Doctors wanting ‘kudos’ driving up care costs

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NHS budget taking the hit for doctors introducing new treatments

Doctors have been taking finances in to their own hands by introducing new treatments to hospitals, without sufficient evidence of their effectiveness, or enough communication with NHS England, in a bid to gain more brownie points and prestige.

The accusations come from senior health leaders who are offering advice on how to cut the previously estimated £900 million deficit in the 2014/15 specialised commissioning budget. Despite predictions now revealing that finances will break even, concerns have still been raised about spending, with officials offering plans on how to find more savings.

Some proposed ideas will prove unpopular with NHS staff, as one suggestion thought restricting the periods when staff could take holiday could eliminate unplanned seasonal variation in elective admissions, reducing the number of beds.

Cost of kudos

In total, 81 money saving ideas were put forward, while clinicians from CRG’s feel that the sprialling costs of specialist services are to blame, with a lack of a prioritisation process costing the NHS, as new technologies and treatments were being introduced and funded by the NHS without an adequate level of understanding. One member believes doctors are “enthusiasts” and will interpret new treatments in “the best possible light” so that they can be the first to get their hands on it.

One CRG member commented to the Health Service Journal “Clinicians wish to give the best treatment to their patients. They are also competitive by nature and wish to be ahead of the perceived clinical competitors.” An example of this would be the recent suggested rollout of robotic assisted surgery, which has now been halted. “This is happening because surgeons want kudos, centres want kudos,” the member continued.

There has also been instances of ‘levelling up’, where services previously only available in some parts of the country are now offered everywhere, stretching NHS resources. With fears of a repeat performance on massive overspend, strategies for specialist spending has been put on hold, as a taskforce aims to rein the budget back in to control.

It has been suggested that a prioritisation framework enabling the fair comparison of the benefits of new treatments against each other would be a solution moving forward.