In the UK there are great variations in the skill levels of both tuina practitioners and teachers as well as the quality and length of the actual courses that are offered. Foundation skills often are never transmitted to students resulting in the dilution of the level of tuina into a practice that is often quite unlike the tuina in China.
For an appraisal of the practice of tuina in the UK and in modern day China please read my recent article which was published in The Journal of Chinese Medicine.