NHS should stop wasting money on “ineffective” operations warns bean counter quango
Health authorities should stop wasting money on “ineffective” operations like tonsil removals and wisdom teeth extractions, according to the quango Audit Commission.
It has calculated that the NHS could save £500 million a year by doing so, that could be put towards more worthwhile treatments.
Its briefing, Reducing expenditure on low clinical value treatments, found that a clearer approach among primary care trusts (PCTs) to what it called “ineffective or inefficient treatments” would ensure more consistency across the country.
It came as another report, by the health think-tank The King’s Fund, criticised “persistent and widespread variations across England in patients’ chances of undergoing surgery for common medical problems”.
Both reports, by coincidence issued on the same day, agreed that some patients were undergoing operations “that do not benefit them”, in the words of The King’s Fund.
However, while the Audit Commission report focused on the potential cost savings of reducing operations, The King’s Fund called for an end to the “unfair” and “inefficient” variations in accessing worthwhile surgery.
The former identified tonsil removals as “relatively ineffective” and hysterectomies in cases of heavy menstrual bleeding as less cost-effective than alternatives.
Wisdom teeth extraction was often not worthwhile, because of a “close benefit and risk balance”, while some procedures, such as orthodontics, were nothing more than “potentially cosmetic”.
Some PCTs, of which there are about 150 in England, could save more than £12 million a year by reducing such operations, the soon-to-be-abolished spending watchdog calculated.
Andy McKeon, its managing director of health, said: “PCTs across the country are currently paying for treatments that cost the taxpayer money, and according to clinical experts have little or no real value to patients. This needs to change.”
The King’s Fund report – Variations in Health Care: the good, the bad and the inexplicable – found that tonsil removal operations in children were 10 times more common in Coventry than in Kingston, even though the procedure “has been queried since the 1930s”.
But it concentrated on lack of access to operations that did work.
For example, it found that rates of admission for hip and knee replacement varied by up to 400 per cent, with people in poorer areas much less likely to receive one.
Rates of coronary artery bypass grafts varied from 34 per 100,000 in Westminster to 197 per 100,000 in Berkshire.
John Appleby, chief economist at The King’s Fund, said: “This report confirms research over decades, both in the UK and internationally, which has shown persistent and unwarranted variations in use of and access to even the most common surgical procedures. This is unfair to patients and inefficient for the NHS.
“Remedying this is urgent given the need to improve quality of care while the NHS grapples with the biggest financial challenge in its history.”
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