Six in 10 doctors prescribe drugs and tests that are not necessary

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

The unprecedented intervention by the Academy of Medical Royal Colleges (AMRC) follows research that found doctors commonly ordering X-rays, scans and drugs without good reason.

More than six in 10 medics said their decisions were driven by a fear of litigation, while a similar number admitted they ordered interventions because they felt under pressure from patients.

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

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

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

Patients with lower back pain should not be offered X-rays unless there are other concerning symptoms, the report says in one example, while children suffering “buckle” fractures do not need plaster casts.

In other cases, it says, patients should be told more about possible sideeffects 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 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 an extended list of up to 150 common treatments that should be reconsidered, she said.

The intervention follows a survey of 500 doctors that found 83 per cent had prescribed or carried out treatments they considered unnecessary. The research by the Medix consultancy found that 20 per cent of cases involved antibiotics, while 16 per cent related to Xrays, and 14 per cent to CT scans or blood tests.

Patients could get drugs and treatment sooner under an “ambitious” new plan, according to a report. Making the latest treatments available more quickly is among the recommendations in the Accelerated Access Review. The report, commissioned by the Government, suggests patients could have medication four years earlier than at present if NHS processes were streamlined.

‘Chemotherapy is a crucial part of cancer treatment. However, it can result in severe side effects’