Acu. spring 2021 by Acu.

Ambition News

BAcC strategy 2021-26 Practice

Wales during the pandemic Everyone needs a Mark EveryBodyCan… get to know the BLS Du mai: channel of the brain Buying my electric treatment couch Working online

Inspiration By members, for members Acupuncture Quarterly from the BAcC | Spring 2021

Learning in lockdown It’s not working Year of the Ox The way to do is to be The BAcC: where from & where to?

Opinion What is it we want?

Community Covid & the colleges An extraordinary year in the life of TAA

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Editorial Acu. is a BAcC publication, written by members, for members. It combines content relevant to the clinical practice of acupuncture with communications from the BAcC office and Governing Board.

Editorial policy Community: we aim to facilitate debate and the sharing of news and information for all members of our acupuncture community. Support: we aim to support members in their professional practice by publishing articles that have genuine practical use. Diversity: we seek to represent all traditions and strands of practice present in the membership. We also welcome content covering other health matters relevant to acupuncture. Freedom and debate: we respect the right of all members to air their views and to challenge the views of other individuals and/or organisations where appropriate. Accuracy and fairness: we strive to be accurate and fair in what we print. We will be open in admitting our mistakes and do our best to rectify them.

Contribute We encourage all members to contribute to Acu. via editor@acupuncture.org.uk For full details of submissions and advertising see Contributions page.

Editorial team Houri Alavi (member) Scott Bridges (member) Tim Brown (member) Sally Crowther (member) Ann Gordon (staff) Joan Maynard (copy editor) Jonquil Westwood Pinto (member) Steve Wheeler (member, chair)

Design Whirligig Creative

Cover Tim Brown

Copy & publishing dates 2021 Issue Spring Summer Autumn Winter

Copy deadline Mailing 19 January 12 March 20 April 11 June 20 July 10 September 19 October 10 December

Tim Brown Member: West Yorkshire

Welcome to Acu. spring 2021 – remaining in digital format but now also available in print on demand. Further details on how to order a hard copy of this issue may be found in the mine of information that is AcuBites. Reflecting on our topic of ambition, I am not sure how many acupuncturists could be called ambitious in the sense of pursuing fame and fortune. Deciding to become an acupuncturist with its commitment to professionalism and ongoing study is perhaps more a vocation than an ambition. In this issue, Andrea Dewhurst provides an insight into the life of an acupuncture student through the turbulent changes and unpredictability that was 2020, which she and her cohort appear to be meeting head on with great resilience and adaptability. I think we can look forward to great things from a new generation of practitioners, who have been forged in the fires of adversity. Harriet Lansdown of the BAAB tells us of a busy 2020 keeping ahead with necessary changes in acupuncture education. She also draws our attention to the enormous dedication of accredited course providers, and again to the commitment and professionalism shown by students, many of whom have had to combine studying with home schooling, alongside such challenges as shared family computers. In a guest WebWatch, Veena Stephenson shares Covid related resources which she has found beneficial, situated as we are at an intersection between traditional Chinese and contemporary Western medicine. While in View From The Couch, Spod Dutton provides us with a further inspiring case history – told from a patient’s perspective. Patients are also central to a richly informative article from Beverley de Valois, on the work of the British Lymphology Society and their 2021

EveryBodyCan campaign. On a more personal level, John Hamwee shares the results of his investigation and reflection into the wide variety of reasons why patients may tell us that treatment isn’t working. We are pleased to announce the arrival of a new regular column which, in a nod to the Guardian, we've called Inner Pass Notes. In this essential briefing John Wheeler aims to disentangle the acronym-laden world of the PRWG in a light-hearted and easily digested manner. Elsewhere Pia Huber takes on a historiographical and forward-looking assignment, tracing where the BAcC came from and where it aims to go in the future. This is the stage at which I realise that I am approaching my word limit, yet I seem to have barely scraped the surface of what can be found in this and every issue of Acu. Just enough space to mention Peter Firebrace’s Just my Point – this time his point is LIV 13. Stuck in lockdown 2, 2.5, 3, it’s another wet grey northern day, and I want to be in the sunlit uplands of Portugal (as by sheer coincidence is another member of our editorial team), so a portion from Lillian Pearl Bridges’ Year of the Ox feels a fitting and positive conclusion to this editorial and a prologue for the delights that follow: ‘Although the tail of the Rat will cause some trouble at the start of the year, the Ox will take over in a slow and steady way to improve circumstances in our lives… be ready to see incremental growth and avoid impulsiveness. Try not to be discouraged and have faith. Better times are coming…’

Keynotes Spring is traditionally the time of year where the cold and dark days fade and light begins to shine again. This is especially true in 2021 where we begin to open back up after a year of a government-imposed lockdowns. Allowing all of us to begin again, in a new normal. Throughout this difficult period members have been steadfast in their resolve to support the efforts to suppress this cruel virus. The global pandemic has brought many changes to our lives, our families and to patients. Internally, the BAcC has had to make some difficult changes to our own structure to ensure that we can continue to provide a service to members. The 25th anniversary of the BAcC passed with little comment and the new strategy, having had so much input from members over a number of years, was shelved as our focus moved to supporting members in this very difficult time. We helped members financially as much as we could and wished we could have done more during the darkest days. We also set up new systems and working groups to support members through the pandemic. Now for the BAcC, in common with many others, 2021 will be about opening up and building a stronger, more supportive organisation. I am delighted that our Strategy 2021-26 is launched within Acu. The strategic plan is an incredibly important document for any organisation – the BAcC plan holds the Governing Board (GB) to a standard. Developed by the membership through consultations and advisory groups, this document lays out our plans for the next five years and provides the basis for all our work. The Board will use this document to measure and report successes to the members in the years to come. Acu. itself is changing and growing. We have listened to members who want a print version and we are so pleased to be able to offer this again to those who choose to take this option. Making this choice available also helps us in striving to be a green and environmentally friendly organisation. In this issue, on page 27, we touch on the history of our relationship with the various governments over the years. I know many of you want to know what we are going to do in the future to avoid any recurrence of the lockdowns you have had to suffer over the past months and to mark out BAcC members as the healthcare providers you are. Relations with government take time to build and involve a significant level of discussion on all issues. In a global pandemic government are less open to deep

This document lays out our plans for the next five years and provides the basis for all our work

structural changes. With this in mind, the GB established a Professional Recognition Working Group (PRWG) last year to begin this work. This group made up of member representatives across the four nations have come together: to map the legislative landscape for acupuncture; to use successes such as the exemption from local licensing in certain areas of the country to begin the process in other regions, including Scotland; and to tackle the question of statutory regulation once and for all. These issues will not be resolved overnight and will involve us working with other organisations to strengthen our voice to government and show that we are representing acupuncture as a whole. Collaborations with like-minded organisations such as the Register of Chinese Herbal Medicine (RCHM) have already brought many benefits to our organisation and have had a significant impact on the support we give you in your practice. I cannot finish without paying tribute to Mark Bovey who is leaving us this spring to, in his words, ‘climb mountains’. Mark has been the backbone of this organisation since its inception. His good grace, charm and unwavering support during a difficult 12 months have been incredibly valuable for

me personally and for the membership as a whole. His kindness and generosity will be truly missed by staff and all BAcC members alike. I hope you join me in wishing him well in his retirement. On behalf of all of the staff team, I would also like to thank all members, for your backing, guidance and help through the past 12 months. This has been a difficult time for all and we know the sacrifices that you have made in 2020. Our aim has always been to put every one of you at the heart of what we do. Jennifer Norton 〉 020 8735 1206 〉 jennifer@acupuncture.org.uk

Jennifer Norton Chief Executive

34%

29%

Not taking medication

By members, for members

News

3 months – 1 year

Issue #30 Patients that have reduced amount of prescription medication Spring 2021

20 60 60 62

4 Acubites 6 BAcC strategy 2021-26

N=176 52%

Practice 7 Wales during the pandemic Snapshot audit from Rachel Edney & Mark Bovey 10 Everyone needs a Mark behind them A song for the retiring Mark Bovey 12 Just my point: LIV 13 Peter Firebrace 13 Inner Pass Notes: PRWG Essential briefing from John Wheeler 14 EveryBodyCan… get to know the BLS Beverley de Valois 16 Du mai: channel of the brain Tian-Jun Wang 17 Buying my electric treatment couch Susan Adams 18 Working online Stacey Chapman 19 View from the couch Patient experiences of acupuncture

Duration of main complaint

N=105

••

N=74

N=1

35%

31%

22% 6

0-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90

24 Age when patient consulted

Anxiety

Depression

Insomnia

None of

Conditions patients presented with

“Lymphoedema doesn’t stop me doing a lap or two of the pool each week” One of the best ways to stop lymphoedema from developing or getting worse is to keep moving. There are lots of easy ways to build safe movement into your day. Go to thebls.com to find the one that’s right for you.

Inspiration

Opinion

Community

20 Learning in lockdown Andrea Dewhurst 21 WebWatch Member picks from Veena Stephenson 22 It’s not working John Hamwee 24 Year of the Ox Extract from Lilian Pearl Bridges 25 The way to do is to be Yvette Masure 26 Finding my way Extracts from Peter Deadman 27 The BAcC: where did we come from & where are we going? Pia Huber

30 What is it we want? Paul Johnson

32 On reflection Pia Huber 33 Covid & the colleges Harriet Lansdown 34 An extraordinary year in the life of TAA College news from Julie Reynolds 35 The classic of difficulties Mark Bovey 36 Regional round-up & RGC contacts 38 Tribute to Anthony Harcourt 39 Committee overview 39 Meet the latest newbie Office contacts 41 Change of hats for Joan 41 Classifieds & call for contributions

#EveryBodyCan

PLATINUM SPONS

News

Acu. | Issue #30 | Spring 2021

Acubites A smörgåsbord of plant-based newsbits prepared with members in mind

Your editorial team

Steve Wheeler

Houri Alavi

Health campaigns coming up Awareness events can be great hooks for your practice marketing or promotion, plus you’ll be supporting everyone in the BAcC Endometriosis Awareness 1 Month 〉 March 2021 〉 endometriosis affects one in ten women and is one of the main causes of subfertility in women – but average diagnosis can take up to seven and a half years. The main focus of these events throughout March is to raise awareness of the symptoms, so that more women receive diagnosis and treatment earlier 〉 endometriosis-uk.org MAR

Stress Awareness Month 〉 April 2012 〉 held every April, since 1992 to increase public awareness about both the causes and cures for our modern stress epidemic. One of the great public health challenges of our time – a significant factor in mental health problems and also linked to problems with the heart, immune system, sleep and digestion. This year’s campaign features a 30-day challenge ‘Regaining Connectivity, Certainty and Control’ 〉 tinyurl.com/3p3ux5hy APR

MS Awareness Week 〉 19-25 April 〉 Most people have a vague idea what MS is, but lots of them are a bit confused. How does it make you feel? And what about the symptoms you can't see? A chance to raise awareness of multiple sclerosis, and spread the word tinyurl.com/33y8bvtb 〉 #LetsTalkMS APR

Jonquil Westwood Pinto

Sally Crowther

Scott Bridges

Tim Brown

MAMPS enters third year

What keeps patients coming back?

A great resource for acupuncturists who treat pregnant patients, including guidelines for specific treatments by Debra Betts and other eminent acupuncturists in the field. With the strapline ‘developing and supporting a community of expertise in maternity acupuncture care’, Maternity Acupuncture Mentoring & Peer Support (MAMPS) – mamps. org – is a collaboration formed by five acupuncturists highly experienced in supporting pregnancy, labour, and postpartum care. They aim to help acupuncturists become safe, effective, confident providers of perinatal care, nurture excellence in the next generation of teachers and providers, and provide a safe and inspiring space for group study. New opportunities for case-based learning and group study are promised throughout 2021 〉 mamps.org/resources

Amally Ding, PhD student at King’s College London, has now successfully completed her research into what drives patient adherence. Some of you may recall reading in Acu. about Amally’s research, Understanding the TCM Consultation: what keeps our patients returning? (autumn 2018, p10). Indeed, some of you will have helped by completing her survey, and/or you may have patients who took part. Results of Amally’s survey were published at the end of last year and are now available for all to access 〉 tinyurl.com/kbeeseew

Moxi(e) enjoys moment on Mars News has reached us that Nasa’s 2020 Perseverance Rover mission has taken Moxi(e) to Mars. Main job: to produce oxygen from the Martian carbon-dioxide atmosphere. Apparently, Moxie makes oxygen by 'breathing like a tree' – inhaling carbon dioxide and exhaling oxygen. Now surely that’s worthy of a spring acubite 〉 tinyurl.com/y2tbcccc

Working with patients on behaviours/ lifestyle change Member Jonquil W Pinto has just published a review synthesis on the role of traditional acupuncture in helping people improve health behaviours. The work was part-funded by the BAcC. Given the increasing emphasis on diet, exercise, smoking, alcohol and sleep by major health organisations, acupuncturists can potentially contribute to this work and expand their practice in this area 〉 tinyurl.com/33xwzhnb

Acu. | Issue #30 | Spring 2021

Free listening line for stressed NHS workers Looking for ways to support NHS workers? Shout 85258 is a free, confidential, 24/7 text messaging support service for anyone who is struggling to cope. What they offer has become increasingly critical since Covid-19, being one of the few mental health support services able to operate as normal at this time Shout 85258 welcome volunteers to help provide a free listening line for stressed out NHS workers, amongst others 〉 giveusashout.org And to read more about how Shout 85258 work and who they’ve been helping, take a look at this Guardian article from January: ‘They were freaking out’: meet the people treating NHS workers for trauma 〉 tinyurl.com/ds3dvn7x

Jade Screen Project treats frontline staff Kevin Durjun has recorded a great interview with Andrew Flower about his amazing Jade Screen Project which supports frontline staff affected by Covid-19 with free Chinese herbal medicine 〉 tinyurl.com/y862v9v3

NICE Guidelines on Chronic Pain The timeline for the chronic pain: assessment and management guideline has been revised. The new publication date is expected to be Wednesday 7 April 2021. Expect more on this via enews as and when further details are released.

#29 Acu. | Issue 36

| Winter 2020

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Acu. print on demand Rejoice! Your efforts in responding to our surveys have not been in vain. After much investigation, discussion and number crunching, we’ve come up with a way of offering Acu. in both digital and print. The solution comes in the shape of hosting Acu. online plus a link to our printer. A hard copy Acu. is now once again within your grasp – free of charge to UK members. Just click on the link below, fill in the online form and submit. If you're an Overseas member – for cost and delivery contact editor@acupuncture.org.uk Benefits are threefold: • members get a choice of print or digital • the BAcC follows its greening strategy • we get a clear picture of how many favour print over digital In summer we'll also be making a few design tweaks to help us: • make Acu. more readable on screen while still working in print • develop mobile-friendly articles for social media

News

Need to know Pressed for time? Want to grab the essential info now and read the rest later? Here’s where to start

New five-year vision for the BAcC read the full strategy word for word 〉 p6 Hankies at the ready! time to wave goodbye to Mark Bovey 〉 p10 So who or what is the PRWG? John Wheeler has all the answers 〉 p13 WebWatch features all things Covid tried and tested by Veena Stephenson 〉 p21 Take a look at the big BAcC picture Pia Huber travels our 30-year timeline 〉 p27

Life is tough...

But for now your passport to a hard copy spring Acu. lies here 〉 tinyurl.com/px3bu45v

Who's won a Moxi t-shirt? Member Liz Wynn was first to spot Moxi teetering on the brink on page 36 of the winter Acu. She's taken it as a good omen that she’ll be back in clinic very soon… Find spring Moxi by 2 April and send word to 〉 editor@acupuncture.org.uk

... for everyone, says member and Moxi creator Toon Min, and especially for those looking after others. Snowdrops in the garden. Such beauty in nature. Keep safe and creative. Keeps me sane – mostly!

And remember, if you spot some news snacks you'd like to share in Acubites, just send them our way 〉 editor@acupuncture.org.uk

News

Acu. | Issue #30 | Spring 2021

BAcC strategy 2021-26 With foreword from acting chair, Pia Huber This strategy has been developed to direct the BAcC how best to serve its members so that in their practice traditional acupuncturists can flourish as healthcare professionals making an important contribution to the health and wellbeing of people in the United Kingdom. In developing this strategy we have involved BAcC members. This included the establishment of a strategy focus group made up of 12 highly engaged BAcC members who volunteered to contribute at the initial thinking stages about scope and priorities shaping. Their involvement continued in developing the main content and at various stages of refinement. Members of the Governing Board collated the input and formed the first draft. A number of iterations were considered by the Board and informed by consultations with our members and BAcC staff. A key focus of this strategy is to keep members at the heart of all the BAcC is doing. A key aspect will be that we continue to listen and to engage with our members with clear and effective communication. Further important aims of this strategy are to raise the profile of our members and of traditional acupuncture in the UK. With the support of our partners, the British Acupuncture Accreditation Board (BAAB), promotion of

continuing professional development and underpinned by accreditation with the Professional Standards Authority (PSA), we will continue to uphold the highest level of professional standards. In this time of growing awareness of the climate emergency, the strategy includes a further core aim to be a green and environmentally friendly organisation. This will also align with our aim to manage the BAcC’s resources prudently and provide our members with value for money. This strategy provides a clear set of goals and aspirations and informs the operational plans which directly translate our aims into the daily work undertaken by the CEO and the BAcC staff; but also by the committees and working groups where we draw on members’ input. The desired outcomes of the strategy will be measured by the Governing Board using a number of key performance outcome measures included in this plan and through regular monitoring of progress with the operational plans. We commend this strategy to all BAcC members and our staff and we are confident that this strategy will help the BAcC to move forwards in its steady work in ensuring our place as important healthcare professionals within the UK’s health provision.

The British Acupuncture Council (BAcC) is the UK’s largest professional and self-regulatory body for the practice of traditional acupuncture with a membership of around 2,500 professionally qualified acupuncturists. This strategy sets out our vision, mission, values and key aims and objectives over the next five years and high level measures of success. Our vision

Our mission

BAcC members being at the forefront of providing traditional acupuncture as an accepted and leading healthcare choice.

To promote members’ professionalism, uphold learning and research, and celebrate diversity of practice. • Promote members’ excellent acupuncture skills and standards of safety. • Uphold high standards of education and support members’ research. • Unify our members by celebrating the diversity of traditional acupuncture practice as well as valuing our common roots.

Our values Holism: We believe in holistic and personalised patient care. Safety: We believe in safe and responsible patient care. Integrity: We are committed to the highest professional and ethical standards in all our work. Evidence: We believe in evidence-based approaches founded in robust research.

Acu. | Issue #30 | Spring 2021

Our aims and objectives 1 Always put members at the heart of what we do • •

•

• •

listen to members’ opinions and needs ensure good two-way communication from the centre out to the regions and back again foster a strong community through facilitating opportunities for members to meet and support each other provide high-level legal, safety and ethical advice and encourage mentoring and peer support develop and focus services to provide value for money work to attract new and past members, making sure that graduates recognise the BAcC as the first choice professional body

2 Raise the profile of our members •

•

• •

•

work to improve public awareness and governmental understanding of BAcC members as acupuncture specialists and healthcare professionals, for example by working with the PSA educate public and media about existing and growing body of research indicating the positive effects of acupuncture promote the credibility, skill set and personalised approach of professional traditional acupuncturists as part of modern healthcare to the public and to government promote the profession of traditional acupuncture to the next generation liaise and cooperate with other acupuncture and East Asian medicine organisations and charities, nationally and internationally communicate and collaborate with relevant charities highlight the BAcC’s leading role in education and practice standards to other health professionals and associations monitor political developments and members regarding any future change in our regulation

3 Uphold professional standards

Maintain the highest professional standards by: • collaborating with the British Acupuncture Accreditation Board (BAAB), ensuring excellence in training the next generation of traditional acupuncturists • supporting members in their continuing professional development (eg provide conference, events whether online and in person to support the development of members) and promoting reflective practice (eg through the BAcC supervision register and the supervision and mentoring network)providing and refining policies on safety and ethics • ensuring best practice in our professional standards procedures, when both responding to the public and providing support for members • increase engagement with

acupuncture students, teaching institutions and the Council of Heads of Acupuncture Courses (CHAC)

4 Help members to deliver best practice and run a business •

•

• • •

disseminate effective positive acupuncture messages via all relevant digital channels support members in promoting their work through positive media coverage, locally and nationally, emphasising safety and effectiveness increase contact with new members to help them build a practice in the early years use PR and marketing strategy to position BAcC membership as a mark of the highest skilled acupuncture treatments for prospective clients encourage innovative approaches in members’ practices and businesses support CPD to enhance members’ business skills promote the BAcC’s Professional Standards Authority (PSA) accreditation

5 Run the BAcC as an organisation that is cost-effective, open, and accountable •

•

• •

•

set the strategic direction of the BAcC and actively monitor the delivery of the strategy and account for its delivery ensure clarity and alignment between the Governing Board’s strategic role and the day-to-day operations for running of the organisation safeguard the financial stability of the organisation basing all decisionmaking by adopting best practice in risk management instigate and maintain a variety of channels to facilitate effective communication between the Governing Board, committees, chief executive, staff, and the members assess the effectiveness of the revised governance structure within two years of implementation continue to ensure adequate member representation in governance alongside expert lay members and ensure committees are effective and fit for purpose foster and support an engaging, talented and committed staff team ensure all proposals for change are evaluated for effectiveness and value for money manage BAcC finances prudently delivering value for money at all times ensure effective plans are in place to build up reserves to cover future development needs and the risks the BAcC is likely to face seek new and diverse sources of income (eg sponsorship, webinars, CPD training and regional and national conferences and events) review the roles of the BAcC as both regulator and promoter of the profession

6 Strive to be a green and environmentally friendly organisation in line with current best practice • •

reduce paper use reuse products wherever possible

News • •

•

recycle wherever possible encourage reduction and recycling of plastic and paper waste in clinical practice continuously review our environmental impact and maximise green potential

Monitoring and evaluating progress and reporting to members This strategy sets out the aims and objectives for the British Acupuncture Council over the next five years. Dayto-day delivery of this strategy will be undertaken by the chief executive and the staff team based on fully aligned operational plans. The Governing Board will regularly monitor and evaluate progress on strategy using a set of key success measures aligned directly to the aims and objectives. Any adjustments deemed necessary to reflect changing circumstances will be made in operational planning consistent with the strategy overall and the reality of resources available. We will seek members’ views on our priorities throughout the lifespan of the strategy and the Board will report on progress being made at the annual general meeting held each year.

