The vast gulf in NHS services, where a life-saving op depends on your postcode

HUGE inequalities in NHS services have been exposed in a new atlas of healthcare.

Ministers say the study will help health chiefs tackle “unwarranted variation” in care to drive up standards for patients.

But the findings are likely to lead to further criticism of Government moves to devolve decision-making over health services to local GPs which critics claim could widen postcode lotteries of care.

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Examples of inequalities highlighted include patients with Type 2 diabetes being twice as likely to receive the highest standard of care in some areas of England than others, while there is an eight-fold variation in the range of patients receiving gold-standard angioplasty treatment for severe heart attacks.

In Yorkshire, the atlas shows patients in Sheffield with dementia are more likely than anywhere else in the country to be given drugs to temporarily improve or stabilise symptoms.

Rates of prescribing of anti-dementia drugs are three times those in North Lincolnshire but more than 50 times higher than in some parts of England, suggesting in some areas many people with the illness are not being identified by family doctors or access to diagnostic services is poor.

The report says there is growing inequity in rates of emergency admissions to hospital of children with asthma, with twice as many youngsters from Wakefield admitted with the illness than those in Rotherham and North East Lincolnshire. It says action is urgently needed to improve asthma care for children involving GPs, hospital specialists, parents and schools.

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Among other findings, the atlas reveals women undergoing breast cancer surgery in Leeds spend a day in hospital but those in Wakefield face stays of nearly three days – despite official guidance suggesting most women can be treated as day cases or with a single overnight stay.

It says patients with lung cancer treated by the NHS cancer network which covers West Yorkshire and parts of North Yorkshire are more likely to receive potentially-curative surgery, the second highest rate among 27 cancer networks nationwide.

It also reveals that children in parts of the region have some of the worst dental health in the country, with a variation of up to seven-fold across the country in levels of dental decay.

Health Minister Lord Howe said the atlas had been designed to help health chiefs learn from one another and investigate when outcomes did not match the investment made in treating health problems.

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“The Atlas of Variation lets us look at how the local NHS is meeting the clinical needs of their local population,” he said.

“This will help commissioners to identify unjustified variations and drive up standards so patients are receiving consistently high quality care throughout the NHS.”

Diabetes experts said it underlined the need for better footcare services to stop the “amputation postcode lottery” which has seen 4,600 undergoing surgery in the last five years.

The report shows rates of lower limb amputations among diabetics in Sheffield are twice as high as in Bradford, Calderdale, Leeds, Barnsley and Doncaster but nationally the variation is sixfold.

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The risk is a key complication of the illness but those who better control the condition or who get quick referral for expert help once foot disease occurs are less likely to need surgery.

NHS Diabetes director Anna Morton said evidence from better integrated services involving GPs, community staff and hospital specialists showed rates of amputations could be cut by 75 per cent.

She said: “The amputation rate is high, and often avoidable, but what is even more unacceptable is that the chances of having this life-changing surgery can come down to your postcode.”