UK Health Centre: Misleading information about osteopathy – a second Advertising Standards Authority (ASA) complaint

Rulings - ASA I CAP_ UK Health Centre - have previously highlighted the many misleading claims about complementary and alternative medicine on the UK Health Centre website. The website is owned by Core Health Ltd and they provide misleading information about osteopathy, chiropractic, acupuncture, homeopathy and herbal remedies. The information they provide is misleading the general public and has the potential to cause people to take unsuitable treatments. In the interest of public safety I therefore reported UK Health Centre to the Advertising Standards Authority (ASA) and focused on their claims relating to osteopathy in the first instance. That complaint was “informally resolved” but rather than addressing their misleading claims, Core Health Ltd actually added more conditions to the list of those that they claim osteopathy can treat. I therefore raised a second complaint to the ASA. This complaint was also “informally resolved” in January 2018. However, Core Health have still failed to address their misleading advertising.

The website has been changed in response to this second complaint with some claims being removed but also some new ones being added. The UK Health Centre website continues to make misleading claims about osteopathy as a treatment for a wide range of medical conditions including:

  • Whiplash
  • Asthma and chest problems
  • Long term illness
  • Stress
  • IBS
  • Infections and illness
  • Improving the immune system
  • Increasing the efficiency of nerve supply
  • Low energy
  • Dysmenorrhoea (period pains)
  • Recovery from childbirth
  • Common infant problems (including colic, sleep problems)
  • Monitoring baby’s growth and development
  • Improving cognitive function
  • Visual and hearing impairment

In this latest update they have removed the following:

  • Diabetes
  • Depression
  • Osteoporosis
  • Glue ear
  • Insomnia

However, this is not an improvement as they have added the following misleading claims in their place:

  • Improve blood flow
  • Reduce heart attack risk
  • Reduce risk of headaches
  • Increase bloody supply to the brain
  • Increase response time and feeling of “wellness”
  • Reduce side effects of drugs

Osteopathy hasn’t actually been shown to be effective for any of the above conditions.

As well as making misleading claims about specific health conditions the UK Health Centre website includes other inaccurate information. Of particular concern are things like this:

“Your GP may have suggested that you visit an osteopath. This is common for people who suffer from chronic symptoms including back pain, shoulder pain, migraines etc. Your GP may also refer you to an osteopath if you are pregnant or have just given birth (especially if your birth was particularly traumatic or your baby is experiencing problems sleeping or appears agitated).” I certainly hope that GPs are not suggesting that people visit an osteopath. There is little or no evidence that osteopathy provides benefit for any condition and GPs ought to be recommending evidence based treatments. There is absolutely no evidence that birth “trauma” causes any problems in babies. This is something that is claimed by some chiropractors and osteopaths but actually isn’t backed up by evidence and indicates the lack of even a basic understanding of paediatrics within these two professions. There is no reason to ever take a baby to an osteopath (or chiropractor). None.

Worryingly, osteopathy is not the only area where the UK Health Centre website makes misleading claims. For instance, they say that acupuncture can be beneficial for people with cancer including the nausea associated with chemotherapy and the anxiety and pain from the cancer itself. There is no evidence that acupuncture is effective for any of these things.

In spite of 2 complaints to the ASA, Core Health has failed to correct their misleading claims. As well as highlighting a problem with Core Health as an organisation, this also further highlights the ongoing problem with the osteopathy profession. It is now almost 3 years since the ASA issued clear guidance to osteopaths on the conditions they may advertise to treat. The General Osteopathic Council (GOsC) has also made it clear that osteopaths should be treating in an evidence based manner. It’s clear that some osteopaths are still willing to go against regulatory guidelines and continue to treat these conditions even though it isn’t in the patient’s interest to do so.


The Charity Commission consultation on complementary and alternative medicines reveals some “interesting” responses

charitycommissionBetween 13th March and 19th May 2017 The Charity Commission held a consultation about whether an organisation which uses or promotes CAM (Complementary and Alternative Medicine) therapies should be allowed to be a charity. This was prompted by the work of the Good Thinking Society. Although the consultation closed over 12 months ago, The Charity Commission have yet to publish the outcome and have stated that they will do so “in the first half of 2018”. A summary of the feedback received is available on this page and makes for “interesting” reading.

