Atlas of Variation 2011

The second NHS Atlas of Variation in Healthcare is now available to view, download or order – see right.

What’s New in Atlas 2.0?

For the second issue of The NHS Atlas of Variation in Healthcare, we have built on what we did in the first, and extended it.

  • There are more than double the number of maps – 71 in Atlas 2.0 compared with 34 in Atlas 1.0
  • A greater number of programme budget categories (PBCs) have been covered – 15 in Atlas 2.0 compared with 11 in Atlas 1.0.
  • There is a new section on time trends in relation to both rate and variation, covering seven surgical interventions
  • There is a new section on the steps local commissioners and providers can take to reduce unwarranted variation in their locality, and which tools to use
  • There is a new section on the challenges of making maps with the data that are available, and the new sources of data we have sought out, giving a snapshot of what might be possible in future.


  There are two main aims for the publication of The NHS Atlas of Variation in Healthcare November 2011.

  • The first is to offer clinicians and commissioners a fresh opportunity to identify variation and take action to reduce unwarranted variation, defined by Professor John Wennberg as:“Variation in the utilization of health care services that cannot be explained by variation in patient illness or patient preferences”
  • The second is to highlight the work being done by Right Care to support anyone – whether commissioner or provider, clinician or manager – wanting to reduce unwarranted variation within their locality or between their locality and other areas of the country.

The Atlas is published alongside the NHS Outcomes Framework to act as a catalyst for driving improvements in quality, outcome and value measurement throughout the NHS by encouraging a change in culture and behavior, including a renewed focus on tackling inequalities in outcomes.However, highlighting variation, not only in activity and cost but also in quality, safety and outcome, is fundamental to the achievement of better value in healthcare, because:

  • It is a first step towards reducing unwarranted variation;
  • It is a way of promoting transparency and increasing accountability in the NHS;
  • It is an important driver for improving not only the quality of services but also patient-determined and population health outcomes.