Measures of success 1 Always put members at the heart of what we do

Members feel BAcC genuinely listens to all its members.

2 Raise the profile of our members

There is increasing evidence that acupuncturists are widely recognised as healthcare professionals.

3 Uphold professional standards

There is growing public trust in BAcC acupuncturists and the very high standards they adopt.

4 Help members to deliver best practice and run a business

Members feel fully supported through the BAcC providing expert and up-to-date guidance.

5 Run the BAcC as an organisation that is cost-effective, open, and accountable

Members say that they are getting value for money from their membership.

6 Strive to be a green and environmentally friendly organisation in line with current best practice The BAcC develops a thorough understanding of its environmental impact and aims to become carbon neutral by 2026.

Practice

Acu. | Issue #30 | Spring 2021

Wales during the6%pandemic 2% Too early to assess

Not sure

0.5%

0 -4 weeks

4 - 12 weeks

1.5% Not sure

A snapshot audit of the work of acupuncturists

Rachel Edney

Mark 32% Bovey

26% No

25%

Yes

Member: Pembrokeshire

1-5 years

BAcC Fellow: Oxfordshire

34%

29%

Not taking medication

This work was part of a longer-term campaign to improve professional standing in Wales and was prompted particularly by the threat to practice Too firebreak early to assess Not sure in the of October-November 2020. Data was collected for a four-week period leading up to the firebreak, when practice was still less restricted. Members in Wales were invited to input audit data online relating Too early to assess Not sure to the characteristics of patients consulting them, the main and secondary complaints according to No Yes ICPC-2 (International Classification of Primary Care, 2nd edition), and the level of personalised care and lifestyle advice provided. All data collected was anonymous, both for No the acupuncturist and Yes the taking medicationand patient. DataNot was collected analysed using Google forms. A total of 341 responses were received each representing an individual patient having acupuncture during the fourPatients that have reduced amount of prescription week period. Not taking medication

26%

34%

medication

Traditional acupuncturists treat significant numbers of key workers and the elderly •

•

Almost a quarter of patients were key Patients thataccording have reducedto amount of prescription workers the government medication definition All adult age groups were well represented, with significant numbers of the over-70s 79 per cent of patients were female

60 60 62

62 29 60 60

0 -4 weeks

1.5% Not sure67 62 60 60 25% Over 5 years 38%53

0-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 Age when patient consulted

Traditional acupuncturists help people manage long-term conditions

Duration of main complaint The majority of patients (63 per cent) seek help for a long-term condition that has persisted for more than a year, and for 25 per cent of them it has lasted more than five years. Only 8 per cent had suffered for less than three months.

N=176

4 - 12 weeks

52%

1-5 years

29 29% 25% Over 5 years

3 months – 1 year

N=105 N=74

38%

3 months – 1 year51-60 61-70 71-80 81-90 0-20 21-30 31-40 41-50

Traditional acupuncturists treat a wide Age when patient consulted variety of medical conditions The main reasons patients consulted their acupuncturist were: Duration of main complaint • musculoskeletal, including back, neck and joint pain, rheumatoid and osteoarthritis (n=110) • psychological, including anxiety, depression and insomnia (n=54) • neurological, including headaches, migraine, dizziness (n=39) • fertility, pregnancy and childbearing (n=38)

N=176 52%

N=120

bereavement issues) and trauma. Anxiety Depression Insomnia None of these The majority of patients presented with more than patients one condition (n=287). Conditions presented with 153 patients sought help with at least two other secondary complaints.

22%

Anxiety

Depression

Insomnia

35%

31%

29% Duration of main complaint

N=105

N=120

22%

1-5 years

35% N=74 31% 52% They also sought help with respiratory, urological, digestive, metabolic, 22% conditions.N=120 and dermatological N=105 In addition, acupuncturists helped 35% 6 patients cope with social problems 31% (including N=74 relationship, work, financial,

0-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 Age when patient consulted

1.5%

0.5%

N=176

4 29 4

0 -4 weeks Patients that have reduced amount of prescription medication 4 - 12 weeks Not sure

32%

34% 32%

3 months – 1 year

0.5%

26%

38%

Over 5 years

None of these

Conditions patients presented with

Anxiety

Depression

Insomnia

None of these

Conditions patients presented with

Half of all patients consulting an acupuncturist were presenting with anxiety

52 per cent of patients presented with anxiety and 31 per cent were experiencing insomnia. This snapshot audit has taken place during the Covid-19 pandemic when levels of anxiety may be heightened. Studies have shown that acupuncture is effective in the management of anxiety 〉 Amorim D, et al. Acupuncture and Electroacupuncture for Anxiety Disorders: A Systematic Review of the Clinical Research 〉 Sniezek D, et al. Acupuncture for Treating Anxiety and Depression in Women: A Clinical Systematic Review

Patients diagnosed with Covid-19

98 per cent of patients receiving acupuncture during the audit period had not received a positive Covid diagnosis. Seven patients who were positive all had Covid symptoms for more than nine weeks and the majority for more than twelve weeks.

Acu. | Issue #30 | Spring 2021

Traditional acupuncture is a valid treatment option for chronic pain

Of the 341 individuals who consulted an acupuncturist during the audit period, 145 reported being in chronic pain (more than twelve weeks duration). • 14 per cent of patients with chronic pain were receiving opioid medications The NICE draft guideline for chronic pain recommends: ‘Consider a course of acupuncture or dry needling, within a traditional Chinese or Western acupuncture system, for people aged 16 years and over to manage chronic primary pain’ 〉 National Institute for Health and Care Excellence. Chronic Pain in Over 16s: Assessment and Management. Draft for consultation, August 2020 Many studies have showed that acupuncture reduced pain and improved quality of life compared with usual care or sham acupuncture. Economic evaluations found that acupuncture is likely to be costeffective for chronic pain.

Patients receiving acupuncture reduce the amount of prescription medication they take 55 per cent of patients were taking at least one prescription medication and some were taking several. • Almost a third of patients had reduced the amount of prescription medication taken during the course of their acupuncture treatment.

Too early to assess

32% Yes

34%

Patients that have reduced amount of prescription medication

Accessibility to traditional acupuncture is limited by ability to pay Of the 341 patients in the audit, 93 per cent paid for treatment out of their own pockets. Access to traditional acupuncture is currently restricted to those who can afford to pay. Widening access to patients based on need remains a challenge.

60 60 62

0.5%

0 -4 weeks

1.5%

Over a period of four weeks, traditional 4 - 12 weeksin Wales Nottreated sure acupuncturists a range of medical conditions including pain, anxiety, and insomnia. Acupuncture is an evidence-based medicine with clinical trials demonstrating its effectiveness in these conditions. 〉 The Scope of Acupuncture: Exploring acupuncture as a modern healthcare solution Over 5 years People often sought acupuncture for 1-5 years help with long-term conditions and chronic pain, which is endorsed in NICE’s draft guideline on chronic pain. The audit revealed that 14 per cent of patients with chronic pain were taking 3 months – 1 year opioid medication. Opioids are not recommended for chronic, non-cancer pain due to the side effect profile and risk of dependence and addiction. It is recognised that multimorbidity Duration of main complaint is frequently compounded by polypharmacy. 〉 The Scope of Acupuncture: Exploring acupuncture as a modern healthcare solution During acupuncture treatment, a third of patients reduced the amount of prescription medication they were taking. Key workers made up almost a quarter of the acupuncture patients, demonstrating its particular value in the current situation. Also significant numbers are elderly, indicating the benefits they perceive at a time when otherwise they might not leave their homes.

25%

38%

29%

Not taking medication

Traditional acupuncture can play an important role in achieving the Welsh government’s long-term future vision of a ‘whole system approach to Health and Social Care focused on wellbeing and preventing illness’ 〉 A Healthier Wales: our Plan for Health and Social Care Traditional acupuncture can provide effective, individualised care without contributing to polypharmacy. Acupuncturists meet the goals of the Allied Health Professionals Framework for Wales: Looking Forward Together (2020) as they inspire and enable people to live healthier lives.

These changes may put members in Wales in a more secure position than anywhere else in the UK

Not sure

Traditional acupuncturists are committed to providing person-centred advice and support to enable patients to make the necessary changes to avoid long-term health conditions and to live long, happy lives. • In the snapshot audit, 97 per cent of traditional acupuncturists provided patients with individualised lifestyle advice and support. • Advice on diet was given to 44 per cent of individuals, 59 per cent received support regarding exercise, 39 per cent on sleep habits, and a half of all patients received social support, for example advice on relationships, work, finance or bereavement. • Acupuncturists also provided advice and signposting to services for stopping smoking and taking recreational drugs.

Conclusion

26%

Acupuncturists empower patients to keep themselves happy and healthy

Practice

N=176 52%

N=105

N=74

31%

N=120 35%

A stronger legal status for BAcC acupuncturists in Wales

There are two very welcome pieces of legislation to note, one already drafted before the pandemic, the other very recent: 1 Members are to be exempt from the requirement to be licensed under the Public Health (Wales) Act 2017, Part 4 Special Procedures, as they belong to a Professional Standards Authority (PSA) accredited voluntary register. Hence acupuncture is being separated from its old tattooing and piercing friends and will no longer be subject to local authority licensing: BAcC membership will suffice. (It’s not yet commenced but hopefully will soon.) 2 The latest Welsh coronavirus legislation lists these services as exempt from closure: ‘Dental services, opticians, audiology services, chiropody, chiropractors, osteopaths, physiotherapy services, acupuncture services and other medical or health services, including services relating to mental health.’ Thus acupuncture has been uncoupled from complementary and alternative medicine and placed explicitly with the statutorily regulated healthcare professions. These changes may put members in Wales in a more secure position than those anywhere else in the UK: just reward for all the lobbying work they’ve put in over the last ten years.

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Acu. | Issue #30 | Spring 2021

‘Everyone needs a Mark behind them’ o. Mark Bovey is an unsung her . him for g son of t So this is a sor

Mark came to the BAcC via the Acupuncture Research Resource Centre (ARRC) 22 years ago. Since then, as the BAcC’s research manager, he’s played a fundamental role. Every time the BAcC has run a media campaign… all the ARRC symposia… every time there’s been an enquiry, a consultation or an All-Party Parliamentary Group presentation… all the Acupuncture Awareness Weeks… the fact sheets… all the NICE guidelines… in fact, every time there’s a need for evidence to underpin what we do, Mark’s been there. Quietly, without drama, and with surpassing diligence, he’s provided us with the science to support the credibility of acupuncture in the public eye. His self-effacing self would demur at this, but there’s no doubt that in this way he’s contributed a huge amount to the respect accorded to our profession. Working with Mark has taught me personally much about generosity, collaboration and balance. Since joining the BAcC Research Committee three years ago I’ve seen at first hand the extra miles he’s gone to encourage and support the researchers amongst the BAcC community. In assessing research quality he is consummately even-handed; and always, always, he acknowledges the contribution of the whole team. I talked with Kathleen Powderly recently about her work on the SIGN guideline on chronic pain,

which included a recommendation for acupuncture; Mark had lent his skills to the huge job of collating and assessing the evidence. We agreed that it was characteristic of Mark to give so generously while modestly avoiding recognition or thanks. ‘Everyone needs a Mark behind them,’ Kathleen said. I couldn’t agree more. Mark, a huge thank you for the huge amount you’ve done for us. I’m sorry you’re leaving us – but also very happy that you’re setting out on a new adventure with energy and health to enjoy it. Go well.

Karen Charlesworth Member: North Yorkshire

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Dear Mark, we first met years ago, and I have always enjoyed talking to you and discussing acupuncture questions with you. I am sorry to hear that you are stepping down from your position at the BAcC. We have had the chance to collaborate with research issues over the last years and I will miss that. But then again, maybe we will still see you ‘around’? Hugs from Terje.

Terje Alræk Senior Researcher: NAFKAM, Tromsø, Norway Professor: Kristiania University College, Oslo Mark was my first point of contact when I began my career as a researcher in 1999. His reply to my query was a full-page email which I have to this day! His advice was truthful, yet encouraging, and I have relied on his advice – and friendship – through the 20 plus years of my work as a researcher. His contribution to the field of acupuncture research is immense. His knowledge and his network of international research contacts is enviable. He has contributed to key developments, written numerous papers and contributed chapters to books. He has played a key role in negotiations with many external organisations and has influenced policy, as well as being involved in various BAcC committees and of course, the Acupuncture Research Resource Centre (ARRC). Mark is committed to teaching acupuncture and research skills to students and is never too busy to become interested in a research project, to advise and critique, to offer helpful ideas. He has been a facilitator and kindly guide, stimulating interest and helping practitioners to navigate the complexities and challenges of conducting research. He respects and honours the plurality in acupuncture approaches, and in spite of being so immersed in research, never loses sight of the mystery and magic that make acupuncture so wonderful. Mark is one of the BAcC’s – and acupuncture’s – great treasures. I thank him for all he has done for our profession and wish him a happy retirement. Adieu Mark, and thank you!

Beverley de Valois BAcC Fellow: Middlesex

Above: Mark among the group that developed ‘Acupuncture Research: Strategies for Establishing an Evidence Base’, just about to get on a boat for a river cruise, York 2006. Below: With Terje Alræk and colleagues, Seoul 2019

Dear Mark, it has been wonderful to have the opportunity to support you in the Research Advisory Group these past years. I have learned a lot from you, especially when you let me loose on looking after your job when you went away… Hats off to you! It’s a busy and challenging, yet very enjoyable role! And I will always be grateful to you for having faith in me and giving me that opportunity. Your motivation and passion to improve research into acupuncture is truly incredible and has helped to move this profession forward. THANK YOU! I will most certainly miss working with you and having a laugh in our meetings. But knowing you, you’ll still somehow have all your limbs in the acupuncture research pie. Promise me you’ll still be at all the conferences and so I can still have a glass of wine with you. With much love and gratitude, Amy xxx

Amy Din Member: Hampshire

I met Mark in 1999 when we shared an office at Exeter University. I became his research assistant soon after, a role which involved helping with literature research requests, arranging the ARRC symposia, organising briefing papers and many management committee meetings. I was also at the first meeting at which STRICTA (STandards for Reporting Interventions in Clinical Trials of Acupuncture) was created, a huge honour. I was very happy to be at the presentation of Mark’s fellowship in 2011. Mark taught me so much with great patience and kindness, even though I’m sure I drove him mad sometimes. His energy is amazing, as evidenced through his involvement in so many foreign research conferences, ETCMA, etc. His calm approach and enormous wealth of knowledge has been a huge asset to the BAcC. He will be greatly missed, but so deserves what comes next for him.

Sarah Budd Member: Devon

ARRC is MARK – what will we do without you?! You have made such an important contribution to the BAcC: giving acupuncture a high profile by developing acupuncture research, encouraging practitioners to engage in building their research capacity, and helping to build the evidence base for acupuncture both in the UK and internationally. Our collaboration and friendship goes back to at least 2005, when ARRC was based in my centre at Thames Valley University. We have shared some great times both in the UK and far afield – China, South Korea, America, Norway, etc. I do hope you do manage to retire successfully (it’s not easy) so you can enjoy the outdoor life that you so love. Very many thanks and best wishes for a happy carefree future. Love Nicky

Professor Nicky Robinson BAcC Fellow: London

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Acu. | Issue #30 | Spring 2021

Just my point LIV 13 Peter Firebrace BAcC Fellow: Denmark LIV 13 is zhang men 章門. Men 門is a gate. As in many points, such as DU 4 ming men Gate of Destiny or HT 7 shen men, Spirit Gate, it is a place of privileged access that can be opened to release and liberate or closed to protect and nurture. Zhang 章 has multiple meanings and the main ones are discussed here. The character is made up of yin音, a sound or musical note above and shi 十, the number ten indicating perfection below, giving the idea of the perfect emission of a sound or note. Zhang 章 then is a complete and well-ordered whole, something beautiful, elegant and clearly expressed, such as a chapter in a book, a stanza in a poem or a piece of music. Zhang is also 樟 camphor wood, a valuable timber, a perfect blending of wood and earth. Zhang 章 is also a 19-year (Metonic) cycle, a period of 235 months, after which the sun and moon return to the same relative places. The cycle of the 12 meridians that starts with the lung – and some sources say with LU 2 yun men 雲門Cloud Gate – ends fittingly with the two gates of LIV 13 zhang men 章門Completion Gate and LIV 14 qi men 期門Cycle Gate, before the meridian cycle seamlessly starts another yin yang rollercoaster round. Located on the border of the middle and lower heaters, its primary places of action, and on the sides of the body, where the liver and gall bladder meridians meet, LIV 13 zhang men

is a very woody point. Its position as start of the dai mai, the belt vessel, reinforces the link with the lower abdomen. As mu 募collecting point of the spleen it is the archetypal point for liver-spleen or more broadly woodearth disharmonies; particularly wood invading earth from an unruly liver or too weak a spleen, or both, giving poor digestion, bloating, abdominal gurgling and pain, watery diarrhoea with undigested food and vomiting. Restoring free flow to the liver and so enhancing the stability of the spleen, LIV 13 is also the hui meeting point of the five zang, a wonderful point to support all five zang, not only the liver and spleen, but also the kidneys, heart and lung, making it a point with great reach and depth. We see here the central importance of the all-nourishing earth. Cf REN 12 zhong wan 中腕Central Cavity, the mu 募 collecting point of the stomach, which is also the hui 會meeting point of the fu organs. In just these two points, LIV 13 and REN 12, through their connections to the earth organs of spleen and stomach, we affect all the zang fu organs. LIV 13 zhang men is my go-to point for chuntering resentment, where the anger is unexpressed, simmering below the surface and taking up a lot of space in ever-circling negative thoughts, undercutting the gall bladder’s breakthrough power, stagnating liver qi and even liver blood and weakening the

transformative actions of the spleen. This is the dangerous background mental/emotional state for the classic symptom of this point, jia ju 瘕聚, accumulations and knots, various growths, masses and hard swellings, often in the abdominal area or the breast. LIV 13 is an important point to transform accumulations and blockages hua ji zhi 化積滯 and to reorder the qi and disperse knots li qi san jie 理氣散結. The Jiayijing text talks of shi shui 石水, stone and water, a swollen abdomen with hard masses, combining LIV 13 with KID 2 ran gu. Sun Simiao adds ST 30 qI chong and KID 14 si man. Such a frustrated and resentful state necessarily also upsets the serenity of the heart, restricts the even rhythm of respiration in the lungs and drains and exhausts the kidneys. Free flowing the liver qi with LIV 13 releases and supports the spleen, re-establishing the stable centre of earth that nourishes and connects all the zang. Interestingly the Zhenjiu Dacheng text talks of fear rather than anger, while Sun Simiao takes it one step further into the rage and fury of madness, indicating the wideranging emotions covered by this point. For those with a knowledge of homeopathic remedies, LIV 13 seems to be an interesting blend of the frustrated liverishness of Staphysagria and the put-upon exhaustion of Sepia. I consider it in some ways as a bigger, beefier version of LIV 3 tai chong 太衝 Great Rushing, which also involves a wood-earth relationship and which I

Acu. | Issue #30 | Spring 2021

Inner Pass Notes The Professional Recognition Working Group (PRWG)

Hang on, where did that come from? I thought we already had committees sometimes combine it with to increase the effect. I often use LIV 13 with P 6 nei guan 內關 Inner Pass to calm and stabilise. This calm stability breaks the endless negative cycle of resentment and can be used to stand apart, readdress the situation and act more appropriately, which may well include an expression of the held-in anger, in time releasing everyone involved. I sometimes combine LIV 13 with P 5 jian shi 間使 Intermediary Messenger, where there is more confusion and mental instability, using its ability to resolve phlegm, clarifying and restoring the connection to the heart. LIV 13 is a deep-acting and powerful point with multiple uses of which only the main ones have been covered here. Its impressive use in blocked emotions can overshadow other uses. One such probably stems from its link as a point of the dai mai, which is itself rooted in the DU 4 ming men area of the lower back. From the earliest times LIV 13 was mentioned as a point for pain, stiffness and rigidity of the lumbar area, with a kind of chronic fatigue. Sun Simiao specifies this is especially in men, with coldness of the area and adds there is disturbed urination with white, cloudy urine. In such a point, with its meticulous recording over hundreds, even thousands of years, we see the strength of Chinese medicine, always adding knowledge to knowledge, experience to experience, building and expanding to create something beautiful, wellordered and elegant, zhang 章, a completionfulfilment of understanding to help hundreds of thousands of people back to health.

