Recommendations
Following the successful completion of our pilot project in Northern Ireland in February 2008, the following recommendations were made to the Health Minister. These are taken from the full report, "Evaluation of a CAM Pilot Project in Northern Ireland (2008)" by Social & Market Research (SMR)
(i) Given the evidence of health gain documented by patients, GPs and CAM practitioners, it is recommended that DHSSPS and the project partners explore the potential for making CAM more widely available to patients across Northern Ireland. Not only has this project documented significant health gains for patients, but it has also highlighted the potential economic savings likely to accrue from a reduction in patient use of primary and other health care services, a reduction in prescribing levels and reduced absenteeism from work due to ill health.
(ii) This pilot project has clearly demonstrated that CAM fits well within a primary health care context, with patients valuing the support and judgement of their GPs in accessing treatments. It is recommended that DHSSPS and the project partners examine ways of integrating CAM within primary care, taking on board the need for a strategy to promote GP knowledge and understanding of CAM to ensure that health conditions are matched appropriately with CAM therapies. A strategy to promote awareness and understanding of CAM among GPs, as well as the positive health gains for patients, should also go some way to addressing issues around scepticism held by some GPs.
(iii) To further assist the process of integrating CAM with primary health care, it is recommended that consideration be given to exploring the potential for sharing medical records with CAM practitioners. Furthermore, consideration should be given to exploring the potential for CAM practitioners to be involved in clinical meetings and case conferences, which may provide patients, particularly those with chronic health problems, with more treatment options. This may also lead to significant cost savings for the health service.
(iv) The project has highlighted a number of areas where the operation of a CAM service can be further improved. In particular, it is recommended that DHSSPS and the project partners explore ways of ensuring that patients are provided with accurate and up to date information at all points of the referral process, as well as at the point of receiving treatments. In addition, the evaluation has found that patients may benefit from a triage system to ensure appropriate matching of health conditions and CAM treatments.
(v) Given that the pilot project has raised expectations among patients, DHSSPS and its partners should consider a mechanism for ensuring that patients who presented with long-term illnesses, and in particular those who experience pain, be offered booster or maintenance sessions beyond the life of the project.
(vi) Given the limited number of CAM practitioners in Northern Ireland, and the difficulties in identifying practitioners to participate in the pilot project, it is recommended that DHSSPS and the project partners consider ways of retaining this resource within a model for wider service delivery.
(vii) Given that the health outcomes for patients have been significant, it is recommended that DHSSPS and the project partners consider the development of a public health information campaign aimed at promoting the potential benefits of CAM. Allied to this point, it is recommended that DHSSPS and its partners examine the role of CAM in supporting health prevention and health promotion strategies, given the evidence that patients are likely to adhere strongly to the advice provided by CAM practitioners.
(viii) The evaluation has documented the positive impact of CAM on patients who are economically active, particularly in the context of helping people back into work following illness. It is recommended that the outcomes from this project be shared with colleagues in other departments (e.g. Department for Employment and Learning), to allow them to examine the potential for CAM within their own operational areas.
(ix) Given that the evaluation outcomes are based on the perception of the various stakeholder groups (i.e. patients, CAM practitioners and GPs), it isrecommended that DHSSPS and the project partners give consideration to integrating other approaches to measuring health impact (e.g. a formal case control study) on an ongoing basis.