We’ve previously outlined our work with the devolved governments and health bodies to bring together the different sources of health data from across the UK – to improve their value and enhance understanding. As we publish the final piece in this phase of work, Michelle Waters summarises our findings and explores what’s next.
How do we improve our understanding of health measures across the UK? And how can we make sure the health data produced is of the most value? As health is a devolved policy area, looking at the health of the UK population as a whole can be complex because data produced by each of the four nations can be different. That’s where our statistical coherence work has come in, as explained in a previous blog. This collaborative project with each of the devolved governments and their health bodies, aims to create a UK wide picture of health.
The value of drawing together health data is that it supports policy making, allowing the UK and devolved governments to learn from each other’s experiences and explore new ways to improve health outcomes.
To compare or not to compare?
With frequent media stories about pressures on the NHS, it’s not unusual to see comparisons of NHS performance across the four nations. But comparisons aren’t always meaningful, for example where important population differences need to be considered, or where differing health targets, procedures and policies result in different data definitions and collections.
We have published a collection of six cross-UK articles exploring important aspects of NHS care, such as ambulance response times, waiting times in Accident and Emergency and NHS planned care waiting times. In each article we outline where comparisons between nations can and can’t be made by exploring how the data sources differ. This allows users to better understand trends in these areas over time and helps to tackle misunderstanding.
What has our work found?
- The first article in the series is a Summary of ambulance response time data. There are differences across the UK in ambulance response categories, standards and ‘clock start and stop times’. Demographic and geographic differences also influence the volume and type of ambulance calls each UK nation receives, meaning ambulance response time data from each cannot be meaningfully compared.
- We have also brought together data for Accident and Emergency wait times. We find this to be broadly comparable for England, Scotland, and Wales. There are differences between the countries which should be considered when interpreting wait time data, including population differences, different health facilities available, and differences in health care policies.However, the data is broadly comparable for England, Scotland, and Wales and can provide a good overall GB picture of wait times in accident and emergency departments.
- Our NHS Experience and Satisfaction article explores the cross-UK comparability of NHS patient experience and satisfaction data. While the nations each conduct surveys on NHS experience and satisfaction, questions vary and there is no single UK-wide survey. This means that, while we can look at trends over time within each country, the questions are different and resulting statistics are not directly comparable.
- By bringing together official statistics on the healthcare workforce, we found that there are several factors meaning these statistics cannot be compared between the four nations. These include differences in NHS structure, workforce policy and employment data sources and standards. While the NHS employment levels in each country of the UK cannot be directly compared, the individual trends considered together show that NHS employment is continuing to increase across the UK.
- Our NHS planned care waiting times article looks at existing official statistics on NHS waiting lists. We conclude each country has different performance measures limiting direct comparisons. The Welsh Government has previously published adjusted data which allowed broad comparisons between official data for England and Wales. We can also draw insight from trends over time in the size of NHS waiting lists across the UK.
The final piece in the puzzle
The final article in this series brings together statistics on waiting times for cancer treatment across the UK between 2012 and 2024.
Our analysis explains why direct comparisons of the performance of the UK nations cannot be made due to the number and complexity of the differences that exist between the cancer waiting times standards. However, comparisons in overall trends can still be made.
Working together
As the UK faces ever more complex health challenges, working together is crucial to creating a joined up statistical picture. Our work is already having a positive impact across devolved nations as these testimonies show…
“Previously cross departments didn’t have a cross-system comparability mindset, however our mindset has changed. We have a much more proactive practical approach to communicating comparability and we want to ensure it persists.” – Will Perks, Welsh Government
“This has been a valuable collaborative process to understand the differences in a range of healthcare measurements across the UK. It provides a basis on which to consider how it may be possible for these to be better aligned in the future, perhaps through a harmonised standard.” – Department of Health Northern Ireland
Going forward
We will continue to work in partnership across the statistical system to improve coherence of health data. The cross government UK Health Statistics Steering Group and its theme groups, made up of subject specialists from across the UK, are investigating existing cross UK data and comparability challenges, to further improve coherence.
This includes work by the Welsh Government and Department of Health and Social Care to better understand cross border NHS service use. We will also continue to improve how we communicate to UK data users, including through our interactive tools.
We will continue to work together to understand the differences, we can help enable meaningful comparisons to be made where appropriate, and explain the differences to our users where direct comparisons cannot be made.
Michelle Waters, Coherence lead, ONS