and physiotherapists, and between individuals within these professions. Patients are all individuals and should be offered the best choice of treatment for THEM. As I understand it, the planned NHS reforms seek to offer patients greater choice in their own healthcare by offering a wider variety of skilled practitioners the chance to bid for NHS contracts that would provide a range of high quality, cost-effective alternatives to which GPs can refer their patients. To not offer patients this variety of options is surely denying them control over their own healthcare, yet NHS Brighton & Hove PCT have told me there is no plan to change their position on this currently or indeed when the new Clinical Comissioning Group (CCG) is set up following the NHS reforms.
Why would I like osteopathy to be available to all?
During my training I worked in a busy NHS GP surgery in London, treating patients with a variety of conditions of musculoskeletal origin and feedback from patients was very positive. I also spent some time in a hospital environment, working in the British School of Osteopathy HIV clinic at the Royal Free Hospital, managing musculoskeletal conditions in patients with HIV. Both were very rewarding places to work and I would really love to be able to provide NHS osteopathy to my local community here in Brighton & Hove but it seems that, for the foreseeable future at least, there is no chance of this.
Discounted treatment for NHS patients
Okay, so Brighton & Hove residents can't expect to have osteopathy provided free of charge on the NHS but surely there must be a way for those patients without the financial means to pay the full cost of private treatment to get access to osteopathic care? I wrote to each individual NHS GP based near my clinics in Wilbury Road and Preston Park, proposing a discounted rate for any NHS patients referred to my practice; I even offered to provide free treatment to a proportion of those patients whom their GPs considered to be most in need but least able to afford treatment. That was two months ago: there has been no response.
I will keep an eye on developments and report any changes in attitude towards provision of NHS osteopathy in the city. In the meantime I would like to offer discounted osteopathic care to any patients who come to me with a referral letter from their NHS GP. I am currently working on the fine points of this scheme and will provide further information in due course. If this is something you feel you would be interested in taking advantage of, please email me or leave me a message on my contact form for more information. Alternatively, you can leave any comments/questions below.
RSS Feed