The first thing that’s apparent is that The Charity Commission is surprised by the number and type of responses they received. They say We received over 670 written responses, far in excess of the number usually received for a Commission consultation.” I’m struggling to understand why this was such a surprise. CAM covers a whole range of therapies such as homeopathy, chiropractic, osteopathy, acupuncture, reiki, reflexology, naturopathy and many others. There are a large number of organisations and individuals who have an interest in this area for a variety of reasons. Therefore it’s to be expected that there would be a large response. The Charity Commission also seem surprised by the number of individuals who responded. They say “The majority of responses received were from individuals apparently writing in a personal capacity”. Many individuals have relevant expertise in this area that enables them to usefully contribute to this sort of consultation even if they don’t work for an organisation that itself has an interest. Again, I’m not sure why The Charity Commission finds this surprising.

The Responses

The Charity Commission say “A broad range of opinions were expressed in response to the consultation, some of which clearly are strongly held.” Indeed they are. Some of those responses are reasonable and make logical sense and some, quite simply, don’t.  Reading through the responses gives an interesting insight to some of the highly illogical thinking of CAM providers.

Responses to the first question “Question 1: What level and nature of evidence should the Commission require to establish the beneficial impact of CAM therapies?” include those that think patient testimony is more valuable than scientific evidence. This is, of course, nonsense. It is well known that most CAM practitioners promote their services largely or exclusively based on testimonials. The trouble is that testimonials actually tell you very little about the effectiveness of a treatment and they should therefore not be used as a basis for making treatment decisions. It’s clear that CAM practitioners either lack an understanding of the science behind measuring treatment effectiveness or conveniently choose to ignore it because it conflicts with the weird and wonderful therapy that they happen to provide. The most sensible responses to this question are the ones that align with this “Some responders expressed the view that the evidence to be considered in respect of CAM therapies should be the same in nature as that to be considered in respect of any other therapies. When assessing effectiveness of a therapy this should be done without bias. Therefore the level of evidence required should be the same regardless of the type of therapy. The suggestion by some respondents that “the breadth and/or history of use of a therapy should be used as a measure of evidence is laughable. Should we go back to using leeches as a treatment because it has a long history? Of course not. Science and medicine gradually improves by accepting new treatments that are shown to be effective and dropping those that are shown to be ineffective or where the risk / benefit ratio is not acceptable. Unfortunately, what we are seeing here is the opinion of CAM practitioners and organisations who have failed to reject the things that don’t work and keep misleading people into taking them as “treatments” for a whole range of conditions.

The second question in the consultation was “Question 2: Can the benefit of the use or promotion of CAM therapies be established by general acceptance or recognition, without the need for further evidence of beneficial impact? If so, what level of recognition, and by whom, should the Commission consider as evidence?” This is a really strange question to ask because the only rational answer is clearly “no”. The suggestion that a benefit of any therapy can be established merely because it is accepted or recognised is nonsense. It requires only a basic understanding of science to realise that this is not how treatment effectiveness should be assessed.

The responses to “Question 3: How should the Commission consider conflicting or inconsistent evidence of beneficial impact regarding CAM therapies?” show an astounding lack of science comprehension from some respondents. For instance, some responders urged the Commission to give applicants “the benefit of the doubt”, or to register CAM organisations unless and until their contentions are disproven.” Again, this is simply not how science works. The person or organisation making the claims needs to provide the evidence that they are valid rather than expecting that there should be proof that they are invalid first. This is really the only way that science can sensibly work and an example will help to make this completely clear. I could choose to make the claim that somebody on the planet is able to fly to the moon by flapping their arms. If we have to disprove my claim before it is seen as invalid then we would have to get every single person on the planet to try before we could do so. This is something that is clearly both impractical and very silly. Instead, we should assume that it’s not possible until someone proves otherwise. We can also use science to calculate the amount of force required to leave the earth’s atmosphere and conclude that even to try going to the moon by flapping your arms is an entirely pointless activity. No further research required. If only the same approach was used with CAM therapies, a lot of public money would be saved that is currently squandered on research into things that are completely implausible.

