guestblog-MCCby Maurice Cheng, Chief Executive of The Institute of Osteopathy

I’m sitting here on a Sunday morning writing this blog post, having missed the deadline, wondering what I could reflect on that would be interesting for ARMA colleagues. The reason I’m late with this is because we’ve just relaunched the British Osteopathic Association as the Institute of Osteopathy; finally got our phase one new website and branding up this week (dead links, typos and all); finalised our annual convention programme in October and embedded it on an event microsite; published a new format members’ journal; and signed off on an extraordinarily long career and lifestyle census questionnaire for osteopathic practitioners – all in the same week.

It wasn’t planned that way…these were all carefully worked out last year to have been phased over the last three months, and of course the plan barely survived first contact with reality as slim resources struggled to cope with the enormity of the task(s), particularly with the need to collaborate with internal and external stakeholders all the way through.

What I’ve found most interesting over this process is that the journey has been as useful as the destination. Our relationships with stakeholders has improved significantly over the period of the programme, as we have had to seek support and collaboration throughout, and certainly within the osteopathic world of clinicians, academia, research, regulation and professional development we now find ourselves in a stronger, better and more teamwork-based place. Which is to say, we’re talking constructively!

As the professional body for UK osteopaths, one of our key responsibilities is building working relationships with other branches of UK health (and indeed we find ARMA to be one of the more useful network groups we are engaged with, despite the iO being a relative newcomer to the party). Our experience of this ‘journey’ has been somewhat longer (about a century so far) and less edifying so far – as some fellow members of ARMA will probably also attest, gaining the support of the medical establishment – NICE et al – for cost-saving initiatives which are based on less ‘mainstream’ approaches is often frustrating. The current call for innovation, cost saving and improvement of patient-centred care is not an unreasonable ask from the National Clinical Directors; but I do wonder whether what looks often like rearrangements of orthodox solutions is the best way to achieve genuine innovation?

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I have a sneaking suspicion that even the call for evidence-based medicine – as this is not an absolute measure – actually gets in the way of genuine innovation, as there seems to be an ever increasing demand for ever more detailed ‘proof’. One of the iO initiatives has been to fund a osteopathic training fellowship at a renowned spinal surgery unit, which has resulted in significant reductions in the surgical waiting list and long term medication; we know of another community-based osteopathic team treating lower back pain which has clinical audit data extending over a decade, where the average cost per patient discharged is around a third less than the NHS standard. Neither is it apparently good enough to satisfy commissioning groups for lack of ‘conclusive’ evidence. I suspect there is no easy solution to this, and the only way forward lies in seeking collaboration over time – and again, congratulations to ARMA for creating such an open environment for sharing and innovating. Here’s to that next step.

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