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Like what?

Educational standards is the biggie. The PSA should have made this an AVR requirement and we’d like our degree-level training to be accepted as the bottom line. Too many short courses, dodgy diplomas, and wacky weekenders. We need the PSA to spell out what it takes to be in independent practice.

Sounds like a good start. Anything else? Well, working with the PSA might help us back on the blood donation trail. Just like NICE guidelines, no really major effect on people’s businesses or patient choice, but immensely good PR value. Give blood. Twice!

You’re not kidding. When the law kept changing last year, though, sharpeyed members spotted that it went from ‘can’t practise unless a medical service’ to ‘can practise unless on this list of also rans’. We looked like being defaulted onto the latter if UK locked down, which prompted the GB to get a small group working on it.

What’s all this about being reclassified by the ONS. Isn’t that a start?

How were the members selected?

SR? Very unlikely, but as Sean Connery’s wife said when he took another Bond role in his dotage, ‘never say never again’. After this year, anything could happen. A Royal Charter for the BAcC by itself? Impossible! But a Charter for all acupuncture, now that could be a challenge. Nothing would be lost in renewing old acquaintances in the Privy Council, though. It’s about time we started taking ourselves more seriously as a profession again.

From people active in four nations, all with different rules, a GB leader and an older member or two with a bit of previous on similar issues.

The issues being?

Recognised in law as legitimate healthcare professionals, for one. In Wales, for example, our PSA accreditation means practitioners are exempt from local licensing, and in London BAcC members have been exempt from licensing for decades. In Scotland, though, annual licences still exist, and in England everyone registers. Being recognised the same in all four countries would be a Great Leap Forward. Hmm, good slogan…

But licensing and registration. Does that matter?

You bet. It costs. Anything putting us on a par with osteopaths, chiropractors and physios is good, and they need to register in England too. Now there’s not many people know that.

We’re not going to get SR, though…

Exactamundo! But the PSA argued the new AVR scheme was the way forward in regulation, ‘right touch’ and responsive, protecting Jo(e) Public and reducing risk without the cost and cumbersome baggage of SR. The PRWG’s mission, on a tape which selfdestructed in well under five seconds, was to come up with sprauncy ideas.

Some hope – good luck!

Well, hope indeed. The PSA is reviewing the AVR scheme, and possibly needs more mazuma to stay viable. There could be some interesting quids pro quo on the table. We’re hoping it’s a big table.

The SOC Code is mainly for the business statistics, just like SIC Codes in 2009 were for sorting out hazardous waste. Neither really impacts on our work or the law, but every little helps.

What about our holy grails of SR and the Charter?

So, the group’s got its work cut out, then Not half! There’s masses of untapped energy in the BAcC after a year of enforced sitting. The main reason the group was assembled was to get a bit strategic. Too many irons in too many fires would mean nothing really takes off. The PRWG is all about priority and direction. It’s a big ask when you’re meeting by Zoom without free coffee and biscuits, but all life is either a) suffering or b) a bowl of cherries. Looks like we got suffering.

When will we get updates?

Get you! That’s for the GB to decide. There’s so much expertise out there, though, it would be better to publish frequently and listen to what members have to say...

Glossary for Rip Van Member

AVR Accredited Voluntary Register BAcC British Acupuncture Council GB Governing Board NICE National Institute for Health and Care Excellence PSA Professional Standards Authority SIC Standard Industrial Classification SOC Standard Occupational Classification SR Statutory regulation

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Acu. | Issue #30 | Spring 2021

EveryBodyCan… get to know the BLS Recently freed up from her duties as chair of the BLS Scientific Committee, BAcC Fellow Beverley de Valois is now working to build bridges between the BLS and the BAcC.

Beverley de Valois BAcC Fellow: Middlesex

The British Lymphology Society (BLS) is a dynamic and innovative body providing a strong professional voice and support for those involved in the care and treatment of people with lymphoedema and related lymphatic disorders, including lipoedema. As well as seeking to achieve high standards of care and equitable access to treatment across the UK, the BLS aims to promote professional standards in lymphoedema care and treatment. You could say that the BLS is to lymphoedema what the BAcC is to acupuncture in the UK.

What is lymphoedema?

Lymphoedema results from a failure of the lymphatic system. Consequences are swelling, skin and tissue changes and predisposition to infection. It most commonly affects the arms or legs, but may also affect other parts of the body such as the head and neck, trunk, breasts or genitalia. It may be: • primary, that is, an abnormality in the lymphatic system present from birth or • secondary, that is, resulting from damage to a normally functioning lymphatic system: damage may be caused by surgery, trauma, radiotherapy or infection in areas that are rich in nodes and vessels, for example the axilla, groin, pelvis and around joints It is a chronic condition for which there is currently no cure and requires specialist management.

Why should acupuncturists be interested?

Lymphoedema affects 400,000 people in the UK. This exceeds UK prevalence

rates for Parkinson’s disease, multiple sclerosis, and HIV. One in five women treated for breast cancer will develop lymphoedema, as will one in two women treated for vulval cancer and one in three men treated for penile cancer. As well as being associated “Lymphoedema “Lymphoedema with other cancers doesn’t stop me doesn’t stop me doing such as melanoma and doing a lap or two of leg flexes while watching head and neck cancers, the pool each week” the football” lymphoedema is a condition that affects people with vascular disease and other chronic diseases such as multiple sclerosis (MS). So, acupuncturists are probably seeing What is EveryBodyCan? many people with lymphoedema. EveryBodyCan is the BLS strategic In general, the condition is campaign; its 2020 theme was ACTIVITY. underdiagnosed, not well understood, The campaign sought to reassure and often inadequately treated. It will patients and practitioners that becoming give the acupuncture profession an more active is beneficial for people advantage if they can recognise with lymphoedema. It emphasised the condition, know when to that regardless of ability and baseline refer, and develop working fitness, there is something enjoyable partnerships with that EVERYBODY can do to improve the lymphoedema specialists performance of their lymphatic system. and clinics. We should As part of the 2020 campaign, I want to become part of presented a paper ‘Lymphoedema the multidisciplinary Acupuncture Activity’ at the 7th management of this National Lymphoedema Conference in distressing condition. London in February (remember those free and easy pre-Covid days?). This was based on research I did some years ago What can investigating the use of acupuncture acupuncturists do? and moxibustion to improve wellbeing While the evidence for and self-management for people with whether acupuncture lymphoedema. I wanted to revive can treat lymphoedema is the findings of this study, to make inconclusive, there is so much lymphoedema professionals aware we have to offer. As we all know, of how having acupuncture improves acupuncture is amazing for managing wellbeing, increases energy and chronic conditions. People with motivation, and helps people to become lymphoedema can experience many more active in their self-care 〉 https:// unpleasant symptoms in addition to tinyurl.com/1h41n8qc swelling and tissue fibrosis, including discomfort, sleep problems, lack We can see this from these patient of confidence, lack of motivation, testimonials: depression – all of which can be ‘I’ve joined Weight Watchers, I’m addressed by acupuncture. One of the best ways to stop lymphoedema from developing or getting worse is to keep moving. There are lots of easy ways to build safe movement into your day. Go to thebls.com to find the one that’s right for you. #EveryBodyCan

One of the best ways to stop lymphoedema from developing or getting worse is to keep moving. There are lots of easy ways to build safe movement into your day.

PLATINUM SPONSOR

Go to thebls.com to find the one that’s right for you. #EveryBodyCan

PLATINUM SPONSOR

Acu. | Issue #30 | Spring 2021

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really being positive about this and I’m really working on my exercises for the lymphoedema, I’m really working hard… and I honestly say this is the acupuncture and the moxibustion… it changed the way I thought about myself.’ 004 BC: research participant with breast cancer treatment related lymphoedema ‘The improved sleep has given me more energy and motivated me to take on more exercise to increase my mobility. On a recent visit to the lymphoedema clinic on examination there was a marked reduction in the size of my legs.’ ‘Faye’: patient with primary lower limb lymphoedema

EveryBodyCan for 2021

Such is the importance of movement and activity for lymphatic drainage and function that the BLS is extending this theme in their 2021 campaign. My goal for the 2021 campaign is to build bridges between the BAcC and the BLS. My plan is to: • increase awareness amongst lymphoedema professionals of the role acupuncture can play in improving the care and treatment of people with lymphoedema: I have published two papers for the BLS membership on this subject • increase awareness amongst the BAcC of lymphoedema and encourage a well-informed approach to managing this condition: this article is one activity to support this, and later I hope to publish a paper in EJOM about lymphoedema

The Secret Weapon

A subtheme of the 2021 BLS campaign is ‘The Secret Weapon’. A secret weapon can be an inanimate object that helps people to become more active. So it can even be an acupuncture needle! I want to have more people with lymphoedema saying that acupuncture is their secret weapon. And to have more lymphoedema professionals saying that their relationship with their local acupuncturist is their best secret weapon!

Lymphoedema Awareness Week

Even though this issue of Acu. just misses this year’s Lymphoedema Awareness Week (LAW) from 1 to 6 March, the BLS maintain that lymphoedema awareness continues year round. So here are some activities to develop that lymphoedema awareness during 2021 – for acupuncturists and for their patients.

Get active! Become a Friend of the BLS Start getting active and interact with the lymphoedema community. The BLS are keen to support healthcare professionals who are not specialist lymphoedema practitioners to learn more about lymphoedema and enhance the care of people with, or at risk of, lymphoedema. To do this, they have made a tier of

BLS SC members for 2020 and beyond, left to right: Dr Beverley de Valois, outgoing chair; Dr Malou van Zanten; Dr Rhian Noble-Jones, incoming chair; Rebecca Elwell, conference organiser; Dr Kristiana Gordon; Eunice Jeffs; Dr Ambreen Chohan; Cara Cole, honorary member; Emma Underwood; Justine Whittaker

FREE membership – Friend of the BLS. There is no fee and no catch, and here is what is on offer: • keep in touch with what is happening in lymphoedema/chronic oedema, for example, the BLS have recently sent its membership coronavirus vaccine information, invaluable for all healthcare practitioners and patients alike: • ‘...anyone with lymphoedema of the arm is advised to get the vaccine in the opposite arm or thigh. This advice also applies to those who do not have lymphoedema but who have been treated for breast cancer. They should request the vaccine in the opposite arm from their breast cancer treatment. If they have had lymph nodes removed or treated on both sides, the injection should be in the thigh or buttocks.’ (BLS email, 10 February 2021) • automatic notifications when new events or resources are posted on the website, as long as you opt in to communications • free quarterly newsletter – News and Views – in electronic format, as long as you opt in to receive this • access to some regional meetings – a great way to start building relationships with local lymphoedema specialists • free access to selected resources and information material (see CPD below) • access to webinars for a small subscription

•

To join, scroll to the bottom of this page and register 〉 thebls.com/membership

British Lymphology Society 〉 01452 790178 〉 www.thebls.com

Do some lymphoedema CPD

Find out more about lymphoedema. Take four minutes to watch this video introducing lymphoedema Access the ‘Lymph Facts’ information sheets. These are fabulous for finding out more about lymphoedema, how it is managed, and can be helpful for working with patients who have or are at risk of lymphoedema. Here are four examples:

• •

•

What is lymphoedema? 〉 tinyurl.com/1kup6l7t Activity and exercise 〉 tinyurl.com/1l5h2qz4 What information, advice and support should be provided for those at risk of lymphoedema? 〉 tinyurl.com/3yafp52v Who has a predisposition to lymphoedema and why? 〉 tinyurl.com/5zt0pgp9

Find out more about using acupuncture in the management of lymphoedema. Watch this four-minute clip from the BAcC film ‘To the Point’, made possible courtesy of the BAcC. This video provides perspectives from a woman with BCRL, a lymphoedema nurse specialist, and a researcher/practitioner of acupuncture (yours truly) 〉 youtu.be/0ZgzrFwuiBY Increase awareness of lymphoedema amongst colleagues and friends. Download materials from the EveryBodyCan page, which has useful information about activities for people with or at risk of lymphoedema – great for lifestyle advice 〉 thebls.com/pages/ everybodycan

Get tooled up!

Let’s make acupuncture everybody’s best secret weapon in the management of lymphoedema!

Practice

Acu. | Issue #30 | Spring 2021

Du mai: channel of the brain Tian-Jun Wang Member: London Based on my 31 years of acupuncture practice and research, I am convinced that du mai is the channel of the brain. There is also increasing evidence from literature reviews, clinical experiences and study trials to indicate that this is a useful way of thinking of the du mai. In this sense we could say that the du mai has a similar physiological function to the other 12 regular channels in relation to their organs: contacting and communication, moving qi and blood, response and conducting, and regulating balance. The pathology changes of du mai could be briefly summarised as spinal and brain related conditions, and du mai points are regularly used in treating brain related conditions. The most commonly used points are DU 20 bai hui, DU 16 feng fu, DU 24 shen ting, DU 26 shui gou, DU 14 da zhui, DU 11 shen dao, DU 4 ming men, and DU 3 yao yang guan. I will take one of the points I use most often as an example: DU 14. DU 14 or GV 14 da zhui (大椎) – Big Vertebrae or Great Hammer – is located below the spinous process of the seventh cervical vertebrae, approximately at the level of the shoulders. In TCM theory du mai (governor vessel GV) is the sea of the yang channels, and da zhui DU 14 is the meeting point of the du mai with the six yang channels of the hand and foot. It can clear heat, release the exterior, expel wind, regulate nutritive and defensive qi, clear the mind, and tonify the yang. DU 14 is commonly used for neck pain and rigidity, back stiffness, malaria, febrile diseases, epilepsy, afternoon fever, cough, asthma, common cold, etc. It can also be used for the conditions along the du mai meridian, such as impotence, prolapse, haemorrhoids, lower back pain, spondylitis, headache, etc. But the specific functions of DU 14 could cover neurological and psychological conditions, such as stroke, Parkinson’s disease, dementia, stress, depression, anxiety, etc. As explored as part of my PhD research, DU 14 is one of the key points to treat major depression. For

moderate and severe depression, acupuncture combined with antidepressants has a significantly improved effect over antidepressants only – it can help expedite the effect of antidepressants as well as increasing their general clinical effectiveness. In my personal experience of using this point, apart from local neck pain, upper back pain and spinal disorders, I mostly use DU 14 – combined with other du mai points and scalp acupuncture – for mental and neurological conditions. The needling of DU 14 is described in most of the textbooks as ‘perpendicular-oblique superior insertion 0.5-1 cun, approximately 1025mm’. Actually, based on the anatomy structure and many CT or MRI scan researches, most average size patients could be safely needled to 30-35mm, with greater effectiveness, particularly for spinal cord diseases and brain related conditions. For the treatment of neck and spine conditions, there is another point which is good for bone problems: BL 11 da zhu 大杼 is traditionally called gu hui 骨会, the hui meeting point of the bones. Most of the textbooks say that BL 11 benefits the bones and joints and can be used to treat bone diseases, rigidity of the nape of the neck, rigidity of the spine, soreness and pain of the back and scapula, lumbar pain, tetany, clonic spasm, contraction of sinews associated with madness, stiffness and pain of the knee. However, like most of my colleagues, I rarely use BL 11 to treat bone and joint diseases, preferring DU 14 instead. One of the reasons is the location of BL 11 is

more risky than DU 14, and DU 14 is directly located on the spine and just below the big vertebrae. Some papers have suggested the hui meeting point of the bones should be DU 14 rather than BL 11, though unfortunately they are all in Chinese: certain scholars believe that at some point during the 1,000 years of transmission, the hui meeting point of bones was mistakenly attributed to BL 11 rather than DU 14. In summary, thinking of the du mai as the channel of the brain encourages us to take a closer look at its points and their functions. Just from this one example of DU 14, we can see how many of its functions are related to the mind and the brain, and how many more are related to the spine, which can be considered an extension of the brain.

Some papers have suggested the hui meeting point should be DU 14 rather than BL 11

Acu. | Issue #30 | Spring 2021

Practice

Buying my electric treatment couch Susan Adams Member: Surrey

I have used around ten different treatment couches in my fourteen years in practice, from my multibed and home visit foldable one, to wooden and electric couches in clinic rooms. In June 2019, when my used, wide, ex-NHS, three-part couch in my garden cabin clinic lost the electrical connection, I was ready to buy the grand finale.

Right: Armrest position in the first couch Far right; New frame with headrest and three armrest positions.

Too wide… too narrow…

Time for a brand new electric couch. I needed width for the larger acupuncture patients, but I also wanted it narrow enough for my husband to use for physio and seitai. The search was on for the narrow/wide, durable, perfect couch… and I was looking for one with armrests. Online I found the usual selection of hydraulic, electrical medical, beauty therapy and physio/osteopathic models. One website offered recycled treatment couches which could be re-upholstered in bespoke colours with new electrical mechanisms. They didn’t work for me, though, as one was too wide and the other too narrow.

Just right!

My three-bears search was starting to get somewhere when I went onto a website but mistakenly ignored that their couch armrests appeared to be in awkward positions. I was just so excited to get a new and sturdy couch. I popped the narrow, two-part couch into the shopping basket, then added a face hole, armrests and couch roll holder, all in lime green upholstery. Within a day of listing my old NHS couch on Facebook Marketplace, I sold it to an eclectic upholsterer. A week later he picked it up and strapped it onto the roof of his VW Bug. I was left with my not-so-robust, narrow, (slightly creaky with larger people), aubergine coloured foldable couch with armrests until the new one arrived. I ended up waiting six weeks during lockdown because they were in high demand in hospitals.

Or maybe not

At long last my lime green couch arrived, and the delivery man told me he had upholstered it himself. He then found a tiny black spot on the armrest and on failing to remove it with a good rub of isopropyl alcohol, he insisted on recovering with new vinyl. Next, he

Left: Final design, showing three armrest positions: the headrest helps people to relax fully when sitting up

popped the armrests on with the back upright to display them. There was no head support. I released the back to its horizontal position and the armrests slanted either down or steeply up (see images). And that’s when I started to feel a little queasy. I called the suppliers, told them about the problems and sent in pictures. I found it difficult to explain the awkwardness of the design to their sales team. Eventually they told me I could send it back for a 30 per cent restocking fee. Heart-sink, I’d spent top of my budget, around £1,000. I insisted that there are consumer rights about products bought online. And that’s when they recommended that I talk to Tom in Essex.

But then again…

Tom immediately said, ‘How can I redesign it to make it work for you?’ In my heart sun rays shone all over and the dark cloud drifted away. Tom told me I should have called him before ordering. But how would I have known to talk to him, the engineer and designer? And that is precisely why I’m writing this article. Tom redesigned the upper section of the frame twice. I settled on three slots on each side for armrest positions and

a headrest (image 3). I made it clear that I didn’t have the budget to pay for an expensive alteration, and he gave me a good deal of £150 for the customised frame and installation in exchange for a review on my experience (which I still haven’t written). They made the couch in their factory and showed up a week later to fit.

Happy ever after

I’ve now used my new couch for five months and it’s a wonderful fit for my clinic, as you can see from the photos. The engineer explained that he would be able to service it annually and if I want to reupholster it, I can! If I were treating a lot of tall people, I might even have considered asking them to design a foot extension for the other end of the couch. As an American with high hopes of fantastic customer service, I ended up being thrilled with this creative, open, and flexible company. And most importantly, I highly recommend finding a Tom to talk to when you want a bespoke electric or hydraulic couch for an acupuncturist… or whoever else needs to use it!

Practice

Acu. | Issue #30 | Spring 2021

Working online Calling on skills from her previous career in IT, member Stacey Chapman offers advice and tips on how to begin finding your way with working online.

Stacey Chapman Member: London

In the last year more and more of our daily personal and work lives have been moving online. But lots of acupuncturists feel intimidated by the online world and the tech side of things and can be hesitant to join in. Another way to look at it is to see how it can benefit both you and your practice and more importantly your patients. There are plenty of online systems out there, from calendar bookings and sending online forms to full patient management systems that also include taking notes, telehealth calls, invoicing and billing. A good place to start is to answer a few questions, to see what is taking up your time. What small steps can help reduce the overload and make things easy for your clients?

