Huge differences in access to health services and the quality of treatment across England have been identified by the latest NHS Atlas of Variation report.
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 unwarranted variation 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, while cancer patients who received an early-stage diagnosis - a critical factor in treatment outcome - ranged from 22.7% to 60.8% between the country’s best- and worst-performing areas.
Huge variation - 21.7% to 84.5% - was also seen for the percentage of people with acute stroke directly admitted to a stroke unit within four hours of arrival at hospital, a timeframe also widely known to be crucial to securing the best outcomes for patients.
Regarding diabetes, the report showed that almost a third of people with diabetes 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%.
And 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 differences in the level of deprivation and associated health inequalities in different localities.
40% variation in GP antibiotic prescribing
Also, from 2010 to 2013, total antibiotic consumption increased by 6%, either because of changes in the number of patients presenting with infections needing antibiotics or over-prescribing. But 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 highlighting 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”.
“Our challenge now is to consider how we can better understand and tackle the underlying causes,” added chief medical officer Dame Sally Davies. “This is not a straightforward task, but exploring the data that lies behind these variations will be an important starting point”.
