The NHS atlas of variation in healthcare : reducing unwarranted variation to increase value and improve quality

In the recent White Paper, Equity and Excellence: Liberating the NHS, there is a commitment to providing better value from the resources available to healthcare. This requires the NHS to address variations in activity and spend. Such variations indicate the need to focus on appropriateness of care, and to investigate the possibilities that there is overuse of some interventions and that some lower value activities are undertaken. In the Atlas, Right Care presents a series 34 of maps of variation selected from topics which National Clinical Directors and others have identified as being of importance to their clinical specialty. We have worked with a wide range of teams in the Department of Health, Observatory network and primary care organisations to create this Atlas.The Atlas also contains a guide to the tools and data available for analysing health investment. Our aim in publishing this Atlas is to stimulate, within all levels of the NHS, a search for un-warranted variation, defined as "Variation in the utilization of health care services that cannot be explained by variation in patient or patient preferences". Commissioners should consider the opportunities to maximise health outcome and minimise inequalities by addressing unwarranted variation. We hope by extension, to stimulate action to tackle the drivers of un-warranted variation to improve quality for patients and increase value for the NHS.