The figures are standardised, but the care certainly is not

Research published by Dr Foster this week shows unequivocally that addressing the problem of variation in quality is one of the biggest priorities facing the service this year (see news, page 7).

The fact that the best hospital trust is twice as good as the worst trust in terms of its standardised mortality rate is an indictment that strikes at the core of the NHS's values and gives a lie to its first initial.

The Department of Health's claim that a hospital's overall SMR is no indicator of the quality of an individual department or medical team shows exactly the challenge. Time and again, data on quality and safety shows that variation within a hospital can be just as great as between hospitals. Which rather begs the question - if it is all the fault of trust managers, why do their failures not affect all of their departments?

Dr Foster's work is complemented by a report in the journal Heart this week that the publication of SMR data on heart surgery increases patients' survival rates (see page 7).

The authors found no evidence to support the persistent claim by some doctors that publishing data would discourage surgeons from taking on the most difficult cases. A 36 per cent increase in risk-adjusted mortality rates is very significant. And although the researchers are careful to say that publishing information is only one factor, it is consistent with the weight of evidence which shows that information, even if imperfect in the beginning, increases quality, even when it does not affect patients' choice.

The growing publication of meaningful data is the great under-reported success story of the Blair years but the continuing disparity it shows in the application of best practice remains the challenge for the NHS under his successor. The tools are there and easily available - whether it is from National Institute for Health and Clinical Excellence guidance, the NHS Institute for Innovation and Improvement, or information providers like Dr Foster Intelligence.

There will be no excuses accepted for not using them.