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NHS Atlas of Variations in Health Care Published

The National Health Service (NHS) Quality, Innovation, Productivity, and Prevention Programme recently published the NHS Atlas of Variations in Health Care for England to promote awareness of variation in medical resources and services that cannot be attributed to patient population differences. Similar to the Dartmouth Atlas of Health Care for the United States, the NHS Atlas comprises 34 geographical maps that document how much each of the 152 English primary care trusts spends on a variety of clinical services, and links this spending to health outcomes.

The Atlas highlights a 14-fold variation in spending on broken hips and a 50-fold difference in spending on anterior cruciate ligament (ACL, or knee ligament) reconstruction. Examples of variation in care include a six-fold difference between primary care trusts in emergency admissions for children with asthma, and a four-fold difference in emergency bed days for people with chronic obstructive pulmonary disease.

The Atlas is expected to help commissioners of care improve services and achieve better value by enabling them to identify low performers and potential for improvement; determine the appropriateness of care; and reveal where there may be overuse of services or where low-value services are being used.

The NHS Atlas is publicly available at:


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