Newcastle PCT

1
Newcastle PCT

• Integrating Complementary Therapy into the NHS
• Dawn Solomon
• Pharmaceutical Adviser/ Project Manager

2
The Project

• Homeopathy
• Acupuncture
• Osteopathy
• Chiropractic
• Aromatherapy/ Massage
• Shiatsu

3
Key Principles

• The aim should be to integrate general practice
  and complementary medicine.
• The service would target people on low income who
  were unable to afford complementary therapy.
• A range of therapies would be provided with a
  focus on those with a strong evidence base.
• All therapies would be free at the point of
  delivery.
• The cost-effectiveness of the service would be
  evaluated.

4
Partnership Working

• PCT
• New Deal For Communities
• Community Action on Health
• Health Action Zone
• University
• Community/ Patients
• Multiple professional Groups internal and
  external
• Voluntary Organisations

5
Evaluation

• Genuine opportunity to test and evaluate a robust
  and sustainable model of PCT commissioning of
  complementary therapy
• Focus on improvements in quality of life
• Focus on cost effectiveness

6
Why did GPs Refer

• 80 because CT were not working
• 20 because CT were causing side effects
• 47 felt CAM would provide additional benefits
  alongside CT that were working

• 7 felt the patient would have a better response
  to CAM
• 47 The patient had already used CAM and had a
  good response
• 13 had seen a good response in another patient

7
Health Improvement
n106
n84
8
Satisfaction with Treatment

• For all therapies
• Extremely 62
• Very 34
• Not Very 4
• n 102

9
Cost per Patient

• Average cost per patient 111
• Ibuprofen 29
• Omeprazole 343
• Rofecoxib 259
• Physiotherapy 150
• Orthopaedic surgeon consultation 265
• Paroxetine 175

10
Further Treatment from GP
No 83 Yes 17 n 60
11
Change in Number GP Consultations

• Consultations per person reduced from 5.7 to 3.9
• Overall 31 reduction in the number of GP
  consultations
• Total reduction of 72 consultations.
• Extrapolated 666 GP consultations per year
  saved.
• Approximately cost difference of 10,000.

12
Referrals elsewhere

• Inpatient treatment for depression every 10 weeks
  for a five week period each time.
• 10 months out of hospital after
  aromatherapy/massage
• Saved 93 days stay.
• Cost saving 15,345

13
Change in Medication

• 39 reduction in prescriptions
• Cost difference 520.
• Extrapolating this for all patients
  4,800/year.
• 31 reduced/stopped painkillers
• 10 reduced/ stopped antidepressants.
• n70

14
Clients perceptions of the service
After first session I was free of pain for the
first time in 10 years- the practitioner was very
pleasant and put me at ease as I was very nervous
15
CONCLUSION

• High level patient satisfaction
• Reports of health improvement
• Reduction in the use of conventional medicine
• Reduced GP Consultations
• Beneficial impact on other services
• GP support for continuation

16
Any Questions? Dawn.Solomon_at_newcastle-pct.nhs.uk