News / Commission urges action on low value

Up to £500m a year could be saved by carrying out fewer ineffective or inefficient treatments, an Audit Commission briefing said.

Primary care trusts took different approaches and rated different interventions as low value, said Reducing expenditure on low clinical value treatments. A single approach to defining low value treatments could cut duplication of effort between trusts.

Without backing any list in particular, the briefing highlighted the types of treatment considered: those seen as relatively ineffective, such as tonsillectomy; those where more cost-effective alternatives are available; those where in mild cases the balance of benefit and risk is close; and procedures that could be classed as cosmetic.

While the potential for reducing costs varied from PCT to PCT, the briefing said some could save more than £12m a year based on the treatments on one widely used list.

Decommissioning treatments was not easy, it said, but strong leadership in PCTs, as well as good communication between PCTs and GPs, patients and the public, were crucial to the success of decisions on low value procedures.

Audit Commission managing director of health Andy McKeon said a single national evidence base would reduce the variation in treatments. ‘We were surprised at the variety of lists used,’ he said. ‘PCTs across the country are paying for treatments that cost the taxpayer money and, according to clinical experts, have little or no real value to patients.’

NHS Confederation PCT Network director David Stout, said the £20bn savings challenge meant effective commissioning would be more important than ever before.

But he added: ‘It is imperative PCTs are transparent on decisions made to reduce or limit treatments available to patients.