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Royal Colleges urge patients to question GPs over tests and treatments



Patients should question their GP about the harms and benefits of tests and treatments they’re being prescribed, according to the Academy of Medical Royal Colleges.

The new guidance forms part of the Academy of Medical Royal Colleges’ Choosing Wisely programme, which launched in 2015 to reduce over-medication.

The academy has also published a list of 50 procedures that they consider to have little value, adding to the 40 avoidable interventions that they published in 2016.

GPs leaders have said that while they support the premise of patient empowerment, it’s important to be realistic about the time this will take and called for longer patient consultations if this guidance is to be implemented. 

The academy, which includes the RCGP among its 24 members, has set out to encourage patients to question their GP about what they are being prescribed.

The guidance has said that patients should be told to ask their GP what the benefits, risks and alternatives are, as well as what will happen if nothing is done.

Professor Dame Sue Bailey, the Academy of Medical Royal Colleges’ Choosing Wisely campaign lead, said: ‘Too often patients just accept what a doctor is telling them without question.

‘We want to change that dynamic and make sure the decision about what treatment is taken up is only made when the patient is fully informed of all the consequences.’

However, Dr Uzma Ahmad, Walsall LMC medical secretary, said: ‘Discussing the treatments in length would require longer consultations. If the patient expectations are too high and they think that every treatment will be discussed in detail, we have to be really realistic about the time this will take.’

She added: ‘We can’t just be given recommendations if we can’t act on them. We need more time with the patients.’

Doncaster LMC chief executive and GP Committee representative Dr Dean Eggitt said: ‘Whilst I support the premise of these questions I think the application of the idea as applied by the academy is going to lack the impact we need.’ 

He added: ‘Rather than empowering patients to question, challenge and understand years of postgraduate medication education, I would far rather we empower them to understand the basics of how they themselves function and dysfunction.

‘To this end, we may then reduce unnecessary encounters with clinicians and do away with the need for some of these questions altogether.’

It follows a study of over two million patients in England, found that patients value GP quality of care – including explaining tests and treatments and involving patients in decision making – more than the ease of access to their practice.

The academy has also added 50 further recommendations to its list of interventions that doctors should avoid or replace with a simpler alternative, bringing the total number to 90.

This follows a two-year consultation with senior doctors from the UK’s medical royal colleges and patient representatives. 

NHS England has launched its own guidance on conditions for which over-the-counter medicines should not be prescribed.

The Academy of Royal Medical Colleges’ recommendation include:

  • Encourage everyone to take vitamin D supplements in the winter, not just the frail and the elderly
  • Extend the period the contraceptive pill is prescribed for women to reduce visits to the GP
  • Discuss the use of antibiotics at the end of life with patients and their family
  • Review the use of antibiotics for patients with bacteria in their urine who have no, minimal, non-specific, or long-standing urinary symptoms
  • Review the use of antibiotics for conditions that are not infections
  • Not routinely image patients with suspected migraine
  • Not use drug treatments to manage behavioural and psychological problems in patients with dementia if they can be avoided

Source: Academy of Royal Medical Colleges