Getting started

I would recommend writing out on paper what your current processes are: • How do you communicate with patients: email, phone, WhatsApp, text message, other social media channels? • How do they book an appointment with you? • What if they want to reschedule or cancel? • What information do you regularly send to new patients/existing patients? • What other tasks are taking up your time? Once this is all written down you can start to look at what the best solutions might be. I normally recommend taking baby steps: focus on the things that can make your life easier with less admin. Having a calendar online to manage appointments and send reminders can be a big help. You may choose to make this available for patients to book in – or maybe it’s just for you to get started. Here are the questions to think about when looking at what is available.

What’s the goal? •

• • • • • • •

Based on your written list, think about the goal of adding in an online system. For example: streamline bookings online bookings for patients sending confirmations/reminders telehealth or automatic links to video services like Zoom keeping treatment notes help with invoicing/billing and financials reporting on your practice

What’s your budget?

There are free options that may work for you. These normally have some limitations on number of appointments/ locations and reduced features available. Paid plans are usually on a rolling monthly contract, often with discounts for an annual subscription.

Do you need to connect to other services? •

• •

You may already have an online calendar to keep your personal time like Google or Apple. Many systems will connect in and sync with these. You may also want to connect with Zoom or Google Meet etc for video calls. Do you send a patient newsletter using something like Mailchimp? Often these services can be set up to sync details automatically.

People/locations/services • • •

Think about locations – do you work from multiple clinics? If you work with an associate, how do you need to manage their bookings? In case you offer different therapies such as qigong classes, many systems also allow for group bookings.

Branding & customisation

What about branding and messaging? Many free plans have restrictions. Is it an important part of your marketing to be able to customise your system so that people recognise when things are connected to you.

Information gathering

Do you want to collect additional information from your clients? For example completing the Covid screening questionnaire before an appointment, or sending your intake form with some questions before you see them in person.

Security & privacy

Think about the security and privacy of any data you collect. Many companies have clear information about GDPR compliance on their websites. You may need to update your data privacy policy and let clients know about this. Secure passwords are essential, so not just the same ones you use for everything online! Adding two-factor authentication is also a good idea, where you get sent an additional code via text or an app to enter when you log in, as well as your password.

Ease of use

As well as fitting in with your processes, your system needs to be easy for you to use. Some of the free systems can be a little more difficult to find your way around. Here are some of my favourites for you to explore.

Scheduling systems

Calendly 〉 calendly.com: really simple interface – free plan allows you to have one appointment type and to send confirmations and reminders via email. Good if you want to keep things simple and just streamline your bookings

Acuity Scheduling 〉 acuityscheduling.com: paid plan with a few more features, from $15 USD/month. Great if you have multiple practitioners, different appointment types and want to customise your confirmation and reminder messages. Can be set up to include forms for patients to fill out and to accept payments.

Acu. | Issue #30 | Spring 2021

Practice

View FROM THE COUCH

In the early 1990s, I was diagnosed with chronic migraine. In a typical month I would experience in excess of 15 debilitating headaches, characterised by a constant, throbbing pain, often located on one side of my temples and a feeling of nausea. The frequency was greatest during my period. I was prescribed daily amitriptyline, which helped with the severity but not the frequency. I also took four ibuprofen hourly on the days I had a headache. I tried a number of alternative therapies – Alexander technique, osteopathy, homeopathy, reflexology and reiki – but none had significant or lasting benefits.

Patient management systems

Taking things a little further, if you want to include online notes and other features like telehealth calls, consider a patient management system. Once again there are many out there with lots of different features, usually with a free trial period or a demo version that you can try out. Cliniko 〉 www.cliniko.com: I’ve been using this in my practice for the last six to seven years. Allows for managing your calendar and taking treatment notes. Last year they added in telehealth, online forms and online payments. I love the values of the company and their support staff are great. From £29/month. Jane App 〉 jane.app: full patient management system with a few more features than Cliniko. More expensive but you do get a lot for your money. Good system for getting consent forms signed and more features around billing information. From $74 CAD/month (around £45). Of course, you may have more specific needs for your clinic and there are plenty of other systems available. If you’d like some help with finding which is your best option, just fill out a questionnaire on my website and I’ll get back to you with my recommendation for the best solution for your needs and budget. 〉 swish-it. com/online-booking-questionnaire/ Stacey Chapman 〉 staceychapman.co.uk 〉 07910 468850 〉 stacey@staceychapman.co.uk

In 2007 I was pregnant with my first child and stopped taking the amitriptyline. During my pregnancy I had far fewer headaches but they returned after my son was born. As I was breastfeeding and hoping for more children, I didn't want to take daily medication and so was prescribed sumatriptan to be taken only when I have a headache. I still use this and find it helpful. Prior to combining sumatriptan with regular acupuncture, I was experiencing approximately one or two headaches a week. I first tried acupuncture in 2006 as I was struggling to conceive my first child due to irregular periods and irregular ovulation. It was effective: my periods stabilised and I went on to conceive easily, twice. As a result of this success, in around 2010 I started to receive acupuncture to treat my chronic migraine, which I was still experiencing once or twice a week. Over the past ten years or so, I have had acupuncture treatments on a fairly regular basis – initially every four to eight weeks for several years, followed by a period of personal change (divorce, employment, moving house) when I found it harder to keep the treatments up, then in the last two or three years every four to six weeks. The treatments have been extremely successful. I now have between zero and two migraines a month on average, and if I do have one, they tend to coincide with my period and respond well to one or two doses of sumatriptan. In 2015 I was diagnosed with depression and after a period of counselling and trying various types of medication (sertraline, propranodol and St John’s Wort) I have now settled on a daily dose of fluoextine which helps with this condition. In terms of mood, I’m not sure how acupuncture helps me with that per se – I wouldn’t want to come off my antidepressants for instance. However, not having to manage almost daily migraine pain anymore has a considerable and

positive effect of my wellbeing. Recently, due to the outbreak of Covid-19, I was unable to have acupuncture for four months, during which time I had a severe twenty-four hour migraine which sumatriptan could not cure. Since resuming acupuncture treatments one month ago, I have had one chronic headache which was helped by sumatriptan. Over the past 30 years, I have found chronic migraine to be extremely debilitating and at times all consuming; at its worst, battling an almost constant pain and always worried that plans would be disrupted by a migraine. The success of acupuncture means I do not experience this anymore, and if I do get a migraine I know the sumatriptan will help. Acupuncture has had a major impact on the quality of my life. Member Spod Dutton writes: I took a five element approach, with outer fire (triple heater/pericardium) as the causative factor. The treatment plan was initiated with an AE (aggressive energy) drain. Subsequent treatments usually consisted of one or more points for the patient’s spirit such as ying tang, BL 43, DU 20, KID 24 and ST 8, followed by the command points on the triple heater and pericardium channels. Direct or needle moxa were used during most sessions. Treatments were initially weekly for four weeks, with ongoing treatments spaced every four to six weeks. To date, the patient has had twenty-three treatments over the course of two years. I’ve observed three significant events during the course of the treatments: • After just two treatments, the patient reported ‘No migraines or headaches – no ibuprofen, first time in twenty-five years.’ • Around treatment 14, the migraines were still under control but regular headaches had reoccurred. I did a second AE drain and the headaches diminished almost completely. • During the forced treatment pause of the first Covid lockdown, the patient’s migraines returned but were quickly managed following her return to treatment.

Inspiration

Acu. | Issue #30 | Spring 2021

Learning in lockdown Andrea Dewhurst Student Member: Hertfordshire

Of course, no-one could have anticipated 2020, or as I now call it, ‘the year that shall not be named’. In March 2020 we were just starting the second half of our second year. At the time I felt fortunate. We were not in the student clinic. All of our theoretical lessons could continue online. And our college adopted the whole process so quickly that our lessons almost continued uninterrupted. We turned up online each Thursday and Friday. Still learning. Still completing exams, assignments and classes, whilst also juggling homeschooling children and/or remote working. Whilst also managing stress and finances and sadness and anger.

We kept going.

Of course, I’m writing this in 2021 with our student clinic back on hold. Keeping going has felt tougher this time, personally. But I wanted to share with any other acupuncture students. That we can and will do this again. The suggestions I am offering are not exhaustive. And if you feel like all you can achieve, at the moment, is to survive then do what is right for you.

Continue to learn

Even if you keep going over the basics. I don’t think you can ever know yin and yang or the functions of the spleen well enough. Revisit pieces that seem basic, and I promise you will find something new. It is the beauty of this medicine. There is always something new. Read books, just because. I found reading a wide variety of books helped deepen my knowledge. I didn’t always (read hardly ever) understand. But sometimes those nuggets crop up in the oddest time. Learn about the history of Chinese medicine. Or about illnesses that interest you. I have just finished a book about Alzheimer’s. It had nothing to do with acupuncture. But health and wellbeing, in general, is our future. Surprisingly, the main thing I discovered about Alzheimer’s is that the food, exercise, mental activities, emotions we have in our lives are what manifest 20 years later with signs of dementia.

Learn to rest

One of the greatest things I learnt from studying is that rest is as important as work. Be kind to yourselves. You are living through a worldwide pandemic. Live according to yin and yang. The yang time of day is the morning. Big tasks, big meals, mental and physical work should be done during this phase. The yin time of day is the afternoon and evening. Rest, small and simple meals. Perhaps look for qi gong videos. They make you feel revitalised and move your body, without running the couch to 5K.

Acu. | Issue #30 | Spring 2021

Build a network

OK, maybe ‘this’ is the greatest thing about Chinese medicine. It is the people. I have never met a better community of wonderful, interesting and kind people. Social media and the regional contacts (you can look in the back of the latest Acu. magazine) have been such wonderful sources of friendship, knowledge and community. As good as I could have hoped to find. I reached out to my local regional contact and she has been so welcoming and encouraging. I joined their pre-Christmas ‘virtual’ meet-up and it was amazing to meet my future local colleagues. And social media may have many pitfalls, but without it I would not have met some of the most wonderful student acupuncturists from CICM, NCA, ICOM and TAA in England. As well as many students from Ireland, USA, Canada, Australia, Europe and many more. And that is just the acupuncture students. I have also virtually met, through social media, acupuncturists covering almost every country in the world. So, let these people show you and encourage you to keep learning. Because one day you will be part of them.

Tools to leverage

Social media can also be very useful for enabling your learning. Without pinpointing any names in particular, you need only search any social media platform for #acupuncture #acupuncturestudent #chinesemedicinestudent #acupuncturerocks #acupunctureworks and even my own #channelproject, and you will come across content that is encouraging your learning. Much of it even for free. I have been collating and building a list but thankfully, this is not an exhaustive list 〉 thechannelproject. co.uk/post/sharing-is-caring

Become the teacher

Are you particularly drawn to a subject in acupuncture? It might be point names? Or western medicine pathologies?

Or anatomy? I am drawn to the theory of Chinese medicine. I spend lots of time on it. I spent virtually no time (don’t tell my lecturers) on western medicine. So, my friend and I, in Year 2, made an agreement. I would teach her my Chinese medicine knowledge, and in return, she would teach me her western medical knowledge. By becoming the teacher we each became more adept at framing our language. The subject matter became more ingrained. And one extra surprising thing came from it. We encouraged the passion in each other. So now, I am more interested in western medicine and she is, in turn, better able to understand why I call the liver Jeff Bezos.

Take case studies

Take cases of friends, family members. People you meet on Zoom. Work colleagues. Heck, I even interviewed people in my local area when I put a call out. I promise you, this is one you will not regret. Take the case. Work through it. Think about your questioning. Think about the organ patterns. Or five elements. Or what the tongue is showing you. Keep practising. Keep revising. Because that is your future self. That is you in three years, or two years or one year. You will be questioning a future client, and at that moment this hardship will seem ages away. And you will be so grateful you continued.

Inspiration

WebWatch Member Veena Stephenson chooses her pick of online Covid-19 resources. Experts

Dr John Campbell 〉 tinyurl.com/nczxnj7n Dr Roger Seheult 〉 tinyurl.com/ b47fhpyu & tinyurl.com/hn7tv74z Vincent Racaniello 〉 www.microbe.tv/ twiv/ & tinyurl.com/53n5d7cx John Campbell is a UK-based retired nurse teacher and A&E nurse. Dr Roger Seheult is an associate professor of medicine in the US and co-founder of MedCram, set up to offer medical clarity. Vincent Racaniello is a professor of virology at Columbia University New York. All three share regular Covid-19 updates and discussions with other experts on current research and policy.

Updates

JAMA Network 〉 tinyurl.com/4y93nf3r & tinyurl.com/cvm9wvs7 BMJ's Coronavirus (covid-19) Hub 〉 tinyurl.com/25ksa8ub HHMI Science 〉 tinyurl.com/2zrdjne2 JAMA Network is a collection of 12 international peer-reviewed medical journals. Covid-19 content includes an introduction, updates, and conversations with frontline clinicians and experts. BMJ hub offer free information with daily updates to support health professionals and researchers. HHMI have a Science of Covid-19 seminar series: this one discusses the molecular biology of coronavirus infection.

Long Covid

NHS England 〉 tinyurl.com/7vnvsctw The Lancet 〉 tinyurl.com/33bm9x6y Latest news about treatment for long Covid and the NICE guideline.

Paediatrics

COCA/CDC 〉 tinyurl.com/5fbhxpv5 Clinician Outreach and Communication Activity (COCA) webinar on multisystem inflammatory syndrome in children (MIS-C) associated with Covid-19.

Immunology

Frank Lectures 〉 tinyurl.com/3ue39kt5 Of the many online medical tutorials, I found the series by Dr Shivani Pandey of Frank Lectures very clear in the verbal and visual explanations. This overview is the first in a comprehensive series. Why not share your favourite online resources with other members by sending a link to WebWatch via editor@acupuncture.org.uk

Inspiration

Acu. | Issue #30 | Spring 2021

‘It’s not working’ Locked down in a Lake District winter wonderland, John Hamwee decided to investigate why the practitioner-patient relationship can sometimes suddenly turn icy

John Hamwee Member: Cumbria Over the years many patients have decided to stop having treatment and they have given me a variety of different reasons for doing so. Although I have chosen to have regular treatment myself, I usually understand their reasons and I am perfectly comfortable with their decisions. Perhaps the symptoms cleared up completely; or maybe, after a reasonable number of treatments, nothing much seemed to have changed; or possibly there was as much improvement in a chronic condition as we both could have expected. However, sometimes a patient will say that he or she is stopping treatment because it isn’t working, even though I think it is. Assuming I am not the only practitioner who has

had this experience I thought it worth investigating. Looking through my notes, a few categories start to emerge. The most obvious one is that the treatment is working alright but I have made a mistake, or a series of mistakes, which undermine the patient’s trust and belief in me. I’m not thinking of mistakes in diagnosis or needling which, for me, are an inescapable part of normal practice, but times when I have failed a patient in some way. It can be apparently trivial. I used to treat two sisters who had a close relationship, albeit with some deep-seated resentments and jealousies between them. One day, by mistake, and not once but twice, I called one sister by the name of the other. A week later I got an email cancelling her

next appointment as ‘treatment wasn’t working’. So my first category is of patients who say this because they don’t want to tell me that I have hurt or upset them – and that is why they don’t want to come back. The next category is where patients say it isn’t working because, although treatment worked well for a while, the symptoms then start to recur or even get worse. I usually think that it is a temporary dip and say so; sometimes I think there is a perfectly plausible reason why it has happened, and I explain that too. In other words, I think it is worth persisting with treatment but the patients don’t. It makes me sad, of course. It also leaves me with some uncomfortable questions. Am I overconfident? And if so, is it overconfidence in my own abilities, in acupuncture itself, or indeed in both? A fifty-year-old man came to me with what he described as chronic fatigue syndrome following a viral infection three years earlier. After two months of treatment he said that he had had a particularly busy week but had coped

Acu. | Issue #30 | Spring 2021 well; after three he had been to a film for the first time since he had been ill; and after four he had walked for five miles and felt none of the expected after-effects. After six months he reported that his energy had suddenly dropped to a new low and he felt he had gone backwards. I said that we knew acupuncture could work for him so I was pretty sure he would recover from this temporary dip. He agreed, though without much conviction. And at his next treatment he told me it still wasn’t working so he was going back to his GP for more tests and then do whatever the GP suggested. I asked him a number of times to explain his change of mind, but in the end I was convinced that he really did believe treatment wasn’t working and that was the only reason he had chosen to stop. I thought about why he might have come to this decision. It seemed to me that at the start of treatment he was willing to give acupuncture a go, however strange or implausible it seemed. As he got better he started to believe in it as a system of medicine. But then, when there was a reversal, he jumped to the conclusion that the previous improvement must have been a coincidence, or some kind of placebo effect which had now worn off. Along with the loss of faith came a kind of disillusionment with me, as if I had duped or at least misled him, with my optimism. He is not unusual. Other patients have made the same kind of decision and, I think, for the same sort of reason. So what is to be done? First, I tell my patients many times that regaining health is not a steady or consistent process; that each day, each week, will not necessarily be better than the last; that what matters is an underlying pattern of fewer bad days, which are less bad than before, and more good ones. Next I also make a point of changing the treatment. Even if I am fairly confident of my diagnosis, and even if the patient has done well with the kind of points and the kind of techniques I have used, I still change them. For one thing, the patient’s whole attitude to treatment has changed and that amounts to a significant energetic shift, so to carry on as before would be to ignore that reality. But to some extent I am trying to rekindle the patient’s original interest and hope. If it was the sheer novelty of acupuncture that amplified the effect of treatment last time, well then I can do something new again, and hope for a similar boost. Finally I take a long hard look at my own expectations and how I have communicated them to the patient. I am passionate about acupuncture so it is easy to slip into thinking it can achieve miracles routinely. We all know of successful treatments for back pain or headaches, for example, but what about my patient’s chronic fatigue, or

many of the other ills that people bring to us? Here are a few recent examples: severe acid reflux; violent itching only in the early morning; diabetes; putting on weight – ‘the less I eat the more I gain’; a mystery pain in one buttock; frozen jaw; and depression due to a sudden loss of faith in God. What is the line to tread between Tigger and Eeyore, between being bouncily overconfident on the one hand and gloomily defeatist on the other? Not an easy question to answer. My final category is where I can see significant change for the better through treatment, but the patient wasn’t looking for that kind of change or doesn’t value it when it happens. Here are two brief examples. A young woman tells me that when she gets ill she struggles to recover – spots on her face can last for months, a cold for six weeks and a headache for ten days. After three treatments, each a week apart, I notice that she looks very much better, with clearer skin and more shen in her eyes, and she says that for the first time she has managed to set some boundaries with her boyfriend. However, she adds that she has had an unusually bad headache for the past week so she is going to stop coming as treatment isn’t working A successful businesswoman tells me that she is ‘hopelessly lethargic’, has put on twenty pounds in the last two years, can’t go for a run like she used to and has eczema under her big toes. I discover that she has two teenage children, no partner and works a twelve-hour day. After six treatments, during which we get on well, she says she has cut her working day to nine hours, spends more time with her children, is sleeping better and is generally less stressed. However, she still can’t go for a run and the eczema is unchanged. She is adamant that acupuncture hasn’t worked. I don’t think it’s just a matter of persuading these patients to stick with treatment or with me; I think the issue goes to the core of much of our work. Many patients live with all kinds of stress, of pain and dysfunction, of agonising anxiety and emotional turmoil and so on, and it never occurs to them that change is possible; sometimes I don’t even know about something really important until the patient mentions, quite casually, that

Inspiration

it is much better. Although I always explain that acupuncture works on what is often called body mind and spirit, and all together, I think that many patients hear the words but don’t really absorb the reality of it. So it is hard for them to accept that something like starting to set boundaries with a partner or working more sensible hours can be a result of treatment. At a deeper level some patients may not even want to change. The young woman with the persistent headache was worried that setting boundaries might have jeopardised her relationship; even though, to my way of thinking, the relationship would never make her happy unless she did so. And the businesswoman told me, at her last session, that now she seemed to have more time she was thinking of opening a new factory – so back to twelve-hour days, presumably. It is not for us to judge, nor even to think we know what is best for a patient, but this kind of thing can be frustrating. I suppose there will always be a gap between what we believe to be possible and the changes any particular patient is willing to undertake; a thought which leads me to my last reflection. With most of my patients, I get interested in, and excited about, the enormous potential that acupuncture can have for them and their lives. But if patients don’t grasp that potential, or choose not to do so, then I can imagine that it makes them feel obscurely uncomfortable with me. They may sense that I am disappointed in them in some way; that they have failed some test they didn’t know they were taking, or that I want them to be someone they are not. So their response is to say, ‘it isn’t working’. The first rule of a genuinely therapeutic relationship is to accept patients as they are and for who they are. So when a patient surprises me by telling me that acupuncture isn’t working, I now think this may be because I haven’t done just that.

They may sense that I am disappointed in some way, or that I want them to be someone they are not

Inspiration

Acu. | Issue #30 | Spring 2021

Year of the Ox The following extract is taken from an online forecast by Lilian Pearl Bridges, well known for her expertise in face reading and feng shui and also a popular speaker at BAcC conferences.

