1. Dr Amir Sheikh, BCS (UK) & Primary Healthcare Corporation (Qatar) Dr. Sirfraz Nazir BCS (UK) 2 nd International Conference on Quality in Prophetic Medicine Jeddah, 4 th April 2016

2. 1. Present a case for the professionalization of Cupping 2. Present BCS experiences with Professionalisation & Standardisation in the UK 1. Planning for the Future – Our Legacy

3.  Why can’t anyone do it?  We have drugs now!  Where’s the Evidence!  The Hijama Clinic!  It’s not Safe!

5.  3 Main Areas Identified ◦ Procedure ◦ Practitioner ◦ Environment

9.  At present practiced by many cupping practitioners both health and non-health professionals  Mainly practiced through dry cupping in the form of Chinese medicine  Gained popularity amongst the Arab, Asian and in general Muslim community  There are a number of clinics at present. ◦ Some clinics offer wet cupping as part of a ‘natural’ approach to medicine and healing ◦ Other clinics have an emphasis on Islamic medicine ◦ Other practitioners practice from home and offer group sessions ◦ Sessions in the local community centre are becoming more common  Clinics make unrealistic claims about Cupping.  No formal training

11.  Blood borne disease exposure  Skin Infections  Adverse Events  People practicing in non-healthcare setting  People not adhering to any codes of a professional body  Effectively resulting in negative publicity and public confidence with long term consequences on our legacy.

12. ProblemAimsSolution Procedure VariationResearch Compliant Procedure STANDARDISED PROCEDURE Inadequate Evidence Base Encourage Cupping R&D INTERNATIONAL RESEARCH COLLABORATION Variable Practitioner Competence Minimum Standard of Practice STANDARDISED CURRICULUM & WORKSHOPS

13. ProblemAimsSolution Variation in Clinical Setting Minimum Clinic Requirements OPERATIONS MANUAL Practitioner not Accountable Increase Public Confidence INDEMNITY, COMPLAINTS & DISCIPLINARY PROCEDURES Public Awareness/Misinforma tion Provide a Platform for information & Enquiries MEDIA & SOCIAL MEDIA ROADSHOWS

18. ProblemAimsSolution International Awareness Lacking Provide an International Academic Platform INTERNATIONAL CONFERENECES Lack of Awareness Amongst Governing Bodies Provide SupportPROVIDE CONSULTATION AT INTERNATIONAL AND GOVERNMENTAL LEVEL

19. Adverse EventNumberPercentage None 33 66% Transient Hypotension 7 14% Dizziness 4 8% Nausea 6 12% Skin Blistering 0 0% Vasovagal Syncope 1 2% Total 50 100%

20. Dermatological Effects Skin ChangesNumber% Normal full healing 38 76% Healing with minimal scar visibility on close inspection 5 10% Scar visible, non-hypertrophic 6 12% Hypertrophic/Keloid scar 0 0% Atrophic scar 0 0% Skin Infection 1 2%

22.  Protecting against Malpractice and jeopordising the therapy  Duty of Care ◦ If we did not professionalise cupping people would access it anyway ◦ Rise in people seeking alternative health therapies  Public Safety ◦ Unscrupulous practice is a public health risk ◦ Practitioners should be accountable to the general public

24.  BCS - Approved National Regulator in Cupping Therapy  Common Code of Conduct  Standardised Practitioner Requirements ◦ Indemnity ◦ Occupational health  Open Access Database  Complaints & Disciplinary Procedures

26. 1. Standardised Knowledge, Competency & Practice 2. CME 3. Governance, Monitoring & Licensing 4. Workplace Guidelines 5. Holistic & Integrated Approach 6. Assimilation - into the healthcare system 7. Research & Development

28. International Consultancy Preston City HealthCare CouncilTurkish Ministry of HealthKorean Institute of Oriental Medicine Wandsworth PCTAustrian Hirudotherapy Association

29. Doctors/ Surgeons Allied Health Professionals Route 1Route 2 Achievement of Competency in Cupping Provisional License Full License

30. Renew Year 1 Renew Year 2 Appraisal Revalidation Year 3

31.  We have COLLECTIVE DUTY to professionalise cupping  We have seen the benefits of cupping – beyond placebo!  We have proposed a framework for professionalisation  We believe this offers a feasible route to ensuring the continued development of cupping  We are willing to work with other professions and health organisations worldwide to help with professionilsation