The next question was “Question 4: How, if at all, should the Commission’s approach be different in respect of CAM organisations which only use or promote therapies which are complementary, rather than alternative, to conventional treatments?” Some respondents “questioned whether there is a real distinction between the two categories referred to in this question, or whether it is possible to draw the distinction clearly.” If you study the way that CAM practitioners use their treatments it does indeed become difficult to separate these two things. Regardless of whether the particular type of CAM that a practitioner happens to use is homeopathy, acupuncture, chiropractic, osteopathy or anything else there is a need to believe in the treatment approach. In most cases this is in direct conflict with mainstream medical treatment and science. For instance, homeopaths believe that “like cures like” and that diluting a substance makes it stronger. Osteopaths and chiropractors believe that structure dictates function. Belief in any of these treatment approaches requires the practitioner to reject conventional approaches because it’s simply not possible to fully understand and accept science and medicine and to hold these beliefs. It’s therefore almost impossible for a CAM practitioner to apply their treatments in a complementary manner to conventional treatments. They will inevitably want to steer their patients away from conventional treatments that do not align with their belief system.

For “Question 5: Is it appropriate to require a lesser degree of evidence of beneficial impact for CAM therapies which are claimed to relieve symptoms rather than to cure or diagnose conditions” we have some further nonsense responses such as “Some responders thought that the Commission should assume that a benefit is provided by a particular therapy, unless it can be shown that it is harmful.” This is pretty ridiculous and again is clearly not how science and evidence actually works. Is it really okay to just use dubious unproven treatments on unsuspecting members of the public and continue to do so until harm is shown? Are we supposed to wait until people die or are suffer serious health consequences before putting a stop to a particular therapy? If conventional treatments were developed in the same way then lots of people would die. There is a reason why treatments are carefully developed and researched over a number of years before they start being used in routine care. Many initially promising treatments either turn out not to work that well or have harmful side effects. The same approach should be applied to CAM therapies. Why do CAM providers not want this? It’s very simple, most or all of them would not show sufficient benefit and have too many risks to recommend using them. CAM providers don’t want this research to be done because it would probably signal the end of their business.

Question 6 was “Do you have any other comments about the Commission’s approach to registering CAM organisations as charities?” Like the earlier questions, there are some responses that really make no logical sense. For instance, “CAM therapies are not susceptible to assessment in the same way as conventional treatments.” This is something that a large number of CAM providers claim. They say they don’t have evidence for their treatments because they can’t be assessed in the normal way or because they treat the individual not the condition. This is a complete cop out. With some thought it should be possible to test pretty much any treatment in a scientific and objective manner to see if it is effective. Again, CAM providers are making excuses because they know that when their treatments have actually been assessed they have been shown to be ineffective. This is the case with many CAM approaches that have been around for a long time such as homeopathy, acupuncture, osteopathy and chiropractic. They have actually had significant research carried out on them and the results are spectacularly uninspiring as they show that they have little or no benefit.

One of the answers to this question raises a classic argument from many CAM providers: “A decision which might result in the removal of CAM organisations from the charity register would compromise patient choice.” There are two key points here. Firstly, this consultation is about whether CAM organisations can be eligible as charities. Even if the decision is that they can’t that doesn’t stop CAM providers from existing, just that they can’t be registered as a charity and receive the associated benefits. Secondly, and more importantly, providing patients with a “choice” that includes treatments that don’t work is misleading and unethical. Imagine if you went to a doctor and they said “Would you like to try treatment A that has been shown to be effective or treatment B that hasn’t?” This kind of “choice” is a false balance argument that is absolutely not in the interest of patients.

At the end of the document is a list of organisations that responded to the consultation.  It’s quite the collection of CAM organisations promoting a whole range of weird, wonderful and unproven therapies from homeopathy to reiki to osteopathy to meridian energy to acupuncture. There are also a small number of organisations that provide a more rational view such as the Good Thinking Society and The Nightingale Collaboration.


Charities are required to provide a “public benefit”. The benefit part states “a purpose must be beneficial – this must be in a way that is identifiable and capable of being proved by evidence where necessary and which is not based on personal views” ( Many CAM charities fail this test as they actually promote treatments that have either been shown not to work or that have not been shown to work. I have written about a couple of examples previously: The Sunflower Trust and CORE of Clapton. An excellent article from Michael Marshall of the Good Thinking Society highlights several others. However, this really only scratches the surface and there are a whole range of charities offering unproven “treatments” from the whole spectrum of CAM. When The Charity Commission finally get around to reaching a conclusion from this consultation it is hoped that they will act in the interest of the health and safety of the general public and remove all CAM charities from the charity register.

