chrisdorney - Shutterstock
NHS patients who live just thirteen miles apart have access to dramatically different performing hospitals despite being under the same administrative board, according to a report by the Medical Technology Group.
An analysis of NHS England monthly Referral to Treatment data between December 2021 and November 2023 found that Wakefield treated the most patients, in relation to the size of their population, while its neighbouring equivalent in Leeds ranked as one of the lowest.
In Humber and North Yorkshire ICB, the third best Sub-ICB Location (formerly Clinical Commissioning Groups) - North East Lincolnshire - sits alongside the 98th - Vale of York. This is despite them, like Wakefield and Leeds, operating under the same management as part of the new Integrated Care Board system.
Despite this, the report stressed that more patients are being seen within health and care settings. Overall 6,156,844 patient pathways were completed from December 2021 to November 2023, a 46.82% improvement from the last MTG report that looked at regional and local variation in NHS performance.
However, across the two-year research project, analysis of Referral to Treatment data has revealed that variation between the highest and worst performing regions of the NHS has persisted. The MTG argues that this is leading to ‘deeply embedded’ local and regional variations in the quality of care across the NHS.
The MTG says it is now calling on NHS England and the Department of Health and Social Care to implement measures to ensure that the medical technology, innovations and leadership methods that have contributed to these highest performing regions are implemented across the health service to help end this variation.
Chair of the MTG, Barbara Harpham, said: “Good practice is abundant across the NHS in England, whether nationally-led or driven within local NHS organisations. However, it is clear that it is often isolated and not regularly shared with those parts of the NHS where it can make an enormous difference in working through the backlog, improving the quality of care and easing pressure on the workforce.
“Our recommendations in this report set out a roadmap for the NHS to deliver improvements by replicating, adapting, and adopting this best practice, providing the support to ensure medical technologies and innovations are available for every patient in the NHS regardless of where they live.”
The report ‘Levelling Up or Levelling Down: The Impact of Integrated Care Systems on the Delivery of Care’ builds on the findings of the MTG’s 2022 report which highlighted the best performing Clinical Commissioning Groups on the eve of them being integrated into the newly created ICS system. It called for NHS England to create platforms and forums for sharing best practice to ensure these highly performing areas of the health service became benchmarks for levelling up care regionally and nationally.
However, MTG says that insights derived from Freedom of Information (FOI) requests revealed limited sharing of best practice within and between ICBs. Although pockets of collaboration exist, the lack of cross-ICB sharing of best-practice limits ICBs’ ability to learn from other areas on how to manage and tackle waiting lists according to the group.
GBMaps
Given the ongoing pressures across the health service, the MTG has called on NHS England and the Department of Health and Social Care to drive the sharing of best practice across the NHS through the following recommendations:
NHS England
- Analyse the ICB areas where there are persistent challenges and variation, and provide support for them to raise their standards to meet the needs of patients.
- Identify areas and examples of best practice within the ICS system that can be shared and adopted in areas with persistent challenges.
- Develop forums for ICBs to discuss common challenges and solutions, and share best practice to help deliver better outcomes for patients.
- Work with the Department of Health and Social Care and other national bodies (including NICE) to standardise the pathway for medical technologies and innovations to access the NHS.
Integrated Care Boards
- Analyse pockets of poor performance within their own Systems, and set up interventions, resources, and support to raise standards across their ICB footprint. ICBs should strive to raise the standards of their poorest performing SICBLs, and improve patients' access to good care.
- Ensure that patients have access to the most appropriate medical technologies, regardless of where they receive care within an ICB.
- Seek support from national bodies and other ICBs where best practice is being carried out, to change practice, help improve standards and deliver best outcomes for patients.
The full report can be accessed here.
