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The waiting game

Dilemma: Renting premises to a complementary therapist

One of your partners suggests leasing a room in the premises to a hypnotherapist, but another partner says the candidate is not qualified to work in an NHS surgery. What checks should you do before leasing a room to a therapist, how might their own practice affect your surgery’s reputation and how can you agree within your partnership which service providers are appropriate candidates to work on your premises?

It is a treatment that requires deep trust between therapist and patient.

Dr Mike Dixon 2 Guy Newman

If the room that the hypnotherapist is using is covered by cost rent/notional rent, you can only charge heat and lighting. If the room is not already effectively being paid for by the NHS then you can charge rent but (assuming that patients will need to pay for the service) you will need to be explicit to patients about the financial arrangement between yourself, the practice and the hypnotherapist, and also offer any available NHS services that might help the condition for which you are suggesting that the hypnotherapist might be an option. Transparency must be the rule. 

There are over 15 hypnotherapists’ organisations. Members of most of the organisations are entitled to register with the CNHC (Complementary and Natural Health Council), the national and respected body for voluntary regulation of many complementary therapies. The GHR (General Hypnotherapy Council) is the largest registering body for hypnotherapists and members can be fast-tracked for membership of CNHC. Nevertheless, there is no substitute for a partners or practice meeting, and the hypnotherapist having a proven track record in providing an effective and safe service.

Finally, it is important that you meet and get to know the hypnotherapist as someone with whom both you and the patients can feel comfortable. There are a lot of myths surrounding hypnotherapy and, among complementary therapies, it attracts a disproportionate amount of complaints and litigation. It is a treatment that requires deep trust between therapist and patient that is safe and effective, in the right hands.

A hypnotherapist in the practice can be an enormous asset.  A hypnotherapist in our practice has helped patients with problems ranging from poor sleep, obesity, phobias and smoking. It produces rapid results and it is a good start for patients beginning to embark on mind/body therapy to change their lives.

Dr Mike Dixon is a GP in Devon. He is also the chair of the NHS Alliance and interim president of NHS Clinical Commissioners.

High quality complementary therapies are playing an increasingly important role in health and social care.

kailash chand arms folded

The ultimate aim of any medical establishment should be to provide a healthier life for all. High quality complementary therapies are playing an increasingly important role in health and social care. Around one in five adults in the UK are estimated to have used some form of complementary medicine. I am a trained acupuncturist myself and believe complementary therapies do have a role alongside orthodox medicine. The Department of Health agrees complementary medicine has a part to play in the NHS.

Complementary medicine should be integrated into the NHS but we should ensure a structure is put in place to ensure the NHS can check there is proper training and regulation of the practitioners. If you and your partners can agree to lease a room to an alternative therapist you should also research which qualifications a practitioner such as a hypnotherapist should hold.

Dr Kailash Chand is the deputy chair of the BMA.

To protect against one partner making unauthorised lettings generally, if you are entering into a lease all of the named legal owners of the property will need to grant it together.

When considering whether to lease space to any therapist or care provider, checks should be made with the regulatory body for the kind of therapy treatment in question and reference should be sought from suitably qualified professionals.

Unless a service provider occupies a separate area which has a clear separate identity, if such provider proves to be unsuitable it could affect the reputation of your practice. Caution should also be employed from a financial perspective. This does not mean however that one should not consider under-letting surplus space. If you own your premises you may consider whether you wish to grant a lease to a provider of ancillary services in order to derive some income from unused property. 

Of course you should ensure that this will not impact on your rent reimbursement and if the property is mortgaged, your mortgagee’s consent may be required. 

To protect against one partner making unauthorised lettings generally, if you are entering into a lease all of the named legal owners of the property will need to grant it together, so realistically in the event that you are not all in agreement there may be some difficulties in reaching this arrangement. 

You may prefer a much shorter term arrangement whereby a genuine licence is granted which would also allow you time to consider whether the new occupier was satisfactory. Care should be taken to ensure that any documentation is a bona fide licence as it is sometimes possible that a lease is inadvertently created without adequate protection for the Landlord.  The advantage a licence does have is that it is usually brought to an end much more easily. 

Finally there should be a contractual protection either in your partnership deed or a suitable declaration of trust preventing under-lettings without either the agreement of all or a majority of the property-owning partners.   

Edwina Farrell is an associate at Hempsons.

Readers' comments (5)

  • I am sure that the future is to integrate
    all therapists under the NHS umbrella.
    Surely it should be whatever helps?
    I've seen a vast number of professional
    therapists over the years and regularly use
    relaxation and sleep hypnotherapy CDs.
    I think the best thing is probably to try out
    therapists for oneself. If gives you a chance
    then to guage their professionalism.

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  • The British Acupuncture Council (BAcC) is the largest professional body regulating and supporting traditional acupuncture in the UK. With a nationwide network of over 3,100 highly qualified, medically trained, individuals (who adhere to high standards of practice and safety), they are perfectly poised to provide efficient, cost-effective traditional acupuncture treatment to NHS patients. Acupuncture is widely used and accepted all over the world, with 4 million treatments a year in the UK.

    BAcC members can make a real difference to GPs who work in muskulo skeletal services. There is a large body of UK and global evidence supporting acupuncture’s role in improving health outcomes.
    In particular, NICE Guideline CG88 for lower back pain recommends the use of acupuncture as part of treatment plans. There are several other conditions where acupuncture is found to improve health outcomes and achieve cost savings.

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  • What you shouldn't do is to rely on organisations like the CNHC. When complaints were made to the CNHC about unjustified claims made by "reflexologists" (ie plain old foot massage) the CNHC agreed that the claims were unjustified, but took no action because they said that reflexologists had been taught things that weren't true during their "training". This episode, more than any other, shows the futility of trying to ensure proper training in subjects that are make-believe in the first place. The same applies to acupuncture, chiropractic and just about every form of made-up medicine.

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  • This comment has been moderated.

  • PS it would be advisable toi wait for the revised NICE guidance before renting space to an acupuncturist. The latest information indicates that acupuncture is no more than a theatrical (and not very effective) placebo.

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  • I would be interested to know which therapies Dr Chand considers to be the 'high quality' ones and what criteria he would use to ensure 'proper training and regulation of the practitioners'.

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