SUTTON TRAINING HUB
Working today for a brighter, and better tomorrow
Self-Directed Learning Pack
Structured learning for GPs and primary care clinicians - all in one place so you don't have to search across multiple websites.
By the end of this pack, clinicians should be able to:
✅ Define overdiagnosis and overtreatment
✅ Identify common areas in primary care
✅ Apply shared decision-making approaches
✅ Communicate risk and uncertainty confidently
✅ Use evidence-based tools in practice
✅ Reflect on personal drivers of overmedicalisation
Only have 20 minutes? Start here
High-yield content selected for busy clinicians
Watch
Choosing Wisely UK - Introduction to overdiagnosis. Short, focused on reducing unnecessary tests.
Read
BMJ Too Much Medicine collection -screening, incidental findings, polypharmacy, diagnostic thresholds.
Use today
BRAN Framework in consultations - Benefits · Risks · Alternatives · Nothing (what if we do nothing?)
Core learning modules - scroll to read all four
High-yield content selected for busy clinicians
1
Understanding Overdiagnosis
Definitions, drivers and how overdiagnosis differs from misdiagnosis and overtreatment
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Overdiagnosis vs misdiagnosis vs overtreatment
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Medicalisation and labelling effects on patients
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Drivers within healthcare systems
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Patient and clinician perspectives on uncertainty
Reflect: Where do you most commonly see overdiagnosis in your practice? What pressures contribute to it? How comfortable are you with uncertainty?
Beginner
30min
CPD
2
Screening & Prevention
PSA testing, thyroid testing, health checks, incidental findings and cancer screening
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Evidence base for common screening tests
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Harms of incidental findings
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Shared decision-making before ordering a test
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NICE shared decision-making guidance
Shared decision-making prompts to use in consultations:
"What are you hoping this test will tell us?"
"How would the result change management?"
"Would you like to discuss the potential downsides as well as benefits?"
Shared decision-making prompts to use in consultations:
"What are you hoping this test will tell us?"
"How would the result change management?"
"Would you like to discuss the potential downsides as well as benefits?"
Intermediate
45min
CPD
3
Polypharmacy & Medication Burden
Deprescribing, medication burden, risk vs benefit in older adults and multimorbidity
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STOPP/START criteria for medication review
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Structured medication review frameworks
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NHS polypharmacy guidance
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Case-based deprescribing examples
Medication review questions:
Is this medicine still needed? Is it improving quality of life? Does the patient understand why they take it? Could any medications be reduced or stopped?
Intermediate
40min
CPD
4
Risk Communication & Shared Decision-Making
Communicating uncertainty, relative vs absolute risk, patient expectations and safety netting
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BRAN and ICE consultation frameworks
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Relative vs absolute risk communication
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Safety netting approaches
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Realistic Medicine principles
Explaining uncertainty to patients:
"At the moment there are no signs of anything serious."
"Sometimes doing more tests can create problems rather than answers."
"Monitoring symptoms carefully may be safer than investigating immediately."
Shared decision-making phrases:
"There are a few reasonable options here."
"What matters most to you?"
"Would you like to talk through the pros and cons together?"
Intermediate
35 min
CPD
Practical consultation tools
BRAN Framework
Use to structure any shared decision-making conversation:
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Benefits
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Risks
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Alternatives
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Nothing -what if we do nothing?
ICE Framework
Explore the patient perspective:
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Ideas
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Concerns
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Expectations
Useful for reducing unnecessary investigations.
Delayed Prescribing
Appropriate for self-limiting conditions:
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Mild respiratory infections
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Self-limiting conditions
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Reduces antibiotic use while maintaining patient reassurance
E-learning & courses
Suggested reading list
Beginner / Introductory
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BMJ Too Much Medicine collection
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Choosing Wisely introductory articles
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NICE shared decision-making guideline
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Brodersen et al., BMJ EBM 2018
Intermediate
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Overdiagnosis in screening programmes
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Evidence-based medicine articles
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Polypharmacy guidance (NHS England)
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Johansson & Brodersen, BMJ EBM 2018
Advanced
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Academic papers on diagnostic thresholds
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Preventing Overdiagnosis conference papers
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Shared decision-making research
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Iona Heath, BMJ 2014
Reflective practice & CPD
Case Reflection Exercise
Think of a recent consultation where a test may not have been necessary, a patient expected antibiotics, an incidental finding created further follow-up or a medication review could have reduced burden. Then reflect:
What happened?
What influenced your decision? What pressures were present? Could a different conversation have changed the outcome?
What next time?
How could BRAN or ICE have helped? What shared decision-making language could you use differently next time?
Team discussion & CPD ideas
Practices or PCNs may wish to use this resource pack to discuss at PLT sessions or practice meetings:
Topics to discuss:
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Local prescribing pressures
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Common low-value investigations
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Patient expectations management
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Variation in practice
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Safety-netting approaches
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Shared consultation language
Suggested activities:
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Journal clubs
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Case discussions at PLT sessions
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Peer review
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Prescribing audits
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Reflective meetings
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MDT discussions
Useful organisations & campaigns
Choosing Wisely
International campaign promoting conversations about unnecessary tests and treatments, organised by specialty.EBM 2018
Preventing Overdiagnosis
Global conference and resource hub bringing together researchers and clinicians working to reduce overdiagnosis
NICE Shared Decision-Making
Evidence-based guidance and patient decision aids for clinicians across all specialties.
Realistic Medicine
Resources focused on personalised care and reducing unnecessary interventions in primary care and beyond.