Illustration: Yvette Masure

The farmer stares out across the fallow field and sees mud and downed branches from the storms of winter, knowing that first he must clean up the field and then wait patiently until the land is ready. When it is time, the farmer puts the yoke on the ox and slowly plows the field. Then the farmer plants the seeds and waits for them to grow. Eventually the farmer brings in a good crop, maybe two if luck is with him. This is the story of this Ox year. The Chinese Year of the Golden Ox started on February 12. The Ox (Cow) is the second animal in the Chinese zodiac system and is a respected animal valued for its ability to work hard and endure. The Ox is credited with the values of constancy and cooperation. These are usually slow-moving animals that are even-tempered and placid unless they are provoked. The element for Ox is yin earth, as it is an animal long connected to farming. The element for the year is yin metal, which is harmonious with the earth element, as earth generates and feeds metal. This implies a calmer and more stable year with less anger, less contentious behaviour and much less potential for violence. Yang behaviour will simply not be supported or be sustainable. Yin metal is about the future and our hopes and dreams, which can start to inspire us again. The overall outlook for the year is positive, especially towards the latter part of the year. Harvest comes in the summer and fall months, which also correspond to the elements of the year. So, there is hope that life will get better in many ways for many people as the year progresses. Life will feel more peaceful and less stressful, but this year requires patience. Forward movement will be mostly slow going toward desired and more ideal outcomes in the future. There will still be some restrictions on growth and movement, but these will lessen. Yin metal will make people and governments more efficient and subtly more productive so that by the end of the year there will be incremental achievements that together will amount to something more substantial. The hindsight gained from looking back to a turbulent 2020 gives this year a special quality and leads to overall themes of the year that involve reactivity and gives rise to many ‘re’ actions: regroup; rebuild; reform; restructure; restore; replace; recycle; renew; re-evaluate; reorganise; re-establish; revitalise and reinvent. The bad news is that there is likely to be a recession, but there will be happy reunions, some economic recovery and eventually rewards. This is due to the yin earth aspect of the Ox, which is involved with agriculture and the idea that you can plough a field more than once, sometimes several times in a year for new crops to grow. Health-wise, there is still some benefit for the immune system from yin metal. Yin metal lowers the over-reactivity of last year’s yang metal that caused so much inflammation. However, it does leave people open to more minor irritations, such as skin rashes, hay fever and other allergic reactions. And while Covid-19 will still be a problem this year, the infections are expected to be somewhat milder for many people and may not spread as rapidly. Lungs, skin and hair will be drier this year, so the use of humidifiers for the lungs, or hydrating yourself more or using moisturisers are all recommended. People will find themselves coughing and clearing their throats more, as phlegm will be harder to move out. It is recommended that people sing more and practise deep breathing to enhance the lungs. Digestion won’t be as strong this year, so it is advised to eat lighter or smaller meals, perhaps enhancing digestion with natural remedies, such as eating ginger or taking digestive enzymes, especially papaya and pineapple-based enzymes as tropical fruits belong to the earth element. Take care of yourself and those you love with special care and consideration, as promoted in the Chinese medicine teachings of yang sheng; nurturing life through positive lifestyle choices. Although the tail of the Rat will cause some trouble at the start of the year, the Ox will take over in a slow and steady way to improve circumstances in our lives. However, it will take time. So be ready to see incremental growth and avoid impulsiveness. Try not to be discouraged and have faith. Better times are coming… You can read Lilian’s full forecast on the Lotus Institute website 〉 lotusinstitute.com

Acu. | Issue #30 | Spring 2021

Inspiration

The way to do is to be It’s spring! Chinese New Year of the Ox. A time for self-reflection, new beginnings… and a very personal enquiry from Yvette Masure.

Yvette Masure Overseas Member: Portugal So who do you aspire to be in 2021? Words are powerful! But can New Year’s resolutions actually help? There is strong scientific evidence to suggest that people who know themselves – and how others see them – make smarter decisions, as well as being happier, better communicators, and more creative. And for the sceptics among you, I say: we live in a world rich in distraction, so invest in yourself… to be of better service to those around you. Of course, it needs extra intention and focus to do so. Let us look towards the future, rooted in the wisdom of the past and with a little bit of help from Lao Tsu. ‘When I let go of who I am I become what I might be. Mastering others is strength. Mastering yourself is true power’ To begin I suggest you choose one or a few words to guide yourself through 2021: to rekindle something inside you, to encourage you, to move you in a different direction. Reset 〉 reinvent 〉 restore A word, or a few, to help you tune up more consciously in the year ahead, perhaps bringing out another aspect of your character, as yet dormant. New ideas are required in these challenging times. Let yourself grow. ‘There is a time to live and a time to die but never to reject the moment’ Find a genetic word or words: I like collaboration and connection, both needed in 2021. Measure yourself, finding an intention to move you, a beacon of light to nourish your selfdevelopment in the year ahead.

‘Knowledge is a treasure, but practice is the key to it’

‘Doing nothing is better than being busy doing nothing’

If you are characteristically inwards and deep thinking, look towards the more outwardly-focused you. If you are outgoing, or spontaneous, take time over this, be thoughtful and questioning. Give yourself time, to grow.

Habits and intentions: Work on changing behaviours. The best way is habit building. We are what we do.

List a few of your favourite words: Words that invoke something meaningful. Words are power after all. Collaboration and connection evoke imagery to me, of the honeybee, and other such animals that survive and thrive. What imagery do your words evoke? Share the imagery and story behind your words. Write it down. Discuss with someone.

Yes, acting out new behaviours could seem or feel superficial initially. But new habits take root. New ideas shared bring it to fruition. New friends and colleagues outside your existing area of focus broaden your horizon. Find someone in your existing network who you have not connected with for over a year. ‘Time is a created thing. To say “I don’t have time” is like saying, I don’t want to’ Spend five minutes, five days, five weeks reflecting on what your word or words are.

For me, bees are habitual, and they serve a purpose to maintain the ecosystem in natural habitat, that the laws of nature provide. They also live on the wing, and flow with the seasons, opportunity along the way… finding nectar, their intention. What is your intention?

Invest in yourself. Explore yourself. You are allowed to ‘not want to’. Just see who you are, how you feel, and work from there.

Create values: Constellations around your chosen word or words. The values give you more insight into the person you would like to grow into. They influence the type of decisions you will make.

Be more conscious and intentional about life, your life, by giving it a wonderful… reboot 〉 refresh 〉 to regenerate… that brings a momentum and direction, through the complexities of Life.

Now join with other explorers around a shared purpose. Think of who can help you, and who you can help. Work with energy multipliers.

‘The wise man is one who knows what he does not know’

All in all, have fun doing this. Be playful with yourself. Allow yourself to grow joyfully.

First and foremost, be kind to yourself. Love yourself as you are.

‘A man with outward courage dares to die, a man with inward courage, dares to live’ Health is wealth.

Inspiration

Acu. | Issue #30 | Spring 2021

Finding My Way In the following three extracts from his new book, Finding My Way: Memoirs & Short Stories, BAcC Fellow Peter Deadman shares some memories of his 1981 trip to study in Nanjing, China. All profits from the sale of the book go to the Chinese Medicine Forestry Trust.

Grilled mackerel

with radicchio & tangerines Jonquil Westwood Pinto Member: East Sussex A great spring dish to counteract any winter stagnation. Oily fish like mackerel are good for resolving damp and phlegm. The drying quality of the bitter tasting radicchio and cooked orange also help to resolve and transform any build up of these unwanted fluids. Ingredients 4-6 fillets of fresh mackerel 2 tangerines 200 g sprouting broccoli 2 radicchio heads 3 Tbsp extra virgin olive oil + extra for cooking 2 Tbsp balsamic vinegar 2 cloves of garlic, crushed Handful of fresh oregano leaves Zest of half a lemon Salt and pepper to taste Method Peel and segment the tangerines, cut broccoli into roughly equal sized stems and quarter each radicchio lengthways. Mix together two tablespoons of olive oil, balsamic vinegar, crushed garlic, oregano and lemon zest in a bowl. Pour over the radicchio, coating it well. Put the mackerel into a large roasting or grill pan. Drizzle both sides with a little olive oil and season before placing the fillets skin side down. Arrange the broccoli, radicchio and tangerines around the fish. Place under a hot grill. After 4-5 minutes remove the pan from under the grill. Carefully turn the mackerel, trying to keep the skin intact, and turn the vegetables to cook evenly. Place back under the grill for about 5 minutes, until the mackerel skin just starts to turn golden and bubble. Served with a green salad or just as it is.

Within an hour, the five beds lined up along the clinic walls were full, and several patients waited their turn to see the doctor. On one couch, a worker had rolled up his two pairs of trousers and two pairs of long underwear to reveal a winter-pale leg, and the nurse was fixing a big slice of moxa stick to one of the needles I’d inserted. She lit it and the comforting smell of the burning herb filled the room. On another couch a woman lay, the needles in her belly twitching in time to the pulse from an electroacupuncture machine. On the couch closest to the stove, an elderly woman was receiving treatment to restore movement to her stroke-paralysed limbs, while patients with migraine headaches, period pain and sciatica had already come and gone. When it was her turn, the next patient was called to the consultation desk. Dr Xiao asked precise, targeted questions and took a long look at her tongue. Then she rested each wrist in turn on a small blue cotton cushion with the name of the hospital printed in faded red characters. We fell silent as Dr Xiao spent an age gently pressing her pulses, as though playing a fine musical instrument, then asked us to feel them ourselves and tell him what we found. Finally, he sat back, gathered himself, and spoke. ‘This disease is sinusitis, not frontal headache. The patient has suffered from it for seven years since catching cold. It is made worse when she drinks alcohol or eats too much greasy food. Also when she gets upset. The pattern is phlegmheat in the Stomach channel. Now what points should we needle?’ Then – as always – he gave advice. ‘No more rich food. And you must stay calm; worry achieves nothing. But it’s OK, we can help you. Just come regularly for a while and you will get better.’ 'That’s right, you listen to the doctor and do what he says,’ shouted one of the waiting patients, drawn up as close to the table as possible to hear every word. ‘That‘s what the doctor told me and now my piles are almost gone.' After the first few weeks I was trusted to needle some of the patients. At the beginning, Dr Xiao was confused. ‘You know a lot of Chinese medicine theory,’ he said. ‘Very good! But you know nothing about needling.’ It was true. I had watched in astonishment as he plunged needles into acupuncture points – far deeper than anything I had ever seen in my three years of training in England. Sometimes – as he pushed a needle two centimetres below the eyeball into the socket, or beneath the ear lobe so far into the head I feared he would spear the brain – he reminded me of one of those circus performers who used to lock his assistant into a box and pierce it from all sides with long swords. And unsurprisingly, the patients felt it, sometimes shouting out with the intensity of the sensation. At the beginning though, when I needled them, they complained loudly that they couldn’t feel anything and these foreigners had no idea what they were doing. The treatment may sound brutal, but it was a revelation to me how powerful acupuncture could be, as patients – often with severe and intractable disorders – got better in front of my eyes. One morning the clinic door burst open and a young man staggered in. On his back was his brother whom he’d just carried up three flights of stairs (the hospital had no elevator). Dressed in filthy olive-green work clothes, this toughlooking peasant was clutching his right ribs and groaning in pain. After asking the brother a few questions, Dr Xiao didn’t hesitate in his diagnosis – biliary ascariasis (worms in the bile duct). This normally rare disorder was common among peasant farmers and was passed on by eating raw vegetables from fields fertilised with human manure – one of the secrets of China’s millennia-long history of sustainable agriculture. When the worms travel from the gall bladder along the biliary duct it causes a pain just like gallstones, which some say is the worst the human body can suffer. This man had been in agony for thirty-six hours, his brother said. He hadn’t slept in all that time, just cried out day and night. Dr Xiao took an acupuncture needle and inserted it next to the patient’s nose, pushed it through the flesh towards a point below the eye, and started twirling it vigorously. ‘This is an empirical treatment,’ he said. ‘The needle sensation has to be stronger than the pain.’ True to his words the patient stopped holding his ribs and started pointing at his face in astonishment. Thirty seconds later, he was snoring.

Acu. | Issue #30 | Spring 2021

The BAcC: where did we come from & where are we going? 1980-95 Council for Acupuncture – set up by the five member groups that went on to form the BAcC

1990 November BAAB established

1993 Spring EJOM publishes first issue: ‘Shen the Spirit in Chinese Medicine’

1995 June BAcC incorporated: first chair Joe Goodman

ia P Huber

Inspiration

The British Acupuncture Council was formed in 1995 – just over twentyfive years ago – out of the Council for Acupuncture (CFA: 1980-1995), a forum which comprised the five member groups: the Chung San Acupuncture Society (CSAS), the International Register of Oriental Medicine (IROM), the Traditional Acupuncture Society (TAS), the British Acupuncture Association and Register (BAAR), and the Register of Traditional Chinese Medicine (RTCM). This was a natural consequence of the collaboration which had formed the British Acupuncture Accreditation Board (BAAB) in 1990

1999 WHO release Guidelines on Basic Training and Safety in Acupuncture

2000 January General practitioner Harold Shipman convicted of murdering patients

1999 Appointment of first BAcC chief executive Mike O’Farrell

2000 November Publication of House of Lords report on Complementary Medicine

2001 Bristol Royal infirmary inquiry report published

BAcC Acting Chair: London When I first joined the Governing Board (GB) in September 2018, I wanted to find out more about the BAcC’s history and thus set out gathering information about it. Over the years the BAcC has always been chaired by acupuncturists. The list includes Joe Goodman, Jasmine Uddin, Ron Bishop, Susan Thorne, Charlie Buck, Phil Rose-Neil and Sarah Attwell. In this article I have put together what I have extracted from the annual reviews and what long-term BAcC members – especially Jasmin Uddin and John Wheeler – have been sharing with me.

to set standards for the teaching programmes in the schools associated with each body. The BAcC’s first Executive Committee had twenty-five members, five from each body. There were initially very few staff but this rapidly changed to the point where the first chief executive was appointed in 1999. There was an ongoing dialogue with the Department of Health (DH) about statutory regulation (SR) and it was widely assumed that acupuncture would follow osteopathy and chiropractic into SR through a private member’s bill in parliament. After the publication of the House of Lords Science and Technology Committee Report on Complementary Medicine in November 2000, the

Inspiration

Acu. | Issue #30 | Spring 2021

Acupuncture Regulatory Working Group (ARWG) was established under Lord Chan. The BAcC, with Jasmine Uddin as chair and Mike O’Farrell as chief executive, held an extensive consultation about whether to pursue SR, and this was endorsed as the BAcC’s primary objective at the 2002 annual general meeting (AGM). The ARWG, which put the BAcC, British Medical Acupuncture Society (BMAS), Acupuncture Association of Chartered Physiotherapists (AACP) and British Academy of Western Medical Acupuncture (BAWMA) around the table with lay experts, finally reported in September 2003. The report was received but not acted on immediately, and in 2004 the BAcC established the Acupuncture Stakeholder Group (ASG) to maintain the momentum. The ASG were invited by Skills for Health, a DH-funded body, to contribute to creating National Occupational Standards (NOS) for acupuncture. The final result was disappointing as it did not reflect the BAcC’s views and the BAcC set up a project group to write its own document, The Standards of Practice for Acupuncture (SPA). During this time the Harold Shipman

2002 ARWG established under Lord Chan

2002 AGM BAcC membership endorse pursuit of SR as primary objective

2003 Final report of ARWG released but not acted on

recognition towards the reduction of risk and protection of the public. The BAcC introduced mandatory continuing professional development (CPD) and support for first aid training in 2008. A shift from committees to paid staff carrying out all tasks was also implemented during that time. The BAcC experienced a rise of its profile, but at the same time the advertising standards authority (ASA) challenged BAcC members. In 2006 the DH had developed national guidelines for integrating complementary medicine into mainstream NHS mental health services (England and Wales) and into the NHS in Northern Ireland, and the BAcC thought that SR might still have a chance. However, over the following two years the political mood changed considerably, and in 2008 the big financial crash turned the government’s focus away from regulating professional bodies and onto very different issues. With the stalling of SR, the decision was taken to seek a royal charter instead. Several consultations and indicative votes took place, and eventually the Privy Council gave the BAcC the green light to submit its petition in May 2010 for their meeting in July 2010. The BAcC,

2004 BAcC establishes ASG with disappointing results

2006 BAcC publishes The Standards of Practice for Acupuncture

2006 DH national guidelines for integrating CM into NHS mental health services

2008 CPD becomes mandatory for all BAcC members

2003 Release of Dame Janet Smith’s report The Shipman Inquiry

scandal, the Stafford Hospital scandal and the Bristol heart scandal rocked the UK’s health system. Dame Janet Smith’s report into the Shipman scandal suggested that the General Medical Council (GMC) should have a far greater lay membership – to ensure more independence from the medical profession – and that self-regulation must be the norm for professions dependent on expertise, ethical commitment and professional pride. This reappraisal of regulatory mechanisms meant that the SR process was put on hold, and another working group under Professor Michael Pittilo was convened. The BAcC’s focus shifted towards revamping its own structure. A major organisational review saw many new committees being created. The regional group network was expanded and all of the professional codes were updated. DH reports started to further shift the rationale of SR from professional

some committees. In February 2011 the government announced that SR for acupuncture was no longer a priority because the profession was robustly self-regulated. Instead, they created the Professional Standards Authority (PSA) in 2012 to extend the regulation of voluntary registers. With the charter-induced changes the BAcC was well equipped to become one of the first associations to apply and it succeeded in gaining accredited status by 2013. However, with the original BAcC members starting to reach retirement age and a difficult financial climate, a decline in membership numbers became a reality. In this period three colleges closed, bringing the accompanying threat of fewer new members. Frustration increased in 2013-14, with more and more short acupuncture training programmes undermining our standards. The BAcC reminded policymakers about BAAB and World Health Organisation (WHO) standards. Under the chairmanship of Charlie Buck members were supported with new regional groups, professional development leads (PDLs), the ARRC symposium, business support programmes and an NHS

expertly led and chaired at that time by Susan Thorne and greatly assisted by our secretary John Wheeler, undertook a huge amount of work to be ready in time. There was bitter disappointment when a last-minute counter-petition by one of the smaller associations of the ARWG caused the process to become deadlocked in discussions, with no prospect of a happy outcome. The charter petition was suspended and will remain there unless and until the charter embraces the whole acupuncture profession. The charter discussions had revealed that the BAcC committee structure needed to be improved. As the membership peaked at over 3,000 members, the BAcC had effectively outgrown volunteer work. Under the BAcC chair, Susan Thorne, and the chief executive, Nick Pahl, a governing board was installed for the first time and specialist staff appointed to replace

2010 Inquiry begins into NHS and poor care at Stafford hospital

2011 Government says SR for acupuncture no longer a priority

2010 May Privy Council gives green light to BAcC royal charter bid

2011 BAcC establishes Governing Board

commissioning workshop. Talks were held with the Association of Traditional Chinese Medicine and Acupuncture UK (ATCM) and the Register of Chinese Herbal Medicine (RCHM). In 2015, with the BAcC 20 years old, a new BAcC branding was introduced, which re-emphasised traditional acupuncture. The chair, Charlie Buck, and chief executive, Nick Pahl, reached out more to members in Wales, Scotland and Northern Ireland, with meetings and support for local issues. By 2016 BAcC members were recognised in the Welsh Public Health Bill. The BAcC lobbied the Scottish parliament against fees for members. The National Institute for Health and Care Excellence (NICE) was challenged over their guidelines and the BAcC continued to lobby the ASA. A new partnership with Anxiety UK was established. In 2016 Nick Pahl resigned. Rob Strange held the office together for the

Acu. | Issue #30 | Spring 2021 interim period until Paul Hitchcock was appointed and took over. The programme of changes put forward by Paul was ambitious but did not find favour with much of the membership and ultimately led to his departure. Rob Strange followed by Teresa Williamson held the fort until a new chief executive could be appointed. Many services continued – such as the conference, symposium, Acu., regional groups and mentoring, as well as the basics of maintaining professional standards and regulatory functions – thanks to a lot of work by staff. However, there was no strategy for the development of our organisation. During 2018/19 with many new GB members bringing in fresh expertise, a new strategy was developed involving a strategy focus group consisting of volunteering BAcC members. In consultation with BAcC staff and the GB, the strategy was formulated and finalised in late 2019 to be launched in 2020. During 2019 the GB held long discussions about whether the BAcC needed or wanted another chief executive. The GB concluded that the role should be retained, but very careful work should be put into the job description, selection procedures

2012 Government sets up PSA

2013 BAcC gains PSA accredited status

BAcC members. Initially all members were asked to stop faceto-face practice – to save lives, stay legal and stay insured – and were transferred to non-practising membership subscription. This meant an immediate shortfall of about one quarter of the BAcC’s yearly income and led to an acceleration of the planned staff restructure to save the BAcC from going bust. Fantastic collaboration with the RCHM – more specifically between Alex Jacobs and Paul Blacker – enabled the rapid production of Covid-19 secure guidelines enabling members to go back to their clinics as soon as the full

and assessment before and after recruitment, as well as into the drawing up of the employment contract, in order to ensure best practice. After two recruitment rounds Jennifer Norton was appointed and took up her position in December 2019. Jennifer found very quickly that the prolonged uncertainties experienced by staff, who had been without a continued clear leadership or strategy, had left its mark. She was in agreement with the GB that in order to create clarity and streamlining of the work a restructure in the staff team was necessary. In March 2020 the first UK lockdown forced the furloughing of over half of the staff, with a small team maintaining the operation of the most important parts of the BAcC by working from home. The GB with the chief executive had to come to quick and clear decisions on how to interpret the ever-evolving government rules for

UK to get back to work. Several local councils looked to the BAcC for direction and the Covid-19 secure guidelines developed in collaboration with the RCHM have supported these moves. More recently the BAcC has set up an acupuncture recognition working group. It will involve re-examining SR and a charter as well as other, possibly more promising, avenues to getting better recognition. Covid-19 shattered all plans to celebrate our 25th jubilee year in 2020 as instead we had to do a lot of firefighting. However, with a new strategy and thus with renewed plans to move our organisation back on track to serve us members well, my hopes for the future of the BAcC are that we:

So, looking ahead, let us now all work together with a renewed vision for our future

2015 BAcC rebrand emphasising traditional acupuncture

2013 Anne Milton, MP and Peter Hain, MP nominated as BAcC patrons

Inspiration

2016 Welsh Public Health Bill recognises BAcC members

2019 December Jennifer Norton appointed as chief executive

2016 BAcC enters partnership with Anxiety UK

lockdown was lifted. Now what? Covid-19 will probably be around for a little while longer, however the vaccination programme and the natural course of pandemics allow for hope that society will be able to soon move beyond the current crisis phase. Jennifer Norton and her team’s weekly enews, as well as new online townhall meetings and regional meetings organised in reaction to local Covid rules, has meant that many BAcC members have renewed or fired up their engagement with each other. Covid-19 has forced us to look again at where we stand. We have made quite a few political gains: By virtue of PSA accreditation and the NHS Act we are more recognised as healthcare practitioners; although the government has not clarified the legal interpretation of this categorisation, the BAcC has used it to help acupuncturists in all areas of the

2020 March First UK lockdown: BAcC staff furloughed or working from home

2021 New BAcC five-year strategy finalised and released

2020 Covid-19 secure guidelines produced in collaboration with RCHM

• •

•

continue to develop to serve members in the best possible ways foster collaboration, exchange, mutual education and camaraderie in all our members uphold our standards keep on critically examining the internal workings of the BAcC and adapt where necessary reach ever more patients to help them experience the amazing healing power of our medicine.

