Nurses could save £150m a year by helping patients to make better decisions about elective procedures, according to research seen exclusively by Nursing Times.
Pilot work carried out by the NHS Institute for Innovation and Improvement, working with Cardiff University and NHS Direct, looked at how patients could be supported to consider alternatives to surgery.
A shared decisions tool has been designed, which asks patients about their expectations of surgery, why they are considering the procedure and if they have considered alternatives.
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Patients discuss the questions with clinicians such as specialist nurses, health coaches and physiotherapists before their appointment with a medical consultant.
Department of Health national clinical lead for shared decision making Stephen Laitner told Nursing Times: “Nurses are ideally placed because they’re not closely aligned to a particular outcome, like surgeons are.
“They’re particularly good at consulting individuals and making decisions that are right for them. People feel they get a very personalised, patient centred conversation with the nurse.”
A US evaluation of shared decision aids has suggested they reduce take-up of surgery by between 20 and 25 per cent.
The UK analysis assumes NHS surgery rates would be reduced by 10 per cent after using the tool, as surgical rates are not as high as they are in the US.
Reducing the need for knee replacements by this amount would save approximately £40m, with a further £24m saved by reducing cataracts procedures and £13m by reducing hernia operations.
If another 10 other common procedures were added, the amount saved would be £150m a year, the analysis suggested.
The pilots were based in Oldham, Middlesbrough and Stanmore, for patients with osteoarthritis, localised prostate cancer and benign prostatic hyperplasia.
There are now plans to expand the programme into amniocentesis, early stage breast cancer and prostate cancer screening.
Last week, Nursing Times’ sister magazine Health Service Journal revealed figures showing that the NHS is spending tens of millions of pounds each year on operations of questionable benefit to patients’ health.
The figures came from patients’ answers to generic questions asked as part of the new patient reported outcome measures data collection.
The patients answers showed, on average, that nearly one third of those undergoing groin hernia, varicose vein and hip and knee operations reported their health and quality of life had either not changed or had worsened after the surgery.