Challenging misleading healthcare claims.

CNHC - Time for Action

There is a regulator of 'complementary' practitioners that is supposed to be protecting the public. How well are they performing that duty?

Complaints form

Last July we were pleased to report on the sensible advice on advertising issued by the Complementary and Natural Healthcare Council (CNHC) to registrants after the ASA upheld our master complaints on reflexology.

This advice on top of their Guidance Sheet on advertising certainly gives the impression that the CNHC takes the issue of practitioners making "inappropriate or unsubstantiated claims" seriously and quite right too — especially given the CNHC has just applied for Accredited Voluntary Register status with the statutory Professional Standards Authority (PSA) — the new name of the CHRE.

When considering an application to become accredited, the PSA issues a 'Call for evidence':

Organisations applying for accreditation will have to demonstrate (by providing evidence) that they meet the standards set out by the Professional Standards Authority. The Authority will check, challenge and confirm the evidence provided by the applying organisation and will take account of feedback from patients, service users, the public, professional and representative organisations and others.

We would like to hear the experiences you have had with organisations applying for accreditation. Your contribution can be as lengthy or as brief as you like, but we will only be able to take it into account if it is supported by evidence rather than just being an expression of your opinion or based on hearsay (i.e. what someone else has told you).

We think the PSA need to be asking some probing questions of the CNHC and we will be submitting our own response. If you have information you think is relevant, we urge you to do so as well — but note the deadline is Wednesday, 3 April 2013.

To provide your feedback, please complete their form and email it to This email address is being protected from spambots. You need JavaScript enabled to view it..

History

But to help understand why we are concerned about the CNHC being granted AVR status, we need to briefly look at their history.

The birth and ongoing problems with the CNHC have been covered by Andy Lewis on The Quackometer and the problems they had with dealing with complaints about their registrants by Simon Perry:

The CNHC wishes to place on formal record their thanks to Simon Perry

OfQuack [the affectionate name for the CNHC] launches six-month bullshit amnesty: the regulator that doesn’t regulate

In summary, as a result of Simon's complaints, the CNHC stated:

  • CNHC will tell practitioners to remove claims they cannot justify.
  • CNHC will conduct a review of evidence base for regulated therapies.
  • CNHC will contact all registrants to instruct them not to make claims without justification.
  • CNHC will contact complementary health course providers and authors to instruct them not to make claims without justification.

A responsible regulator would have already done all that, particularly one whose stated aim is to act in the public interest. But it's good they realise they had to do this to protect the public from being misled by their registrants.

Progress? What progress?

But what progress have they made?

The CNHC originally produced 'Therapy Descriptors' for each therapy they registered. These detailed what the therapist could do for you and what you could expect at a session. For example, their Therapy Descriptor for reflexology originaly stated:

How reflexology may help

Numerous disorders may benefit from reflexology depending on the specialism and expertise of your practitioner. Examples include pain, headaches, sinus problems, hormonal imbalances, back problems, stress and tension.

This clearly misleads the public into thinking that reflexology can help with those conditions. After lengthy discussions with the Advertising Standards Authority (ASA), these therapy descriptors had to be re-written and are now CAP Code friendly, with no mention of any medical condition anywhere. All they are left with are vague notions of 'well-being' and 'relaxation' and what a practitioner will do to you. Read them all here.

For example, the new reflexology descriptor now simply says:

Reflexology works on an individual basis and may alleviate and improve symptoms such as everyday stress and tension.

We have no doubt many of these therapies are relaxing, but there is little or no evidence they can do any more than that.

Any CNHC registrant keeping within these new descriptors is far less likely to be challenged and far less likely to mislead an unsuspecting public.

Making a difference

With these therapy descriptors in place for — in many cases — well over a year, have CNHC registrants removed misleading claims from their websites? Have the CNHC enforced their advertising rules (never mind what they promised Simon)?

No doubt some registrants, aware of their responsibilities and wanting to live up to them, will have changed their websites, but swathes of claims well outside the therapy descriptors remain across a wide range of therapies.

It is clear that, however well intentioned the CNHC may be, they are not being vigilant enough about what their registrants are claiming. If registrants are making claims that cannot be substantiated with good evidence, their customers cannot give their fully informed consent to treatment and that is a critical breach of their Code of Conduct, Performance and Ethics.

So, we need to make them aware of the extent of these claims and we want to see how they deal with registrants as a test of their professionalism and ability to properly protect the public.

We are therefore asking our supporters to submit complaints about questionable claims made by CNHC registrants.

Submitting a complaint

CNHC registrants can be found by choosing a particular therapy and searching for registrants in your area using their Search facility. But first, familiarise yourself with these CNHC documents:

  1. What types of complaints against registrants can we consider?
  2. Code of Conduct, Performance and Ethics
  3. Advertising Guidance
  4. Complaints Procedure
  5. Complaints Handling Process

Once you have found a registrant who you believe may be making claims about the therapy for which they are CNHC registered that you don't think can be properly substantiated or that go beyond the Therapy Descriptors or the ASA's CAP Code and guidance, you can submit a complaint. Please check carefully to ensure that it is a CNHC registrant who is making the claims and for a therapy for which they are registered.

Submitting the complaint can be done in several ways: using FishBarrel (which has recently been updated to include the CNHC's complaints form) or by filling the CNHC's complaints form manually. Because this form is a simple pdf, we have turned it into one that can be filled in electronically — download it here. Remember that you need to sign the form and that the CNHC are unlikely to accept any complaint not presented on their form.

Some suggested overall text can be downloaded here, but please feel free to use your own words or adapt the text to suit. But please remember these rules:

  • Keep it simple and to the point;
  • Keep it impersonal and factual;
  • Make sure you give the name of the registrant, his/her therapy and the claims for that therapy you are questioning.

If you use our electronic version of the form, you should be able to fill it in electronically in your pdf reader and add a scan of your signature. To do this on recent versions of Adobe Reader, click on 'Sign' at the top right of the Reader, then 'Place signature', then choose 'Use an image' to add your pre-scanned signature into the form in the correct place. Make sure your text is fully visible on the form, but if it is longer than the text box will allow, add it as an additional sheet (Word, text, etc) and list it on the form under Additional Information. Remember to keep a copy of everything you send. Ideally, take a snapshot of all web pages you are complaining about and monitor them for changes.

The completed form can then either be sent by post to the address given on the form, or emailed to This email address is being protected from spambots. You need JavaScript enabled to view it. (FishBarrel will do this automatically) marked for the attention of the Fitness to Practice Officer.

Please tell us when you submit a complaint and when it has been resolved to your satisfaction.

27 March 2013

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