RCoA supports Choosing Wisely campaign

The Academy of Medical Royal Colleges, supported by the Royal College of Anaesthetists (RCoA), has today launched the Choosing Wisely campaign across the UK.

Choosing Wisely is aimed at encouraging patients and doctors to discuss the risks and benefits of available treatments and procedures to help choose and deliver the most appropriate and necessary treatment. While it is the doctor’s responsibility to choose the most appropriate treatment for the patient, the campaign is calling for the avoidance of unnecessary tests and treatments that are of little or no benefit. This is part of a global initiative to reduce over-medicalisation.

In a recent study, 82% of doctors said they had prescribed or carried out a treatment which they knew to be unnecessary. The vast majority of this group cited patient pressure or patient expectation as the main reason.

The RCoA has contributed to a list of forty treatments and procedures that are of little or no benefit to patients, which have been drawn up by the UK’s medical royal colleges.

For Choosing Wisely, the RCoA has developed five evidence-based recommendations for elective surgery, all of which have been endorsed by the Royal College of Surgeons. The recommendations were developed to not only improve patient care and safety, but deter the use of unnecessary treatments which cost the NHS millions of pounds every year.

RCoA’s recommendations are:

1. Day surgery being considered the default for most elective procedures
2. Patients do not need to come into hospital the day before surgery if they have had the appropriate preoperative assessment and preparation
3. Most patients do not need routine preoperative tests before minor or intermediate surgery
4. All patients considering an operation should have shared decision making consultations to discuss their individual chance of benefit or harm and to identify their personal preference
5. For many patients the chance of harm after an operation may be reduced if they improve fitness, stop smoking, reduce alcohol intake and in some cases reduce weight in the weeks or months before their surgery.

Dr Liam Brennan, RCoA President, said: “While doctors have the best interest of the patient at heart, we are also responsible for delivering the most appropriate treatment, not simply the one which a patient asks for or expects. By having a discussion about treatment options and their associated benefits and risks, the reduction of unnecessary interventions can improve patient care and safety, while freeing up resources which can be used more effectively elsewhere.”

View the RCoA's five evidence-based recommendations for elective surgery here.