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Senior doctors condemn 40 treatments and tests as being of little or no use

Published 24/10/2016

Many doctors have admitted prescribing or carrying out a treatment which they knew to be unnecessary
Many doctors have admitted prescribing or carrying out a treatment which they knew to be unnecessary

Dozens of common tests and treatments for a range of ailments are of little or no use, senior doctors have said.

The Academy of Medical Royal Colleges (AMRC) recorded 40 regularly-used medical procedures as largely pointless.

Tap water is as good as saline solution to clean cuts while a plaster cast is unnecessary for some wrist fractures in children, the AMRC said.

The widely-applauded guidelines also note that chemotherapy may be used to relieve terminal cancer symptoms but can also be painful, cannot cure the disease and may bring further distress in the final months of life.

And they said routine screenings for prostate conditions using the Prostate Specific Antigen test do not lengthen life and can cause unnecessary anxiety.

Another example is that X-rays do not help to deal with lower back pain if there are no other concerning features.

The list comes after 82% of doctors admitted prescribing or carrying out a treatment that they knew to be unnecessary in a study carried out last year.

Patient pressure or expectation was given as the main reason, the AMRC noted as part of its Choosing Wisely UK campaign.

Professor Maureen Baker, chair of the Royal College of General Practitioners, hopes the guidance will enable GPs to focus on the patients most in need.

"At a time when patients in some areas of the country are having to wait for nearly a month to see their GP - due to rocketing demand and not enough GPs to keep pace - this report is a dose of common sense," she said.

"The guidance shows there are many minor ailments and conditions that can be treated quickly and effectively without needing to see a GP, meaning that family doctors can dedicate their valuable time to those patients who really need our expert skills."

Katherine Murphy, chief executive of The Patients Association, questioned why the list of unnecessary treatments surfaced "so late in the day in light of well-documented and huge financial pressures on the NHS".

She said: "If this advice is so obvious to health care professionals, why was more not done before this point to rectify the situation? It is important that patients receive the best possible care and so every penny counts."

Professor Bill Noble, executive medical director at Marie Curie, said some terminal cancer patients would benefit more from early access to palliative care than palliative chemotherapy.

"It is true that while some people benefit, in some cases the side effects of palliative chemotherapy do more harm than good, and many patients would see more benefit from early access to palliative care, as opposed to invasive medical interventions," he said.

"We need to get past the idea that providing palliative care is giving up on a patient. Early access to palliative care will greatly improve quality of life for both patients and their families."

The global campaign aims to cut down on over-medicalisation and to help provide the groundwork for a fully-informed conversation about the risks and benefits of treatments and procedures.

The AMRC said patients should ask about the risks or downsides, the possible side effects, if there simpler or safer options, and "what will happen if I do nothing?"

It issued the list, which drew from advice from its medical royal colleges and facilities, to help patients and medics make the right decisions about care with the warning that "more doesn't always mean better".

AMRC chairman Professor Dame Sue Bailey said there is a duty to wisely use resources " especially when the NHS is under so much pressure".

But she added: "What's much more important is that both doctors and patients really question whether the particular treatment is really necessary. Medicine or surgical interventions don't need to be the only solution offered by a doctor and more certainly doesn't always mean better".

Press Association

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