Lives being put at risk, NHS report suggests

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Media captionDominic Hughes reports: "NHS leaders say there is clear evidence some patients are missing out on the best treatment"

Differences in access to key NHS services, including stroke and cancer care, are putting patients at risk, an official report suggests.

The NHS Atlas of Variation - published by NHS England and Public Health England - looks at service performance in more than 200 local areas.

It found a two-fold variation in early cancer diagnosis and quick stroke treatment between the best and worst.

The atlas also pointed to "unwarranted" differences in diabetes monitoring.

Patient groups called the findings "extremely concerning", while NHS bosses warned action must be taken by local health chiefs as the variations in care would be costing lives and harming health.

The atlas found:

  • A little more than one in three patients in the worst-performing areas are admitted to a stroke unit within four hours of arrival at hospital, compared to eight in 10 in the best.
  • Some 30% of patients in the worst-performing areas are diagnosed with cancer when the disease is at an early stage - increasing the chances of survival in the worst areas - compared to 56% in the best.
  • Only 42% of patients get the right diabetes checks in the worst-performing areas, compared to 72% in the best.
  • One in 10 diabetes patients have to undergo foot amputations in the worst-performing areas - four times the rate in the best areas.
  • More than half of patients suffering from psychosis for the first time get help from specialist early intervention teams - six times more than those in the worst areas.
Image copyright Public Health England

NHS England medical director Prof Sir Bruce Keogh urged local health bosses to take action.

"The atlas exposes some inconvenient truths about the extent of variation in care for some common conditions."

And Prof Julia Verne, from Public Health England, said: "It is really important to tackle this unwarranted variation because patient lives are being put at risk.

"If we can iron them out then more patients will survive, they will have fewer complications and they will have better quality of life."

Image copyright Public Health England

Understanding the atlas

The report is effectively an annual stocktake of what is happening in each of the 211 clinical commissioning groups in England.

It has been compiled using official data across more than 100 different areas of care. Extreme outliers - the very best and worst - are excluded to try to ensure the figures are not skewed by possible data collection errors.

This, the authors believe, is a more accurate way of reflecting the true differences in performance.

There are some areas - liver disease and tooth decay in children for example - where the variation is as much, if not more, to do with how people are living their lives as it is about the quality of care.

But in other areas, such as stroke and diabetes, the differences are more likely to be down to how the NHS is performing.

Alexis Wieroniey, of the Stroke Association, said: "Immediate treatment on a stroke patient is essential as this helps to minimise the long-term effects and can prevent death.

"The wide-ranging variation in the time it takes people to be admitted to a stroke unit across England is extremely concerning and it is unacceptable that too many people are still not admitted within four hours.

"Wherever they live, people must have an equal chance in getting the immediate treatment they need to make their best possible recovery from stroke."

And Nick Ormiston-Smith, Cancer Research UK's head of statistics, added: "Cancer survival is improving, but these statistics show that cancer services are not meeting the needs of all patients.

"We know that catching cancer early saves lives. Diagnosing the disease at an early stage means patients have the best chance of their treatment being successful. Improving early diagnosis and ensuring patients get the best possible treatments must be a priority for the NHS."

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