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GPs buried under trusts' workload dump

GPs to develop list of unnecessary interventions under scheme to tackle overtreatment

A group of royal colleges including the RCGP is launching a new initiative to tackle overuse of unnecessary drugs and procedures that they say are doing more harm than good.

Led by Dr Aseem Malhotra, from the Academy of Medical Royal Colleges, the ‘Choosing Wisely’ campaign will encourage GPs to discuss potential harms of treatments with patients, as well encouraging patients to ask if tests are really needed.

By autumn, each of the colleges will submit a list of the top five tests or procedures that are of ‘questionable value’ and will advise doctors on stopping using them.

The move comes after a team of GPs, led by RCGP Council member Dr Margaret McCartney, set up a working group on over-medicalisation.

Professor Maureen Baker, chair of the RCGP, said: ‘If there is evidence to show that a particular intervention might be of little benefit to a patient, it is good practice that alternatives are explored.’

She added that GPs were ‘under considerable pressure to prescribe, or take some form of action’ so it will be important to work together with people so they ‘realise that drug or surgical treatment isn’t always the best way forward’.

BMJ 2015; available online 12 May

Readers' comments (23)

  • Why blame GPs?We are just following orders.Rave at NICE or the QOF designers for spreading the poison of over medicalisation.Also don't forget those politicians and charities in the pockets of Big Pharma.

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  • I'll vote this a success when someone can elaborate a coherent approach to PSA testing

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  • I agree with Gerry Roberts and would like to see this group address PSA testing with some urgency, it is a unique test on a world basis whether private or NHS in that the decision to request the test rests with the patient not the clinician, therefore, despite the clinicians reservations the patient is entitled to the test on the NHS under Department of Health guidance, despite the fact that the clinician may feel it is not in the patient interest
    personally I feel this would be an excellent example of a situation where the group should push the Department of Health to put their money where their mouth is and make PSA testing an open access service
    this would be costly and futile for the Department of Health rather than ourselves

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  • my bad ... mis read heading thought it said

    'RCGP to develop list of unnecessary interventions'

    thought between RCGP, NHSE, DOH, CQC, Monitor, NICE, BMA/GMC/LMC, CCU,CCU, King's fund, Qunago number 99 etc etc that between they have done a great job of coming up with a lot of 'ideas'.

    perhaps that is part of the problem - there are more people working in quangos, the establishment, and think tanks than there are doctors....

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  • Unnecessary intervention and tests?

    CSA? :)

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  • More "one-size-fits-all" guideline-driven medicine. Why can't doctors be left to make good clinical decisions with the individual sitting in front of them?

    Does the evidence base apply to all patients, all of the time?

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  • The conclusion of this 'innovative' idea will be some vague recommendation with the small print caveat that if you withhold treatment or veer from guidance you will be utterly a gonner. I do not need their guidance to not do something or not order a test. You do it hundreds of times a year! Its called a brain.

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  • Another ovrdiagnosis conference coming up 'Winding back the Harms' - in september nr Washington USA.a few freebies (bursaries) left get in quick if a three day jolly appeals otherwise there's the cost of travel, the cost of accomodation and the fee for attending. So who gets to go? How is the effect of these events measured? Could the funds be better used?

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  • Hi practice manager re 'i do not need guidance ......or ~(be told) not to order a test....' practice managers on't normally treat people clinically??

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  • 1) stop paying RCGP fee
    2) stop paying GMC fee - they also are pointle and achieve nothing, but drain resources;
    3) switch 'gluten-free' products and other ordinary 'groceries' from prescription to entitlement card so patients can choose at the supermarket instead of bothering GPs;

    4) switch continence products from prescription to a supply system not policed by GPs (but someone will still have to police it to prevent supply companies 'exagerating' what they have supplied;
    5) stop the DWP sending well people to GP to get a med3 so they can have benefits they are clearly too fit to be rightly entitled to.


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