MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

I wish people would think a bit before naming things! What is ‘natural health’? Is it the opposite of ‘unnatural health’ or of ‘natural illness’? But who am I to question the terminology of the NHS? I am not even a native English speaker!

Therefore, let me rather look at what this oddly-named school does. Here is how the ‘NHS Natural Health School‘ explain their work:

The NHS Natural Health School has been developed to meet the standards of practice, and experience that are essential for complementary therapists wishing to treat patients within an NHS healthcare setting. The school offers a wide range of approved and accredited courses, taught by highly qualified and clinically skilled lecturers who are experienced in working clinically within NHS Healthcare settings and providing complementary therapy treatments for patients with a range of complex needs including cancer diagnosis. By welcoming you into the multi-disciplinary care team, we not only prepare you as a confident, competent practitioner ready to meet the needs of a demanding industry, but we are able to support the provision of specialist care for a wide range of patients and clients who otherwise would miss out on beneficial treatments.

Courses include supervised clinical placements across hospital and community healthcare settings. All proceeds raised from the courses are reinvested into the Harrogate Hospital and Community Charity’s SROMC Complementary Therapy Fund to ensure the financial sustainability of the HDFT NHS Trust Complementary Therapy Service. For more information on the courses and education available please click the courses link above.

Naturally, I am intrigued and have a look at their courses. They include shiatsu, holistic massage and reflexology. Having published several papers on the latter, it is of particular interest to me. Reflexologists have maps of the sole of the foot where all the body’s organs are depicted. Numerous such maps have been published and, embarrassingly, they do not all agree with each other as to the location of the organs on the sole of the feet. By massaging specific zones which are assumed to be connected to specific organs, reflexologists believe to positively influence the function of these organs.  Here is what the NHS Natural Health School advertise about their reflexology course:

A combination of theory and practical modules designed to equip the learner with the skills required to provide Reflexology treatments for a wide range of clients. On successful completion of the course you will be able to register with the relevant regulatory and professional associations and gain full insurance to practice.

Course content includes;

  • Explore the history and origins of Reflexology
  • Explore the use of various mediums used in treatment including waxes, balms, powders and oils
  • Explore the philosophy of holism and its role within western bio medicine
  • Reading the feet/hands and mapping the reflex points
  • Relevant anatomy, physiology and pathology
  • Managing a wide range of conditions
  • Legal implications
  • Cautions and contraindications
  • Assessment and client care
  • Practical reflexology skills and routines
  • Treatment planning

Assessment: You will produce evidence of 30 reflexology treatments. An additional assessment of your competence will determine your readiness to undertake 72 in-depth case studies and complete a practical assessment.

Course Duration: Attendance is required at 8 Reflexology technical days over 12 months, during which time you will demonstrate a minimum of 100 practical hours.

Special Notes: The core modules; Anatomy, Physiology and Pathology, Business Practice and Principles and Practice of Complementary Therapy are normally completed concurrently as part of the diploma.

Learners who already have a Level 3 diploma in a complementary therapy may be exempt from the core modules.

A first aid certificate is required prior to completion of the diploma.

Fascinating! Personally I am most intrigued about the module on anatomy, physiology and pathology, because all of the three squarely contradict what reflexologists believe. But I wonder even more why there is no mention of the evidence. Have they forgotten to mention it? Unlikely; their other courses on SCAMs such as aromatherapy, holistic massage or shiatsu have similar omissions. Or does the ‘NHS Natural Health School’ not think that evidence matters to ‘competent practitioners’ of the NHS? Or perhaps this is where ‘natural health’ is different from unnatural health?

No, silly me! The reason clearly lies elsewhere: the evidence fails to show that reflexology generates more good than harm. So, the clever people from the ‘NHS Natural Health School’ decided to hide it discretely. Shrewd move! Albeit slightly embarrassing as well as just a little unethical, particularly for the NHS Harrogate, I’d say.

Just in case some readers do wonder nonetheless what the evidence does tell us about reflexology, here is the summary table from my recent book:

PLAUSIBILITY Negative
EFFICACY Negative
SAFETY Positive
COST Debatable
RISK/BENEFIT BALANCE negative

I cannot help but being reminded of something I stated many times before: EVEN THE MOST PROPER TEACHING OF NONSENSE CAN ONLY RESULT IN NONSENSE.

