NHS to withhold treatments to combat ‘too much medicine’

Doctors may soon be required to follow a ‘Choosing Wisely’ approach in order to reduce wasted resources and avoid patient ‘overtreatment’ on the NHS

18 May 2015 by Ryan O'Hare

Doctors in the UK look set to adopt a US-style approach to healthcare delivery, which could result in treatments being withheld from patients in order to “reduce the harms of too much medicine.”

The call comes from the Academy of Royal Medical Colleges, which represents all of the royal medical colleges in the UK, which set out its plans for a ‘Choosing Wisely’ initiative for UK medicine in an article published in the British Medical Journal last week (12 May). 

The initiative has already been implemented in the US and Canada as well as a number of other countries, including Australia, Germany and Japan, and aims to stop doctors from providing treatments that are unlikely to work, waste resources, or could be potentially harmful to the patient.

These wide description includes repeat testing, but could also lead to the restriction across a number of other services, including imaging, such as x-rays and CT scans, or the prescribing of antibiotics, for certain patients.

The report’s authors include the current and former chairs of the academy and calls for each of the Royal Medical Colleges – including General Practice and Ophthalmology – to set out a ‘top five’ list of treatments which should not be used routinely, or at all, by the autumn.

The authors state that doctors should provide patients with information they need to better understand the risks of treatment and “help them understand that doing nothing can often be the best approach.”

It states the need for an end to ‘overtreatment’ in order to save the NHS, warning that the health service will not be able to cope with the growing demand from patients for treatments. It also cites the “health illiteracy” of GPs, and a lack of understanding around relative risk reduction in screening procedures, which may lead to excessive medical or surgical treatment, with little added benefit to the patient.

While elements of the approach are in line with NHS England’s Five Year Forward View around improving information for patients to make more informed treatment decisions, patient groups are concerned it could lead to the rationing treatment. 

Chief executive of the Patients Association, Katherine Murphy, told The Guardian: “We acknowledge that the NHS has to balance the books, but that should not be at the expense of treating patients appropriately.”

OT contacted the Royal College of Ophthalmologists for comment, but had not received a response at the time of publication.

Image credit: Pollo

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