Damiani M, Propper C and Dixon, J, (2005)

‘Mapping Choice in the NHS: analysis of routine data’

British Medical Journal, 330 (2 February): 7486

• Empirical paper trying to identify where in the country there are most likely to be constraints on hospital choice for patients waiting over 6 months for elective care.
• The government is currently attempting to introduce more patient choice into the NHS, including offering a choice of hospital for patients waiting over 6 months.]
• The authors use Department of Health and 2001 Census data to calculate areas with the most and least NHS Trusts and beds (NHS & private) within easy travelling distance.
• A series of colour-coded maps indicate areas with high and low potential choice.
  

Key results:

• For most of the population there is significant potential choice of hospital.
• Almost all have access to an NHS Trust within an hour’s travel time, and for over 90% there is a choice of two NHS providers.
• Areas with the lowest number of NHS Trusts to choose from within an hour’s travel include: the Scottish borders, north Yorkshire, East Anglia, Devon and Cornwall. These are also the areas with the lowest access to unoccupied NHS beds.
• Taking into consideration the demand for beds change the pattern somewhat. Some areas with low supply also have low demand (e.g. the Scottish borders) while some high supply areas also have high demand and a large stock of patients already waiting for treatment (e.g.a large part of the South East outside London).
• The authors conclude that to make choice meaningful and equitable, travel subsidies may have to be offered to people in low choice areas.
  

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