Introducing the Atlas of Variation in Healthcare for People with Respiratory Disease



Over 6 million people in England suffer from asthma or COPD, conditions which inflict a heavy burden on patients and carers and account for a significant proportion of NHS and social care expenditure.

Respiratory disease is the third leading cause of death in England after circulatory disease and cancer.

The powerful case for change to improve outcomes in respiratory disease was clearly articulated in the recently published Outcomes Strategy for COPD and Asthma and the accompanying NHS Companion Document.

In revealing the extent of variation in clinical activity and outcomes, the indicators presented in this NHS Atlas of Variation in Healthcare for People with Respiratory Disease underline the substantial scope clinicians and commissioners have to improve outcomes by ensuring that all patients receive the quality of care that is delivered in the best-performing localities.

 “…an individual’s chance of being admitted or readmitted to hospital as an emergency, of receiving appropriate treatment, of dying from lung disease or even of being diagnosed in the first place differs according to where they live. Clearly, admission to hospital, premature death, receiving inadequate or inappropriate treatment and delay in diagnosis are important adverse outcomes for patients. Of course, some degree of variation may be explained by population composition, levels of deprivation or disease prevalence. However, much of the variation highlighted in the Respiratory Disease Atlas is unwarranted.

The most striking illustration of unwarranted variation is that, after adjusting for population differences, if all the PCTs in England were to achieve the COPD mortality rates of the best-performing PCTs, around 7,800 lives would be saved each year.”


About the Atlas

The central message of the NHS Atlas of Variation in Healthcare is that it is possible to achieve better outcomes for patients. Although data may be open to more than one interpretation, the power of the Atlas lies not in the answers it provides but in the questions it raises. When looking at local data, clinicians and commissioners need to ask whether the outcomes they are achieving for patients are as good as those achieved by the best.

The 2011 Outcomes Strategy for COPD and Asthma sets out six over-arching objectives to help improve outcomes in respiratory disease. The NHS Companion Document to the Strategy identifies the key actions that NHS providers need to take to deliver these objectives and to improve the quality of care and outcomes experienced by patients across the five domains of the NHS Outcomes Framework. Together with the Respiratory Disease Atlas, these two important documents can be used by healthcare professionals to increase the value of care they offer to people with respiratory disease.

The Respiratory Disease Atlas has been prepared in partnership with a wide range of organisations

The East of England Public Health Observatory (ERPHO) NHS Information Centre
The national Child and Maternal Health Observatory (ChiMat) NHS Improvement – Lung
British Lung Foundation Asthma UK
Solutions for Public Health (SPH)