Misleading the public into fundraising for evidence free osteopathic treatments

fundraisingMany members of the public give up their time to undertake fundraising activities for the benefit of others. Indeed many charities are heavily reliant on the generous work of their fundraisers in order to carry out their charitable activities. Sometimes individuals or organisations ask people to carry out fundraising in order that they can provide healthcare. For instance, the Alder Hey Children’s Charity raises funds to carry out research, innovation and education in medical care for children. A very worthwhile cause. What about when an individual or organisation raises funds for treatments that have not been shown to be effective? That seems rather less worthwhile and potentially involves misleading the fundraisers in order to persuade them to help the cause. That seems to be the case with CORE of Clapton and their osteopathic treatments.

On the face of it, the CORE of Clapton website gives the impression of trying to benefit the community. They state “We believe everybody has the right to a pain-free life and our aim is to make osteopathy accessible to all.” Wanting to make people more pain-free can only be a good thing. However, suggesting osteopathy as the solution seems to be misguided. Osteopathy is a treatment for which there is very little evidence of effectiveness. In the case of low back pain, the “home ground” of most osteopaths, osteopathy is no longer recommended as a first-line treatment. When it comes to treatment of other conditions, the evidence for osteopathy is even weaker or in many cases non-existent. Unfortunately, the treatments being offered at CORE of Clapton don’t even align with this weak evidence base but instead use approaches that are outdated and have been shown to be ineffective.

Treatments at CORE of Clapton

There has been coverage of the types of treatments being offered at CORE of Clapton in the news recently. The treatments described in that article are far from evidence based. For instance, the NICE guidelines for low back pain and sciatica make it clear that exercise is the first line treatment and that things like osteopathy should only be offered in addition to exercise. Is there any mention of exercise in this treatment program? No. It therefore doesn’t comply with the guidelines and is not evidence based. Things get far worse than this, however. In the sixth and final session, acupuncture is used as a treatment. Now, acupuncture has been removed entirely from the latest NICE guidelines due to lack of evidence of effectiveness. The treatment being offered by CORE of Clapton clearly does not follow relevant guidelines or recent research and this can’t be in the best interest of patients.

At this point you may be wondering whether fundraising for CORE of Clapton is such a good idea after all, but there is more. The treatment approach being used came in for stiff criticism from within the osteopathic profession on twitter. There were a large number of comments including “Focusing on fixing posture and mechanical dysfunction reinforces negative beliefs and from a pain science perspective clinically ineffective” and “In some case more than clinically ineffective, but potentially harmful”. So, here is an organisation that’s asking members of the public to donate or fundraise and yet the treatments they’re offering are “clinically ineffective” or even “potentially harmful”.

As an aside, it’s good to see that some osteopaths are trying to bring about change in a profession that is closely associated with quackery. They are few in number but it’s good that they are willing to challenge the many osteopaths who are using outdated, non-evidence based treatments and frequently misleading the public into taking these inappropriate treatments.

Research at CORE of Clapton

CORE of Clapton are keen to carry out research in osteopathy. When planning to carry out research it’s important to have a good understanding of all relevant existing research so that the new research is relevant and appropriate. Unfortunately, that doesn’t seem to be the case at CORE of Clapton. First of all, the treatments described above are clearly not based on a good understanding of the latest research. The “Research” section of the website makes this lack of understanding even more obvious. For instance, it says that “NICE recommends osteopathy for sub-acute and chronic low back pain” and provides a reference to the NICE guidelines from 2009. Now, these guidelines were superseded by the version published in November 2016 which downgraded the role of osteopathy in the treatment of low back pain. So, here is an organisation that is keen to carry out “research” yet still refers to NICE guidelines that were superseded nearly 6 months ago.

