The NHS is planning to ration 34 diagnostic tests and treatments, including back x-rays, hernia repair surgery and knee scans, in a move that could affect millions of patients in England.
According to the Guardian, the plans to deny “unnecessary” treatments to patients except in exceptional circumstances are part of a drive to save money and relieve the pressure on the NHS.
They impact many forms of surgery, as well as ways of detecting illness including CT and MRI scans, and blood tests, for cancer, arthritis, back problems, kidney stones, sinus infections and depression. The clampdown would see patients told to use physiotherapy or painkillers to dull the pain of an arthritic knee rather than undergo an exploratory operation called an arthroscopy.
Kidney stones would no longer be removed in an operating theatre and instead would be treated with sound wave therapy to reduce the pain.
Similarly, in future adenoids would not be removed because evidence now shows that it “is not necessary, doesn’t work well and can cause problems like bleeding and infection”, according to the document seen by the newspaper.
An NHS spokesperson said the document was out of date and had not been approved or implemented, but added there was “strong support from senior doctors in the Academy of Medical Royal Colleges for action to eliminate wasteful interventions that don’t benefit patients”.
The Patients Association said the changes would force patients to either endure the pain of their condition or pay for private care to tackle it.
Rachel Power, the association’s chief executive, said: “Patients have seen the range of treatments offered by the NHS cut back over recent years, and the NHS has been upfront about this being to save cash. Often there are good reasons for not using these ‘low value’ treatments as a first choice, but they are appropriate for some patients. We are unhappy at any new barriers being erected between patients and the treatments they need.”
The medical bodies involved in drafting the document believe many of the interventions should be scrapped, or at most used very sparingly, because they could make patients anxious or even put them in danger.
For example, they suggest the prostate-specific antigen test, which is used to detect prostate cancer, is used much less often.
The document says: “Blood tests to check your prostate are not needed except for very specific cases. Blood tests can lead to further investigation that may also be unnecessary and can cause anxiety.”
The four medical bodies planned to put the proposals out to public consultation this month but had to delay because of general election “purdah” rules.