Third Prize: Chiropractic and the national health care system: a basis for partnership in the UK.
BACKGROUND
Changes in United Kingdom (UK) health care policy and legislation have the potential to radically change care for patients with musculoskeletal conditions by widening access to manipulation services under its National Health Service (NHS).


OBJECTIVE
To investigate chiropractors past and current provision of musculoskeletal services for NHS patients and optimal future arrangements.


METHODS
One thousand forty-two UK chiropractors on professional registers were sent a 2-part questionnaire. The profession was divided into 2 groups and each group answered part of the questionnaire from either a practitioner or patient perspective.


RESULTS
Sixty-nine percent responded. Of these, 29% had previously provided services for NHS patients, and 18% were currently providing them, reporting moderate to high levels of satisfaction. Ninety-five percent were interested in future arrangements but on a part-time basis and in a way that most closely resembled private practice.


CONCLUSIONS
The majority of UK chiropractors favor future partnership with the NHS. National health care reform and the statutory self-regulation of chiropractors have brought this closer to a more widespread reality. However, to prosper in this setting, the profession may benefit from a greater understanding of the competing priorities and constraints faced by NHS purchasers, who, for their part, should be prepared to implement policy based on evidence.
Langworthy
Jennifer M
JM
Institute for Musculoskeletal Research and Clinical Implementation (AECC), Bournemouth, UK. imrci.jlangworthy@aecc.ac.uk
Breen
Alan C
AC
Vogel
Steven
S
Collier
Richard
R
D001291:Attitude of Health Personnel; D002684:Chiropractic / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000592:standards*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D013222:State Medicine / Q000191:economics / Q000592:standards*; D011795:Surveys and Questionnaires; D006113:United Kingdom