Doctors urged to stop offering 40 'unnecessary' procedures

Forty NHS procedures that offer scant benefit, or no benefit at all, to patients have been identified in an unprecedented list of treatments that should no longer be routinely offered.

The Academy of Medical Royal Colleges (AMRC), which oversees 24 medical bodies including the Royal College of Surgeons and the Royal College of General Practitioners, made the unprecedented intervention to advise doctors against ordering procedures simply "by force of habit".

Among the commonly used interventions that are not ordinarily necessary, the AMRC report cites X-rays for lower back pain, plaster casts for small fractures and check-ups for routine surgeries such as cataracts.

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"Most controversially", the Daily Telegraph reports, the AMRC suggests chemotherapy for advanced cancer should be carefully considered, as "benefit is likely to be small, and the harm may be great".

Fear of legal repercussions and patient expectations were cited by doctors as the leading reasons for ordering unnecessary procedures.

The AMRC consulted experts from 11 different medical fields and asked them to identify commonly used treatments or procedures that were not always necessary or beneficial. The guidance is part of the body's Choosing Wisely campaign that aims to provoke frank dialogue between doctors and patients about treatment paths.

Despite increasingly urgent warnings in recent months about the financial sustainability of the NHS, Professor Dame Sue Bailey, the chair of AMRC, said that the guidance was not intended primarily as a money-saving measure, but to encourage frank dialogue between doctors and patients.

"Patients should ask 'what would happen if I do nothing?'" she said. "Medicine or surgical interventions don't need to be the only solution offered by a doctor and more certainly doesn't always mean better."

Among the 40 procedures that AMRC wants to see phased out of common use are:

• X-rays for lower back pain without other cause for concern
• Electronic monitoring of a baby's heart in normal pregnancies
• Prostate Specific Antigen blood test to detect signs of prostate cancer
• Blood tests to diagnose the menopause
• Plaster casts for children with small wrist fractures
• Saline solution rather than plain tap water for cleaning small cuts and grazes