Thursday, 3 May 2018

National Occupational Standards for Homeopathy

As part of UK lay homeopathy's attempts at legitimisation, it has signed up for National Occupational Standards (NOS). The NOS were agreed in 2008 and subsequently updated in 2009. The NOS for homeopathy is notionally endorsed by Skills for Health - but arguably this is just a box ticking exercise. Skills for Health do not validate that groups or individuals meet NOS. Skills for Health do seem to have the ability to re-examine a particular NOS.

Due to continuing computer use problems this will be relatively brief.

Homeopathy Course Providers Forum
The HCPF represents the majority of the organisations that provide homeopathic education in the UK. It accredits the courses offered by some of its members and accredited requires meeting or exceeding NOS. These providers are -

The HCPF has an interesting history to say the least which reveals some of the mess that UK lay homeopathy has got itself into over time.

Trade Associations
The trade associations vary in which training providers they recognise. The Society of Homeopaths (SoH) recognises these not all of which are are accredited by the HCPF. The Alliance of Registered Homeopaths (ARH) recognises these - again, most are not accredited by the HCPF. The Homeopathic Medical Association (HMA) recognises these, ditto most are not validated.

The SoH graduate entry form makes no mention of NOS. There is an entry route for those who do not have a qualification recognised by the SoH. It involves some kind of assessment. However the SoH's Code of Ethics and Practice makes explicit mention of NOS -
1.16 Practise in accordance with the Core Criteria for Homeopathic Practice and the Complementary and Natural Healthcare National Occupational Standards for Homeopathy.
The Core Criteria seemed to be shared with the Irish Society of Homeopaths. They were developed with help from Richard Winter.

The ARH graduate entry form makes it a requirement that someone at the course provider that confirm that the applicant meets NOS. This obviously requires knowledge of NOS. The practitioners entry route seems to include an assessment of whether the applicant meets NOS this is not entirely clear. The ARH Code of Ethics makes no mention of NOS.

The HMA application form makes no mention of NOS. Neither does the Code of Ethics.

Note that none of the trade associations has a specific process for determining whether members abide by NOS. It is possible that some members may have qualified from currently HCPF accredited providers before they were accredited/introduction of NOS.

The Standards
The NOS for homeopathy can be found here. The Standards are -

  • CNH1 Explore and establish the client’s needs for complementary and natural healthcare
  • CNH2 Develop and agree plans for complementary and natural healthcare with clients
  • CNH15 Explore and evaluate with individuals factors relating to their health and wellbeing within the context of homeopathy
  • CNH16 Integrate and evaluate information about an individual’s health and wellbeing within the context of homeopathy
  • CNH17 Prescribe homeopathic treatment for an individual
  • CNH18 Dispense homeopathic remedies for an individual
  • CNH19 Review and evaluate homeopathic treatment, case management and practice development 
They make for dull reading to say the least. Many familiar with NOS and other standards in actual professions will find nothing remarkable here but will recognise some innate contradictions.

CNH1 states -
You will need to know and understand:....12. The conditions for which the discipline is appropriate and those where it must be used with caution 13. How to recognise conditions for which your discipline is unsuitable and for which the client should seek advice from other sources....
As previous posts have made clear, many homeopaths fail on both of these points.

CNH2 states -
You will need to know and understand:  
1. The range, purpose and limitations of different methods or approaches which may be used for clients’ individual needs...4. The alternative options available to clients for whom your discipline is inappropriate....6. How to support and advise the client to make informed choices....
Again, previous posts clearly demonstrate multiple systematic failures. The anti-vaccination and anti-medicine stance of some can very extreme. Informed choices? 

CNH15 states -
You will need to know and understand:
....3. Physical functioning and development of the human body 4. Disease processes and their manifestations sufficient to recognise a conventional diagnosis and to understand its implications 5. Medical terms and disease processes sufficient to maintain a dialogue with other health care practitioners and to assist in exploring the following for the purpose of homeopathic assessment, prognosis and treatment:     a) the meaning and significance of medical information and diagnoses     b) the difference between common and characteristic symptoms and modalities    c) which, if any, examinations are relevant and safe for individuals, referring to other health care practitioners for advice if necessary or desirable     d) the likely causes and progression of disease processes     e) possible distinctions between common, pathognomonic, iatrogenic and characteristic symptoms    f) integration and management of the individual’s treatment when they are seeking to comply with different and or multiple regimes     g) common and major signs and symptoms of conditions which could pose a serious risk to individuals’ health and well-being, and which are consistent with the practitioner’s role in relation to medical diagnosis 6. How to access informed advice on unfamiliar conditions 7. The nature of disability and the role of the practitioner in working with individuals who have disabilities8. The relevant legislation, professional standards and codes of conduct 9. How to obtain consent from individuals in accordance with legal and professional standards...13. The importance of not imposing one’s own beliefs, values and attitudes on individuals, of enabling them to express themselves in their own way and of recognising the value of their own beliefs, attitudes and experiences 14. Significant aspects of appearance, body language, speech and behaviour, and how to recognise and interpret them 15. Situations where it may be necessary or useful to involve someone else in consultation (eg when treating children)....22. The limits and boundaries of the practitioner’s role and when there may be a need to advise the individual to consult other health care practitioners....
This previous post on CEASE therapy raises questions about practitioner knowledge item 3. The description of "detoxification" bear little relationship to the function of the human body. Item 4 - well, it is clear that many homeopaths do not understand the implications of certain diagnoses - they offer "cure" for incurable conditions. Likewise the attitude of many CEASE practitioners raises questions about item 7. As was made clear in an even earlier post, many homeopaths have no autism awareness training and likely any kind of disablity awareness training of any kind.

But it is 5. g) that raises most concerns. To refer to a previous post, certainly CEASE therapy regards some signs of conditions that pose a serious risk to a patients as something to be celebrated and not to be treated. Item 15 is obviously ignored in many cases. Not just in terms of insisting that a patient seeks medical attention but the active dissuasion against.

CNH16 is of little interest except for -
You will need to know and understand:...10. How to access, understand and use information on the effects, side effects and interactions of drugs and substances 11. The dangers or consequences of individuals withdrawing from drugs and substances
It is clear from the anti-vaccination and anti-medicine rhetoric of many UK lay home that they do not meet the requirements of 10. A key tenet of homeopathy is that conventional medicine ("allopathy") suppresses symptoms and causes more serious "dis-ease". There is often an overplaying of the frequency/severity of side-effects. Disinformative propaganda is often accepted verbatim and real information discounted or ignored.

NOS for homeopathy has no value. It seems largely ignored by both the trade associations and their members. Yet again, UK lay homeopathy attempts to ape the standards, etc of healthcare professions.

Skills for Health really should examine whether i) they should be completely withdrawn or ii) amended to emphasise the inherent limitations of homeopathy and its practitioners.

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