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Postcode rationing of NHS services hitting patients in the South disproportionately

There is significant regional variation in NHS waiting times and access to medical technology, a report claims.

Patients in the South of England are waiting longer to access vital medical treatments such as pacemakers, cataract surgery, and hip and knee replacements than those in the North, a study by the Medical Technology Group (MTG) reveals.

The report examined data from all 209 Clinical Commissioning Groups (CCGs) from across England to find out how effective they are at giving patients access to medical technology.

It finds that nine out of the ten CCGs that performed worse when measured against the NHS 18-week ‘referral to treatment’ target were in the South.

In cardiology and cardiothoracic medicine for example, figures ranged from 100% of patients receiving treatment within 18 weeks in North Durham, while Medway CCG failed to hit the target for half of its patients.

The report also reveals that waiting times are steadily increasing across all CCGs. NHS performance reached a peak in late 2012 when nearly 19 out of 20 patients (94.8%) were referred to a consultant within the 18-week timeframe.

However, in April this year the figure had declined to nine out of ten, with almost three times more patients (380,000) waiting longer than 18 weeks for treatment compared with 130,000 in November 2012.

A similar north-south divide was revealed when data from the NHS Atlas of Variation were analysed.

The study found that Erewash in the East Midlands is the northernmost CCG in the list of worst performers when it comes to commissioning treatments including colonoscopies, lower limb amputations, and stroke treatments such as mechanical thrombectomy.

An analysis of the number of treatments being performed across the country again revealed wide differences between the regions.

Less than one patient (0.173) per 100,000 population in Southampton was referred for a computed tomography colonoscopy, compared to nearly 59 patients per 100,000 in Fareham and Gosport. CT Colonoscopies are a vital procedure for diagnosing or ruling out bowel cancer as early as possible.

Rapid treatment of stroke patients, using technology such as mechanical thrombectomies, can also make the difference between life and death.

The NHS recommends that patients are admitted to a specialist stroke unit with four hours of arrival at hospital. However, analysis of data from the Atlas of Variation found a vast range, from over eight out of ten patients being seen within this time (84.5%) in Hillingdon to just a fifth (21%) in Wyre Forest.

Chair of the MTG, Barbara Harpham, said, “Delivering high quality healthcare, no matter where you live, is one of the fundamental principles of the NHS. But budget cuts and rationing is having a huge impact on the service patients receive, and the outcome they can expect.

“This enormous north-south divide can’t simply be explained by the regional differences in populations. There is an unprecedented strain on the health service and patients are not being given equal access to the treatment – and most importantly – the technology they need.”

The MTG report sets out seven recommendations for addressing the current variation in NHS services, including:

  • Publication of aggregate waiting time figures so patients can compare the performance of their local NHS against other regions.
  • The creation of a tribunal board to rule on commissioning decisions made by local CCGs.
  • Inspections of the worst performing CCGs by NHS England.

Read the full report.

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