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.Conclusion: 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