Doctors have drawn up a list of treatments they say bring little or no benefit to the patient and should no longer be used.
The Academy of Medical Royal Colleges – which represents all 21 medical royal colleges in the UK – says doctors are giving patients too many tests and drugs that they don’t need.
More than four in five medics said they had given a treatment to get pushy patients off their backs.
Here are the full considerations/recommendations:*
- Having fluids administered directly into a vein while under the influence of alcohol will not make you feel better any more quickly.
- When discussing treatment for adult schizophrenia with your doctor or specialist nurse, you should consider whether medications taken by mouth or longer-acting medications given by injection would be better for you.
- Back pain is not likely to need an x-ray.
- You should only receive a blood transfusion if it is really necessary, such as for major bleeding.
- Small fractures in the foot do not usually need to be put in a plaster cast – they can heal just as quickly in a removable boot.
- Chemotherapy in the final months of life for cancer patients can “do more harm than good”.
- If you are receiving palliative chemotherapy or radiotherapy, post-treatment CT scans and MRI scans are unlikely to benefit.
- It is not necessary to have a calcium test for kidney stones, bone disease or nerve-related disorders unless you undergo major surgery.
- Small fractures on the wrist in children do not normally need a plaster cast – a splint will do.
- Breathing problems in children usually get better without medical treatment. Breathing tubes have little to no effect.
- For children with chronic constipation, changes to diet and lifestyle should be considered first before medical treatment.
- If this is ineffective, children should be given Polyethlene Glycol rather than lactulose.
- For children having a prolonged seizure, giving medications that can be dissolved in the mouth are preferable to those which are injected – they are just as effective and may stop the seizures sooner.
- Helmet therapy is not effective in treating what is known as flat-head syndrome in children. Adjusting sleep patterns and physiotherapy are more effective.
- Women using the coil should be taught how to check its placement every month – professional advice only should be sought when the patient cannot feel the threads.
- Quality tap water is just as effective for cleaning cuts as saline solution.
- Routine screening programmes do not exist for dementia.
- Ineffective antidepressants should be changed or additional medication added.
- Discussions should be had with patients and families about maintaining life support for those at the end of life.
- Those who are at the end of their lives should try to decrease the number of medicines they are on. Only those which control symptoms should be used.
- Minor head injuries do not normally require imaging.
- You should only be considered for medication to treat blood pressure, prevent heart disease or strokes if you have other risk factors.
- Those taking statins for high cholesterol do not need to have their levels checked regularly unless they have pre-existing conditions.
- Some injuries such as hip and shoulder dislocations do not need to go under general anaesthetic to be treated.
- If you are over 45 you do not usually need blood tests to diagnose the menopause.
- Pregnant women should not be prescribed sodium Valproate for migraines, epilepsy or bipolar disorder unless other medications are not working.
- Aspirin, heparin or progesterone should not be used to reduce the risk of further miscarriages.
- If you have a simple ovarian cyst of less than 5cm in diameter, and have not undergone the menopause, you are unlikely to need a follow up appointment or checking of protein levels.
- If your doctor suspects you have polycystic ovaries you should have a blood test before other investigations.
- If you are pregnant, aspirin is not recommended to help reduce the chances of blood clots.
- Unless you have diabetes, ultrasounds should not be used to check if your baby is bigger than normal.
- Electronic monitoring of the baby’s heart is only needed in labour if the mother is at high-risk of complication.
- Unless you are at risk of prostate cancer due to family history, screening does not lead to a longer life.
- CT or MRI scans of the head can only be used to diagnose psychosis in specific situations.
- When considering surgery, you should be given the chance to discuss potential benefits and harms.
- If you are having surgery, day surgery should be the default option to allow a quicker recovery.
- You do not need to come into hospital the day before your surgery if you have had the right preparations beforehand.
- Most vaginal discharge is normal and does not require being seen by a professional.
The Academy has previously estimated £2bn a year is wasted on useless medicines, operations and tests. It will later publish a full list of up to 150 treatments it believes should be reconsidered.
It recommends doctors listen closely to what patients want rather than using new technologies for the sake of it, and tailor care more to the individual.
*Note: As far as we can tell, the list we were supplied with only listed 38 treatments. We have reached out to the Academy for clarification.