6.  CONCLUSIONS
      and Bibliography


The results from this three year experiment in the use of complementary medicine in general practice showed that this was widely welcomed by patients themselves, appeared to have considerable effectiveness in a wide range of health problems, and led to a reduced demand on other aspects of health care provision, particularly referrals to secondary care.

The complementary therapies to which patients were referred appeared to be particularly effective for conditions which were short-term, and severe, and for musculo-skeletal conditions, although the majority of referrals were patients with longer-term health conditions. There was some evidence that patients with experience of complementary health, and who had an active approach to their own health management, had a better outcome, although patients who themselves initiated the request for complementary medicine did no better than others. Indeed, the outcome for self-requesting patients appeared to be poorer than patients for whom the referral was GP initiated.

Provision of complementary medicine in general practice is not an easy option: it is very difficult to find a way of funding such a service, although there did appear, from this study, to be evidence that such a service is at least cost-neutral, on account of savings made elsewhere, and at best, cost-effective. It is also demanding in terms of administrative time, and, with demand for the service outstripping supply, can easily lead to a build-up in waiting lists.

However, the benefits of such a service did appear to be considerable, both for the patients and for other staff at the practice, particularly since it provided another option of treatment for patients for whom conventional treatment was ineffective, and also met with a high level of satisfaction from the patients receiving the service.

Implementation of services of this kind currently appear to be limited by the lack of funding. The complementary health service in the study practice is now being maintained through a charity, with funding from patients’ donations and outside grants. Whilst this is encouraging as a sign of general public and patient support for a service, long term NHS funding does need to be realised if the service is to provided on a secure financial basis. Other obstacles to further expansion of services of this kind within an NHS setting are the difficulty for health professionals in accessing good quality information about these therapies, particularly information about the evidence base that is beginning to evolve.

Funding for research also remains very limited, and there is an urgent need for research which would take further some of the tentative results to be drawn from the present study: particularly further research into the cost effectiveness of these therapies within a primary care setting.



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