NHS to scrap 'unnecessary or risky' procedures

Breast reductions and snoring surgery among 'unnecessary or risky' procedures to be scrapped by NHS

'Sometimes doing nothing, or doing less, really is the best approach,' experts say

Alex Matthews-King
Health Correspondent
Saturday 30 June 2018 17:44
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The NHS is planning to end or radically reduce its use of 17 routine surgical procedures in a bid to save £200m a year, health officials have said.

Back pain injections, breast reductions or surgery for arthritic knees and snoring are among those deemed to be “ineffective or risky” and face the axe.

The reductions being proposed by NHS England, which will now go out for consultation, will mean 100,000 fewer procedures take place each year, freeing up staff, operating space and money.

It said for many of these procedures the “risks outweigh the benefits” and alternative treatments such as injections, dietary changes or physiotherapy will be effective in most cases.

Procedures for carpal tunnel, haemorrhoids and varicose veins will only be offered where there is a pressing medical need or other options have been exhausted.

National medical director Professor Stephen Powis said: “If we want the very best clinical care for our patients, we need to stop putting them through treatments where risks and harms outweigh the benefits.

“By reducing unnecessary or risky procedures for some patients we can get better outcomes while reducing waste and targeting resource to where it is most needed.”

Speaking to The Times, he added this would be the “first stage” in looking at situations where surgery is better avoided.

He told the paper: “We shouldn’t, at best, inconvenience or disappoint patients by offering treatments that are not effective and, at worst, harming patients.”

This follows moves last year to blacklist ineffective procedures, like homeopathy, and restrict prescribing of painkillers and medications that can be bought more cheaply over the counter.

Other procedures on the list of 17 include grommets for glue ear and tonsil removal, with the plans drawn up in consultation with the National Institute for Health and Care Excellence (NICE).

Four of them will be offered only when a patient makes a specific request, with the other 13 being offered only when specific criteria are met.

Professor Gillian Leng, deputy chief executive at NICE, said: “It has become commonplace for us to associate action with treatment.

“However, sometimes doing nothing, or doing less, really is the best approach.

“Treatments and procedures that carry a high risk or are associated with serious side effects should only be offered when there is compelling evidence that the benefits are worthwhile.”

Dr Graham Jackson, cochair of NHS Clinical Commissioners, said: “It is important that we have an honest conversation with the public, patients and clinicians about what can be expected from the NHS within the constrained funds it has available.”

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