Almost 10 years since constitutional devolution can we see any differences in the quality of healthcare provided in the different UK populations, based on the emerging differences in policy?



Through The Health Foundation’s Quest for Quality and Improved Performance initiative, Kim Sutherland and Nick Coyle have produced a chart book which draws together the available data to answer this question.

The book contains 94 charts and shows how England, Scotland, Wales and Northern Ireland compare across the different aspects of quality, such as access, safety, effectiveness, person centred care, equity and capacity to improve.

The authors note that the differences between UK countries are still small compared with the larger differences between the whole UK and other countries. For example, the UK still has significant room for improvement in mortality rates due to cancer and circulatory disease, despite impressive gains.

Overall the chartbook shows considerable improvement in many aspects of care, especially in access to treatments and compliance with care guidelines and the provision of effective care in general practice, where rates of compliance are around 80-90 per cent or above.

Highly satisfied

Overall, patients are highly satisfied with healthcare, although there are communication difficulties. Only 50 per cent of patients report being given clear instructions about what to look for and when to seek help, or clear goals and plans for their treatment.

Looking across the UK countries the results show a mixed picture of performance. For example, Scotland shows the worst mortality outcomes but also has the highest vaccination rates for children and people aged over 65.

England has made the most significant improvements in mortality. But it leads the UK’s increase in diagnostic rates of chlamydia infections - one of the few areas that show worsening outcomes for the population.

Wales has the lowest rates of MRSA, although the biggest improvements in recent years have been in England. Wales and Northern Ireland tend to have longer waiting times than England and Scotland but Northern Ireland appears to have performed best overall in terms of IT and in training in quality improvement methods.

It may be too early to see differences that result from policy but without due attention to the data, the measures may diverge before we can determine effects on performance.