A tenth of prescription medicines doled out by GPs are unnecessary, pushing the NHS drugs bill to more than £9 billion, a landmark review has found.
Patients are routinely being harmed by a "culture" of overprescribing, the investigation found, with a fifth of hospital admissions among pensioners caused by adverse effects of medication.
The Government-ordered review identifies "very significant" waste across the system, saying that too often patients felt unable to question medics who did not look up from their keyboards.
It found that an average of 20 prescriptions are now issued per head of population annually, a doubling in two decades. And 15 per cent of patients were found to be taking five or more medicines every day.
The review, led by Dr Keith Ridge, NHS chief pharmacist, said patients should be offered alternatives to drugs, including exercise, talking therapies and social activities.
Check the medication
And it called for regular checks of their medication, with too many patients left on medicines for years, or even decades, when it was no longer appropriate.
The review estimated that “at least” 10 per cent of the 1.1 billion prescription items dispensed by GP practices annually may be overprescribed, meaning a "very significant" share of their £9.2 billion drugs budget is going to waste.
It follows calls from MPs for a root and branch review of spending, after the Government announced a £36 billion boost for NHS and social care , funded by a rise in National Insurance.
Around one in five hospital admissions among those over the age of 65 was found to be caused by adverse effects of medicines. Some medicines, such as medication for blood pressure, can increase the risk of falls, with other patients harmed by the combined effects of a cocktail of daily drugs.
Doctor knows best
The review was ordered in 2018 by then-health secretary Matt Hancock amid growing concern about a culture of a "pill for every ill".
"In some cases there is still a paternalistic tendency to believe that 'doctor knows best' and to treat the illness not the person, and a belief in the primacy of medicines to treat people's ills," the report found.
Too often, patients felt they were not listened to, and were prescribed medicines without understanding why, or knowing the risks or side-effects.
"Patients report that the unspoken signals given by busy clinicians during appointments, such as not looking up from their keyboard, discourage them from asking the questions that might reassure them or help them to manage their own health better," the report said.
No time to get to the cause
Clinicians said they often didn't feel they had time to get to the root of their patient's problems, or were forced to prescribe pills because waiting times for other types of help were too long.
The review also called for better use of technology to prevent errors, and ensure clinicians can access more details about previously prescribed medications.
Health and Social Care Secretary Sajid Javid said: “This is an incredibly important review which will have a lasting impact on people’s lives and improve the way medicines are prescribed.
“With 15 per cent of people taking five or more medicines a day, in some cases to deal with the side effects of another medicine, more needs to be done to listen to patients and help clinical teams tackle overprescribing.
Health officials said all of the recommendations had been accepted.
Dr Ridge said: “Medicines do people a lot of good and the practical measures set out in this report will help clinicians ensure people are getting the right type and amount of medication, which is better for patients and also benefits taxpayers, by preventing unnecessary spending on prescriptions."
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