Integrated health: Investigating the integration of homeopathy into primary and secondary healthcare in the NHS, in England

There is demand for homeopathy in England amongst both doctors and patients. Exploring this demand remains the key to understanding the extent of integration of homeopathy in Primary and Secondary Care Practice and the potential significance of the role of GPs as gatekeepers. This thesis explores how qualified General Practitioners (GPs) and Medical Homeopathic Physicians in England adopt homeopathy as a healthcare innovation, and employ and integrate homeopathy treatments in their everyday work within healthcare practice in England. This study was conducted prior to the large scale changes that were introduced by NHS Mobilisation June 2010, championing the spread of activity to support the cost and quality agenda across the NHS, captured in the Quality, Innovation, Productivity and Prevention (QIPP) goals, during the period covered by this study. The term, “integrative medicine” has become a common term to describe teams of health care providers working together to provide patient care. It is currently used interchangeably with complementary and alternative medicine, and at other times refers to treatments that combine conventional medicine and alternative modalities. The aim of this thesis is to determine how homeopathy is integrated into healthcare, its clinical and practice benefits and how GP/Medical Homeopath Physicians’ views and experiences effect integration. This two phase study, using an adapted General Practice Assessment Questionnaire (GPAQ), to audit patient satisfaction, explored patient experiences of available homeopathic services in two established Primary Care GP Practices between 2007 and 2008 and further explored in 2009 twenty General Practitioners and Medical Homeopathic Physicians views of the integration of homeopathy, through semi structured telephone interviews.The findings in Phase One confirm that homeopathy has been integrated to a degree within the National Health System (NHS) in England since its inception in 1948. Two Geographical Information Systems Maps utilised in this study identified and illustrated the locality of GP homeopaths in England and explored geographical demographics associated with homeopathy availability and use. A clinical audit of two established homeopathy services report patients satisfaction with the homeopathic services provided in Primary Care settings. Phase Two findings identified that Non-Homeopath GPs were not antagonistic about the use of homeopathy in Primary Care practice. Constraints against full integration of homeopathy were not specifically related to gate keeping but those predominately of the time necessary to fit in homeopathic consultations within regular patient consultation time. This is coupled with findings from the Medical Homeopathic Physicians that indicate it is not the future of homeopathy that is in question but that of the NHS itself.