PIC 5

Setting up a free-to-user clinic? Things to think about

 Trustee Barbara Robinson takes us through what will be required to set up a free-to-user clinic, using a World Medicine Acupuncture in Action Grant.

What will your clinic look like? WM’s experience at Grenfell, Wapping and in India has provided us with a few tips and considerations for setting up and managing clinics such as this, which we are happy to share.  (Staff at JRS Wapping refer to patients as Refugee Friends or Friends, and we have adopted that.)

Clinic type:
Multibed? Seated? This will depend on space, equipment, daily setting up time, personal inclination and targeted beneficiary group.  WM’s experience is that good results can be achieved with seated auricular treatments and is time efficient for stress/trauma/anxiety/insomnia treatments. It is also more suitable for mixed gender groups. Where full body qualified acupuncturists are volunteering they can also offer distal points to great effect.

In our India clinics where 80% of complaints are musculo-skeletal we have access to hospital beds, and this has some benefits – not least it prevents patients wandering around with needles in!
Where space is limited, think carefully before running a mix of seated and couch – we have found that patients directed to seated areas perceive they have been short-changed compared to lying down on the couch, which they think implies a more thorough treatment.  Explaining the workings of acupuncture points regardless of physical position becomes difficult when there are translation issues.

Space and equipment:
A large roomy space with plenty of natural light that does not have through traffic is ideal.
Is it accessible for both volunteers and Friends?
Community spaces are often already equipped with chairs which, hopefully, are wipeable.  If placed in pairs with a good space around you have a place to perch yourself while working and not be hampered by being close to a wall or other furniture.  Good spacing also encourages Friends to enjoy the quiet and get the most from their needle time.

Stacked chairs in the corner of the room take only minutes to set out and equipment is stored in a bag with treatment notes in a locked cupboard in the same room, if possible.
A table is needed to set out equipment during the clinic.
A list of suggested equipment is here

Is the space free to use? This is where costs could mount up – by seeking out ‘hosts’ it is possible to benefit from a committed partner who knows their Friends and provide translation if needed.

You could start by checking out charities in your area with similar target groups (eg British Red Cross); acupuncture or multidiscipline practices able to donate space a regular time each week (perhaps check with colleagues at your BAcC regional group – would also be good for gathering volunteers); social groups with a shared interest in helping your target recipients (Association of Ukrainians in Great Britain)
Volunteers: 
To be sustainable, and by that I mean still be operating in a year’s time, a weekly clinic with two practitioners attending will probably need a minimum of 8 volunteers to rotate, even better if you have 10 or even 12.  Sounds a lot, and you may think that you will be able to run it by yourself with perhaps another to help you and perhaps you can.  But wait – life has a way of intervening – what if that hospital appointment comes round at last and you don’t want to miss it/you wake up with a migraine/covid/a sick child? Having others to call upon is invaluable if you are not going to cancel a clinic.

Planning the rota well in advance is appreciated by volunteers, but it takes thought and prompt action is needed for last minute changes. A whatsapp group for volunteers to quickly contact each other is invaluable, its wonderful for letting the other volunteers know how the clinic went that week, and for the cohesion of the group when they rarely see each other.

The success of your clinic depends on your volunteers. It goes without saying that volunteers should be qualified, insured and DBS checked.  Sometimes DBS checking can get forgotten by the most conscientious of acupuncturists so it is useful to be able to offer this to your volunteers.  We use an online company – Aaron’s Department – for our DBS processing.  Your group will need to have at least 2 nominated admin/checkers set up on their system.  It is very simple and you can take advantage of the admin only charge which means for processing volunteers, the cost is as low as £8 per person – this is easily covered by the grant: why not offer this free to your volunteers?

Understand your beneficiary group:
How are you going to let them know you are there? Any advertising, discussions with host/partners should be targeted.  Consider your response if other groups outside of your target wish to avail themselves of your service. Is that okay with you – do you say Yes to everyone – or do you say No?
It’s a difficult one ……… What was your original reason for setting up the clinic?  A ‘mission statement’ is useful here as it provides a clear pointer in the minds of the volunteers who their beneficiary group are, and that in turn helps with their commitment.  Consider also where the financial support has come from – does what you are doing still align with your and your donors’ intentions?

Finances:
WM is offering £2000 for set up costs, usually 50% initially and 50% after 6 months.  However, if there are circumstances that require 100% initially then this can be considered. It will be necessary to have a bank account in the name of your group. Recipients of the grant are free to use it as they wish, but we think equipment and volunteers’ travel expenses have highest priority.  Having a limit on amount that may be claimed per volunteer, per session, is useful as it facilitates planning.

Reporting:
We feel it is important to be able to assess, after a time, how your clinic is doing. Your gut feeling may be that all is wonderful, which is great, but if you intend to revisit your original sponsor or even try elsewhere for continuation funds, it is useful to be able to demonstrate the success of your clinic. Perhaps after 6 months or so you could also ask your refugee friends for some feedback. 

WM use a standardised treatment form which has been modified over the years to hold all the relevant details of patient, data and tx consent box, date, practitioner, category of ailment, treatment, a severity ‘score’ and number of needles used.  Without creating an admin burden, we find that these details provide sufficient information to keep track of treatments, improvement rate and equipment usage so that reporting is possible. We are happy to share this with groups who may be interested.

Equipment list:
Most working acupuncturists will have an idea of what they need to operate, but to get you going without too much outlay I would suggest the following.  Of course, it will depend on how many Friends you will be treating per session and how complicated your treatments.  Regarding needles, based on a keystone treatment of 10 ear needles plus possible addition of 5 (average) body needles, treating 15-20 friends weekly for 3 months you might consider an initial order of the following, but review after a couple of months to check usage.

2000 auricular needles
1000 1” needles
1000 ½” needles

Ear seeds (clear backing)
Cotton wool and/or cotton buds
Sharps bin
Massage oil
Small paper cups for transporting needles to/from patient
Sterilising hand gel/wash
Magnet
Ear probe (optional)
PPE if still using

(If chairs are needed, I find enquiries at local secondary schools, churches or office refit companies result in some no-longer-used furniture either free or for a small donation.)

April 2022