So, looking ahead, let us now all work together with a renewed vision for our future. With thanks to John Wheeler, Jasmine Uddin, Paul Blacker, Mark Bovey, and Naresh Rao, for their knowledge, support and help in crafting this history.

Opinion

Acu. | Issue #30 | Spring 2021

What is it we want?

For the purpose of this discussion, I will be referring to acupuncture as a patient-centred, holistic intervention with the practitioner as a clinician able to choose their own method of treatment, rather than a technician following set protocols dictated by a centralised authority.

Paul Johnson Member: Surrey

Should acupuncturists aspire to be recognised as part of mainstream medicine in the UK? In the 20 years I have been in practice there has always been the idea that research into acupuncture is increasingly positive in its outcome, and that, as a result, acupuncture is becoming much more widely accepted by the medical community; but is that really the case? At one point it seemed like our profession was on course to align itself with 'scientifically plausible’, state-regulated allied health professionals, but lack of protection of title or ‘chartered’ status was never achieved. What direction should our profession take? Should acupuncturists aspire to be recognised as part of mainstream medicine in the UK, working for a wage (rather than volunteering for free)? Does mainstream healthcare provision – and in the UK we are referring specifically to the NHS – even want us? During the course of writing this article I spoke to acupuncturists both inside and on the edges of the NHS, to enable me to understand the key issues involved in answering my question.

The science bit

There has certainly been an immense growth of credible research into acupuncture in the past two decades. In 2000 the German Federal Committee of Physicians and Health Insurers instituted a series of trials into acupuncture to develop an evidence base for acupuncture – widely known as the GERAC trials – which concluded that acupuncture is effective for a range of chronic conditions with acceptable cost-effectiveness. The Acupuncture Evidence Project (2017), commissioned by the Australian Acupuncture and Chinese Medicine Association Ltd (AACMA), was a distillation of systematic reviews and meta-analyses from 2013 to 2016 showing evidence for the effectiveness of acupuncture for 117 conditions, although evidence of costeffectiveness was identified for only 10 conditions. 〉 tinyurl.com/1po608yt Here in the UK, since as far back as 1983, Acupuncture in Medicine (AIM) has been publishing articles using the ‘Western understanding of neurophysiology and anatomy to interpret the effects of acupuncture’, although it does consider ‘evidence-based articles on traditional acupuncture’. To discuss the possibility of integrating acupuncture into mainstream healthcare provision in the UK, one of the issues we need to address first is the ‘What constitutes acupuncture?’ question. Dry needling is used by some physiotherapists in outpatient settings, and of course there are a limited number of acupuncturists working in the NHS itself, such as Beverley de Valois who has done remarkable studies into the use of traditional acupuncture in various cancer settings. The Gateway Clinic in Lambeth still operates as part of the Guy’s and St Thomas’ Trust, and the Royal London Hospital for Integrated Medicine includes (medical) acupuncture on its list of therapies, but these are notable exceptions to the accepted norm.

The NHS?

In 2013, the Any Qualified Provider scheme was a way for the NHS to commission a range of services, in various settings, for certain conditions. Physiotherapists, osteopaths, chiropractors and acupuncturists were able to bid to supply treatments for the NHS. This was poorly advertised within the traditional acupuncture community, resulting in very little uptake. The fee for the individual treatments was minuscule, with practitioners only able to recoup their expenses by retaining their patients as fee-payers once the NHS-sanctioned number of treatments was exhausted. In the past, acupuncture had been begrudgingly accepted for a number of conditions by the National Institute for Health and Care Excellence (NICE), but even this has now been whittled down to just tension-type headaches and migraines. To shed light on my original question, perhaps I should rephrase it as, ‘Does the NHS want us to be part of their healthcare provision?’. NICE published a draft guideline in August 2020 called Chronic Pain: Assessment and Management [G] Evidence Review for Acupuncture 〉 tinyurl.com/y538aybe Mark Bovey summarised the draft guideline on page 9 of the Autumn issue of Acu. [Final publication date is now expected to be Wednesday 7 April.] Coming in at a weighty 212 pages, this review asks, ‘What is the clinical and cost-effectiveness of acupuncture or dry needling for the management of chronic primary pain?’. The answer to that question seems to be a bit of a fudge. The review agrees that, ‘Acupuncture treatments offer the opportunity to treat several painful places and affected body functions at one time, which makes it an attractive option for people with many ailments and emotional components to their predicament’. Operating on an eversqueezed budget, the NHS rightly needs to show the cost-effectiveness of an intervention, and the study seems to pussyfoot around the issue, stating that some studies show economic effectiveness but then discounting those and stating that uncertainty about cost-effectiveness still remains. It struck me that there were two interesting issues (amongst others) cited in this review for not recommending acupuncture. One is a concern that the therapist themselves ('practitionereffect’) might have a significant influence on the outcome of the intervention. So, they like the idea of the therapy, but not the therapist – if only they could get rid of the pesky acupuncturist, everything

Acu. | Issue #30 | Spring 2021 would be OK! Death by assimilation has always been a concern for acupuncturists – that being absorbed into mainstream health provision would run the risk of us losing everything that is good about the way we work. The other issue of interest to me in the review was the observation that a recommendation to supply acupuncture could have a resource impact to the NHS in England given the large size of the population living with chronic pain, noting that ‘acupuncture used to be widely available in clinical settings but many services have been decommissioned over recent years’. Basically, given the option to have acupuncture over drug-based therapies, too many people might go for the acupuncture option (never that ‘widely available’ to my knowledge) that the NHS has allowed to wither! Why would that be the case? Why might a substantial number of people choose the acupuncture option? Is that because we sit outside of the medical mainstream and offer an alternative approach to healthcare that looks at people in a holistic manner, treating a number of conditions and ailments simultaneously? A colleague who worked in the first NHS complementary therapies unit in Westminster – now closed – told me that one of the biggest issues he faced treating patients within the NHS was that he was told to address only the symptom that patient was referred for, and not the constellation of other conditions that the patient presented with and might request him to address.

Integrated healthcare?

But what of the sunlit uplands of integrated healthcare that we were all promised? In the Chinese healthcare system you might be offered any mixture of herbs, acupuncture, tuina and drug therapy. In Europe, the picture is different due to the primacy of drug therapy and the dominance of Big Pharma. A meta-analysis of studies into the integration of acupuncture into conventional healthcare (GarciaEscamilla, Rodriguez-Martin & Martinez-Vizcaino, 2015 〉 tinyurl. com/y4u3t22e) discusses the fact that although some healthcare providers are interested in acupuncture for its holistic and patient-centred approaches, there are a number of barriers preventing its adoption: primacy of the biomedical model, time constraints, lack of economical compensation, funding, institutional support, scientific evidence and recognised teaching levels. Time constraints were highlighted as a particular concern: acupuncture that we, as practitioners, deliver is simply too expensive to be used. Where acupuncture has been integrated into mainstream healthcare, it is typically using a biomedical model (‘medical acupuncture’). Subordination of medicine to economic concerns means that traditional acupuncture is simply too expensive to be considered.

A colleague who works both as a nurse in the NHS and in a private acupuncture practice told me that she had a referral from her local clinical commissioning group (CCG) for a patient able to choose funded acupuncture treatment as part of a personal health budget. These do indeed exist, but their availability is limited at the moment and once again, hardly a priority for the NHS. Until the acupuncture profession has a clearer evidence base, it will struggle to find an accepted place in health and social care provision. As always, funding to provide such research is not forthcoming.

What do BAcC members want?

A BAcC membership survey of 2017 gives insight into what its members think and want 〉 tinyurl.com/ y232p5xf Over 50 per cent of those polled felt that western medical professionals they had been in contact with thought that acupuncture is ‘somewhat accepted’. This acceptance is, however, somewhat piecemeal. When I moved into my local area, I asked if I could speak at the local GP practice meeting. The response was that no, I couldn’t speak, but they ‘couldn’t stop me working if I was properly qualified and insured’. Hardly a ringing endorsement. The next I heard from them was several years later when they had some spare space to rent out and wondered if I was interested in hiring it! Over 60 per cent of that same poll felt that acupuncture should be recognised as part of the mainstream health and care landscape in the UK, with a similar number wishing to be paid by the NHS to deliver traditional acupuncture whilst working independently from it. This would be the dream ticket, but I am not holding my breath! As we have seen above, time is money and the NHS struggles to deliver the core services it is already committed to. So maybe, as traditional acupuncturists, we are better turning our backs on the idea of integrating into mainstream healthcare provision in the UK. Maybe we need to be less idealistic and more pragmatic. Maybe my initial question should be rephrased yet again as, ‘What benefits could closer alignment with the NHS offer me as a practitioner?’. At this point, I struggle to see what they might be. I think my clients come to me specifically to

Opinion

experience something outside of the established health system – and that includes the scientists, nurses, doctors and consultants that I have treated in my practice. If integration is not to be our goal, then perhaps increased recognition should be. In the aforementioned BAcC survey, a whopping 99 per cent agreed that the main activity our membership organisation should engage with was developing the standing and perception of the profession. We would like recognition that we, as clinicians, can operate in areas where there may not be conventional treatments, or where there are a number of comorbidities that western medicine tries to manage one by one. We have the diagnostic tools (and time) to look at the patient as a person, not just a collection of pathologies. Acupuncture is perhaps an intervention that avoids some of the shortcomings of conventional treatments by taking a patient (person?)-centred approach to ill health that includes the social, emotional, and – dare I say it – spiritual aspects of being human. Does this then mean that acupuncture should become a reserve of the middle classes who can afford treatment? What about patients who would greatly benefit from our treatment but can’t afford our fee? Hopefully, with the growth of community and multibed acupuncture, our treatments can still be affordable to a large percentage of the population.

Time is money and the NHS struggles to deliver the core services it is already committed to

What do you think?

This is, of course, a personal opinion, and I expect that there will be others who heartily disagree with me. People I have taught point location to over the past two decades probably think of me as having a black-and-white approach to my work, but I embrace the grey area that acupuncture currently sits in – grudgingly recognised by science, but still on the fringes of mainstream medicine. Do you have opinions about where the UK acupuncture profession should be heading? Send us your thoughts – however brief or lengthy – to editor@acupuncture.org.uk

Community

Acu. | Issue #30 | Spring 2021

On reflection

Pia Huber BAcC Acting Chair: London

The new Chinese year gives me reason for a big sigh of relief. I am not too familiar with the Chinese zodiac, I have to admit, but reading through the forecast from Lillian Pearl Bridges on page 24, I hope with all my heart that the year of the ox does indeed bring us what it promises – namely more stability, less anger and more harmony. The BAcC is a broad church. It houses acupuncture styles as diverse as five element, TCM, the Balance Method, Master Tung, channel palpation, stems and branches, Kiiko Matsumoto, toyohari meridian therapy and Japanese acupuncture, and many more. In fact, each and every acupuncturist develops their own style and brings their own skills and talent to the couch. This is very exciting as we can have interesting exchanges and learn from each other. Sadly, it can also lead to division and infighting. The past year of the rat has been full of division, in the UK over lockdown versus not lockdown, hard Brexit versus soft Brexit, in the US being for Trump or against Trump. The BAcC wasn’t excluded from this division: practitioners who wanted to carry on working regardless of Covid infection numbers and others berating the BAcC for not stopping practitioners earlier or more often. Some BAcC members can’t wait to get their Covid vaccine while others despise vaccines and the whole industry behind it. So how do we work together in such a divided world? To all those divisions and arguments often played out on social media platforms and in strong worded letters to the BAcC – in the name of the Ox – I would like to call a halt. Let’s review, rebuild and revitalise our common ground. I was happy to start working in my clinic as soon as we could in June last year, but I respect and understand that others have taken a

much more cautious approach as they want to wait for what they feel is a much safer environment for them. I still vividly remember the sentiment (if not so clearly the detail) of a lecture at a BAcC conference given by Danny Maxwell, editor of the Journal of Chinese Medicine (and also one of my teachers during my acupuncture training). Danny called all traditional acupuncturists to remember and honour our common ground: yin and yang and qi, the fundamental concepts for all our different styles. Yes, I would agree, let’s keep asking questions and exchanging ideas and opinions. But let us do this with respect, honouring each other’s styles and views. And let’s listen to each other with open ears and with an open heart. I am deeply impressed by the article on page 18 by John Hamwee. What great honesty, what wonderful searching and amazing reflection comes out of John’s contribution! John has beautifully expressed many of the thoughts and sentiments I have had over the years. And yet there are other voices with which I may agree less, and I try to listen and to understand. Our new Professional Recognition Working Group (PRWG), for the advancement of acupuncture recognition in the UK, will only have a chance to move forwards if we listen to each other and value each other’s talents and skills. At the same time of course, it is important also to honour our traditions and build on our very high standards, which have not gone unnoticed as evidenced by the recent reassessment of acupuncture by the Office for National Statistics (ONS). A fantastic collaboration with our colleagues from the Register of Chinese Herbal Medicine (RCHM) over the past year has opened up new ways of working together. I would love us to find common ground with other acupuncture bodies and explore how we may work together. I hope that we can build more bridges to other therapists who use ‘the insertion of very fine needles’ in order to promote a safe and powerful way to help patients find relief and healing. Let me finish my reflections by revisiting the news, previously sent out in enews, that Sarah Attwell has decided to step down from the Governing Board (GB) and her role as chair, in order to be able to fully attend to her new son and her family. We wish them all the very best. I would like to give my heartfelt thanks to Sarah for her chairing of the GB over one of the toughest times we have faced in the last 25 years. She did it brilliantly!

Acu. | Issue #30 | Spring 2021

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Covid & the colleges Harriet Lansdown Lead Accreditation Officer: BAAB

I don’t need to tell you it’s been a difficult year, but I do want to tell you about how the staff and students of the accredited course providers have responded to the challenges posed by the pandemic. The course providers have demonstrated enormous resource and dedication to ensure, wherever possible, that teaching and learning can continue. Initially this meant moving all their teaching online, which had to happen really quickly. Since then, they have worked hard to create Covid-safe environments for practical skills and clinical classes, whenever it’s been possible to keep premises open. They could not have done this without the active collaboration and support of their students, who have shown their commitment and professionalism by continuing to study assiduously in such trying circumstances. Many students have had to study whilst managing jobs as frontline key workers, home schooling their children, dealing with problematic internet connections and having to share computers with everyone in the family. The situation has required everyone to be flexible, to stay in regular communication with each other, and to appreciate the difficulties everyone is dealing with. We have seen this being achieved with dedication, hard work, creativity and positivity. The British Acupuncture Accreditation Board (BAAB) has also strived to keep in touch and actively listen to the course teams and their students to find how we can support acupuncture programmes to continue to be delivered. One of the biggest problems has been with clinical practice. Even when student clinics have been able to open, numbers have had to be kept to a minimum, and travelling to clinics has not been advisable. As all acupuncturists practising in the

pandemic know, the extra safe practice requirements are timeconsuming, and fewer patients can be seen. All this has resulted in delays for students achieving their clinical hours. Frustratingly for some, they only had a few hours left to complete. The BAcC and the BAAB have agreed that students due to graduate before 1 October 2021 can achieve the final 40 hours of their clinical practice under ‘indirect supervision’ from their college, with the benefit of full membership of the BAcC. They must have passed all other course requirements and will have to demonstrate when they have successfully achieved their full clinic hours. The BAAB has also introduced 30 hours of video consultations that may be counted towards clinic observation. This allows students to remotely view patient consultations and treatments in clinic and participate in the discussion. Assessments have also had to change. Taking a timeconstrained unseen exam under the watchful eye of an examiner uttering ‘you may now turn your paper over’ is not possible at the moment. Sitting such exams from home runs the risk of plagiarism and cheating. New arrangements have had to be put in place quickly, and have led to creative solutions; for example, setting more complex questions, written answers replacing multiple choice questions and essays replacing exams. Such changes have to be agreed with students and the BAAB must ensure standards are maintained. With all this, the BAAB has also kept everyone closely informed about how the higher education community as

a whole is managing changes, as well as ensuring our degree-level courses maintain parity with everyone else. Something which has really been changed by the Covid era, is the extent of communication made possible by meetings of all kinds being held online, opening them up to a much wider audience. We were able to invite student reps, as well as teachers to our annual education day in June last year. Without the time and expense of travel, we had our largest attendance to date, and the contribution from students really enriched the discussions. We’ve held accreditation events online, and appreciated increased numbers of staff and students being able to join meetings. The BAAB has been invited to attend Quality Assurance Agency (QAA) events for professional, statutory and regulatory bodies (PSRB) online. We’ve been able to engage and be recognised in a way that hasn’t been possible previously. This opportunity has probably been supported by the Office for National Statistics (ONS) reclassifying acupuncture from unit group Standard Occupational Classification (SOC) 2010 (associate professionals) to major group 2 in SOC 2020 (professionals). The reclassification happened because in 2020 over 50 per cent of acupuncturists were recorded as having a degree-level education. This, along with the BAcC’s accreditation with the Professional Standards Authority (PSA) has led to the Department of Health and Social Care confirming that BAcC members are considered frontline healthcare workers in the context of the vaccination rollout. So, it’s been a difficult year, but one that has also been full of opportunities.

We've been able to engage and be recognised in a way that hasn't been previously possible

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Acu. | Issue #30 | Spring 2021

An extraordinary year in the life of TAA Julie Reynolds Joint Principal & Head of Clinical Year: TAA

So… 2020, what can we say?! Huge personal challenges, but some real opportunities too, in the face of this once-in-a-lifetime pandemic. In some ways, we were lucky. Firstly, our 2019 move into a lovely, light, and well-ventilated new building, right in the heart of Leamington Spa, gave us space and good air circulation, enough to be able to run Covid-secure classes outside of lockdown. The first lockdown in March also brought home how lucky we are compared to most UK universities, as blended learning has always been embedded at the heart of our curriculum. Students kept on learning remotely then, if their lives permitted, and we all stayed connected in a healthy, positive and familiar fashion through our virtual learning environment (VLE). And what about Zoom? Previously uncharted territory that proved invaluable in so many ways: regular group meetings and tutorials, acupuncture pub quizzes (beer optional), and even a couple of Zoom graduation events! So, our e-lessons did the ‘teaching’, our usual forums fielded questions, and Zoom meetings pulled everything together for individual cohorts. All worked a treat, exceeding expectations really, so Zoom is here to stay as an extra benefit. And practical work during lockdown? Not so easy, but Zoom stepped in again, as did our new Facebook offshoot, the TAA Playroom. Light-hearted sharing of clips of family members reading for diagnosing sound, sharing videos for possible emotion/energetic, setting tasks to develop our odour diagnosis; all student driven, and as upbeat and fun as possible as many were faced with home schooling, key working, or both! While we haven’t been able to speed students towards graduation then, we have massively consolidated learning and had a lot of fun at the same time.

