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A University Polyclinic at Westminster

by Dr David Peters(more info)

listed in complementary medicine, originally published in issue 46 - November 1999

On 14 May HRH the Prince of Wales opened the University of Westminster's new clinic of complementary therapies. It's called the Polyclinic because acupuncture, homoeopathy, chiropractic, therapeutic bodywork, herbal medicine and nutritional therapy are all represented. Before it became a University, Westminster was the very first Polytechnic: the old Central London Poly, which spawned dozens of other Polys across the land. So the clinic's name is a reminder of the founders' vision of lifelong learning, of meeting the needs of the community and access for everyone: values that will shape the growth of our complementary therapies project.

Westminster is the first university in Europe to provide such a wide range of complementary therapies alongside facilities for teaching and research. There are currently 350 undergrads (and more than 500 BSc students expected by 2000) so the Polyclinic is already humming with activity: students doing their first year clinical observation studies, final year students treating patients under supervision, postgrads developing audits and clinical trials.

We want to see complementary therapies secure their place in the healthcare system of the future. To do this it is important to demonstrate that they have academic rigour as well as recognised standards of teaching. Practitioners also need to learn how to work as part of a team with other healthcare professionals. In the Polyclinic, students from the various disciplines interact and through this develop a respect for the strengths and limitations of their own and other disciplines. This interprofessional dimension is crucial for effective collaboration and teamwork. The Polyclinic will also be the base for a research programme auditing and evaluating the therapies as they are practised for cost and effectiveness. We will draw on the wide range of research expertise that exists in departments as diverse as bioscience and psychology because illness and complementary therapy interventions impact on more than the body's biochemistry.

Delivering the Goods

The next step for the Polyclinic will involve close co-operation with local GPs and community groups as we create a referral and outreach network. Knowing that more than a third of GPs are keen to offer these therapies to patients we want to make sure our service is available to them and that it reaches people who normally cannot get to or afford complementary therapists. Central London has more than its share of disadvantaged people and we intend to find the resources to deliver the therapies where they can make a difference. And because making that difference depends on knowledge, skill and integrity, the Polyclinic is aiming high in terms of education and the evaluation of practise.

GPs are the key players, because since last April the new Primary Care Groups control 90% of all NHS expenditure. Their job is to commission appropriate health care determined by local needs, so they have to know if complementary therapy can provide cost-effective solutions for people with chronic illness. One of our aims is to help them find ways of integrating complementary into mainstream health care. Experience of using complementary approaches in the NHS has convinced us they have a place, but with Group Commissioning GPs will have less freedom to develop their own individual practice-based complementary therapy services. Perhaps community-based clinics like ours may show a way. Initially the Polyclinic will pilot and evaluate a service to establish the cost-effectiveness of GP access; first of all acupuncture and bodywork clinics for patients with musculo-skeletal pain; then asthma, migraine, irritable bowel – all conditions where the evidence for complementary therapies is fairly good.

Research and Development

Complementary medical research calls for bridge-building, between the different therapies and towards conventional practice and the sciences. The challenge of this cross-disciplinary research is already underway at the Centre: developing and evaluating 'complementary therapy packages of care' in NHS practice; developing information for patients and data systems to improve good communication between practitioners; exploring the value of complementary therapies for complex illness; looking at the ways GPs use a homoeopathic clinic based in general practice. Lately, we have begun to discuss inter-departmental projects in health informatics and herbal medicine.

Life-Long Learning

With pressure on all health professionals to take part in continuing professional development more senior complementary practitioners and teachers are looking for relevant postgraduate programmes and research support. We want to see the Polyclinic used for master-classes, clinical post-grad courses, audit workshops, case-conferences. Our aim is to understand and develop complementary therapies as part of the totality of health and social care. Centre for Community Care & Primary Health (CCCPH) already has an Interplan Masters programme for GPs, Nurses and Social Workers, some parts of which can overlap with the CT Masters and we are currently developing new postgraduate courses in acupuncture, phytotherapy and TCM herbs which will make full use of the clinical opportunities. Practitioners can start with a short course or taster modules – dipping their toes in the academic water – and if they enjoy working reflectively with colleagues from other parts of the healthcare territory they can build up a portfolio of modules and get their MSc. This multi-disciplinary post-graduate approach helps break down the traditional boundaries between the professions. And, since the future of health care will be increasingly multi-disciplinary, the CCCPH approach plus the multi-professional environment of the Polyclinic provides a unique focus for inter-professional learning, research and service delivery. We are very excited about the possibilities. The Prince of Wales said at the opening:

"I think this unique development at the University is a truly significant step towards educating complementary therapists for professional life. And a marvellous opportunity to provide these therapies to the local community and to make them available for the new primary care groups. Because the challenges we face call for – a new generation of practitioner who can understand how doctors, nurses, the social care professions and complementary therapies can work together to achieve integrated medicine"

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About Dr David Peters

Prof David Peters is Chair of the British Holistic Medical Association (BHMA.org), an open association for everyone concerned to develop medicine as if people matter. David is the Clinical Director and Professor of Integrated Healthcare at the University of Westminster (U of W), is on the Board of Directors of the U of W Institute of Health and Wellbeing, a transdisciplinary research and training group exploring biopsychosocial approaches to health creation and treatment. He may be contacted via petersd@westminster.ac.uk

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