In a recent campaign to improve communication between clinicians and patients in order to avoid unnecessary tests, treatments and procedures the Royal College of Anaesthetists and the Royal College of Surgeons’ recommended that:
- Day surgery should be considered the default for most surgical procedures (except complex procedures). Variation in the use of day surgery for specific operations should be measured and this information should be available to patients.
- Patients do not need to come into hospital the day before surgery if they have had the appropriate preoperative assessment and preparation.
- Most patients do not need routine preoperative tests before minor or intermediate surgery. There are national guidelines to determine who needs preoperative tests.
- 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. Patients choosing surgery who are at a high risk of dying (predicted 30 day mortality >1%) should be identified by their age, type of surgery and additional medical conditions.
- 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.
The Choosing Wisely Report is part of a world-wide initiative and was produced by the Academy of Medical Royal Colleges on 24th October 2016 having been put together following consultations with patient groups and experts. Medical colleges and faculties were asked to identify five treatments or procedures that were considered to be of questionable benefit to patients taking particular concern that they provided suggestions that were evidence based and relevant to NICE guidance.
I’m not from an anaesthetics background, does anyone who is have any other suggestions or recommendations?
Emily Farrow (CSH Clinical Programme Deputy Director)