UK doctors have ‘ethical duty’ to prevent waste

Posted 07/11/2014

The health secretary has said he is determined to tackle avoidable waste in healthcare and a report on the subject has issued by the Academy of Medical Royal Colleges. The report is based on the premise that one doctor’s waste is another patient’s delay, and may even mean treatment is withheld.

There are 16 examples of changes to clinical practice which have saved money and benefited patients. They include medication reviews to prevent adverse drug reactions, which account for 6% of all hospital admissions. The report says eradicating this problem would save £466m.

It also suggests more than £200m could be saved by stopping unnecessary scans. Other recommendations include prescribing lower-cost statins, which could save £85m, and reducing unnecessary face-to-face contact between patients and healthcare professionals by using technology such as e-mail and Skype.

Cutting the number of X-rays for lumbar spine or knee problems could save a further £221m while further benefits would be derived from more frequent consultant ward visits to ensure patients can be discharged promptly. The report does not provide a definitive total of potential savings, but indicates what a change in culture – where doctors resolve to eradicate waste – could potentially deliver.

In some quarters active steps have already been taking to cut out unnecessary costs. For example, surgeons at the Royal Throat Nose and Ear Hospital in London have reduced the number of instruments required for cochlear implant operations, from 96 to 28. This has saved money on cleaning and wear and tear and reduced the risk of cancellations or costly delays caused by incomplete equipment. A surgeon at the Trust said doctors were well-placed to identify savings because they actually know which pieces of equipment they need to treat a patient.

The report has been welcomed by Professor Sir Bruce Keogh, the NHS England Medical Director, who commented: “We need to be innovative to tackle the huge financial challenges we are facing, but there are also some more everyday changes that we can make to improve efficiency.”

It has been was noted that  staff and management should work closely to maximize the use of the NHS’s very limited resources, but a doctor’s primary duty is to their patient, and it is vitally important that decisions around patient care are around clinical value.

Julie Crossley, a medical injury lawyer at Ashtons Legal, commented: “There is a lot of waste within the NHS and these cost saving measures need to be carefully thought out to ensure that the patients still receive the best treatment and that attempts to reduce costs do not ultimately lead to increased claims.”