Health Board Votes to Axe Overnight Ward at CIC
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The Faculty of Homeopathy Newsletter February 2017 Health board votes to axe overnight ward at CIC embers of NHS Greater proceed without a consultation, as the and Clyde Glasgow NHS Greater Photo: Glasgow and Clyde (GGC) have Scottish Health Council has decided Mvoted to close the seven-bed the reduction of the CIC’s clinical ward at the city’s Centre for Integrative capability does not constitute a major Care. The proposal to “move to service change. Many supporters of ambulatory care” – as the health board the CIC fear further cuts to services at describes closing the in-patient service the centre. This follows news that after – was carried by 21 votes to nine at a initially claiming the axing of the ward meeting in December. would save the health board £180,000, Audrey Forbes, a patient from the managers are now stating the saving ward at the CIC, said: “It’s devastating. will be £400,000. Chronic ill health is on the rise. There Bloodied but unbowed, should be more of these services not campaigners are now focussing their less.” efforts on getting the CIC designated The health board’s decision is a a national service. They say that as major disappointment to the staff, NHS GGC chairman John Brown the centre is the only one of its kind patients and supporters of the CIC who opposed the closure of the ward in the country and receives patients campaigned tirelessly to save the ward. from other health boards, it should be Even as the meeting convened at the In its submission to NHS GGC the funded by the Scottish government. William Quarrier Conference Centre, Faculty of Homeopathy listed many of More praise protesters could be heard outside the benefits afforded by the in-patient chanting “No! No! No more cuts!” But Ironically, the health board’s decision to service, including 24-hour assessment their pleas fell on deaf ears. close the ward comes at a time when of pain and sleep patterns; review of One angry protester said: “Despite the CIC is receiving more plaudits for its the patient’s medication, family and high levels of patient satisfaction, person-centred approach. In addition community circumstances; enable the support from MSPs, petitions and to the CIC receiving the 2016 Best patient to engage with their self-care protests, the majority of health board Self-Management Resource Award members appear blinkered, blind or and management of their health; from Health and Social Care Alliance just bloody-minded when it comes encourage social interaction and peer Scotland (reported in November’s to recognising the important and support for patients who may be simile), the centre’s nursing team won innovative contribution the Centre for isolated and socially withdrawn as a the Outstanding Nurse Award at Integrative Care makes to patient care result of their long-term ill health; and Glasgow’s Community Giants Awards in Scotland.” provide an atmosphere where patients ceremony, which recognises those can feel secure which is particularly groups and individuals who make an Not convinced important when there is a history of outstanding contribution to the local John Brown, chair of NHS GGC, said he abuse and trauma. community. disagreed with the planned closure, but The Faculty went on to point out Judges praised the team for its other members were not convinced that many patients would find the approach and ethos and described it as overnight care was necessary for the limitations of their chronic illnesses “quite different from that experienced type of treatments available at the CIC. overwhelming and prevent them from elsewhere in the NHS”. They went on This highlights a fundamental failing by attending day care at the CIC. to say how group work sessions and many members of the health board to also peer support helped patients to recognise the clinical value that the Bloodied but unbowed engage and become more proactive ward offers to patients and clinicians. The closure of the ward will now and motivated in their own healthcare. EDITORIAL Over the summer of 2016, Viewforth of any public money at all being spent broader context of the economic and Consulting Ltd conducted an engendered considerable hostility social value of homeopathy provision, exploratory study for the Faculty among critics of homeopathy. In which is not solely reliant on proof of of Homeopathy which took a fresh the course of our research we were “scientific efficacy”, but which can take perspective on whether or not public somewhat taken aback to discover how into account the broader impacts on funding support for homeopathy heated the arguments had become, patients, their families and the rest of could be justified. Study leader society. Ursula Kelly explains. Ursula Kelly At a practical level we recommended the adoption across the he study came about through profession of a common approach to discussions I had with Greg White, measuring health related outcomes and Tthe Faculty’s Chief Executive, wider social quality of life outcomes, about the relative success that higher using instruments (such as the EQ-5D education has had in recent years in questionnaire) as close as possible demonstrating evidence of return on to those recognised and used by the public investment. National Institute of Health and Care For a number of years the higher Excellence (NICE). education sector has been very aware Outcomes measured using the of the need to provide evidence of same or similar instrument as that used economic and social impact when by NICE would allow the calculation of making a case for public or charitable Quality Adjusted Life Years (QALYS). This funding. I have worked on many impact would mean that credible comparisons studies of individual universities and with other kinds of health intervention degenerating at times into little more of the sector as a whole, regionally, could then be made using the than name-calling with even respected nationally and internationally. The recommended NICE cost-effectiveness and educated individuals resorting question arose: would any of the ratios and related monetary thresholds to intemperate language to describe methodologies applied to assess for the value of each QALY gained. At broader economic and social benefits things with which they disagreed. Thirdly, despite the fundamental the very least, a common approach to generated by higher education outcome measurements could enable be relevant to the evaluation of issue being whether or not homeopathy is worth spending public the derivation of agreed weights for homeopathy? money on, we could not identify a application to an economic valuation Neither I nor my colleagues had any single review of homeopathy in recent or for weights that could legitimately particular experience of, or knowledge years in the UK that has included be used to develop a range of about, homeopathy and hence started more than even a cursory evaluation “effectiveness” measures. with no preconceived views. The basic of economic benefits or the broader Evidence generated using idea underpinning the pilot study benefit to society of homeopathy recognised methods of economic was to explore the development and provision. This was as true of the valuation, such as social cost-benefit application of an economic framework House of Commons Science and analysis, which are also used by the for assessing broader benefits to society Technology Committee 2010 Report as major funders and evaluators (such arising from homeopathy provision, of subsequent PCT and health board as NICE and HM Treasury) would help using the recognised methodologies, reviews across the UK. provide some of the hard evidence techniques and language that are It seems that discussions about on value that is needed for any used in other sectors when a case homeopathy have become locked into for public funding support is being future PCT or Health Board reviews an unproductive circular debate over and would increase the credibility made. Such an approach would be the scientific evidence for efficacy, for public support of homeopathy. It neutral in that it would not be making which precludes consideration of would present evidence in language a case “for” or “against” but would lay any other kinds of evidence (such as and terms with which policy-makers out the conceptual framework within patient benefit or satisfaction) that are familiar and which are commonly which valid points could be made and could genuinely be relevant to the evidence assessed. issue of justifying public expenditure. used in considering issues of public funding and public policy. Highlighting What we found The homeopathy profession has consequently reached an impasse in economic value of homeopathy and The study held a number of surprises terms of being able to demonstrate contribution to broader social well- for us. Firstly, the amount of public the value of homeopathy and reasons being could also encourage a wider money actually being spent on for its continued public funding. public and political understanding of homeopathy in the UK is vanishingly the potential worth of homeopathy to Ways forward small – estimated at no more than society. 0.0035% of the total healthcare budget. We proposed that both the tenor and Secondly, and despite the modest the content of future discussion could Ursula Kelly expenditure involved, the idea be improved by highlighting the Director, Viewforth Consulting Ltd 2 NEWS simile • February 2017 • The Faculty of Homeopathy Faculty responds to RCVS CAM review The Faculty of Homeopathy has justification for banning a small number framework controlling veterinary submitted a paper to the Royal of veterinary surgeons from practising homeopathic practice in the UK; and College of Veterinary Surgeons’ (RCVS) homeopathy.” the issue of clinical freedom that allows review of its policy on the use of Nevertheless, the RCVS says it veterinarians to practise according to complementary medicine.