36 Responses to Re-inventing anatomy, physiology and pathology: the ‘NHS Natural Health School’

  • To Dr Sarah Wollaston MP (Liberal Democrat, Totnes).
    Chair, Health Select Committee:

    Dear Sarah,

    I appreciate you have rather a lot on your plate at the moment, but could I ask you to have a look at this website which gives every appearance of being that of an NHS institution:
    http://www.nhsnaturalhealthschool.co.uk.

    If the National Health Service Natural Health School (NHS NHS) is entitled to use the NHS branding, there is a serious and important question as to how the NHS can endorse this range of pseudoscientific ‘therapies’, SCAMS, and quackery, whilst at the same time urging NHS staff to base their professional work on evidence of safety and effectiveness (EBM or science-based medicine).

    The claims made by the NHS NHS are fatuous, misleading and harmful – even claiming to treat cancers:

    “Our highly qualified therapists offer a course of FREE treatment to patients and carers affected by a cancer diagnosis following referral by their healthcare professional. The treatments currently provided include Reiki, Reflexology, Therapeutic Massage, Daoyin Tao, The Bowen Technique and Acupuncture. “

    I appreciate suffering people need care and deserve support and attention, but professional integrity and honesty surely demands patients (and those who serve them professionally) are not misled – especially by the NHS.

    If the pseudoscientific treatments endorsed by the NHS NHS are allowed to be incorporated into NHS care, we can all pack up and go home. And Harrogate and District NHS Foundation Trust of which the NHS NHS proudly declares itself to be part, should be exposed as being dishonest and taking advantage of the vulnerable and gullible.
    Do you agree that is to be deprecated?

    Kind regards,

    Richard

    • Professor Ernst – I have just read your post on the NHS School and your remarks about reflexology and your ‘evidence ‘ graph that it is ineffective.

      I recalled many years ago having my first reflexology treatment (my experience, your anecdote) and was astonished when the reflexologist, having only just started working on my feet ,asked me if I had just lost a back tooth. I had and there was no visible indication of this. I was impressed, and have had many years of beneficial reflexology treatments.

      Now the question is….. did that ‘diagnosis ‘ /experience convince me there is something special going on….,,,? Well, it was certainly hard to ignore. I fail to see – evidence or no evidence- how reflexology can do more harm than good.

      • if a treatment has no proven benefit, its risk/benefit profile cannot ever be positive, even if its risks are only minor.

      • Angela has probably never heard of one of the oldest high-street “tricks” in the book, cold reading. Usually the marks don’t remember all the other questions the reader asked before hitting the right one. Cold reading involves asking about common occurrences like loosing a loved one, having a “flu”, having a dental cavity filled, etc. Loosing a back molar is a very common occurrence, especially during a certain period of life. A reflexologist, medium, conjurer or salesman only has to ask a few simple questions about commonplace things before making a hit. Asking if an adult recently lost a wisdom tooth is very likely to hit home and “make the sale” 😀
        I would also think the “reflexologist” had no idea what she was doing either. Many purveyors of so called alternative therapies use cold reading to impress on their clients and reinforce their own feeling of superior powers, without deceptive intent.

      • @Angela

        Your story would fit in well with those of people who have been astonished by psychic readings. Your reflexologist is only one step ahead of cold readers (“I’m getting an M; does an M mean anything to somebody here?”)

        Maybe you’re just too trusting, but you don’t tell us anything of the circumstances of your visit. Did you not meet the reflexologist face-to-face before he/she got to work on your feet? Was there no conversation before he began the footwork? You see, when I read your tale I see the reflexologist as someone who wants to impress the client and who has therefore picked up some of the tricks of the mind-reading trade. (Maybe Richard Rawlins can correct me if I’m wrong.)

        By impressing you with a pretty trivial observation that he got right (and might have deduced from looking at your face when you first met), he/she knows you’ll take anything they now say and do as true. If I’d been in your place I’d have at least asked him/her which back tooth I had lost, but then I’m less trusting of others than you.

  • My understanding is that this is a charity. It is not part of the NHS. There are rules https://www.england.nhs.uk/nhsidentity/identity-guidelines/nhs-logo/ about the use of the NHS logo. NHS England do sometimes take legal action. My memory is a bit fuzzy but didn’t the Mike Dixon incarnation of the NHS Alliance get into trouble? It’s now the New NHS Alliance presumably to distance itself from Dixon and his various schemes. It’s likely NHS England would not be happy about the use of NHS in the title of the school.

