[London, UK/ Medicine] - The NHS Atlas of Variation 2011, published by the Department of Health (DH) this month, highlights the amount each Primary Care Trust (PCT) spends on clinical services and links this with health outcomes.
Consisting of 71 maps, the Atlas is aimed at helping commissioners learn from one other, consider the appropriateness of a service, and investigate when clinical health outcomes are not reflecting the financial investment that has been made. The first NHS Atlas of Variation, consisting of 34 maps was published in November 2010. Over 120,000 copies have been downloaded and 10,000 hard copies requested.
The 2011 atlas has increased the number of programme budget categories to 15 and has new sections on:
- time trends in relation to rate and variation, covering seven surgical interventions;
- steps local commissioners and providers can take to reduce unwarranted variation in their locality, and which tools to use; and
- a snapshot of what might be possible in the future from new sources of data.
The DH acknowledges that variation occurs naturally in the NHS and this is encouraged where the NHS tailors services to meet local needs. It says that it has expanded this year′s Atlas to support commissioners to expose unwarranted variation and help the NHS provide consistently high quality care for patients.
Examples of variations highlighted in the Atlas:
- a 25-fold variation in anti-dementia drugs prescribing rates across England;
- patients with Type 2 diabetes are twice as likely to receive the highest standard of care in some areas of England compared others;
- there is an eight-fold variation in the range of patients receiving angioplasty treatment for a severe (STEMI) heart attack — this variation may be due to long travel times to reach patients living in rural areas.
There is an online version of the Atlas that displays variation in healthcare by PCT for 33 indicators, for example, rate of A&E attendances per 100,000 population (see image above, which shows values ranging from 149 in Buckinghamshire to 2798 in Southwark).
Health Minister Lord Howe said, “Our modernisation plans for the NHS will result in a more patient-centred NHS that achieves health outcomes that are amongst the best in the world and gives people a greater say about their healthcare. The Atlas of Variation lets us look at how the local NHS is meeting the clinical needs of their local population. This will help commissioners to identify unjustified variations and drive up standards so patients are receiving consistently high quality care throughout the NHS. We are committed to improving results for patients and our new NHS Outcomes Framework will hold the NHS to account for this. Commissioners will be able to apply contractual penalties if any organisation is failing to deliver improvements for patients." [hw]
The Atlas of Variation 2011
The online Atlas version