A new NHS Atlas of Variation has laid bare the regional variations in treatment that patients receive based on what part of the country they live in.

Published by the Department of Health, the atlas shows that wide variations in the care are linked to different practises in health trusts. The document shows how some trusts are failing in key areas, including cancer, stroke and diabetes care.

The atlas provides 34 maps showing high and low spenders among the 152 primary care trusts in England, and colour codes different outcomes.

The atlas is intended to provide a reference tool to help inform commissioners of care – a responsibility about to shift from PCTs to GPs – to more effectively commission services.

"In order to improve unwarranted variations in services, it is vital to expose existing flaws in the system," said health minister, The Earl Howe. "While this data predates the coalition government, the information is essential to drive improvements across the NHS."

So far the atlas has only been published in print, but an online interactive version is promised in the New Year.

Sir Muir Gray, joint leader of the NHS Right Care project, which is behind the atlas, said the maps will “help root out unwarranted variations in care”.

“Our aim in publishing this atlas is to stimulate, within all levels of the NHS, a search for un-warranted variation,” says the project website.

Many of the maps are standardised to take account of differences in age, sex and prevalence of the condition – key factors that usually skew regional comparisons.

NHS trusts vary in ways that cannot always be explained by social or patient factors.

On cancer, the atlast suggests that PCT spend per 1,000 members of the population varies by up to 100%. In some cases, the figure was more than £40,000, while in others it was less than £20,000.

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

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

Wide variations also exist on diabetic amputations. NHS trusts that have a specialist team dealing with diabetic foot care have fewer amputations than those without.

The data provided in the maps is intended to be linked to treatment outcomes data, to help commissioners identify both where additional investment in services was required and where it isn’t delivering good health outcomes.

The DH’s Right Care programme has also, for the first time, sought to put a figure on how much the NHS spends by disease area.

Top of the list is the £10 billion a year spent on mental health, with £7.5 billion on circulatory diseases, and another £5 billion on cancers.


Right Care