Editor—Recently there has been much interest in integrating complementary medicine into the NHS. In May the Foundation for Integrated Medicine hosted a conference on integrated health care. Although much debate took place, no definite criteria for integration emerged from the discussions.
To determine which criteria might be useful we questioned healthcare professionals and unit managers from a wide range of clinical disciplines. Subsequently, a questionnaire was designed, which included suggestions made by these professionals and some additional possible criteria generated from published literature and reports. This resulted in a list of 25 items. In the final questionnaire criteria appeared in alphabetical order, thus according equal weight to each option. The questionnaire was sent to all 122 directors of public health and all 140 primary care fundholding consortiums in the United Kingdom. Recipients were asked to indicate, in no particular order of priority, the five criteria that they considered to be the most important when deciding whether to purchase complementary medicine.
Altogether, 98 directors of public health and 47 individuals each representing one general practice consortium responded (response rates of 80% and 34% respectively). The five criteria most frequently selected are shown in the table. There are strong similarities between the two groups. Other data show that the criteria of “patient preference/pressure/demand/expectation” was selected by only 20% of respondents in both groups and “anecdotal evidence” by less than 2%.
To our knowledge this is the first attempt to establish, in a systematic manner, criteria to inform the discussion of how complementary medicine might actually be integrated into the NHS. Rigorous research ought to precede integration, a notion that seems obvious1 but is, at times, forgotten.
Table.
The five criteria most frequently chosen by respondents when deciding whether to purchase complementary medicine
| Criterion | No (%) directors of public health (n=98) | No (%) consortiums of fundholding general practitioners (n=47) |
|---|---|---|
| Evidence of effectiveness (for example, from randomised controlled trial or systematic review) | 89 (91) | 37 (79) |
| Evidence from outcomes studies | 79 (81) | 37 (79) |
| Evidence of cost effectiveness | 78 (80) | 29 (62) |
| Recognised accreditation procedure and professional standards | 55 (56) | 28 (60) |
| Availability of qualified practitioners | 27 (28) | 17 (36) |
References
- 1.Ernst E. Integrating complementary medicine? J R Soc Health. 1997;117:285–286. doi: 10.1177/146642409711700504. [DOI] [PubMed] [Google Scholar]