From nurse to reflexologist: how I became interested in integrated care...

I have been fortunate in having a long and fulfilling nursing career in the NHS within both the acute and primary care sectors.  Experience as a professional, a patient and a carer clearly demonstrated that the NHS is committed to giving high quality, compassionate care and regularly seeks ways in which it  'could do better' for patients. 

It has long been recognised that in the event of acute illness or accident the NHS is the exemplar of high quality, responsive health care. 

It is in the care of those with long term conditions that the 'could do better' adage applies.  We hear about ‘patient led services’ and ‘giving patients control over their health’ but what does this mean in practice?  The financial and time constraints within orthodox health care make it difficult to ‘put patients at the centre’ and keep them there. Some patients do not want ‘control over their health’; nor do they want the burden of decision making in relation to treatment options, preferring instead to rely on the knowledge, skills and expertise of health professionals.

Others, however, are reluctant to relinquish their health care entirely to professionals, preferring instead to view orthodox health services as a resource to be utilised on their journey towards optimising their health potential.  This is aided to a great extent by the internet, probably now the most significant source of information on both orthodox and complementary medicine for those with health concerns.  

What is clear is that, in relation to long term conditions and the health needs of vulnerable people in society, health care provision must be capable of responding to individual need as well as being part of a nationally driven health care policy.  To achieve this neither orthodox medicine nor complementary medicine can be mutually exclusive.  We know that neither on their own can be all things to all people. 

It was from a background in orthodox health care that I began to explore the possibilities and benefits of an integrated approach to health. Originally very sceptical about all complementary therapies, it was personally experiencing the benefits of reflexology that opened my mind to complementary medicine.  For me, this was the right therapy, at the right time and was provided by a therapist in whom I had trust and confidence.

Having left full time work in the NHS I studied reflexology for two years and did additional training in the safe use of complementary therapies in pregnancy and post natal care.  I now have a practice in a small market town in Lancashire where, for the past three years, I have provided clinical reflexology for people with long term conditions, for carers and for pregnant and post natal mothers.

This has presented a considerable ‘business’ challenge, not least because those clients who use my service are often on limited fixed incomes.  Consequently, pricing flexibility has been has been an essential element in maintaining this service along with a realistic expectation of personal income.

Experience within my private practice made me realise that what occurred during the treatment session was a lot more than simply providing reflexology.  Therapeutic relationships were developing within clearly established boundaries which were of as much benefit to me as to my clients.  The client’s wellbeing improved and my knowledge and awareness of need deepened. 

Having conducted a small survey within my practice I learned that clients needed and welcomed the opportunity to talk about their fears and hopes regarding their own physical, mental and emotional health and the health of those close to them.  It also became clear  that many clients were not aware of everyday risks to their own health and wellbeing , despite all the healthy living messages from the NHS, the Department of Health and the media.

This led to the development of 'The Wellness Programme'; a structured programme of care, support, education and therapy.  The pilot study has been completed and is currently being written up before being presented to a wider audience in the New Year.  I’ll be talking more about this in future blogs.

In the meantime, some food for thought:

 - The concept of Integrated Health currently represents too many things to too many different people to be truly meaningful. We need a widespread debate about what integrated health is. We must work towards a definition of integrated health meaningful to both the public and professionals.

- Integrated health must be more than simply bringing complementary therapies into orthodox medicine as yet another treatment option within an NHS setting. It must also be about taking orthodox medicine out to complementary medicine and finding sustainable means of delivering Integrated health without relying solely on Central Government funding.