Part 1.
The International Council of Reflexologists ICR held their first face to face conference since covid this September in Athens Greece. The conference theme “Making Reflexology Mainstream” was announced in 2024 with a call for papers (abstract submissions). I submitted my abstract “Providing evidence to support reflexology provision in mainstream healthcare” and was thrilled when chosen to present at the conference. Delivered over 2 hours my presentation was divided into part 1 a series of slides that illustrated the strategic route and data evidence (presented as graphs) that enabled an externally funded reflexology project move from trial phase to sustainable daily service status within a UK NHS hospital Cancer Service that remains operational to date.
NHS Clinical Reflexology Service Project Pathway.
- Identifying a need: The Project Proposal. ( Keep it simple= Why? Who? What? Where? When? How?)
- Guidelines and Permissions: Behind the Scenes Paperwork. (Governance Policy & Procedure. Standard Practice. Risk Assessments. Training).
- Service Delivery: Practicalities and Assessment Process. (Adapting reflexology. Consent/evaluation form. Annual patient survey and Staff Engagement Event. Clinical Audit – Urgent & Integrated Care Division (A). Annual Reports).
- Internal 2019 Award-Winning Audit Data Findings. (2,078 patient feedback data)
- Service Development 2014-2022. (Over 10,000 patient feedback data)
- 5 year NHS Clinical Reflexology Service Model.
- Getting Published. (Process of study submission, external double blind peer review)
- Barriers to UK NHS Mainstream Integration. (Lack of Degree status training that would enable membership of Allied Healthcare Professionals Council HCPC)
- Special Mention. (Belinda Ryan 1961-2019 a friend that opened doors to benefit others. Prof David Machin who donated research expertise and statistical analysis to the project. Patricia Miller OBE, CEO Dorset ICB whose professional support “made things happen” and Beryl Crane for her inspirational teachings.)
With focus on the 2019 NHS Clinical Reflexology Clinical Audit aims, objectives and outcomes that included the evaluation of the Clinical Reflexology Service from a patient perspective. Identification of patient concerns (physical/emotional) : Patient perceived outcomes : Patient experience comments on Service, Beneficial Effect and Therapeutic Effect. The audit outcome report findings were that of the 2,078 patient feedback data Service uptake was 70.60% Female 29.40% Male with the highest number of patients 48.80% aged 61-75. 50.10% were Chemotherapy patients 42.11% Ward in-patients 7.80% Radiotherapy patients. The top three patient identified concerns were Anxiety (45.62%) Pain (22.81%) and Swelling (10.59%). 1,839 Patient Experience Comments were collated and categorized 638 patients commented on the Service with 126 rating excellent. 247 patients commented on Beneficial Effect (physical change) with the highest number 36 citing a reduction in pain after reflexology. 954 patients commented on the Therapeutic Effect with 517 feeling relaxed after reflexology. The Audit data informed the external double-blind peer reviewed published article in the Royal College of Nursing Cancer Nursing Journal and can be viewed in full on line Open Access (citation) Langstone-Wring A, Whatley J (2023) Patients’ experiences of clinical foot reflexology in a hospital cancer service. Cancer Nursing Practice doi:10.7748/cnp.2023.e1841. My presentation was well received by colleagues from around the world, there were questions throughout about the complex processes involved in setting up and running a complementary service within the UK NHS. Delegates took away the Consent/Evaluation form I specifically designed for use in clinical settings to introduce in their settings so they might start to collect patient data in a standardized manner. So hopefully more meaningful data will be published and further the cause of reflexology recognition and integration into mainstream healthcare provision going forward.
Part 2 Practical demonstration of Professional Clinical Reflexology PCR-The Langstone-Wring 20 minute Method
Part 2 of my presentation consisted of training slides and video demonstrating my 20-minute Method Professional Clinical Reflexology PCR developed whilst working with NHS patients during their cancer treatment in the Fortuneswell Ward, Chemotherapy and Radiotherapy (Robert White Centre|). A standard (level 3) model of reflexology treatment is normally 1 hour and aims to provide a relaxing experience to enhance wellbeing. However, providing a high standard reflexology service to NHS cancer patients in busy clinical settings with identified complex challenges required a new model of adapted advanced reflexology.
- Firstly, the reflexology treatment needed to be shortened, and the usual firm pressure replaced with a gentler and smoother technique due to heightened sensitivity and vulnerability of this patient group both emotionally (facing fears associated with cancer diagnosis and treatment) and physically (coping with side effects of cancer treatment).
- Secondly, adapting the reflexology service delivery so as not to disrupt the day-to-day activities of a busy cancer unit and address identified challenges and risks.
a) In–Patients in a busy ward in a hospital bed (the bed end and equipment needed to be removed pre and replaced post treatment for access to patients feet)
b) Out-Patients receiving chemotherapy in reclining chairs in busy clinic connected to drips etc.
c) Out-Patients attending precisely timed radiotherapy ( in a separate building). - Thirdly, gaining a deeper understanding of medical terminology and clinical procedures whilst working under supervision and in collaboration with staff, engaging in mandatory training, assessment processes and producing governance guidelines to meet NHS standards. Considering all the above and to ensure a safe, effective, consistent, timely and transferable service model Professional Clinical Reflexology PCR-The Langstone-Wring Method Training was developed.
Aimed at giving qualified reflexologists the opportunity to obtain evidenced and certified by leading industry accreditors, CPD training to support their applications to join complementary therapy teams in UK NHS hospitals and hospices. Graduates include DCHFT Reflexology team and Weldmar Complementary Therapy team having completed my PCR Method training. My PCR Method is gentle and lends support to the various nervous systems of the body with focus on balancing the Sympathetic and Para-sympathetic branches of the (peripheral) Autonomic Nervous system using the Vagus or X 10th cranial nerve as the main conduit, modulating the autonomic cardio-vascular, endocrine, respiratory, gastro-intestinal and immune systems. When anxiety is triggered (fear or trauma) the adrenal glands release adrenalin and cortisol this “fight or flight” sympathetic drive response heightens nervous system activity, increasing intensity of pain, affecting blood pressure, heart rate, swallowing and breathing, digestion and all bodily functions that are automatic (not under our control). In contrast the body releases Prolactin, Oxytocin, Vasopressin and Acetylcholine to calm and enable the body to “rest and digest” promoting balance and Homoeostasis. Delegates watched the demonstration video whilst practicing my PCR Method on each other’s feet, questions came thick and fast throughout the session. When questioned as to the versatility of PCR, I replied that my PCR Method can be integrated into existing reflexology protocols or can be used a stand-alone treatment and is not just for cancer patients. For example, patients diagnosed with chronic sciatica and/or piriformis syndrome have reported significant relief from symptoms after PCR treatment. Graduate feedback has reported the PCR Method therapeutic and beneficial in calming agitation in End of Life, palliative care, and dementia patients. It has also been used to support Parkinson’s patients and many other diagnosed conditions where neurological symptoms are present. My presentation was well received, and delegate feedback supported my call for future degree status training for Clinical Reflexologists. It would be wonderful if a university would take on the challenge of providing such a course, who knows perhaps someone reading this might be in a position of influence………..fingers crossed. I am not qualified to diagnose conditions however, I am qualified to prescribe and experienced to support patients with medically diagnosed conditions. Many patients tell me they feel their symptoms eased following a treatment and that they feel relaxed, and their sleep improved. If you think I might be able to help you or someone you know please get in touch, always happy to try and help.
