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26 October 2016

United Kingdom: Too Much Needless NHS Treatment Says Royal College, As It Draws Up List of Those with Little or No Benefit

Too many doctors are ordering treatments and investigations
which are not necessary, says the Academy of Medical
Royal Colleges.  
Credit:  Peter Byrne/PA
Too much needless NHS treatment says Royal College, as it draws up list of those with little or no benefit
by Laura Donnelly, health editor, The Telegraph, 24 October 2016

Doctors are giving too many patients tests and drugs they do not need, senior medics have warned, as they published a list of 40 treatments which should no longer be in routine use.

The unprecedented intervention by the Academy of Medical Royal Colleges (AMRC) follows research which found doctors commonly ordering X-ray, scans and drugs, in cases they believed to be pointless.

More than six in 10 medics said their decisions had been driven by a fear of litigation, with just as many saying they ordered interventions because they felt under pressure from patients.

The Academy – which represents all 21 medical royal colleges in the UK – has today drawn up a list of 40 treatments and procedures which it says are of little or no benefit to patients.

Prof Dame Sue Bailey, AMRC chairman, said doctors and patients should question whether interventions were “really necessary” before embarking on tests and treatments.

It came as Simon Stevens, head of the NHS, said GPs were being driven by “box ticking” systems – which link their pay to treatment targets – which would now be phased out.

The list drawn up by medics includes a string of investigative procedures which it says are of little or no benefit. For example, patients with lower back pain should not be offered X-rays, unless there are other concerning symptoms, the report says, while children suffering “buckle” fractures do not need plaster casts.

In other cases, it says patients should be told more about the side-effects they may face before deciding whether to embark on treatment.

Most controversially, it suggests chemotherapy for advanced cancer should be carefully considered, as “benefit is likely to be small, and the harm may be great,” the report says.

It also recommends against regular scans for terminally ill patients, and routine checks for patients who have undergone cataracts and other common forms of surgery.

Dame Sue said the changes were not primarily about saving the NHS money, but about having an “intelligent conversation” with patients.

“Patients should ask ‘what would happen if I do nothing?’” she said.

In time, the Academy will draw up a list of up to 150 treatments in common use which should be reconsidered, she said.

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