- Too many invasive ops, not proven to actually save lives, are being done
- Overall, unnecessary treatments cost the NHS at least £2.4 billion a year
- Cardiologists say the focus should be on prevention rather than cure
- Public must be encouraged to diet, exercise and quit smoking, they say
Hospitals are wasting millions of pounds a year on unnecessary treatments for heart attacks and strokes, leading cardiologists have warned.
Calling for a complete overhaul of NHS cardiac care, experts say that we should focus on prevention rather than cure.
Writing in the Postgraduate Medical Journal, the doctors said that we are carrying out too many invasive heart operations which have not been proven to actually save lives.
Instead of spending millions on potentially dangerous operations, the NHS should instead stop more people smoking, encourage exercise and improve diets, they say.
Overall, unnecessary treatments cost the NHS at least £2.4billion a year.
The authors include Sir Muir Gray, former chief of knowledge for the NHS, Dr Andrew Apps of Oxford John Radcliffe Hospital, and Harvard cardiologist Dr Vikas Saini.
The doctors point to the results of a recent Imperial College study, in which scientists found that expensive intra-aortic balloon pumps – inserted into the heart in the wake of a heart attacks – have not actually reduced death rates.
They wrote: ‘Despite decades of use, a recent meta-analysis revealed no lasting benefit.
‘The average cost of the machine is about £40,000, with individual pumps costing £800.
‘Injudicious use of this technology not only wastes resources but also puts patients at risk of harm.’
Another study found that thrombectomy catheters – a technique used to remove blood clots during heart attacks – costs the NHS £2 million a year, but has not been shown to reduce the risk of death or repeat heart attacks.
In fact, it actually increases the risk of strokes soon after treatment.
The authors said that in many cases patients are not properly informed about the risks of surgery, or offered an alternative.
‘Overtreatment offers only unnecessary risk; shared decision making, starting with the physician investing time in a fully informed, evidence-based consent process, is essential,’ they wrote.
‘With 80 per cent of cardiovascular disease attributable to lifestyle, preventive cardiology with public health and educational campaigns is essential to reduce the burden of cardiovascular disease further; there is simply not enough support to help patients change their lifestyle.’
Dr Malhotra, a London cardiologist and consultant to the National Obesity Forum, said that doctors feel compelled to use expensive equipment, simply because the NHS has spent so much money on it.
‘We have a history now that we have spent a lot of money on technology for which the benefits are marginal at best, but can also do great harm,’ he said.
‘We need better regulations, so that we have more robust evidence before technology gets introduced.’
England’s top doctor last night backed the authors.
NHS medical director Professor Sir Bruce Keogh, himself a heart surgeon, said: ‘Over-treatment is not only bad for the patient affected, but deprives other patients of needed care, so if we shift the money and effort spent on unneeded treatment to other areas, everyone will gain.’
But Dr Mike Knapton, associate medical director at the British Heart Foundation, said that technological advances have contributed to reducing deaths from cardiovascular disease by more than half in the last 50 year.
‘While there might be examples of overtreatment, it could equally be argued that undertreatment is of concern,’ he said.
‘What’s important is the efficient and effective use of resources within the NHS to ensure as many people as possible are getting the best possible outcomes.’