News / Atlas spells out spending differences

Variation in expenditure across primary care trusts may be justified, but much may be due to years of investment without regard to the needs of the population, according to the new NHS atlas of variation.

The atlas, which looks at expenditure and activity and value, maps variations in spending, incidence and demand (bed use) across 17 treatment areas. ?Published by the Department of Health’s right care group, which aims to empower patients and give commissioners information to improve value, it showed big differences across England.

For example, there was a more than two-fold variation in cancer expenditure across the 152 PCTs. Even when the five highest spending PCTs per 1,000 people and the five lowest were excluded, cancer expenditure ranged from £22,000 per 1,000 population to £38,000.

Right care co-leaders Sir Muir Gray and Philip DaSilva said some variation was inevitable  but it was concerned about unwarranted variation. Where there are high rates of activity, some patients may be receiving treatments clinicians in other areas would see as unnecessary. This spending could be used to fund preventative work or the unmet needs of other patients.

NHS Confederation acting chief executive Nigel Edwards welcomed the report, but warned the government’s reforms will create more commissioning bodies, resulting in greater variation. ‘Disparities in expenditure, outcomes and activity are not always as simple as a result of poor commissioning or poor provision,’ he added.