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Variation and how to deal with it to improve value and quality in healthcare for children and young people

Dr Ronny Cheung Consultant Paediatrician Evelina London Children's Hospital, and Clinical Advisor to the Child & Maternal Health Intelligence Network at Public Health England spoke at today’s Maximising the potential of Clinical Networks for Children conference on using variation analysis to improve value and quality in healthcare for children and young people; including:

• How do we identify variation in service quality and outcomes
• Assessing ones own results/practice against national standards
• How can we improve outcomes by reducing variation

Abstract of Dr Cheung’s talk

A picture is worth a thousand words: Using variation analysis to improve value and quality in healthcare for children and young people

"Postcode variation" is a familiar concept to tabloid headline writers. Many clinicians and healthcare organisations argue that variation in health services reflects all that is good about patient-centred care. Healthcare that is responsive to differences in patient preference, needs and expectations will necessarily differ in process, and perhaps even outcome, from one service to the next. But the magnitude of variation often seen across the country cannot be explained solely by these reasons. Jack Wennberg pioneered the analysis and mapping of ‘unwarranted variation’ to describe variation which ‘cannot be explained by variation in patient illness or patient preferences.’ The key is to identify and minimise the latter while promoting the "good" variation that reflects patient-centred care. 

This talk will explore the nuances of variation analysis in healthcare, with a particular focus on the findings of the NHS Atlas of Variation in Healthcare for Children and Young People, and an outline of current national initiatives to highlight and reduce unwarranted variation.

Key References: 
1.    Atlas of Variation in Healthcare for Children and Young People. In Davies SC. Annual Report of the Chief Medical Officer 2012, Our Children Deserve Better: Prevention Pays. 2013. Stationery Office: London, UK. https://www.gov.uk/.../33571_2901304_CMO_Chapter_Anx_9.pdf

2.    Cheung CR, Gray JAM. Unwarranted variation in health care for children and young people. Arch Dis Child 2013;98:60-65 http://adc.bmj.com/content/98/1/60.full 

3.    NHS QIPP Right Care. NHS Atlas of Variation in Healthcare for Children and Young People March 2012. 2012; London. http://www.rightcare.nhs.uk/index.php/atlas/children-and-young-adults/ 

4.    Wennberg JE. Tracking medicine. A researcher's quest to understand health care. Oxford: University Press, 2010 

5.    Goodman DC. Unwarranted variation in pediatric medical care. Pediatr Clin N Am 2009;56:745–55. 

Dr Cheung’s full presentation is available for download at the end of this page.

Dr Ronny Cheung is a Consultant Paediatrician at the Evelina London Children's Hospital, and a clinical advisor to the Child & Maternal Health Intelligence Network at Public Health England.

He has a strong interest in research, policy and practice to reduce inequality in healthcare quality and outcomes for children and young people. He was the clinical editor of NHS Right Care's Atlas of Variation in Healthcare for Children and Young People 2012, which mapped variation across 26 indicators of child health in England. Working with Public Health England, he edited the 2012/13 version of the Child Health Atlas as part of the English Chief Medical Officer's Special Report into Child Health.

He was previously seconded as a clinical advisor to the Chief Medical Officer in 2010-11, and was a health policy advisor to the Cabinet Office Behavioural Insights Team. He was a member of Phase 2 of the NHS Future Forum, an independent committee which advised the Secretary of State during the implementation of the Health and Social Care Bill in 2012. 

In 2013, he was named by the Health Service Journal as one of the NHS's "Rising Stars". He remains a member of several national advisory bodies, including the Children and Young People's Health Outcomes Forum and the Child & Maternal Health Intelligence Network partnership board. 

Also of interest:

Improving Adolescent Mental Health Services & Bridging the Gap between Adolescent and Adult Mental Health
Thursday 9 October 
Hallam Conference Centre, London


Download: Dr Ronny Cheung full presentation

27 September 2014

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