Integration of osteopathy in the Portuguese National Health Service: Perceptions and expectations of citizens and health professionals

<h2>Abstract</h2><h3>Background</h3> Osteopathy's framework varies globally in healthcare systems due to context-specific factors like legal status, healthcare system integration, and implementation levels. With osteopathy expanding in Portugal and recognising the importance of defining its role in the National Health Service, it is essential to understand public perceptions and expectations in the Portuguese context even for more significant equity of access. <h3>Objective</h3> Explore citizen and healthcare professionals' perceptions and expectations regarding integrating osteopathy into the Portuguese National Health Service. <h3>Methods</h3> The study used a qualitative design. Two focus groups were conducted—a citizens' focus group (n = 8) and a health professional's focus group (n = 6). Citizens' focus group was in-person, and the health professional's focus group was online. Analysis of focus group transcripts followed a constructivist paradigm utilising thematic analysis. <h3>Results</h3> Thematic analysis resulted in four principal themes: osteopathy concept; competent osteopath; concerns and expectations, and National Health Service integration. Despite diverse and limited perspectives on its scope, participants generally held positive attitudes towards osteopathy. Nevertheless, barriers to NHS integration were noted, along with suggestions for improving osteopathy's integration into the healthcare system. <h3>Conclusion</h3> This study highlights a positive attitude among participants towards the integration of osteopathy into the National Health Service. However, they acknowledge that the profession faces significant challenges in achieving this integration. Overcoming these obstacles may require a gradual approach, which includes focusing on evidence of effectiveness, wider dissemination, and the establishment of supportive reimbursement systems. <h3>Implication for practice</h3> <ul><li>•The findings highlight the importance of ensuring credible training, practical experience, and relational skills in osteopathy. These factors are key in influencing how individuals choose osteopaths and can guide practitioners in building trust with patients and positioning their services effectively.</li><li>•Addressing concerns related to diagnostic capacity, technique safety, and quality assurance is crucial for improving the safety and quality of osteopathic care, as well as reducing public concerns.</li><li>•The study provides valuable insights into the potential benefits and challenges of integrating osteopathy into the National Health Service, offering useful guidance for policymakers and healthcare professionals involved in this decision-making process.</li></ul>