NHS reforms could reinforce postcode lottery

 The new NHS reforms will make it more difficult to track and remedy health inequalities, according to experts writing in the BMJ.

The fact that CCGs and can take patients from anywhere in the UK threatens the comparative value of their health data, the authors said.

In addition, the fact that they are likely to outsource public health services to the private sector means that data quality and completeness will not be regulated.

Professor Allyson Pollock, Professor Alison Macfarlane and Sylvia Godden argued that the new Health and Social Care Act has “severe implications” for data regarding health needs and access to care.

Although it will be possible to compare the patient populations of the new CCGs, the authors said, “the instability of the denominator population will hinder accurate interpretation of the data”.

Public health services such as childhood vaccination, mental health and sexual health are now the responsibility of local government, which will subcontract them to CCGs – which, in turn, may outsource them to private providers.

As a result, crucial data on unmet needs and access to treatment may not only be sourced in inconsistent ways but be subject to commercial criteria including the confidentiality of business information.

Cancer registries will also be affected, the authors warned, with health data being treated as commercial property rather than as a shared resource.

They concluded: “The abolition of area-based structures and the transfer of most responsibilities to non-geographically based CCGs undermines the availability of information and routine data required to monitor the comprehensiveness of the health service, inequalities in access, the resourcing of services, and outcomes of care.”

As a result, they argued, it will become “almost impossible to take the action needed to tackle inequalities in health and in access to healthcare.”