Another thing that’s absolutely key when carrying out research is to minimise the risk of bias. When research is carried out it should be to test IF something works rather than to deliberately try and search for evidence that it does. The latter would be a clear case of bias and is unfortunately what happens far too frequently in most research in complementary and alternative medicine, such as osteopathy. The Research page on their website lists a number of “further positive trials”. Unfortunately, this appears to be a cherry-picked list of studies that apparently show the benefits of osteopathy. There are no trials listed that showed a negative outcome for osteopathy and the list of trials presented are far from a complete list of all research in any of the areas mentioned. There is clearly a very strong bias here towards trying to show that osteopathy works rather than genuinely researching to see IF it works.

What’s worse is that the interpretation of the trials themselves is actually incorrect and clearly suffers from further bias. For instance, CORE of Clapton say that “In elderly patients hospitalised with pneumonia, treatment significantly reduced the duration of intravenous antibiotic use and length of hospital stay compared to a sham treatment.” The trial they reference doesn’t say that at all! It’s actually a negative trial and shows that osteopathy was NOT beneficial for this patient group. In the results section it clearly states “Intention-to-treat (ITT) analysis (n = 387) found no significant differences between groups”. In other words osteopathy was NOT effective. On the basis of this study, further research in this area is not warranted.

What is the chance of the “research” that’s going to be carried out at CORE of Clapton resulting in an accurate unbiased assessment of the effectiveness of osteopathy? Based on the extremely biased view presented on their website I would say “zero”. Whatever “research” does get carried out is therefore unlikely to add anything at all to our understanding of what osteopathy can and cannot treat. Any public money spent on such “research” is being wasted and could be spent better elsewhere.


A Community Interest Company (CIC) like CORE is supposed to be of benefit to the community. CORE are asking the general public to donate to them or fundraise for them because they want to improve access to osteopathy for the public and to carry out research into osteopathy. These are goals that, on the face of it, appear to be in the public interest. However, once you look more closely it’s very clear that this is not the case. The treatments offered are not evidence based and in some cases potentially harmful. The “research” that they plan to carry out is likely to be so biased as to provide no useful information on the effectiveness of osteopathy. It’s hard to imagine how this venture can benefit the community at all given the types of treatments and research being offered. Misleading the public to fundraise for something that isn’t actually going to benefit the community is unethical. Public time and money should instead be given to other organisations that provide a genuine benefit.

UK Health Centre: Misleading information about osteopathy, chiropractic, homeopathy and acupuncture all on one site

The UK Health Centre website says that it provides “Access to Health and Medical Information on the Internet”. However, this is not a site that just provides information. It has an appointment booking service and the focus seems to be primarily on providing information that encourages people to make bookings for private treatment. Unfortunately, the information is therefore somewhat biased and in some cases very misleading. Some of the information on the site is actually of a good quality and provides evidence based advice. One example of this would be the information on vaccines. The area where the advice is much more misleading is alternative medicine. This includes osteopathy, chiropractic, acupuncture, homeopathy and herbal remedies. Mixing this misleading information about alternative treatments with more accurate information about conventional medical treatments is likely to cause confusion for the general public and could result in them opting to take treatments that are completely unsuitable.


The UK Health Centre website promotes osteopathy as a treatment for a wide range of medical conditions including:

  • Whiplash
  • Asthma and chest problems
  • Diabetes
  • Long term illness
  • Stress
  • Depression
  • Tiredness
  • Osteoporosis
  • IBS
  • Glue ear
  • Infections
  • Insomnia
  • Growing pains
  • Dysmenorrhoea (period pains)
  • Issues specifically related to pregnancy (such as morning sickness, wounds from childbirth)
  • Common infant problems (including colic, colds and teething pain)
  • Conditions arising from oxygen deprivation during birth
  • Monitoring baby’s growth and development
  • General poor health

Osteopathy has not been shown to be effective for any of these conditions and therefore advertising such treatments breaches advertising regulations. It is in conflict with the guidance provided by the General Osteopathic Council (regulatory body for osteopathy in the UK), the Advertising Standards Authority and the Committee of Advertising Practice ( and ). This misleading information could result in someone booking an appointment with an osteopath when their treatments are completely unsuitable. Some of the conditions on the list, such as asthma, are serious medical conditions that should only be handled by a suitably qualified MEDICAL professional and definitely not an osteopath.


