Call for action as postcode lottery on NHS care for children exposed

There are wide variations between some health trusts in England in areas such as emergency admissions for bowel disease, epilepsy and asthma, and the number of A&E attendances among under-fives.

While some of the difference can be explained by socio-economic factors, health needs, ethnicity and the choices that families make, variation is also down to concerns about inappropriate clinical practice and unequal access to care.

The NHS Atlas of Variation in Healthcare for Children and Young People report is based on health service data from primary care trusts (PCTs).

A&E attendances among children under five resulted in a 36-fold variation between the best and the worst PCTs in England, the report showed.

The study also found a 25-fold variation between the best and worst PCTs over emergency admissions among children with asthma.

Emergency admission rates for inflammatory bowel disease varied tenfold between the best and the worst, and for children with epilepsy, there was a ninefold difference between the best and the worst.

Professor Terence Stephenson, president of the Royal College of Paediatrics and Child Health, said: “The extent of variation is a real concern and not explained solely by deprivation.

“We need to bring the worst up to match the best.”