FHT Statement on Charity Commission's decision reagarding charitable status of organisations that use or promote complementary and alternative medicine (CAM)
Statement published: 13 December 2018
In March 2017, the Charity Commission for England and Wales launched a review of its approach for deciding whether an organisation that uses or promotes complementary and alternative medicine (CAM) is eligible to register as a charity.
The Commission stated the purpose of the review was ‘not about whether complementary and alternative therapies and medicines are ‘good’ or ‘bad’, but about what level of evidence the Commission should require when making assessments about an organisation’s charitable status’.
As part of its review, the Commission ran a public consultation between 13 March and 19 May 2017, and held two discussion events at its London offices for organisations with ‘a particular perspective on the issues under consideration’.
As a key stakeholder, the FHT responded to the consultation and was invited to attend one of the discussion events chaired by the Commission, where the FHT represented the interests of its members working in the charitable sector.
The Commission has completed its full review and on 11 December 2018, published an Outcome Report and supporting documents, highlighting the following:
‘Our review has confirmed that the basic legal principles that apply to our work in assessing applications for charitable status by CAM organisations remain unchanged. But as a result of our review, we are updating our approach to assessing CAM organisations against those legal principles.’(1)
When assessing whether a CAM organisation meets the legal requirements for charitable status, the organisation must still be able to demonstrate to the Commission that ‘its purposes are exclusively charitable and for the public benefit. This means that applicants must provide evidence that their intended purposes can benefit the pubic, and will not result in any inappropriate harm.’(1)
Prior to the review, the Commission focused on whether there was medical evidence regarding the efficacy of the treatments in question. However, it has now established ‘that some CAM organisations do not aim to provide the same benefits as more conventional medical organisations might. Instead, their purposes may relate to relieving suffering or providing comfort to patients, either generally or in the context of certain medical conditions. In such situations, evidence of benefit may come in the form of outcome reports by patients or observational studies based on patient responses. This type of evidence may, for example, be the best available source to evidence a patient’s level of pain, functional limitations, or other symptoms (fatigue, mood, and so on).’(1)
CAM organisations applying for charitable status will still need to ‘back up’ and ‘match’ any claims they make with appropriate evidence. However since its review, the Commission has broadened its approach and will now consider patient-reported outcomes that measure elements of physical health (such as fatigue, pain intensity, physical function and sleep disturbance), mental health (anxiety or depression) and social health (the ability to participate in social roles and activity).(2)
With regards to assessing whether there is any risk associated with the CAM provision, where the organisation applying for charitable status can confirm that its therapy practitioners are listed on an Accredited Register, such as the FHT’s, then examining the level of risk will not need to be detailed.(2)
Where a CAM organisation already has charitable status, the Commission will look at whether this needs to be revisited. However, for the vast majority of registered CAM charities, it has highlighted that ‘no action will be needed, either because the efficacy of the relevant treatment has already been established under our previous approach, or because it is clear that benefit can be demonstrated under the current approach. In some cases, it may be that we recommend that a registered CAM charity amends its objects, so that they are limited to what can clearly be demonstrated by the available evidence’.(1) With regards to what the changes will mean to the public, the Commission believes these will ‘serve to ensure that our decisions on registering CAM organisations continue to be robust and will reduce any potential for harm, while promoting informed public choice regarding charities and donation, and ensuring that organisations that are capable of providing public benefit can demonstrate this without being hampered or restricted by requirements for inappropriate types of evidence’.(1)
The FHT welcomes this very positive review outcome from the Charity Commission.
The Commission’s decision will ensure that some of the most deserving members of society will still be able to access complementary therapy services offered by charities in their local community, to benefit their health, wellbeing and quality of life. It will also bring FHT members working in the charitable sector renewed confidence, knowing that they can carry on providing support that is truly valued by their clients, as well as other professionals that work at or link into the same charity.
It is also very encouraging that the Commission has identified the value and importance of patient reported outcomes as evidence base for CAM, particularly in relation to relieving suffering or providing comfort to patients.
The FHT will continue to encourage as many of charities as possible to appoint complementary therapists who are listed on an Accredited Register, such as the FHT’s, which is part of a government-backed programme overseen by the Professional Standards Authority for Health and Social Care. Choosing a therapist listed on an Accredited Register helps charities to protect their service users, by providing extra assurance that the practitioner is suitably qualified, insured and accountable.
1. Charity Commission for England and Wales. (December 2018) Outcome report. The use and promotion of complementary and alternative medicine: making decisions about charitable status. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/763303/CAM_Outcome_report.pdf [Accessed 11 December, 2018.]
2. Charity Commission for England and Wales. (December 2018) Operational Guidance (OG) 304 Complementary and Alternative Medicine https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/763305/CAM_OG304.pdf [Accessed 11 December, 2018.]