Belfast Telegraph

Monday 22 September 2014

NHS 'postcode lottery' revealed

Patients face a postcode lottery of NHS care that is strongly linked to different practises in health trusts, a study says

Patients face a postcode lottery of NHS care that is strongly linked to different practises in health trusts, a Government document has revealed.

The NHS Atlas of Variation published by the Department of Health found some NHS trusts were failing in key areas, including cancer, stroke and diabetes care.

It includes maps so members of the public and NHS managers can see how their region is performing compared to other parts of England.

Many of the maps are standardised to take account of differences in age, sex and prevalence of the condition - some of the major reasons typically cited for variations in care.

The report therefore reveals that practices between NHS trusts vary in ways that cannot always be explained by social or patient factors.

The study looks at quality of care, outcomes for patients, how much activity there is in a trust, value and expenditure. On cancer, it found primary care trusts (PCTs) varied in how much they spent per 1,000 members of the population, from more than £40,000 in some areas to less than £20,000 in others.

High spending regions included Norfolk, Devon, Suffolk, Lincolnshire, Yorkshire, Cambridgeshire and Northumberland and low spending areas included London, Durham and Derbyshire.

The report said that even when the five PCTs with the highest rates and the five PCTs with the lowest rates were excluded "the variation ranges from about £22,000 per 1,000 population to about £38,000 per 1,000 population".

There are also "wide variations" in how trusts use beds for cancer patients, with some keeping patients in far longer than others.

When it comes to diabetic amputations - which can result following complications caused by the disease - there is a lottery over how many are performed, with NHS trusts that have a specialist team dealing with diabetic foot care have fewer amputations. Across the NHS, there are over 70 amputations a week, of which 80% are potentially preventable.

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