PCTs abandon funding for homeopathy

By Tom Moberly on the 17 October 2012

Only 15% of PCTs are now providing NHS funding for homeopathy as managers scrap support for it to focus on more cost-effective treatment, GP has found.

Homeopathic treatment: now classified by PCTs as low priority (Photo: SPL)

Freedom of Information requests by GP magazine found that one in seven of PCTs in England paid for homeopathy services in 2011/12.

The number of PCTs funding homeopathy has fallen by a quarter since 2010/11, when one in five trusts funded it, and by half since 2008/9, when a third of trusts provided funding for it.

A total of 116 out of 152 PCTs responded to GP's request for data about trusts' 2010/11 and 2011/12 expenditure on services involving homeopathy. Previous GP research found 34% of PCTs funded it in 2008/9.

PCTs said homeopathy was now classified as a low priority because of poor evidence for its clinical effectiveness.

Two trusts withdrew funding after the House of Commons science committee said in 2010 that the NHS should not fund it. Another two said they planned to stop funding in 2012/13.

Click here to see the Homeopathy timeline

BMA view

BMA policy is that homeopathic remedies should not be funded on the NHS. GPC prescribing lead Dr Bill Beeby told GP: 'The BMA view is that scarce resources in the NHS shouldn’t be devoting to something that doesn’t have a strong evidence base.'

East Midlands GP Dr Joanne Watt said she expected NHS funding to fall further.

'In the difficult financial climate, we need to ensure the effectiveness of all interventions, and clinical effectiveness has not been proven for homeopathy,' she said. 'People may still choose to buy homeopathic products privately and that is their choice, but NHS finances should be spent in the most cost effective way possible.'

Shropshire LMC chairwoman Dr Mary McCarthy said NHS resources must be allocated carefully in times of financial restraint.

'The NHS should not continue funding homeopathy when trials have shown no evidence of benefit apart from placebo effects,' she said. 'This is not to say it should be unavailable but that those who want homeopathic remedies should pay for them.'

NHS Alliance

But NHS Alliance chairman and Devon GP Dr Michael Dixon said the NHS 'should embrace treatment that might obviate more costly care'.

'Homeopathy should be given to patients with conditions that might be helped, fully audited and assessed and then continued if found to be cost-effective,' he said.

Jeremy Hunt's appointment as health secretary led to suggestions he could promote the use of homeopathy. Before becoming health secretary, Mr Hunt told a constituent of the 'benefit' of homeopathy and signed a parliamentary motion on the 'positive contribution' of NHS homeopathic hospitals.

Other GP views on homeopathy
Glasgow GP Dr Des Spence said he does not believe that homeopathy provides effective treatment. But he thinks homeopathy faces an unwarranted focus for criticism from proponents of evidence-based medicine. I’m not homeopath,’ he said. ‘But I think the focus on homeopathy is disproportionate. It is very cheap, relatively.’ Dr Spence points out that there are many other medicines, such as antidepressants, which GPs are happy to prescribe despite weak evidence of effectiveness. Most patients [who want to have homeopathy] have medically unexplained symptoms, all of which tend to require expensive tests to investigate, and that can reinforce patients’ illness behaviour,’ he said. ‘Homeopathy is cost effective in dealing with patients with medically unexplained symptoms.’ Dorset GP Dr Tim Robinson said he was ‘disappointed to see this insidious erosion of homeopathic services’. Many PCTs are using the excuse that there is no evidence of effectiveness, while ignoring the double-blind trials, in-vivo and observational studies that are supportive of homeopathy,’ he said. Dr Robinson added: ‘PCTs believe that cutting homeopathic services will save the NHS money. Bu they fail to recognise that homeopathic provision saves money by reducing both drug spend as well as referral on to secondary care. Any financial saving will be short-term and will eventually result in an increased financial burden.

Other GP views on homeopathy

Glasgow GP Dr Des Spence said he does not believe that homeopathy provides effective treatment. But he thinks homeopathy faces an unwarranted focus for criticism from proponents of evidence-based medicine.

I’m not homeopath,’ he said. ‘But I think the focus on homeopathy is disproportionate. It is very cheap, relatively.’

Dr Spence points out that there are many other medicines, such as antidepressants, which GPs are happy to prescribe despite weak evidence of effectiveness.

