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18.09.15

NHS Atlas of Variation launched to tackle unwarranted service inequalities

Public Health England, NHS Right Care and NHS England have launched the third and biggest Atlas of Variation today (18 September) in a bid to help commissioners, providers and health professionals improve service delivery.

The 284-page document identifies opportunities to address “unwarranted” variations in healthcare – related to quality, safety, equity, outcomes, and costs – by revealing overuse and underuse of different services.

An example of this includes the diagnosis and support for people with dementia, wherein there is a 2.7-fold variation in claims by GPs for direct enhanced services.

John Newton, chief knowledge officer at PHE, said: “Variations are not always bad. Some can be explained by local circumstances or patient-centred care, but unwarranted variation is very different. While some patients are missing out on the right care, others are being given care they don’t need.

“We hope this collaboration of work… will encourage commissioners, service providers and clinicians to engage with this tool and ensure resources are being used effectively, and that outcomes improve.”

The data also spans supporting commentary, links to resources and ‘options for actions’ so services can take on inspiration from the highest achieving areas.

It has had clinical leadership from the national clinical directors and other clinical leads, as well as support from the PHE intelligence teams and other data providers such as the Neonatal Data Analysis Unit, national audits, royal colleges and specialist organisations.

Sir Bruce Keogh, national medical director of NHS England, said: “This atlas exposes some inconvenient truths about the extent of clinical practice variation in care for some common conditions.

“The good news is that – at a time of financial pressures across the health service – hospitals, GPs and mental health providers have substantial opportunities to unleash greater value from their existing NHS budgets.”

Professor Matthew Cripps, national director at NHS Right Care, added that the atlas will now be embedded in their ‘right care’ work with CCGs in a bid to locate efficiency opportunities. Right Care is a programme of NHS England focusing primarily on increasing the value in healthcare by looking at the best value opportunities to clinicians and commissioners, and by supporting CCGs to change commissioning accordingly.

New features of this year’s atlas include 24 maps – forming one quarter of the data – covering the care of mothers, babies, children and young people, as well as 19 maps on cardiovascular-related indicators.

There is a strong focus on mental health and sections on cancers and elderly care have been expanded.

The new volume also scopes a range of issues including neurological problems, learning disability issues, emergency care and end-of-life care. Critical care is included for the first time with two indicators.

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