    There are no hard and fast rules about medically unqualified CAM practitioner practicing in an NHS setting. Some trusts have published guidance but whether it is adhered to is another matter. I’ve seen mention that CAM practitioners should belong to Professional Standards Authority (PSA) Accredited Registers. In any case, they will be under the supervision of a clinician. Clinician is generally understood to mean member of a statutorily regulated medical profession – some of the language used by the school is problematic in that regards.

    Their services tend to be funded by charities rather than NHS bodies.

    This kind of thing always reminds me of “Lord” Ken Ward-Atherton. Sometimes those involved in these types of charity use them and the supposed association with the NHS as a way to boost themselves.

    • how does this tweet fit in then?

      Harrogate NHS FT

      @HarrogateNHSFT
      ·
      Dec 4, 2018

      Gwyn Featonby from our NHS Natural Health School has won Complementary Therapy Tutor of the Year Award at
      @FHT_Org
      ’s 2018 FHT Excellence Awards. Julie Crossman was also a finalist in the Complementary Therapist of the Year category. Well done both! nhsnaturalhealthschool.co.uk.

  • I particulalrly relished this: “A first aid certificate is required prior to completion of the diploma”…

  • The Sir Robert Ogden Macmillan Centre is funded by the Harrogate and District NHS Foundation Trust.
    https://www.hdft.nhs.uk/services/cancer-services/

    The centre offers “complementary therapies” alongside cancer treatments (e.g. chemotherapy) to “ensure we deliver a truly holistic and therapeutic service”.
    https://www.hdft.nhs.uk/services/cancer-services/sromc/

    The complementary “service” is free to users and funded by “public donations and revenue created by the NHS Natural Health School”.
    https://nhsnaturalhealthschool.co.uk/

    So the complementary therapies are not funded by the NHS. But who or what exactly is the “NHS Natural Health School”? Presumably it is a device used by The Sir Robert Ogden Macmillan Centre to generate additional public donations. Is it a charity?

    The Harrogate Hospital & Community Charity is also involved.
    https://hhcc.co.uk/

    Looks to me as if a stack of charities fund the “NHS” complementary stuff. Looks like an “NHS” scam.

    • Leigh Jackson – I know nothing about The Natural Health School ( NHS) but to call it a SCAM seems unfair.

      It can’t be a surprise that most hospitals have a Complementary Health centre ( Macmillan centre) alongside. I have noticed, having taken friends for radiotherapy to different hospitals, that the centres are close to the radiotherapy units, in plain sight. They are not funded by the NHS and all complementary treatments administered are known to medical professionals.

      I have volunteered in similar charities, and the funding is difficult. Many people ( and we are in the UK fortunate) give their time freely and with humility to support patients and medical professionals. To call it a SCAM is inappropriate.

      As is your personal attack on Lynne.

  • this drivel would appear to be supported not only by Harrowgate NHS trust but is also supported here by Macmillan as it is provided in their centre.
    What is worse is that the same trust is now adopting Shiatsu – see here – https://www.shiatsuhealthpoint.co.uk/shiatsu-accepted-by-nhs-harrogate-district-natural-health-school/ they are now expanding its use to maternity! (for what one might ask?)
    and Cancer Research UK is recommending Shiatsu as a treatment to cancer sufferers “because it makes them feel good”

    Does anyone else think it inappropriate than a cancer research charity should be endorsing a SCAM therapy to cancer sufferers on such a basis when they are supposed to be a scientific based research body? They are encouraging sufferers to waste money on flim-flam and SCAM artists when there is good evidence this “therapy” doesn’t work for anything.

    Harrowgate seems to have taken leave of its senses as they are currently advertising for more reflexologists and aromatherapists and are expanding the service outside of cancer patients at two sites – they must have a SCAM practitioner on the board or something or is Jeremy Hunt the local MP?

    Something must be done!

    • Macmillan and Cancer Research are contaminated by association with SCAMs. It is a SCAM if there is no good scientific evidence that touchy-feely therapies help to reduce the stress and pain caused by cancer and cancer treatment, beyond the placebo effect. Kindness and sympathy dressed up as nonsensical “therapies” should not be touted as NHS approval of nonsense.

