Pseudoscience in Cancer Services; a survey of National Health Service Trusts in England

Abstract

AbstractBackgroundScientifically implausible treatments are offered by some hospital cancer departments. Examples are reiki, aromatherapy, and reflexology. Salaried practitioners are employed to deliver these therapies, which are provided as palliative care, although they lack evidence of effectiveness. Such practices seem to conflict with efforts to make health care evidence based.AimTo estimate the extent of certain pseudoscientific practices in NHS Trusts, and to evaluate the rationale for such provision.DesignRelevant documents were requested from NHS Trusts under the Freedom of Information Act 2000 (FOIA). Main outcome measures were: number of trusts offering pseudoscientific practices in cancer departments, time to full FOIA response, presence and content of practice governance documents, and presence and quality of evidence for practices.Setting/ParticipantsCancer care departments in NHS hospitals in England. No patient participants were involved in the survey.Results13.6% of eligible NHS trusts were offering pseudoscientific clinical practices. No trust provided a valid business case, or any robust evidence for the practices. The governance documents included claims about chakras, meridians, and invisible “energy”. Ten trusts required that informed consent be obtained from patients. This could not have been obtained because information given was misleading.ConclusionsPseudoscientific practices are embedded in the NHS in England, and governance documents show poor understanding of clinical evidence.