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Title: Working at the coalface : an action research study into the experience of 'integrated medicine' in the NHS
Author: Welch, Margaret Irene
ISNI:       0000 0004 2745 7051
Awarding Body: Lancaster University
Current Institution: Lancaster University
Date of Award: 2010
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A growing body of research has emerged over the last two decades describing how complementary medicine (CAM) and orthodox medicine might work together to provide a new 'integrative medicine' (IM) approach to healthcare. My research adds to that knowledge by providing an experiential insight into the problems and the possibilities of IM, specifically in the National Health Service (NHS) primary care setting in the UK. As a non-NHS massage therapist and researcher, I began the action research (AR) cycle by negotiating with GPs a 'transformative' approach to collaboration (Luff and Thomas, 1999:11). This approach entailed working, as seamlessly as possible, as a member of the clinic. I provided free massage therapy treatments for one afternoon each week (in two clinics), but only to patients referred by a GP who had identified them as having uncomplicated but debilitating musculoskeletal conditions. The aim was not to replace other therapies, or to study outcomes for massage therapy, but rather to participate in the clinic and to study the practical problems for IM by looking closely and reflexively at the interface between complementary and orthodox practitioners working with the same patients. The methodological approach of AR provided the framework for gathering contextual data whilst simultaneously affording reflexive and collaborative, inter- professional opportunities for problem solving, thus grounding the data in real-to- life experiences. This provided data from multiple perspectives, responding to the needs and views of the other stakeholders as well as those of the CAM therapist (myself as researcher/therapist). As planned, this research generated opportunities to identify both problems and collaborative solutions. However, the reflective cycles inherent in AR also _ brought to light unexpected, emergent themes, providing learning cycles which culminated in a new awareness of the barriers facing IM. The conclusions suggest that more thought needs to be given to ways in which the structural and inter-professional barriers inhibit IM. Recommendations identify that structural changes would help CAM therapists to understand and negotiate the centrist and complex governance in the NHS; and that improved opportunities for inter- professional dialogue would help to reduce the inherent problems of occupational closure and inter-professional conflict.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available