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    Bradbury, Katherine Al-Abbadey, Miznah Carnes, Dawn Dimitrov, Borislav D Eardley, Susan Fawkes, Carol Foster, Jo Greville-Harris, Maddy Harvey, J Matthew Leach, Janine Lewith, George MacPherson, Hugh Roberts, Lisa Parry, Laura Yardley, Lucy and Bishop, Felicity L 2016. Non-specific mechanisms in orthodox and CAM management of low back pain (MOCAM): theoretical framework and protocol for a prospective cohort study. BMJ Open, Vol. 6, Issue. 5, p. e012209.

    Olaniran, Bolanle A. and Zhang, Yan 2016. Encyclopedia of E-Health and Telemedicine.

    Wye, Lesley Shaw, Alison and Sharp, Debbie 2013. Same difference? Complementary therapy consultations delivered in NHS and private settings—A qualitative study. European Journal of Integrative Medicine, Vol. 5, Issue. 4, p. 339.

  • Primary Health Care Research & Development, Volume 13, Issue 3
  • July 2012, pp. 269-278

Health-care sector and complementary medicine: practitioners’ experiences of delivering acupuncture in the public and private sectors

  • Felicity L. Bishop (a1), Nicola Amos (a2) (a3), He Yu (a4) and George T. Lewith (a5)
  • DOI:
  • Published online: 09 February 2012

The aim was to identify similarities and differences between private practice and the National Health Service (NHS) in practitioners’ experiences of delivering acupuncture to treat pain. We wished to identify differences that could affect patients’ experiences and inform our understanding of how trials conducted in private clinics relate to NHS clinical practice.


Acupuncture is commonly used in primary care for lower back pain and is recommended in the National Institute for Health and Clinical Excellence's guidelines. Previous studies have identified differences in patients’ accounts of receiving acupuncture in the NHS and in the private sector. The major recent UK trial of acupuncture for back pain was conducted in the private sector.


Semi-structured qualitative interviews were conducted with 16 acupuncturists who had experience of working in the private sector (n = 7), in the NHS (n =3), and in both the sectors (n = 6). The interviews lasted between 24 and 77 min (median=49 min) and explored acupuncturists’ experiences of treating patients in pain. Inductive thematic analysis was used to identify similarities and differences across private practice and the NHS.


The perceived effectiveness of acupuncture was described consistently and participants felt they did (or would) deliver acupuncture similarly in NHS and in private practice. In both the sectors, patients sought acupuncture as a last resort and acupuncturist–patient relationships were deemed important. Acupuncture availability differed across sectors: in the NHS it was constrained by Trust policies and in the private sector by patients’ financial resources. There were greater opportunities for autonomous practice in the private sector and regulation was important for different reasons in each sector. In general, NHS practitioners had Western-focussed training and also used conventional medical techniques, whereas private practitioners were more likely to have Traditional Chinese training and to practise other complementary therapies in addition to acupuncture. Future studies should examine the impact of these differences on patients' clinical outcomes.

Corresponding author
Correspondence to: Dr Felicity L. Bishop, Primary Medical Care, Aldermoor Health Centre, Aldermoor Close, Southampton, Hampshire SO16 5ST. UK. Email:
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Primary Health Care Research & Development
  • ISSN: 1463-4236
  • EISSN: 1477-1128
  • URL: /core/journals/primary-health-care-research-and-development
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