Patient demand is key. Patients have a right to evidence based treatment for back pain recommended by NICE regardless of their ability to pay.
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Ask for the treatment that has been recommended and if by chance they say ‘no’ – ask why? And keep on asking.
The National Institute for Clinical Excellence (NICE) recommends which treatments the NHS should provide. The recent NICE back pain guidelines (2009) advise GPs to offer patients the choice of a course of manual therapy (Chiropractic, Osteopathy), exercise or acupuncture. Up until now Primary Care Trusts who have managed the NHS budgets have been slow to take this forward. There are currently only a few examples of chiropractors providing manual therapy funded by the NHS, such as in N. E. Essex where this has been operating successfully for about 2 years. Patients have been very satisfied with this service, having reduced pain and disability, with fewer being referred to hosipital for back pain thus saving NHS costs.
Now with the recent NHS reforms, set out in the Government’s Health and Social Care Bill 2011, things should change. The Department of Health believes that the implementation of the Bill will empower patients and improve patient care.
This presents a huge opportunity for chiropractors who wish to see patients on the NHS to contact their local GPs to find out who are the key players involved in setting up the Consortia and developing clinical pathways such as for back pain.
Patients can help enormously with this.The voice of the patient is paramount because GPs will listen to patient demand. Ask your GP if the new Consortia are considering contracting chiropractors to provide manual therapy in a back pain pathway (clinical language for appropriate management of a condition). If patients ask their GP for the recommended treatment such as manual therapy, not currently available on the NHS, then this will carry more weight than your chiropractor or osteopath who has a vested interest in selling their services to the GPs.
Patients should quote the NICE guidelines saying that these recommend a course of up to 9 sessions of manual therapy (Chiropractic, Osteopathy), which is one of the best treatments for persistent back pain and there is evidence to show its effectiveness and cost savings. See www.nice.org.uk/CG88 for more information such as a patient leaflet and fact sheet.
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