Written evidence submitted by Brian Finney (FGP0148)

 

1.0 Summary

The submission calls for an independent organisation to be established that assists Primary Care and thereby the patient in two areas:

i)                     Informs and supports the patient in the process of decision making leading to more effective consultations, requiring less Primary Care time on the basics.

ii)                   In addition to this informing and supporting role the independent organisation will measure the real life effectiveness of medications and treatment compared to the rational and assumptions used to implement. 

 

2.1 The concern of Too Much Medicine is well supported by such as British Medical Journal (BMJ) having it as a standing topic, an annual international Preventing Overdiagnosis conference, the RCGP Over-diagnosis group and a plethora of papers, abstracts and podcasts. Clearly, Too Much Medicine is a growing concern and has implications for Primary Care resources, which in turn result in barriers to access, together with budget and patient detriments.

2.2 Why does the organisation need to be independent? The NHS is a well-recognised as being subject to influence – this Committee produced a report in 2005 highlighting the Influence of the Pharmaceutical Industry, and more recently we have the NHS England Press Release dated 16 November 2021 informing that an additional 610,000 people can now receive DOACs (Direct Oral Anti-Coagulants ) as a consequence of an agreement with pharmaceutical companies. Quite whether they are clinically necessary is not mentioned, and if they are clinically necessary why were they not available previously? The agreement is of course confidential, but it could be construed that the budget remains constant while the volume of DOACs is increased, possibly leading to over prescribing; DOACs being blood thinners do carry a risk of bleeding, with the real potential for harm.

2.3 There is a recent history of effectively promoting DOACs directly to the public by such as an Academic Health Science Network North West Coast project and medical charities.

2.4 If we are to move further towards Evidence Based Medicine, which must be the goal for the benefit of Primary Care, NHS budget, and effective Patient Care we must close the feedback loop to demonstrate that new medications and treatment are effective in real life as soon as possible after implementation and provide support to the patient in the decision making process. 

2.5 The author has no conflicts of interests, but suggests that an academic organisation may well have the independence and capability required. Of course, any organisation appointed must have a Constitution that maintains independence with a strong patient oriented view.

 

Brian Finney has been involved in and around the NHS for over 35 years in a voluntary capacity as a patient advocate. His experience includes past Trusteeship of a major Medical Charity and local representation. He is professionally qualified as a Chartered Engineer.

His particular interest and concern is ‘Too Much Medicine’ which he has held for over 20 years.

Dec 2021