Most patients [who want to have homeopathy] have medically unexplained symptoms, all of which tend to require expensive tests to investigate, and that can reinforce patients’ illness behaviour,’ he said. ‘Homeopathy is cost effective in dealing with patients with medically unexplained symptoms.’

Dorset GP Dr Tim Robinson said he was ‘disappointed to see this insidious erosion of homeopathic services’.

Many PCTs are using the excuse that there is no evidence of effectiveness, while ignoring the double-blind trials, in-vivo and observational studies that are supportive of homeopathy,’ he said.

Dr Robinson added: ‘PCTs believe that cutting homeopathic services will save the NHS money. Bu they fail to recognise that homeopathic provision saves money by reducing both drug spend as well as referral on to secondary care. Any financial saving will be short-term and will eventually result in an increased financial burden.

Examples of NHS funding of homeopathy
Of 116 PCTs replying to GP’s Freedom of Information request, 17 (15%) funded services involving homeopathy in 2011/12: 1. Bath and North East Somerset: NHS Bath and North East Somerset supported individual funding requests for £50,000 in 2010/11 and for £33,000 in 2011/12. The PCT said it was ‘currently engaging on the proposal that homeopathy is a low priority for use of NHS resources and should not be routinely commissioned’. 2. Bournemouth and Poole: The Pan-Dorset Cluster funded individual funding requests for homeopathy treatment in 2010/11 and 2011/12, in line with local policies. 3. Bristol: NHS Bristol estimates it spent £240,364 in 2010/11 and £169,638 in 2011/12 on homeopathy services. The PCT said that patients do not need to obtain individual funding approval to access locally provided services and that no review has been carried out of whether the PCT should continue to fund homeopathy. 4. City & Hackney: In NHS City & Hackney, NHS Tower Hamlets and NHS Newham, there has been ‘some historical funding of services’ at the Royal London Hospital for Integrated Medicine in 2010/11 and 2011/12. This funding was largely related to follow-up appointments linked to previous commissioning decisions. 5. Dorset: The Pan-Dorset Cluster funded individual funding requests for homeopathy treatment in 2010/11 and 2011/12, in line with local policies. 6. Gloucestershire: NHS Gloucestershire provided money to support individual funding requests for £48,733 in 2010/11 and for £27,154 in 2011/12. 7. Leeds: NHS Leeds agreed in 2010/11 and 2011/12 for one patient to attend a homeopathy hospital for eight sessions at a cost of £567.42. The PCT also agreed to fund treatment for some patients before 2010/11 and it continued to pay for their treatments in 2010/2011 and 2011/2012. 8. Leicester City: NHS Leicester City and NHS Leicestershire County and Rutland commissioned and funded homeopathy outpatient services in 2010/11 and 2011/12. 9. Leicestershire County and Rutland: NHS Leicester City and NHS Leicestershire County and Rutland commissioned and funded homeopathy outpatient services n 2010/11 and 2011/12. 10. Newham: In NHS City & Hackney, NHS Tower Hamlets and NHS Newham, there has been ‘some historical funding of services’ at the Royal London Hospital for Integrated Medicine in 2010/11 and 2011/12. This funding was largely related to follow-up appointments linked to previous commissioning decisions. 11. Nottingham City: NHS Nottingham City said it did not intentionally commission or fund any services involving homeopathy, but that activity data showed the PCT funded £2,096 of services in 2010/11 and £977 of services in 2011/12 from the Royal London Hospital for Integrated Medicine. 12. Sheffield: NHS Sheffield spent £32,000 on homeopathy treatment in 2010/11. The PCT also agreed to pay for homeopathy on an individual funding basis. 13. Somerset: NHS Somerset funded services at University Hospitals Bristol NHS Foundation Trust totalling £60,815 in 2010/11 and £46,846 in 2011/12. Applications for funding involving homeopathy were approved through the PCT’s individual funding review panel. The PCT has no plans to change its policy. 14. South Gloucestershire: NHS South Gloucestershire spent £49,079 in 2010/11 and £32,709 in 2011/12 on services involving homeopathy. 15. Tower Hamlets: In NHS City & Hackney, NHS Tower Hamlets and NHS Newham, there has been ‘some historical funding of services’ at the Royal London Hospital for Integrated Medicine in 2010/11 and 2011/12. This funding was largely related to follow-up appointments linked to previous commissioning decisions. 16. Wirral: NHS Wirral provided money to support individual funding requests for £35,270 in 2010/11 and for £18,610 in 2011/12. 17. Worcestershire: NHS Worcestershire commissions a homeopathy service with the United Bristol NHS Trust as part of a ‘non contracted activity’ arrangement.