      In this Harrogate Macmillan Centre NHS cancer treatment is given alongside nonsense treatments. If the benefit of nonsense treatments is better feeling, due to the soothing personal time and attention received, then the treatments should be offered as soothing treatments, intended to help with the mental strain of dealing with cancer and cancer treatments. Nonsense should not be proffered as cancer treatments; mental health treatment, perhaps.

      The primary push for nonsense treatments in Harrogate looks to be Harrogate Hospital and Community Charity.

      Promoters of nonsense medicines will of course promote this Harrogate Macmillan Centre as evidence of NHS support for nonsense medicines.

    • Should be noted that Harrogate is a NHS Foundation Trust. These new form of NHS Trusts are supposed to deliver core NHS services but each one is an independent legally defined “Public Benefit Corporation”.

      They are not under central government NHS control and are not performance managed by Health Authorities.
      They can raise capital from public and private sectors. So SCAMs can buy in if a Foundation Trust chooses to take their money or the Trust can buy into SCAMs if they wish to.

      So to say that because Harrogate NHS Foundation Trust funds NHS treatments in the Macmillan Centre, the Harrogate Hospital and Community Charity funded SCAMs in the same Centre are therefore NHS approved, is clearly false.

  • Harrogate Hospital and Community Charity set up the Natural Health School at The Sir Robert Ogden Macmillan Centre.
    https://www.neighbourly.com/project/5b30bcdbc7ac890bac7be4c4/information

    “we fund the complementary therapy service at The Sir Robert Ogden Macmillan Cancer Centre for patients and their carers. These therapies are offered alongside conventional treatment and helps to reduce the stress and pain of our patients.”

    “We have also just launched a new Natural Health School, where we will be training therapists and providing them with the specialist training needed to enable them to work in an NHS setting, giving them the confidence to treat cancer patients.”

    So long as the therapies are taught to trainees and offered to patients only as help to reduce stress and pain I have no objection, as long as there is good evidence of efficacy.

    If there is good evidence the therapies should be available on the NHS. If there isn’t good evidence the public should not be asked to splash out to charity.

  • Frank Odds- I didn’t think you would be interested in the circumstances of my visit. Here is a little more information, although it’s unlikely to change your view ( we know how our conversations go…..)

    I hadn’t met the reflexologist before but she had been highly recommended and had plenty of clientele. You think she wanted to impress me? Why? hadn’t mentioned anything about teeth prior to treatment, and yes she did identify the exact tooth. The extraction was probably a couple of months earlier so no swelling (and you know how a dentist won’t rectify until full healing? )You think it’s a pretty trivial observation. I would disagree on the basis it was hidden: a truly trivial and easier observation would be something she could deduce from my appearance. It was a pretty risky punt to mention a removed back tooth one could not see with a wide open mouth.

    So you are less trusting of others than I am. How do you know ? I am starting to think you are the cold reader or psychic : picked up some of the tricks of the mind reading trade? Sounds like you may be in training- good luck.

    • …and she did identify the exact tooth! Wow! How does that work!? Does a callus form in a precise location under a certain toe for every tooth, or…?? Can she count the fillings also? And tell if you have gallstones?

      No, Angela. You’we been deceived. There is no way anyone can diagnose missing teeth or anything else in your body for that matter, by petting the feet or looking into the iris of your eye or whatever well known fake diagnostic trickery this lady was using.
      Her modus operandi was cold reading, which is a very simple conversational technique to extract information from someone. And when the subject is gullibly awstruck over the result, like you were, the subject readily forgets all the other probing questions. Your memory functions automatically reinforce the reverence. That is how it works, not by some magical ability of a reflexologist being able to sense a missing tooth. If you can prove us wrong then please do. The onus is on you, who brought up the claim. But before you go further out on the limb about your epiphanous experience, please read the Wikipedia piece on cold reading and watch a few of the many videos on Youtube that explain how cold reading works. You might even begin to recall some forgotten details about your encounter with the tooth-sayer reflexologist and how she went about making you yourself tell her about your tooth. Memory is an unreliable asset 😉

      • it would be very easy to conduct a test of reflexologists’ ability to diagnose this or similar conditions.
        HOLD ON!
        we did such a test (https://www.ncbi.nlm.nih.gov/pubmed/11068346); and what did it show?
        our conclusions surprised nobody:
        “… the results do not suggest that reflexology techniques are a valid method of diagnosis.”

