GP earnings are linked to meeting NHS targets, which include those for drug prescribing Credit:Alamy It came as Simon Stevens, head of the NHS, said GPs were being driven by “box ticking” systems – which link their pay to treatment targets – which would now be phased out.The list drawn up by medics includes a string of investigative procedures which it says are of little or no benefit. For example, patients with lower back pain should not be offered X-rays, unless there are other concerning symptoms, the report says, while children suffering “buckle” fractures do not need plaster casts.In other cases, it says patients should be told more about the side-effects they may face before deciding whether to embark on treatment.Most controversially, it suggests chemotherapy for advanced cancer should be carefully considered, as “benefit is likely to be small, and the harm may be great,” the report says.It also recommends against regular scans for terminally ill patients, and routine checks for patients who have undergone cataracts and other common forms of surgery.Dame Sue said the changes were not primarily about saving the NHS money, but about having an “intelligent conversation” with patients.“Patients should ask ‘what would happen if I do nothing?’” she said.In time, the Academy will draw up a list of up to 150 treatments in common use which should be reconsidered, she said. “We all have a duty to look after resources in healthcare, especially when the NHS is under so much pressure, but that’s not the main motivation for this initiative,” Dame Sally said.“What’s much more important is that both doctors and patients really question whether the particular treatment is really necessary. Medicine or surgical interventions don’t need to be the only solution offered by a doctor and more certainly doesn’t always mean better.”Making better decisions would speed up access to treatment for other patients, in need, she said.“For some of these treatments it would simply be better for the patients if they weren’t being used,” she said. “In others, the fact you are giving them to patients who do not need them is meaning that the patients who do need them need to wait longer.” The new campaign urges patients to ask questions of doctors when treatment is recommendedCredit:Dominic Lipinski/PA Fertility charities say IVF ratioining is the worst it has been for more than a decade Credit:PA The intervention follows a survey of 500 doctors which found 83 per cent had prescribed or carried out treatments they considered unnecessary.The research by the Medix consultancy found that 20 per cent of cases involved antibiotics, while 16 per cent related to X-rays, and 14 per cent to CT scans or blood tests.Overall, 63 per cent of doctors polled said they had proceeded with treatments or prescriptions because of fear of litigation, with just as many saying they had been driven by patient pressures. When it came specifically to decisions to order interventions which were thought to be needless, patient expectations were the key factor cited.Dame Sue said too many doctors were ordering interventions from force of habit, or in order to satisfy patient expectations.Adrienne Betteley, From Macmillan Cancer Support, said: “Every single person living with cancer, regardless of what stage they are at, should have access to the treatment and the support they need.“Chemotherapy is a crucial part of cancer treatment, having had an enormous impact on rising survival rates over the years,” she said. “However, it can result in severe side effects therefore, it’s important that health care professionals consider the full impact when delivering something so powerful.”Last year the NHS recorded a deficit of £2.45bn – the highest in its history – amid deepening rationing of treatments, including IVF and cataracts, as services draw up plans to attempt to reduce spending.The academy said doctors needed to help the NHS spend money wisely, but said the needs of patients must be put first. The head of the NHS, Simon Stevens, last week said a system of performance pay for GPs had “descended into too much of a box ticking exercise”Credit:PA Doctors are giving too many patients tests and drugs they do not need, senior medics have warned, as they published a list of 40 treatments which should no longer be in routine use.The unprecedented intervention by the Academy of Medical Royal Colleges (AMRC) follows research which found doctors commonly ordering X-ray, scans and drugs, in cases they believed to be pointless.More than six in 10 medics said their decisions had been driven by a fear of litigation, with just as many saying they ordered interventions because they felt under pressure from patients.The Academy – which represents all 21 medical royal colleges in the UK – has today drawn up a list of 40 treatments and procedures which it says are of little or no benefit to patients.Prof Dame Sue Bailey, AMRC chairman, said doctors and patients should question whether interventions were “really necessary” before embarking on tests and treatments. It came as a study suggested that up to 46,000 patients a year are dying because NHS treatments are not as good as those available in other countries.Former cabinet minister Owen Paterson said it was time to “debunk the myth” that the UK has the best healthcare system in the world.The study examined 32 countries, for treatment of a range of diseases, ranking the UK 23rd or lower for each condition. Speaking at the launch of the report by think tank UK2020, Mr Paterson said it was considered “almost unpatriotic” to criticise the NHS, which was preventing improvement being made.An independent review of drugs access, commissioned by the Government, today pledges to speed up access to new advances in treatment.The report said streamlined processes could bring forward access to new drugs by up to four years.Health Minister Lord Prior said: “This Government has a strong commitment to the life sciences and to building a long-term partnership with the life sciences industry. We are determined to make the UK the best place in the world to develop new drugs and other products that can transform the health of patients.”Treatments and investigations that may bring “little or no benefit to patients,” according to the Academy of Medical Royal collegesX-rays for lower back pain, if no other concerning featuresPlaster casts for children suffering small wrist fractures which will heal themselves with a removable splintChemotherapy for those in the final months of terminal cancerBlood tests to diagnose the menopause, if women are over 45 and suffering typical symptomsAspirin, heparin or progesterone to reduce the chance of miscarriagesThe new campaign Choosing Wisely urges patients to ask doctors five questions when seeking treatment. These are:Do I really need this test, treatment or procedure?What are the risks or downsides?What are the possible side effects?Are there simpler, safer options?What will happen if I do nothing? 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