NHS atlas highlights significant variations in care


An atlas published by the Government that maps variations in health spending and outcomes across England has highlighted some significant regional differences including amputation rates among diabetics.

The NHS Atlas of Variation consists of 34 maps representing 152 primary care trusts with data on quality of care, outcomes for patients, and value and expenditure in key areas such as cancer, stroke and diabetes. The data is complex and patient groups have set about analysing variations and pressing for change.

Amputation rates among diabetics showed one of the most striking variations. Data revealed that the amputation rate for patients with Type 2 diabetes in the South West (3 in 1000 patients) is almost twice the rate in the South East. The Charity Diabetes UK was also concerned that the data showed less than half those with the disease (Types 1 and 2) had received nine key healthcare checks.

"This demonstrates that the NHS is failing to provide universally high quality care across the country and shows that diabetes care is still a postcode lottery," Barbara Young, chief executive of Diabetes UK, told the Guardian newspaper.

More than 70 major amputations a week are carried out on Type 2 diabetes patients in England and it is thought 80 per cent are potentially preventable.

On cancer the atlas shows wide variation among primary care trusts (PCTs) in how much was spent per 1,000 members of the population, from more than £40,000 in some areas to less than £20,000 in others.

Another example of wide variation was in referral for stroke. National guidelines recommend that patients suffering suspected ‘mini-strokes’ are at higher risk of a major stroke and should have specialist tests within 24 hours. The atlas shows a greater than 10-fold difference in the percentage of patients getting such gold standard treatment across different regions of England.

Sir Muir Gray, the public health academic who led the research within the Department of Health, said: "Most people in the health service are so focused on what they're doing, working so hard, they've got no idea if they are doing better or worse than someone else.

"The atlas is now going, for the first time, to give them a clear idea of where they are."

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