      • Wow Björn- you have covered just about everything to disprove my experience. Who could possibly doubt your hypothesis? Thank you. Meanwhile, sorry to say I know my experience, but thank you anyway: I don’t have to prove anything – this is a mere blog, not a court of law, and commenters are full of different experiences/opinions/assumptions/theories. It is what it is. I also read many comments that I think are nonsense, but move on.

        Professor I feel another banner impending. Or maybe devise a court room like forum with judges, barristers, lawyers, witnesses and so on….

  • “I don’t have to prove anything”

    What you are really telling us is you cannot and you do not want to change your mind 🙂
    Good for you. Just stay on comfortably in your preferred beliefs. But don’t expect us to buy into your feeble attempts at claiming reflexologists can perform ‘magical’ diagnoses or treat illnesses or ailments by petting the feet or whatever. Reflexology is only one of many parlour tricks used, usually in good faith, by gullible people to extract income from and impress on other gullible people.
    Of course there is an element of relaxation and temporary soothing in the rituals, but that is all there is to it.

    • the danger with people ‘s belief is that it is used to ersuade others who.may be desperate and vulnerable and feeds into the ‘believers’ midplaced sense of authority and supposed superiority. These sort of people should be exposed and ridiculed for what they are. Opinions can be dangerous.

  • Björn- ‘how does that work?’truthfully I don’t know. Maybe Reflexologists reading this (if there are any) could help us.

    I didn’t have a conversation about it at the time, and had forgotten about it until I read the Professor’s piece on reflexology.

    I do think you are getting a bit carried away with your assumptions though: I don’t expect you to
    buy into anything. If I want diagnoses I would personally go to a medical professional.

    Where is the deception? She remarked, I agreed and we moved on with the treatment. How have I gone out on a limb? I commented on a reflexology treatment. But as always when I post an experience I am accused of all sorts of things, which would be amusing, if it wasn’t regarding the serious subject of CAM.

    But to be clear: I don’t influence anyone regarding my use of CAM whether family, friends, clients, or generally anyone I meet. I don’t think I told anyone I knew about ‘toothgate’ You see ,unlike the skeptics, I kind of think we should all have choices, without being told we are gullible or much worse.

    You are so off beam in your assumptions, it’s becoming silly. You cast aspersions on the reflexologist : she is this and she is that and its unpleasant. The truth is she became a great friend and I became less of a client. Not a lot of exchange of fees. No cold readings ….. no parlour tricks. But I guess this is difficult to understand in a black and white assumptive world: where all CAM practitioners are charlatans and all CAM users are gullible. Maybe one day there will be a poll to learn the truth.

    Meanwhile note to self: do not comment on personal CAM experiences as one never knows the extent of the unfortunate responses this will illicit.

    I especially note that you think you know so much about me : my memory, my perceived influence on others ….I could go on. It’s quite a skill you have, borders on spooky, but more than anything shows a complete ability to get it so wrong.

    • @Angela

      Maybe one day there will be a poll to learn the truth.

      Thank you for letting us know the kind of thing you regard as sound evidence to establish a truth.

  • Frank it’s not my regard: there are obviously anomalies in that according to this blog all CAM is bad, superfluous ( no evidence etc etc ) and in the outside world it is ever more popular. Eg my chiropractor, acupuncturist and so on increase clientele daily and lengthy waiting times ensue for appointments. Just having general conversations I hear a lot of praise for CAM, often people who haven’t tried it before. What is interesting is that these busy practitioners don’t advertise, all recommendations. That disparity requires looking at: maybe a poll is flippant in your eyes but there you go.

    Frank there is something not making any sense in this debate, and I would say it’s not just me who thinks there must be another way.

  • The Chair of Harrogate and District NHS Foundation Trust is Angela Schofield: https://www.hdft.nhs.uk/about/meet-the-board/angela-schofield/ I suggest that several of us write to her to point out the unsuitability of these treatments and how they are wasting scarce NHS funds. There doesn’t appear to be an e-mail address that can be used so it would have to be by post to this address, marked for her attention:
    Harrogate and District NHS Foundation Trust
    Harrogate District Hospital
    Lancaster Park Road
    Harrogate
    North Yorkshire
    HG2 7SX

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

If you want to be able to edit your comment for five minutes after you first submit it, you will need to tick the box: “Save my name, email, and website in this browser for the next time I comment.”
Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”

The most recent comments from all posts can be seen here.

Archives
Categories