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Jim Easton column for November

This is Jim's column from The Month, an update of key messages from NHS Chief Executive David Nicholson and the NHS Leadership Team to share with staff, teams and organisations.

Jim Easton column for November

NHS Atlas of Variation

Jim Easton, NHS National Director for Improvement and Efficiency,  talks about two publications that have been published in November  to support local QIPP delivery. Both are essential reading for leaders throughout the system

It’s been good to see this month the publication of two products to support local QIPP delivery. 

The Back Office Efficiency Guidance, written by Tony Spotswood, Chief Executive of Royal Bournemouth and Christchurch Hospitals NHS Foundation  Trust and published in conjunction with the Foundation Trust Network sets out ways in which efficiencies can be made in back office functions and identifies some key next steps. Its estimate of the potential for efficiencies here was actually slightly higher than our initial estimates, and it sets out where and how these savings can be delivered.

The second product we’ve launched this month is the NHS Atlas of Variation, developed by the Right Care workstream. This is a tool to aid better commissioning. It takes existing data and presents it in a comparative way that highlights areas where there appears to be unwarranted variation in the level of NHS service on offer.  Some variation is to be expected as populations differ in terms of age, disease prevalence and health inequalities. But, the Atlas standardises the data to account for local exceptions and we are then left with real evidence of variation in the availability and quality of services between areas.

The Atlas has already gone beyond the commissioners it was primarily developed for and patient groups, third sector organisations and frontline NHS staff have all commented on its findings. For example, variation in the management of type-2 diabetes is demonstrated but cannot easily be explained away. The same is true for the difference in the numbers of stroke patients treated in a specialist stroke unit, or the length of time cancer patients spend in hospital.

The reasons for the variation in services may be financial, historical or organisational but the outcome of low quality services is the same: less effective patient care that has the potential to result in costly interventions down the line. So high quality care can be cheaper, more effective care. A foot check for a diabetic patient that avoids future amputations is a stark example of QIPP efficiencies.  Hugely better for the patient.  Hugely more efficient for the service.

They are both essential reading for leaders throughout the system.