Our lovely new building

Our clinical year groups deserve special commendation for adaptability this year. They all rose to the challenge, taking on board the huge amount of additional guidance on safe practice, at a time when they already had to cope with everything being new and a bit scary. Their professionalism throughout has been incredible. S2017 have now graduated and are building their practices, and M2018 have already helped many patients as prequalification practitioners. We are so proud of all of them! Our experienced graduates too have been doing great work: Cara Beckinsale, M2012 graduate, presented a BAcC webinar recently on her project in Brighton and Hove, working with colleagues to provide treatment to NHS workers. This was so successful that one NHS trust decided to put aside funding for staff treatment. Another incredibly positive project here at TAA is our student mental wellbeing research clinic. Funded by a BAcC research grant, this multibed clinic offered eight free treatments to

local university and college students aged 18-30 who were experiencing mental wellbeing issues. Lucy Ward, Lucy Priest and Clare Watkins provided excellent treatments, aided by Sue Harrington in data collection and analysis. Later, more recent graduates Michelle Venter and Lucy Inman joined the treatment team, and now do a fantastic job running the permanent clinic that has grown out of the project. While the mental wellbeing clinic was suspended during the first lockdown, we analysed the data already received. At that time, 24 participants had completed at least five treatments, and 96 per cent had experienced a clinically significant improvement in their main symptom. Some of you may have seen Michelle presenting the interim results at a BAcC webinar in September 2020, still available online here 〉 tinyurl.com/y2vybvss We have now completed treatments for all participants, so watch this space for the final data. We hope the results will help all members wanting to run something similar in their communities. We’ve had many trainee doctors from Warwick Medical School participating as patients in the study (obviously a very stressful course!) and they all plan to recommend acupuncture to their own patients when qualified. We’ve even been pleased to welcome two of the study patients onto our college Advisory Board, as well as one participant who decided to study with us. Another exciting project coming to fruition now is the analysis of outcomes data for patients treated by our clinical year students, 1,600-plus treatments over five years. An interesting thing to come out of this data was that the most common reason for seeking treatment was long-term musculoskeletal pain. Ok, so far, so not new: BUT this has historically been an area where five element acupuncture has been considered weaker. No surprise to any of us here, but in fact 91 per cent of patients reported a clinically significant improvement in their main symptom after just five treatments, and 94 per cent reported feeling better overall at follow up.

Acu. | Issue #30 | Spring 2021

Community

The classic of difficulties Guiltiest pleasure

Eating Eccles cakes by the packet

Favourite song lyric

As Abdul’s long knife was extracting the life In fact he was shouting ‘Huzzah’ He felt himself struck by that wily Calmuck Count Ivan Skavinsky Skavar

Desert island disc

Beethoven String Quartet 15 in A minor Op 132

Desert island film

The Last of the Mohicans

Desert island book

Ulysses, 'cos there’s no excuse not to on a desert island

Hero/heroine

Liu Bei, scion of the Imperial House

If you weren’t an acupuncturist what would you be doing? Marine biologist: somewhere with beautiful seas

Superpower of choice

The ability to mete out justice without getting caught

A one-way ticket to…

Top: Pre-Covid classroom Above: Just some of the class of S2016

Anywhere in the NW Highlands

Which word/phrase do you overuse? Why has my phone done that?

Looking ahead, 2022 will be our tenth anniversary year (yes already!!), and to celebrate we have been inspired to begin collating case studies for a publication which will also honour the life of Hugh MacPherson. As my MSc supervisor back in 2005, Hugh empowered me to put my learning into practice. We hope this project, with Hugh’s memory at its core, will encourage our students and graduates to make research work for our profession. If any Acu. readers would like to contribute to our research project, I’d love to hear from you. We plan to intersperse longer cases from our clinical students with ‘snapshot’ cases – unusual, interesting or topical – to showcase the breadth and power of five element acupuncture. If you’re interested in sending us a case history, just get in touch and I’ll send you a template. Strength to strength then, against stiff odds this last year, supported by each and every one of our dedicated students, tutors, supervisors, staff and graduates. We are family, and at no time has this been clearer to us than right now. To take part in the TAA research project email Julie Reynolds for a template 〉 julie@taa-uk.net

What do you see when you turn out the light? My Kindle

Fantasy dinner party guests

My father and brother (if able to return) plus Arsène Wenger

What is your diagnosis?

Trees of various different types

Worst nightmare

Anything that renders me immobile

If any Acu. readers would like to contribute to our project, I'd love to hear from you

Favourite proverb

Let go or be dragged

One bed or multibed? One very large bed

What’s your animal?

Anything in the cat family

What has life taught you? That Socrates was right

Tell us a joke

Man goes to fancy dress party with woman on his back: ‘I'm a snail’ ‘No mate, a woman on your back doesn’t make you a snail’ ‘That's not just a woman, mate, that's Michelle’

Mark Bovey Member: Oxfordshire

Community

Acu. | Issue #30 | Spring 2021

Regional round-up Join a regional group today… or two, or three, or as many as you like!

Fiona Lam Learning & Events Manager Regional groups are run by members, for members, on a voluntary basis, with some funding from the BAcC. Regional group co-ordinators (RGCs) are passionate about bringing members together and each group sets their own programme to suit their own needs and interests. I’m finding there’s often an assumption that regional groups are defined by their geographical boundaries – once upon a time perhaps, but that’s no longer the case. With the increase of meetings currently on virtual platforms such as Zoom, members can join any groups they like, and as many groups as they like! And even when we’re able to return to in-person meet-ups, you are still welcome to be part of any regional groups around the country.

What you get

Being a member of a regional group brings all sorts of benefits: it can help you to feel connected, inspired, informed, supported, engaged, and excited about practising acupuncture. Plus, taking part in regional group activities also counts as CPD hours! Of course, the other bonus of online regional group meet-ups is no travel costs… and you can wear your pyjama bottoms. So go on, give it a go! Join a group today and connect with other practitioners.

What some groups have been up to… Devon & Cornwall

In December, 16 of us had the pleasure of meeting Martin Powell on Zoom, for an information-packed presentation on mushrooms. Martin is immensely knowledgeable and has an infectious enthusiasm for his subject. Mushrooms can reduce cancer risk, support healthy immune function, and maintain gut flora balance. Some can lower cholesterol or blood pressure, are antiviral, or can enhance sleep. As ever, they are better cooked, especially in soups.

Get in touch

If you’re not yet part of a group, why not sign up to your local RG newsletter to find out more about what’s going on. Please visit the events calendar on the Member website to see upcoming events, or contact the RGCs directly to find out more – you can find full contact details for all RGCs over on page 38.

Get a taste of

Ever thought about supporting other acupuncturists by becoming an RGC? Or maybe you’d like to organise a oneoff event to get a taster. Some parts of the UK currently have no RGCs or active groups – so why not take the lead and share your ideas? You could just grab a few friends and do it together! Alternatively, if you would like to arrange a one-off event for local or all BAcC members, be it online or in person, let me know and we can get started together. If the answer is yes and you would like to be involved, then we can help you all along the way. We may even be able to provide financial support for your event.

Top tip of the evening for me was when you've brought mushrooms home, leave them gills upwards in sunshine for an hour. This can increase their vitamin D content by a factor of ten. Thank you so much, Martin: I have now doubled the quantity and variety of mushrooms in my risotto and it's delicious. Robin Costello 〉 ancotello@yahoo.co.uk

North & North West London

Fiona Lam 〉 020 8735 1222 〉 f.lam@acupuncture.org.uk Our first meeting in 2020 was held at The City College of Acupuncture. We decided to tackle complex syndromes and had a case study discussion about fibromyalgia and chronic fatigue. Shelley Berlinsky did a fabulous job presenting a case we could all talk

Acu. | Issue #30 | Spring 2021

Community

Regional groups through with some really helpful insights from everyone in the group. Then lockdown meant all our lovely plans were re-arranged. We decided that we’d had enough of online sessions at that time and managed to schedule an outdoor picnic social event at the end of September, just as restrictions changed AGAIN. Somehow, we didn’t need to invoke our risk assessment strategies of sitting in groups of less than six, as everyone popped in as and when they could over the afternoon. We’ve now resigned ourselves to the idea that more things are staying online in 2021, so we’re moving over to Zoom. Our first Zoom meeting was held in February on the theme of Working Online, discussing systems which may be helpful to help manage patients, as well as sharing ideas that can help support our practices whilst we have additional restrictions. You can read more from Stacey about Working Online in her article on page ?.

Regional groups help circulate information and provide local forums and support, especially in these uncertain times.

Stacey Chapman & Michelle DawesJenkins 〉 nnwlondonregionalgroup@gmail.com

BERKSHIRE Kim Child 〉 07563 537872 kimchild@me.com

Surrey

So please don't feel that you're on your own. Now more than ever, with so many get-togethers happening via Zoom, any member is welcome to attend any meeting. Check the Member website for upcoming sessions and contact the local RGC to find out more.

REGIONAL GROUPS ASHDOWN FOREST & WEST SUSSEX Ninette Sapir 〉 01342 826374 nsapir@yahoo.co.uk Ioonah Woods 〉 07719 576652 ioonahwoods@gmail.com BEDFORDSHIRE Louise England 〉 07933 046232 tweega@btinternet.com

BRISTOL & NORTH SOMERSET Lynda French 〉 07740 435245 lyndafrenchacupuncture@gmail.com CAMBRIDGESHIRE & NORTH HERTFORDSHIRE Leah Claydon 〉 07555 339590 Iga Amal Czarnawska-Iliev 〉 07515 886727 cambshertsrsg@gmail.com CHESHIRE MERSEYSIDE & NORTH WALES Jackie Fairweather 〉 07398 450390 bacc.jackie@gmail.com DEVON & CORNWALL Robin Costello 〉 01392 424276 ancotello@yahoo.co.uk

Our most recent regional group event was held on Zoom, and we were joined by practitioners who studied at six different colleges, including members from Essex, Suffolk, Gloucestershire, and London, as well as Surrey. The topic for this meet-up was to discuss case histories with a focus on mental health: we invited local acupuncturist Julia Bletcher to join us, who talked to us about her approach when treating mental health with acupuncture. Julia’s presentation was really helpful and informative and gave us a great starting point for further discussion about case histories. We then opened the meeting up to the floor and discussed case studies for 10-15 minutes each: our members love this activity as it’s a great opportunity to discuss and share ideas, as well as support one another. Sarah Casbolt 〉 sarah@acupuncturehealthcare.co.uk

EAST SUSSEX Terry Simou 〉 07802 423127 terry@tsclinic.co.uk HAMPSHIRE Sahar Hooti 〉 020 7129 7552 info@acucareclinic.co.uk HEREFORDSHIRE & WORCESTERSHIRE Debbie Smith 〉 01544 327447 58debbs@gmail.com HERTFORDSHIRE & ESSEX Manvinder Hutchings 〉 07940 345203 vindy.hutchings@gmail.com LANCASHIRE Sandra Hart 〉 07908 806027 Larissa Mosca 〉 07917 290899 baccnorthwestrg@gmail.com LEICESTERSHIRE & RUTLAND Catherine Esworthy 〉 07547 054666 cath@catherineesworthy.co.uk LINCOLNSHIRE Jackie Betts 〉 07515 740512 jackiebetts17@gmail.com

LONDON NORTH & NORTH WEST Michelle Dawes-Jenkins 〉 07775 273399 Stacey Chapman 〉 07910 468850 nnwlondonregionalgroup@gmail.com LONDON SOUTH EAST Susana Pires 〉 07985 448102 susana@fertilitypoint.co.uk LONDON SOUTH WEST & CENTRAL Sarah Joseph 〉 07553 636841 info@acupuntureaccess.co.uk LONDON WEST Susanne Weichhardt 〉 07411 009595 susanne_weichhardt@yahoo.com Natalie Johnson 〉 07444 919040 Lydia Howarth 〉 lydia@howarthonline.net NORFOLK Alan Longcroft 〉 07745 149735 baccnorfolkregionalgroup@gmail.com NORTH EAST ENGLAND Michael Ranft 〉 07518 529234 michael@northumberland-acupuncture.com NORTHAMPTONSHIRE Philip Rose-Neil 〉 07913 641515 phil.roseneil@gmail.com NORTHERN IRELAND Susan Evans 〉 07966 885894 sueacupuncture@gmail.com Trish O'Hara 〉 07525419320 trish@theacupuncturistni.com SCOTLAND: ABERDEEN & NORTH Sheila Harper 〉 07796 574625 sheila-harper@hotmail.co.uk SCOTLAND: EDINBURGH & SOUTH EAST Jonathan Clogstoun-Willmott 〉 07950 012501 jncw@enhc.co.uk Angela MacLean 〉 07956 363507 info@limethistle.co.uk SHROPSHIRE Sherrie Thorley 〉 07856 177897 sherrietacu@gmail.com SOMERSET Kay Hay 〉 07882 793528 kay.hay@outlook.com SURREY Sarah Casbolt 〉 07714 721969 sarah@acupuncturehealthcare.co.uk WARWICKSHIRE Kathleen Conway 〉 07813 120747 kath.acup2015@gmail.com Heather Adams 〉 07929 260039 aloeheather@yahoo.co.uk WILTSHIRE Kay Hay 〉 07882 793528 kay.hay@outlook.com YORKSHIRE WEST Caitlin Allen 〉 07971 927675 acupuncture@caitlinallen.co.uk Rachael Hardiman 〉 07951 762861 acupuncturerachael@gmail.com WALES: SOUTH WEST Rachel Edney 〉 07815 097473 rachel@racheledney.co.uk

Community

Acu. | Issue #30 | Spring 2021

TRIBUTE

Anthony Harcourt

Tony was a qualified osteopath and acupuncturist, having graduated from the British College of Naturopathy and Osteopathy in Hampstead in 1970. His interest in acupuncture commenced when he worked at the Tyringham Clinic, set up by Sidney Rose-Neil, one of the early pioneers of acupuncture in the UK. Tony was inspired by Mr Cecil Chen to study acupuncture, realising his dream in 1981 when he travelled to China, attending the Zhongshan Medical College in Huangzhou. Prior to this he had a year out and worked his passage to South America. From there he hitch-hiked through Mexico and into California, then headed up to Seattle and joined a fishing fleet which took him to the Aleutian Islands off Alaska. On his return he worked at Enton Hall in Surrey where he met Jean, whom he married in 1977. He moved to the Dundee area, where he worked until 1979, then joined Clifford Davies in Wotton-under-Edge working two days a week in his practice and setting up another practice in Bath. In 1994 he started his own practice near his home in Chipping Sodbury until his retirement in 2019. The love of his life, other than wife Jean, was history. He was a doyen of Hawkesbury Historical Society, sometimes known as the ‘Hystericals’. He loved being part of a similarly minded group, greatly enjoying the monthly history evenings in Hawkesbury Village Hall. Medieval re-enactment was his forte and he was never happier than when chatting to the public about the battle of Agincourt, and with Jean he attended the 500th anniversary in France. He had a passion for archery and woodworking at which he excelled. He was not only a longbowman, which requires considerable strength, but brilliantly made his own arrows – the ancient art of ‘fletching’ – which took him all over Britain and abroad. He regularly participated in the Jane Austen Festival in Bath, dressed as a sailor (Austen’s brother ended up an admiral), and helped the Long John Silver Trust with its activities, either on The Matthew or at Blaise Castle. Tony discovered timber framing when he came across the Silk Wood Barn project at Westonbirt Arboretum in the 1990s, a community project run by Carpenter Oak and Woodland

in Wiltshire. In 2002 he began working voluntarily every Wednesday and became known as ‘Tony Wednesday’. He was hugely popular for his quiet, dry humour, great strength and enthusiasm for the craft. In 2018 he joined the Charpentiers sans Frontières on the Château d’Harcourt bridge project where he spent many happy hours hewing. He introduced the group to traditional fletching, one of his major pursuits, and spectacularly defeated the French in the archery to reclaim his ancestral seat! He was, in fact, distantly related to French and Russian aristocracy. He enjoyed walking in the Gloucestershire countryside, finding a seat somewhere along the way, and often picked up some wood to be taken home and used. I knew Tony because we’d both been to the same boarding school, King Edward’s in Witley, Surrey (KESW). It was more a boarding school than a public school since it was founded in 1553, along with Christ’s Hospital, by Edward VI to educate children from disadvantaged backgrounds. Many of the children there were paid for by their local councils or were on a bursary so the school was a real mix of different social backgrounds. Tony had, like many there, a difficult childhood. His father died when he was quite young and his mother struggled in 1950s Britain to find work but managed to get him into KESW on a scholarship basis. Tony excelled there in swimming and woodwork. His mother worked in nearby health hydro Enton Hall, and this was where he was inspired to take up osteopathy as a career. Tony was several years my senior so wouldn’t have mixed with a mere minnow like myself at school. However, I caught sight of his name badge at a BAcC conference and recognised him as a fellow survivor of KESW. We attended some of the same lectures and sat together at the Saturday night banquet. Like me, he was very reluctant to dance so we had very interesting talks about acupuncture, osteopathy, KESW and much else besides. A fellow Old Witlean provided this anecdote. Whilst cutting wood on a plot of woodland he was managing, a very posh lady passed by with her dog and asked Tony what he was doing. After a little explanation the lady commented on Tony's faithful hound – a long-haired, gingery sort of cross between a Jack Russell and a Lurcher – and enquired as to its breed. Tony’s quick response was, ‘He's a Stroud Otterhound!’ There’s no such thing… but the lady replied, ‘Oh yes, I've heard of those!’ He leaves his wife Jean and many grateful patients, former school friends and colleagues.

Marek Urbanowicz Member: East Sussex

Acu. | Issue #30 | Spring 2021

Committee briefing A snapshot guide to your Governing Board and committees: why they do what they do and how you can get in touch. Governing Board (GB) Acting chair: Pia Huber

Remuneration Committee (RC) Acting chair: Pia Huber

•

• • •

•

ensures that the BAcC continues to flourish and aspire to ‘a world in which traditional acupuncture is accepted as a valid healthcare choice’ sets strategy and policy, in consultation with and advised by members appoints the chief executive and approves committee members oversees implementation of strategy and effective/efficient management of the BAcC through the chief executive and committees ensures compliance with the company's objects, governing documents and all relevant legislation and regulation ensures prudence in respect of managing the company's assets chair@acupuncture.org.uk

•

s.scruton@acupuncture.org.uk

Professional Recognition Working Group (PRWG) Chair: Susan Evans •

• •

Finance, Risk and Audit Committee (FRAC) Chair: Richard Costella (BAcC treasurer) •

•

responsible for reviewing and providing guidance on the BAcC’s financial matters, including participation in overseeing the development of the BAcC gives assurance to the GB by: monitoring financial performance against budget, internal controls, accountability policies and financial planning, distribution of timely accurate and user-friendly financial reports

•

• • •

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development and promotion of standards for the profession policy development for education and training and associated services oversight of policy and guidance concerning safe practice ensuring enhancement and maintenance of the BAcC’s Professional Standards Authority accredited register status developing effective professional recognition activities p.blacker@acupuncture.org.uk

LINCOLN COLLEGE Albena Asenova Veronika Gurov Shan Jiang Dorothy Lawrie Tememyzhka Maughan Maarika Rool Zhiyong Yang NORTHERN COLLEGE OF ACUPUNCTURE Jennifer Watson Charlotte Worswick The copy deadline for this issue was 19 January 2021. We apologise to anyone who graduated on or after this date and so will have been missed off this list. Your name will appear in the next issue of Acu. Please note: BAAB graduates have up to three years from date of graduation (ie successfully completing the course, not the ceremony) in which to automatically register with the BAcC. After three years, entry onto the register can only be gained via fast track application.

ensure that key positions in the BAcC governance structure are filled with the most suitable candidates, recruited via open, fair and professional processes ensure that proper reviews and recommendations are carried out on behalf of the GB regarding sixmonthly funding bids and annual nominations for fellowships chair@acupuncture.org.uk

British Acupuncture Accreditation Board Chair: Professor Mike Saks • •

Professional Standards and Regulatory Committee (PSRC) Chair: Paul Blacker •

Congratulations to the following graduate practitioners who are now eligible to register as BAcC members.