Examples of NHS funding of homeopathy

Of 116 PCTs replying to GP’s Freedom of Information request, 17 (15%) funded services involving homeopathy in 2011/12:

1. Bath and North East Somerset: NHS Bath and North East Somerset supported individual funding requests for £50,000 in 2010/11 and for £33,000 in 2011/12. The PCT said it was ‘currently engaging on the proposal that homeopathy is a low priority for use of NHS resources and should not be routinely commissioned’.

2. Bournemouth and Poole: The Pan-Dorset Cluster funded individual funding requests for homeopathy treatment in 2010/11 and 2011/12, in line with local policies.

3. Bristol: NHS Bristol estimates it spent £240,364 in 2010/11 and £169,638 in 2011/12 on homeopathy services. The PCT said that patients do not need to obtain individual funding approval to access locally provided services and that no review has been carried out of whether the PCT should continue to fund homeopathy.

4. City & Hackney: In NHS City & Hackney, NHS Tower Hamlets and NHS Newham, there has been ‘some historical funding of services’ at the Royal London Hospital for Integrated Medicine in 2010/11 and 2011/12. This funding was largely related to follow-up appointments linked to previous commissioning decisions.

5. Dorset: The Pan-Dorset Cluster funded individual funding requests for homeopathy treatment in 2010/11 and 2011/12, in line with local policies.

6. Gloucestershire: NHS Gloucestershire provided money to support individual funding requests for £48,733 in 2010/11 and for £27,154 in 2011/12.

7. Leeds: NHS Leeds agreed in 2010/11 and 2011/12 for one patient to attend a homeopathy hospital for eight sessions at a cost of £567.42. The PCT also agreed to fund treatment for some patients before 2010/11 and it continued to pay for their treatments in 2010/2011 and 2011/2012.

8. Leicester City: NHS Leicester City and NHS Leicestershire County and Rutland commissioned and funded homeopathy outpatient services in 2010/11 and 2011/12.

9. Leicestershire County and Rutland: NHS Leicester City and NHS Leicestershire County and Rutland commissioned and funded homeopathy outpatient services n 2010/11 and 2011/12.

10. Newham: In NHS City & Hackney, NHS Tower Hamlets and NHS Newham, there has been ‘some historical funding of services’ at the Royal London Hospital for Integrated Medicine in 2010/11 and 2011/12. This funding was largely related to follow-up appointments linked to previous commissioning decisions.

11. Nottingham City: NHS Nottingham City said it did not intentionally commission or fund any services involving homeopathy, but that activity data showed the PCT funded £2,096 of services in 2010/11 and £977 of services in 2011/12 from the Royal London Hospital for Integrated Medicine.

12. Sheffield: NHS Sheffield spent £32,000 on homeopathy treatment in 2010/11. The PCT also agreed to pay for homeopathy on an individual funding basis.

13. Somerset: NHS Somerset funded services at University Hospitals Bristol NHS Foundation Trust totalling £60,815 in 2010/11 and £46,846 in 2011/12. Applications for funding involving homeopathy were approved through the PCT’s individual funding review panel. The PCT has no plans to change its policy.

14. South Gloucestershire: NHS South Gloucestershire spent £49,079 in 2010/11 and £32,709 in 2011/12 on services involving homeopathy.

15. Tower Hamlets: In NHS City & Hackney, NHS Tower Hamlets and NHS Newham, there has been ‘some historical funding of services’ at the Royal London Hospital for Integrated Medicine in 2010/11 and 2011/12. This funding was largely related to follow-up appointments linked to previous commissioning decisions.

16. Wirral: NHS Wirral provided money to support individual funding requests for £35,270 in 2010/11 and for £18,610 in 2011/12.

17. Worcestershire: NHS Worcestershire commissions a homeopathy service with the United Bristol NHS Trust as part of a ‘non contracted activity’ arrangement.