The Department of Health has published the 2011 Atlas of Variation, a tool to help the NHS identify unwarranted variation in healthcare services across England.  The Atlas highlights the amount that each PCT spends on clinical services and links this with the health outcomes of their patients.  The aim of the Atlas is to enable clinicians, managers, commissioners and providers to focus on the questions that need to be addressed. 

The 2011 edition of the Atlas consists of 71 maps, 6 of which relate directly to medicine use:

• Map 10 - Insulin: total net ingredient cost per patient on GP diabetes register broken down per PCT - shows a variation ranging from £79 to £176 per patient.  An additional analysis shows no correlation between spending on insulin items and the percentage of people with Type 1 diabetes or with Type 2 dabetes whose last HbA1c measurement was 7.5% or less at PCT level.

• Map 11: Non-insulin diabetic drugs: total net ingredient cost per patient on GP diabetes register broken down per PCT - shows a variation ranging from £65 to £180 per patient. An additional analysis shows no correlation between spending on these drugs and percentage of patients with Type 2 diabetes whose last HbA1c measurement was 7.5% or less at PCT level.

• Map 14: anti-dementia drugs prescribed per weighted population (STAR-PU) in primary care broken down by PCT - shows a variation ranging from 0.03 to 1.6 - a 52-fold variation

• Map 19: Parkinson's disease drugs prescribed per weighted population (STAR-PU) in primary care broken down by PCT  - shows a variation from 1.8 to 8.8 ADQ per STAR-PU - a 5-fold variation

• Map 37: Rate of expenditure on home oxygen per population broken down by PCT - shows a variation from £1039 to £7422 per patient - a 7-fold variation

• Map 71: Hypnotic drug items prescribed per weighted population (STAR-PU) in primary care by PCT - shows a variation ranging from 2.3 to 9.2 ADQ per STAR-PU - a 4-fold variation.