Nominations Committee (NC) Acting chair: Pia Huber

Membership Services Committee (MSC) Chair: Joanna Brown oversight of the development and promotion of membership services, including professional development, regional support public relations and opportunities for businesses oversight of the recruitment and retention of members, ensuring that membership policies and s.rainbird@acupuncture.org.uk

improve the status of acupuncturists as healthcare professionals within local and national government work on gaining UK-wide exemption from local licensing work on gaining exemption for BAcC members for the blood donation referral period

•

independent body working closely with and on behalf of the BAcC fosters and monitors high educational and professional standards for accredited acupuncture course providers, so that the general public can be assured that graduates from BAAB-accredited programmes are knowledgeable, reflective, competent and safe acupuncture practitioners believes that it is through the accreditation and approval of teaching programmes, that our profession demonstrates its maturity, its capacity for effective self-regulation and its public accountability baab@acupuncture.org.uk

WELCOME

h.bowie-carlin@acupuncture.org.uk

juliana@acupuncture.org.uk

•

advises the GB and chief executive on pay and reward issues throughout the BAcC, with a particular focus on the pay of the chief executive and any reward, incentive or pensions issues reviews the level of attendance allowance payable to committee members across all committees

Community

Look out for little Moxi... Whether digital or print, somewhere in the pages of this Acu. sits a teeny-weeny Moxi. To win a Moxa Moments t-shirt designed by Toon Min, just find little Moxi by 2 April and you’re in with a chance. Email details of your Moxi sighting to editor@acupuncture.org.uk

Community

Acu. | Issue #30 | Spring 2021

BACC OFFICE 1 MARK BOVEY Research Manager 020 8735 1203 m.bovey@acupuncture.org.uk 2 HANNAH BOWIE-CARLIN Safe Practice Officer 020 8735 1226 h.bowie-carlin@acupuncture.org.uk

3 GLORIA JEAN-BAPTISTE FLAMENT Systems & Operations Manager 020 8735 1217 gloria.jbf@acupuncture.org.uk 4 ANN GORDON Publications Manager 020 8735 1204 a.gordon@acupuncture.org.uk 5 CAROLINE JONES Professional Conduct Officer 020 8735 1213 c.jones@acupuncture.org.uk 6 FIONA LAM Learning & Events Manager 020 8735 1222 f.lam@acupuncture.org.uk

ANNA MASSEY Communications Officer 020 8735 1216 a.massey@acupuncture.org.uk 7

8 JENNIFER NORTON Chief Executive 020 8735 1206 j.norton@acupuncture.org.uk

STEPHEN RAINBIRD Membership Manager 020 8735 1208 s.rainbird@acupuncture.org.uk 9

10 JULIANA ZIPPERLIN Finance Manager 020 8735 1201 j.zipperlin@acupuncture.org.uk

MONTANA SHEIKH Membership Engagement Officer 020 8735 1209 m.sheikh@acupuncture.org.uk 11

Meet the latest newbie Hello to those of you I haven’t met yet. I am Montana, your new membership engagement officer. I joined the BAcC at the start of December, just in time for our renewals, so have been chatting to lots of you on the phone and via email getting ready for the year ahead. I come from a background in public service communications, sharing stories from communities built and supported with public service funding, and nurturing the relationship between them and the organisation. Over the coming months, I will be reaching out to members and students to introduce myself as your touchpoint with the BAcC; providing support and information as well as helping continue to build a community among our membership. Through webinars, events and surveys, Stephen Rainbird, membership manager, and myself will be taking the time to listen to you about the services that you find most useful, as well as what more we can do for members at each stage of their career. I grew up travelling all over the world with my family, from the US to Nepal and the Middle East, from tiny islands to big cities – all of which has fostered in me a genuine love for people and deep curiosity. I enjoy learning from people, experiencing different ways of living and thinking from anyone willing to share. I am also an avid podcast listener and love to read, so recommendations for either are always welcome. This is an exciting time to join the organisation and I am very much looking forward to the opportunities that lie ahead, as I get to know the membership body and you all get to know me.

Montana Sheikh Membership Engagement Officer

Change of hats for Joan Classifieds Some of you may know Joan Maynard from the years when the BAcC first formed and had its offices in Latimer Road, West London. As well as being a qualified acupuncturist, she is one of the founding BAcC staff members and has covered many roles throughout that time – from answering phones to assisting the office manager, with plenty more alongside and in between. Not to mention the cornucopia of committees she has worked on. But most of you will know Joan as the copy editor of your very own Acu. magazine. And I’m pleased to say she still is, but in a slightly different capacity. Last year we had to say goodbye to Joan as a permanent staff member but she has graciously swapped hats and stayed on with the Editorial Team to produce Acu. with us, as ever. Although you may no longer see her name so much in general office business, the mark of her unparalleled copy editing expertise is still etched into every page of Acu. The whole wit and personality of your magazine is a reflection of Joan’s spirit. Indeed, these words themselves will have been checked over thoroughly by Joan herself! I can rest assured that the way I typed this – full of spelling errors and bad punctuation – will end up gleaming and faultless by the time you come to read them (and, as one former

member of the Editorial Team once said, ‘sounding like English was my first language’). All of the staff team at the BAcC have appreciated the reassuring presence, experience and support of Joan’s copy editing and proofreading skills for over 15 years now, this being the role she eventually settled into after having worn almost every other hat at the BAcC. Incidentally, she was a pioneer of remote working. The situation we find ourselves in now during lockdown is water off a duck’s back for Joan. She relocated to the islands of Orkney in late 2001 and has been thriving there ever since. I will occasionally call her to discuss articles and deadlines – all wound up in my hectic daily life – and Joan will point the phone out of the window so I hear the roaring wind and lashing rain coming in from the nearby sea. It has a very calming effect on the soul. On the wall opposite my desk, I still have a photograph of the wide windswept landscape taken from Joan’s office window in the roof. So, on behalf of the Editorial Team, thank you Joan, for your tireless and fastidious work, eagle-eyed accuracy in spotting typos, and for all the wisdom and careful consideration you bring to crafting and creating Acu.

Ann Gordon Publications Officer

For up-to-date classified adverts and free posting for members go to the member website Community 〉 Forum 〉 Advertisements

EMPLOYMENT OPPORTUNITIES Cambridgeshire & Norfolk Experienced acupuncturist required for two highly regarded, multidisciplinary practices in Ely, Cambridgeshire and Heacham, Norfolk. For further information, please contact Alexander Spence DO on 07798 640002 or email a.spence@sphere-health.co.uk St Albans Freelance acupuncturist required for major St Albans clinic with busy and loyal client base. All round treatments but good skills on women’s health would be advantageous. Hours by arrangement. Please send a CV to enquires@gingernaturalhealth.co.uk

Acu. print on demand Online or on paper: the choice is now yours! Order your Acu. hard copy here.. tinyurl.com/px3bu45v

Contribute!

Your Acu.

In summer we will be kindling the fire of the shen, exploring the realm of the heart and mind and the healing of both that will need to happen after 18 months of Covid.

Issue #31...

We welcome your thoughts on anxiety and mental health, reconnecting and unifying after a fractious time, consciousness in practice, or even (dare we say it) spirituality, as well as any other issues. Send your ideas, submissions and pictures to editor@acupuncture.org.uk

Community

Acu. | Issue #30 | Spring 2021

PROFESSIONAL DEVELOPMENT EAST ENGLAND & MIDLANDS Balquees Ali 〉 01484 541095/07958 202313 alibalquees@gmail.com

SUBMISSIONS Acu. is for you and by you, so we invite you all to share your opinions, knowledge and images in these pages: • articles can be up to 1,800 words, letters up to 500 • please use generic terms rather than brand names where applicable • submissions are published subject to space • we may edit for length or clarity with permission of the author We reserve the right to edit or decline any submission in which the content: • may be in breach of libel laws • may damage the reputation of the BAcC or its members • denigrates another individual or organisation • is found to be inaccurate or misleading • is considered to be inappropriate to the profession And if you have something to say but you don’t feel confident as a writer, the editorial team is here to help you work your thoughts into a finished piece. Send your copy for the next issue of Acu. to editor@acupuncture.org.uk

ADVERTISING For full details of our advertising policy, guidelines and rates, please contact editor@acupuncture.org.uk NB Whenever we edit or decline a submission we keep full records of our decision and all relevant correspondence.

MENTORING & SUPERVISION

Contact details listed below are for BAcC registered mentors/supervisors who charge for their service

1 Follow the link below 2 Fill in the form 3 Press send 4 Sit back and wait for the postie

〉 tinyurl.com/px3bu45v

LOUGHBOROUGH, EAST MIDLANDS Catherine Esworthy 〉 07547 054666 cath@catherineesworthy.co.uk MIDLANDS & LEAMINGTON SPA Debbie Collins 〉 07960 040985 info@debbiecollins.co.uk MIDLANDS WEST & WORCESTERSHIRE Holly Timmermans 〉 0121 449 9500 holly.net1@tiscali.co.uk

BRIGHTON & HOVE, LONDON WEST Sarah Matheson 〉 07808 633643 mathesonsa@gmail.com

MIDLANDS & YORKSHIRE WEST, SOUTH & NORTH Di Shimell 〉 07866 417830 di.shimell@gmail.com

BRISTOL Jill Glover 〉 0117 377 1186 acupuncture@almavalecentre.co.uk

NORTHERN IRELAND Susan Evans 〉 07966 885894 sueacupuncture@gmail.com

CAMBRIDGE Frankie Luckock 〉 07771 28524 frankieluckock@me.com

OXFORD Sue Pennington 〉 01865 776759 supipennington@gmail.com

DEVON, CORNWALL EAST, DORSET WEST Sally Blades 〉 07896 369885 sallyeblades@hotmail.com Sarah Horswell 〉 07981 141410 sarahhorswell@gmail.com

OXFORDSHIRE SOUTH Frances Turner 〉 07510 710245 francesturner.info@gmail.com

HAMPSHIRE SOUTH, DORSET, ISLE OF WIGHT Carole Parker 〉 07594 586821 carole.acupuncture@hotmail.co.uk HERTFORDSHIRE & SURROUNDING AREAS Helen Thomas 〉 07790 363867 helenthomastcm@aol.com HERTFORDSHIRE, ST ALBANS Sarah Barnard 〉 07968 140516 s.h.barnard@btinternet.com LANCASHIRE & NORTH WEST ENGLAND Cathy Chapman 〉 01524 67707 castleviewclinic@hotmail.co.uk LEEDS, WEST YORKSHIRE Caitlin Allen 〉 07971 927675 acupuncture@caitlinallen.co.uk

LONDON CENTRAL & LONDON SOUTH EAST Doug Foot 〉 07818 068262 dougfoot@gmail.com

Four-step guide

LONDON WEST & CENTRAL Kim Chan 〉 07947 361021 kimsclinic@icloud.com

BIRMINGHAM Lucy Fox 〉 0121 449 9500 lucy.mannion2@icloud.com

LONDON Jane Broughton 〉 07957 362180 jane@nottinghillacupuncture.com

Acu. print on demand

LONDON SOUTH, SOUTH WEST, WEST & EAST Mina Haeri 〉 07957 726072 info@minahaeriacupuncture.co.uk

LONDON GREATER Pia Huber 〉 07719 987933 info@help2helpyourself.co.uk LONDON NORTH EAST Maggie Bavington 〉 07802 954490 maggiebavington@gmail.com LONDON NORTH, FINCHLEY CENTRAL & HERTFORD Angelika Strixner 〉 07791 516733 strixner_craniosacral@hotmail.com LONDON NORTH & HERTFORDSHIRE Mary Hurley 〉 01923 240793 mary@maryhurley.com LONDON NORTH WEST Naava Carman 〉 0345 310 5354 naava@fertilitysupport.co.uk

SOMERSET, DORSET & WILTSHIRE Jane Robinson 〉 07968 182455 jane@ninespringsclinic.org SUSSEX EAST, LONDON Amanda Edward 〉 07703 561616 amanda@awakentoheal.com YORKSHIRE WEST Joanne Dyson 〉 07798 627037 acumedica@gmail.com CANADA: REMOTE SERVICE Lucy Griffiths 〉 +1 902 329 3743 LGTCMA@gmail.com

Courses for practitioners STARTING IN SEPTEMBER 2021

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NCA’s 2021 Research Conference 9-10-11 November 2021 - SAVE THE DATE! ACU-Track is here! ACU-Track is a new online system that allows acupuncture practitioners to easily record and demonstrate their clinical results. All intake forms and outcome questionnaires can be sent to patients automatically via email. Our user-friendly system also includes comprehensive acupuncture and TCM specific clinical notes features, including visual body charts, acupoint and herb lists. Record and store all your clinical data and patient notes securely on our GDPR compliant system. ACU-Track is offering a substantial discount to all BAcC members at £12 per month or £90 annually. Launching April 2021. Sign up now and start recording your clinical results! Helping turn anecdotal reports into validated research acu-track.org

Following our hugely successful research conference in 2019, we’re back with a bang in 2021! Three days of online research and practice-led presentations in quick-fire slots to fit your tea-break: Acupuncture, Nutritional Therapy, Chinese Herbal Medicine and Complementary Medicine. Pay as you go, or get the whole conference package - and either way, you can join us live, or watch on catch-up. PLUS: join us and the rest of the world for the FREE inaugural Hugh MacPherson Memorial Lecture at the start of the conference! Grab your cuppa of choice and join us!

For more information call our enquires desk on + 44 (0) 1904 343309

www.nca.ac.uk

Disclaimer: Articles, letters, advertisements and any other material published in Acu. does not necessarily reflect the opinion or carry the endorsement of the British Acupuncture Council. Advertising guidelines are available from editor@acupuncture.org.uk

LAUNCHING OUR UPDATED RANGE OF HIGH QUALITY ACUPUNCTURE NEEDLES

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BAcC approved Suppliers ● CJ: 100 needles. Single wrap with guide tube, Chinese style copper wound handle with loop ● CJ500: 500 needles. Cost effective reduced packaging option. 5 needles to a blister with one guide tube ● JJ: 100 needles. Single wrap with guide tube, Japanese style metal tube handle 20% discount code: BACC TRUSTED BRAND | FULL SIZE RANGE | ELECTRO ACUPUNCTURE COMPATIBLE

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Find out more www.fertilitysupport.training

FIRST AID TRAINING & CPD COURSES

HOLOS HEALTHCARE & TRAINING Ltd / EASTWEST HEALTHCARE

www.holoshealthcare.com OPEN EFAW COURSES 1-day Level 2 Emergency First Aid at Work (EFAW) courses: ! Blended learning ½ day online + ½ day practical; ! Practical elements held at London, Bristol, Malvern, Reading & Leamington venues. ! Cost £80 per person + VAT ! ! !

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ONSITE EFAW FIRST AID COURSES at your clinic / venue start at £50 per person + travelling & VAT (minimum size 7 people)

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Alex BRAZKIEWICZ is a Paramedic, Osteopath, Acupuncture and Tuina Practitioner; He has been teaching First Aid for over 30 years and has studied Classical Chinese Medicine & Channel Theory in Beijing with Prof WANG Ju Yi and Jason ROBERTSON, Gua Sha under Arya NIELSEN PhD and MSK with Phil McQUEEN. HIGH QUALITY training delivered in a FUN, INFORMATIVE WAY at a FAIR PRICE.

MENTORING/SUPERVISION The following practitioners have all completed Postgraduate training in mentoring/supervision specifically for acupuncturists and are in continuing supervision with Isobel Cosgrove, Sally Blades or Caitlin Allen Contact your nearest practitioner to join a group, or for individual sessions Argyll, West Coast of Scotland Emma Vaughan 01546 606611 Birmingham Lucy Fox 0121 449 9500 Holly Timmermans 0121 449 9500 Bristol & North Somerset Charlotte Brydon-Smith 07900 814100 Jackie Pamment 01934 876558 Cambridge Frankie Luckock 07717 285248 Essex Lorna Withers 07960 852338 Glasgow Francesca Howell 07895 108473 Hampshire & Surrey Irina Bogdanova 07747 775362

Hertfordshire Kate Henley 07887 565174

London Kim Chan 07947 361021

Gail Lazarus 07946 231075

Isobel Cosgrove 07791 581608

Helen Thomas 07790 363867

Mina Haeri 07957 726072

Hertfordshire/ St Albans Sarah Barnard 07968 140516 Herefordshire & Welsh Borders Sandy Sandaver 01497 821625 Ireland Susan Evans 07966 885894 Lancashire Cathy Chapman 01524 67707 Leamington Spa & the Midlands Debbie Collins 07960 040985 Leicestershire & East Midlands Cath Esworthy 07547 054666

Pia Huber 07719 987933 Angelika Strixner 07791 516733

Oxfordshire & Berkshire Frances Turner 07510 710245 Reading Magda Koc 0118 996 8574 Sheffield & South Yorkshire Di Shimell 07866 417830

London & Brighton Somerset & Dorset Sarah Matheson Jane Robinson 07808 633643 01935 422488 London & Wales Audley Parry Burnett 07980 986808

South West England Sally Blades 07896 369885

Manchester/Cheshire/ Lancashire Joshua Enkin 0161 434 0195

Sarah Horswell 07981 141410

Mid & West Norfolk Kate Stewart 07899 953806

Watford Mary Hurley 01923 240793

North Yorkshire Julie Williams 07512 304444 Oxford Sue Pennington 01865 776759

West Yorkshire Caitlin Allen 07971 927675 Naomi Nash 07725 842979

“ As practitioners we offer our patients guidance, support and encouragement – it seems a good idea to offer it to ourselves” Isobel Cosgrove www.mentoringsupervision.org Disclaimer: Articles, letters, advertisements and any other material published in Acu. does not necessarily reflect the opinion or carry the endorsement of the British Acupuncture Council. Advertising guidelines are available from editor@acupuncture.org.uk

College of Integrated Chinese Medicine Diploma Courses We are running the following one-year diplomas. We are maintaining covid-secure distancng guidelines in the college. To find out more about the measures we have in place, please contact us.

Gynaecology, Fertility and Obstetrics

❉ 🐦🐦

Starts May 2021

Clare Venter-Smith, Rebecca Avern, Sarah Budd, Kim Chan, Jill Glover & Sharon Yelland This course covers diagnosis and treatment of women, from pre-conception, to pregnancy related conditions, to post-birth replenishment. The course will fully equip you to increase your effectiveness and confidence in treating these issues.

Nutrition: Introduction to Chinese Dietary Therapy Starts spring 2021

❉ 🐦🐦 💮💮

Danny Blyth & Greg Lampert This online course will give you a better understanding of food and an in-depth knowledge of Chinese dietary principles. This will enable you to give better dietary advice to your patients, helping them on the path to health.

Tuina Starts spring 2021

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Alex Evans, Rebecca Avern, Mandy Barter, James Unsworth & Kevin Young Develop the practical skills and techniques needed to become a competent tuina practitioner. This one-year practical course will equip you to use tuina as a stand-alone therapy or as an adjunct to your acupuncture practice.

Paediatrics The 2021 course is full. Now enrolling for spring 2022

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Rebecca Avern, Danny Blyth, Lynn Diskin & Julian Scott This in-depth course will prepare you to treat babies, children and teenagers for a wide range of both physical and emotional conditions. You will be part of a small class with an emphasis on making classes informative, collaborative and supportive.

College of Integrated Chinese Medicine 19 Castle Street Reading RG1 7SB admin@cicm.org.uk

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First day is required

🐦🐦 Early Bird rate applies if you book six weeks in advance

💮💮 New to our programme

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To find out more and book online go to cicm.org.uk or call us on 0118 950 8880 Disclaimer: Articles, letters, advertisements and any other material published in Acu. does not necessarily reflect the opinion or carry the endorsement of the British Acupuncture Council. Advertising guidelines are available from editor@acupuncture.org.uk

Acupuncture

Research Symposium

Bridging the gap between research and practice Saturday 27 March 2021 • Hear leading researchers provide new evidence that will support your practice • Be inspired by the latest research developments • Learn how you could conduct your own research BAcC/AACP/ ATCM/ ETCMA/ RCHM members £30 BAAB accredited college students/ undergraduate students £20 Other attendees £40

Confirmed speakers include: Terje Alræk

Professor at Kristiania University College, Oslo

Karen Charlesworth Research Director of the Northern College of Acupuncture

Catrina Davy

Acupuncturist, Royal London Hospital for Integrated Medicine

Spod Dutton

Director and Data Specialist at ACU-Track

John Hughes

Director of Research, Royal London Hospital for Integrated Medicine & Associate Professor, the University of West London

Nick Lowe

Director and Lead Researcher at ACU Track

Michael Popplewell Acupuncturist, Sydney, Australia

Jonquil Westwood Pinto Lecturer and researcher, Sandro Graca

Fellow of the ABORM, and a Director at Evidence Based Acupuncture

Acupuncturist and PhD researcher at Southampton University

This is an online event

For more information and to book your place: https://www.acupunctureresearch.org.uk/symposium/about-arrc-symposium

Fully Registered Dietary Supplements Vegan & vegetarian friendly

Recognised by the FSA

100% plant-based ingredients

GMP certified

Gluten free

Fully tested by German lab GBA

Non-GMO ingredients

COA certificates available

Fully registered in the EU

Recyclable packaging

O r d e r o n l i n e f r o m www.phoenixmd.co.uk Contact us for a practitioner guide and trade price lists info@phoenixmd.co.uk | www.phoenixmd.co.uk |

+44 (0)1245 350822

LET’S CELEBRATE OUR PROFESSION British Conference of Acupuncture and Oriental Medicine

Save the date Saturday 18 September 2021

Acu. spring 2021

Articles inside

Learning in lockdown

Tribute to Anthony Harcourt

The way to do is to be

Year of the Ox

It’s not working

WebWatch

Working online

EveryBodyCan… get to know the BLS

Just my point: LIV 13