Patients hit by postcode lottery on health care

The NHS Atlas of Variation published yesterday lays bare major differences in treatment after taking into account local patient and social factors which are often blamed for inequalities.

Reducing variations in performance will be vital in coming years as the NHS tries to make the best use of shrinking funding.

In Yorkshire, the study shows children with asthma are as much as four times more likely to need emergency hospital care in Barnsley than in some other parts, while adults with the condition in Bradford are twice as likely to need urgent help.

People with epilepsy are at least twice as likely to need emergency hospital treatment in northern Lincolnshire and Hull than in other areas.

Rates of obesity surgery are among the highest in the country in East and South Yorkshire, amid a 12-fold variation in access across the country. Similarly, patients in North Yorkshire are more likely to get knee replacement surgery than anywhere in the North despite having less serious symptoms.

Patients from Doncaster undergoing surgery for fractured hips spend twice as long in hospital as others from Leeds or Bradford. Over-75s in Hull and Rotherham are twice as likely to need emergency hospital treatment as those in best-performing areas. The report said admissions could be combated by developing improved community services.

Expenditure on inpatient cancer care is nearly twice as high in the East Riding and North Yorkshire than in South Yorkshire despite evidence sufferers can be treated more effectively on programmes which allow them to return home earlier.

In Barnsley and Hull people are twice as likely to die from heart disease as in huge swathes of southern England due to clear links with deprivation.

The report said some variations occur naturally according to the needs and wishes of patients but unwarranted variation was a "cause for concern".

Speaking on behalf of 10 health charities, Ciaran Devane, chief executive at Macmillan Cancer Support, said numbers of people living with long-term illness was set to increase "dramatically".

"If the NHS stands any chance of coping, it needs to be clear about where best practice is taking place, so that under-performing areas of the country can improve their performance urgently," he said.

Professor Chris Ham, chief executive of the King's Fund thinktank, said: "With the NHS needing to find 20bn a year in productivity improvements, reducing unwarranted variation is no longer an option – it is a necessity.

"If performance across the NHS can be brought up to the level achieved by the best, then much of the pressure on local NHS budgets can be relieved without having to cut services for patients."

Health Minister Lord Howe said: "Making this information available to commissioners and patients will help them to identify and address unwarranted variation to better meet the needs of their local populations."

Outcomes change across region

Death rates from suicide are among the highest in the country in Doncaster, Kirklees and Rotherham.

Spending on Caesarean sections is about half in Leeds, Wakefield, Barnsley and Rotherham than elsewhere.

Prescribing of some antibiotics is three times higher in East Yorkshire and North Lincolnshire as other parts including South and North Yorkshire.