16.07.15
NHS is ‘over-treating, over-diagnosing and over-prescribing’
The NHS has been spending billions on unnecessary over-treatment, over-diagnosis and over-prescribing, a new report by think-tank the King’s Fund has found.
The investigation, ‘Better Value in the NHS’, determined that general over-use is common across the NHS, particularly with elective treatments of low clinical value and over-prescription of drugs that are not needed or likely ineffective.
Over-utilisation of the hospitals themselves also contributes to excessive spending – often due to a lack in alternatives.
Hugh Alderwick, one of the authors of the report, told NHE: “There’s a range of reasons why over-use or too much care happens. They include failure to follow professional guidelines when delivering care or, in some cases, lowering the threshold for treatment.
“Over-use of hospitals at the end of people’s lives is often cited as an example where there are significant costs from treatment, but the contributing factor of over-use in that scenario is often a lack of alternative to treatment in the community.
“In many cases, reducing an over-use might require investment in some out of hospital services, which over the longer term are likely to be cheaper.”
The report also estimated that £500m a year could be saved if the NHS cut down on low-value elective procedures, despite there being little agreement on which services are of low value.
Scrapping unnecessary requests for pathology testing for a range of conditions could also save an extra £1bn a year.
Alderwick also cited mental health as one of the main areas where over-use and over-diagnosis is a problem (although under-diagnosis and under-treatment of depression and other mental illness is also common).
The report suggested this could be due to diagnoses of people with milder symptoms and a widening of diagnostic classifications.
It said: “As well as causing potential harm to patients, over-diagnosis of depression can lead to unnecessary costs from over-prescribing of antidepressants, with the number of antidepressants prescribed in the United Kingdom doubling between 1998 and 2010.”
A new study by Public Health England also found that people with learning disabilities are being over-prescribed psychiatric drugs, wherein one in six adults are given medication by their GP normally suited for treating major mental illnesses. More than half of them do not have a recorded diagnosis of the conditions the medication is intended to treat.
Over-use of medical facilities and treatments has been cited as a source of unnecessary harm, discomfort and stress for patients, while also signifying wasted resources and rising costs for the health system.