NHS seeing three fold differences in cancer referrals

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A new atlas of the NHS has been produced highlighting variations in coverage of 71 different treatment areas across the country.

It will also emphasise concerns about postcode lotteries of treatment for differing diseases and lend weight to insurers' claims of inconsistent care in different parts of the country.

According to the data, the rate of urgent GP referrals for suspected cancer cases varies by as much as a 3.2 times when all PCTs were included, but this fell to a 2.5 fold difference when the top and bottom five were removed.

The Department of Health report sought to downplay this variation but noted that it could be indicative of factors other than the local population.

‘It is important to emphasise that there is no right or wrong level of referrals,' it said.

‘Work is being undertaken to understand the reasons for variation. The appropriate rate of referral will vary from one cancer to another, and will be influenced by the age structure of the population.

"However, the degree of variation observed for this indicator is probably greater than could be accounted for by the age distribution of populations,' it added.

The government said the atlas of 151 primary care trusts (PCTs) in England would help 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.

‘While variation occurs naturally in the NHS and is encouraged where the NHS tailors services to meet local needs, we have expanded this year's Atlas so we can support commissioners to expose unwarranted variation and help the NHS provide consistently high quality care for patients,' it continued.

Examples of variations identified in the Atlas include:

• a 25-fold variation in anti-dementia drugs prescribing rates across England,

• patients with Type 2 diabetes being twice as likely to receive the highest standard of care in some areas of England in comparison to others,

• 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.

Lord Howe, the Health Minister, added: "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."

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