Audit Commission suggests savings in orthodontics

The Audit Commission has published a health briefing suggesting that the NHS could save up to £500 million a year by carrying out fewer ineffective or inefficient treatments. These include orthodontics and the removal of wisdom teeth. The Audit Commission has developed an online tool that allows the user to identify savings opportunities.


The briefing called ‘Reducing expenditure on low clinical value treatments’ argues that a single approach to defining low value treatments could help to reduce the duplication of effort between primary care trusts (PCTs) and help to ensure consistency across the country.

It also considers some PCTs’ efforts to decommission treatments of low clinical value. Types of low value treatments identified included:

  • Those considered to be relatively ineffective, eg a tonsillectomy.
  • Those where more cost-effective alternatives are available, eg not performing a hysterectomy in cases of heavy menstrual bleeding.
  • Those with a close benefit and risk balance in mild cases, eg wisdom teeth extraction.
  • Potentially cosmetic procedures, eg orthodontics.

Decommissioning treatments can free up money that could be better spent on other treatments, but decisions can be controversial. The briefing shows how strong leadership within PCTs, as well as good communication between PCTs, and GPs, patients and the public, are crucial success factors.

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