Patients in new NHS regions experience widespread variation in care

New reforms must be a ‘turning point’ says thinktank report

Patient experiences vary widely across the healthcare system (Getty Images)

A new analysis of the different experiences for patients living in one of 42 new NHS regions has revealed wide discrepancies in treatment in different parts of the country.

Ministers are pushing through parliament one of the biggest NHS re-organisations in almost a decade with the aim of creating new integrated care systems across England from April next year. They will be tasked with delivering better joined up care across different organisations.

But the new bodies face an uphill struggle with widespread variation in outcomes revealed in a new report by the Institute for Public Policy Research (IPPR).

It has found there is a north south divide in how well the emerging ICS regions are already integrated and leading to stark differences and worse experiences for patients depending on where they live.

The IPPR report found the maternal mortality rate for women was 16 times higher in the Sussex and East Surrey area than in the Suffolk and North East Essex region. There were nine times as many delayed discharges, where patients are left stuck in hospital, in Norfolk and Waveney compared to Sussex and East Surrey.

On mental health patients with severe problems in Bath, Northeast Somerset and Swindon and Wiltshire ICS were three times more likely to have a care coordinator than those in the Leicestershire region.

Similarly, children with a mental health emergency in Birmingham and Solihull were 80 per cent more likely to be seen by a mental health specialist within four weeks compared to children in Gloucestershire.

Patients with diabetes are 2.6 times more likely to have a foot amputated in Northamptonshire than in Lincolnshire.

A postcode lottery in NHS outcomes has been well known for years but the IPPR warned the new Health and Care Bill alone won’t tackle the problems. Instead, it argues the new organisations need to create a new culture of working together with investment upfront alongside legislation to drive changes.

The variation between NHS integrated care systems ( IPPR)

Dr Parth Patel, an NHS doctor and research fellow at the thinktank said: “A record £36 billion investment paired with major structural reform in the NHS and social care must ultimately be judged on whether they improve outcomes for patients.

“The Health and Care Bill is promising, but getting health and care services to work together better depends at least as much, if not more, on culture as it does on structure. A culture of collaboration cannot simply be bottled and shipped – but it can be shaped. The government should do more to empower local leaders to drive the creation of a truly connected health and care system.

“People and communities need better ways to hold the health service to account. At a time when the NHS is critically stretched, it cannot afford to another restructure that does little to improve sustainability and patient outcomes. This must be a turning point for health and care.”

IPPR said patients should be put on the boards of the new organisations and power devolved away from Whitehall to local leaders. It also calls for a

It also calls for a new community health-building fund for local areas to improve non-NHS services that impact on health inequalities. Other proposals include more funding to boost digital technology and data sharing as well as investment in leadership training to help individual bosses break out of traditional silos.

The IPPR analysis, in partnership with Carnall Farrar consultancy, found that if all the new 42 regions matched the performance seen in the top 25 per cent it would mean 42,600 more bed days available in the NHS because of fewer delayed discharges.

An extra 63,300 people would have a mental health care plan and there would be 68,600 fewer A&E attendances by people with mental health problems.