NHS Atlas of Variation Report Shows Huge Gaps in Care Quality and Access

Latest NHS Atlas of Variation report indentifies huge differences in access to health services and the quality of treatment across England.

The report (compiled by Public Health England and NHS England) looked at the performance of all 211 clinical commissioning groups across the country, and found high levels of unjustified variation which are putting patients’ lives at risk.

The data shows a 2.1 fold variation in the number people under the age of 75 losing their lives to cancer, ranging from 85 to 176 per 100,000 population. Whereas cancer patients who received an early-stage diagnosis (a critical factor in treatment outcome) ranged from 23% to 61% between the England’s best and worst performing areas.

There was also a huge variation (approx. 22% to 85%) for the amount of people with acute stroke directly admitted to a stroke unit within four hours of arrival at hospital, another timeframe that is widely known to be crucial for ensuring the best outcome for the patient.

With regards to diabetes, the report showed that almost a third of people with the condition are not receiving the basic standard of care, given that the percentage who received NICE recommended care process (excluding eye screening) ranged from 30.4% to 76.4%.

Deaths from coronary heart disease in people aged under 75 years also fluctuated widely, ranging from 22 to 113 per 100,000 population, the key reason being the variation in the level of deprivation and associated health inequalities found in different localities.

Also, from 2010 to 2013, total antibiotic consumption had increased by 6%, this could be due to changes in the number of patients presenting with infections needing antibiotics or over-prescribing. However usage in the NHS area team with the top level of prescribing in general practice was over 40% higher than that with the lowest level, again showing a very uneven playing field across the country.

“This Atlas exposes some inconvenient truths about the extent of clinical practice variation in care for some common conditions,” said Sir Bruce Keogh, National Medical Director of NHS England. “The good news is that – at a time of financial pressure across the health service – hospitals, GPs and mental health providers have substantial opportunities to unleash greater value from their existing NHS budgets”.


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