Although less outrageous than the treatment claims made for osteopathy, the information provided about chiropractic is also misleading. The site suggests that chiropractic treatment can improve the immune system, provide a solution to fertility problems and also to treat asthma. None of these claims can be substantiated and this information is therefore misleading. Elsewhere it says “The National Institute for Health and Clinical Excellence (NICE) support the use of chiropractic for treatment of acute lower back pain as they have analysed the results of studies that prove its effectiveness in this area.” Actually, the recent NICE guidelines have downgraded the role of chiropractic in treatment of low back pain due to a lack of evidence for its effectiveness.

Besides treatment for specific medical conditions, the site has other misleading information about chiropractic such as “It is considered most beneficial to undergo chiropractic treatments on a regular basis in order to prevent future damage to the skeleton.” Wow! There is no evidence to suggest that chiropractic is suitable as a preventative treatment. Furthermore, suggesting that not having such treatment might result in “future damage to the skeleton” is blatant and unsubstantiated scaremongering to try and get people to take treatments.

Interestingly, they do highlight risks of chiropractic: . What’s rather puzzling is that the site doesn’t consider similar risks of osteopathy even though many of the same risks apply to both.


The UK Health Centre website recommends acupuncture or acupressure for a range of different conditions including:

  • Tooth pain
  • Other pain
  • Muscle tightness
  • Nausea
  • Erectile dysfunction
  • Bronchitis
  • Anxiety
  • Stress
  • Drug use / alcoholism
  • Overeating
  • Fertility
  • Conditions during pregnancy including tiredness, anxiety, tenderness in the breasts, varicose veins, induction of labour, to correct foetal position

Acupuncture hasn’t been shown to be effective for any of these conditions and claiming otherwise is misleading. This also conflicts with the Advertising Standards Authority guidelines for acupuncture.

It then goes on to say that effectiveness of acupuncture for some conditions is in a “grey area”. Conditions that it puts into this category include depression, neck pain, stroke, sciatica, tinnitus, asthma, addictions (substance abuse). However, there is no such thing as a “grey area” in treatment effectiveness. Either a treatment has been proven to work or it hasn’t – in this case it hasn’t and suggesting otherwise is misleading.

Like osteopathy, some of the items on the list are serious medical conditions that should only be handled by a suitably qualified MEDICAL professional and definitely not treated with acupuncture.


The site suggests that homeopathy is an effective treatment for hay fever ( ) and snoring ( ). It then goes on to say that homeopathy is the most suitable treatment during pregnancy ( ). None of these claims are backed by any sort of evidence and are misleading the general public into potentially taking a treatment that is completely ineffective.

Herbal Remedies

The UK Health Centre website suggests that herbal remedies are effective for allergies, menopause, erectile dysfunction, skin tags and sleep problems. There is no evidence to back up these claims and they are therefore misleading the general public.

Actions Taken and Next Steps

I contacted UK Health Centre in November 2016 to ask them to amend the misleading content on their site. In the first instance I opted to focus on the content about osteopathy to see if they would be willing to correct their site. If they responded positively I then planned to tackle the other issues. Here is the e-mail I sent:

“I’m following up on the information provided about osteopathy on your website. A number of the claims made about osteopathy on your site do not have evidence to support them and are therefore misleading prospective patients and the general public. Furthermore, making these kinds of claims breaches advertising regulations and is in conflict with the guidance provided by the General Osteopathic Council (regulatory body for osteopathy in the UK), the Advertising Standards Authority and the Committee of Advertising Practice. See this link for the guidance they provided to osteopaths: Many of the pages on your site breach these guidelines and provide misleading advice. This includes references to treatment for whiplash, asthma and chest problems, stress, depression, tiredness, osteoporosis, IBS, glue ear, infections, growing pains, common infant problems and “general poor health”. Furthermore, your site suggests that preventative osteopathic treatment is appropriate and that “osteopathy can provide health benefits to most people”. However, there is no evidence to support either of these claims and therefore your site is misleading prospective patients and the general public.

Could you please remove all of your misleading articles about osteopathy from your website or amend them to make it clear what osteopathy can / cannot actually treat? I look forward to hearing from you.”

I received no response so sent a follow up in December 2016. Again there was no response. The information they provide is misleading the general public and has the potential to cause people to take unsuitable treatments. As such, the information on this site represents a risk to the public. I have therefore reported UK Health Centre to the Advertising Standards Authority (ASA). It will be interesting to see the outcome of this.