Author of a recent Kings Fund report on variation in emergency admissions discusses why there is variation in the NHS at all – after being asked why the NHS can't be more like Pizza Express
"When I go to Pizza Express I am guaranteed a good quality pizza, why can't the NHS do the same?" This incredulous question was put by a regional radio presenter who interviewed me about our new report Older people and emergency bed use - exploring variation.
Our report describes a fourfold variation in the rate of hospital bed use by older people admitted as an emergency. This is driven in equal part by differences in length of stay and rates of admission for older people. Our working hypothesis was that we would be able to link the use of hospital beds with other factors like spend on social care, the number of community beds, and the number of GPs, but we couldn't demonstrate a relationship.
The variation in these other factors was just as great if not greater than the variation in bed use and no clear pattern emerged. The only factor that those areas with the lowest use of beds had in common was that a high number of them had a history of joint working between health and social care. Guardian
Candace Imison is deputy director of policy for the Kings Fund, and lead author of Older people and emergency bed use - exploring variation.