NHS Atlas of Variation in
Diagnostic Services
Prof Erika Denton
NCD Diagnostics
Projected Rate Of Population Growth
By
Age
Last
Birthday
Graph
showing
projected
rate of growth of Projected populations at mid-years by
age last birthday (under 60 years and over 60 years) over the next 8 years.
The vast majority of
increase in
population over the
next 6 years is
predicted to be in
the 60+ age bracket.
Source: Government's actuarial department
16%
14%
Under 60 (% increase from 2004)
Over 60 (% increase from 2004)
12%
10%
Projected Population
Increase from 2004 % 8%
6%
4%
2%
0%
2004
2005
2006
2007
2008
2009
2010
2011
2012
Under 60 (% increase from 2004)
0.0%
0.5%
0.8%
0.8%
0.7%
0.9%
1.0%
1.3%
1.5%
Over 60 (% increase from 2004)
0.0%
1.4%
2.8%
5.6%
7.9%
9.8%
11.5%
13.1%
14.6%
Year
(Source: Government’s actuarial
department).
Causes Of Death, over 60s
Respiratory
Diseases
80% of death of
the over 60s
attributed to 3
underlying
causes
GI Disease
Neoplasms
Mental/Behavioural
CNS Disease
Abnormal Findngs
All Others
Circulatory Diseases
6+ week waits April 06 – July 13
Waiting List & Activity: all imaging
1 – Data refer to exams in hospital only.
1 – Data refer to exams in hospital only.
2 – Data refer to exams outside hospital only.
2 – Data refer to exams outside hospital only.
1 – Data include equipment in hospital
only.
1 – Data include equipment in hospital
only.
Map 1: Rate of magnetic resonance imaging
(MRI) activity per weighted population
by PCT
2012/3
Domain 1: Preventing people from dying prematurely
© Crown copyright and database rights 2013 Ordnance Survey 100039906
Map 2: Rate of magnetic resonance imaging
(MRI) activity per weighted population
by PCT
2012/3
Domain 1: Preventing people from dying prematurely
© Crown copyright and database rights 2013 Ordnance Survey 100039906
Map 3: Rate of non-obstetric ultrasound
activity per weighted population by PCT
2012/3
Domain 1: Preventing people from dying prematurely
© Crown copyright and database rights 2013 Ordnance Survey 100039906
Map 6: Median time (minutes) from arrival at
hospital to brain imaging for stroke patients
by hospital
October–December 2012
Domain 1: Preventing people from dying prematurely
Domain 2: Enhancing quality of life for people with long-term conditions
Domain 3: Helping people to recover from episodes
of ill health or following injury
© Crown copyright and database rights 2013 Ordnance Survey 100039906
Map 7: Proportion (%) of stroke patients
undergoing brain imaging within 1 hour of
arrival at hospital by hospital
October–December 2012
Domain 1: Preventing people from dying prematurely
Domain 2: Enhancing quality of life for people with long-term conditions
Domain 3: Helping people to recover from episodes
of ill health or following injury
© Crown copyright and database rights 2013 Ordnance Survey 100039906
Rising to the Challenge?
Demographics + Patient/Public
Expectations + Quality
Money
Solution = transformational change to the
current way of delivering health care
Traditional vs ‘New’ change methodology
Transactional change:
Doing things better
Transformational change:
Doing better things
Tools to effect change
• Accurate diagnostic data: activity, capacity, reporting times
• Published evidence
• Guidelines: NICE, collegiate etc
• Official reports: NAO, NCEPOD, CQC, Francis etc
• Policy drivers, eg: Commissioning changes, Stroke Strategy,
Cardiac networks, Cancer reform,
• Predictable demographic changes
• Communication: clinical, managerial & with commissioners
‘You can’t solve a problem by using
the same thinking that created it’
Albert Einstein