Mixed results for UK in international care quality indicators

THE UK still lags behind other developed countries in survival rates for commons cancers but scores well for cancer screening, according to a report published by the Nuffield Trust and the Health Foundation.

The report – Focus on: international comparisons of healthcare quality – is based on analysis of 27 care quality indicators in up to 15 OECD countries between 2000 and 2011/2012. It shows that the UK’s performance has improved on almost every measure since the start of the millennium but lags behind most other countries in preventable hospital admissions, cancer survival and mortality from heart attacks and strokes.

For example between 2007 and 2012, 82 per cent of women survived over five years for breast cancer compared to 87.4 per cent in Sweden, and five-year survival rates for cervical and bowel cancers were also worse than other countries. Overall cancer mortality rates remain higher than comparable countries.

The UK has made headway in reducing mortality from heart attacks in recent years but still lags behind the five other countries where data are available, with 10 per cent of people over the age of 45 dying after 30 days compared to 8.2 per cent in Norway, 8.4 per cent in New Zealand, and 8.5 per cent in Sweden in 2011.

The UK performs better than other countries in achieving high flu vaccination rates and lower antibiotic prescribing rates, suggesting a well-functioning primary care system. But rates of potentially preventable hospital admissions for chronic respiratory conditions, including asthma and lung diseases, remain relatively high in the UK (for example, by 2011 there were 61 UK admissions for asthma per 100,000 population, compared to 13.6 in Canada and 11.4 in Italy).

The UK also scores well on cancer screening, with over three-quarters of 50-69 year old women being screened for breast cancer over the period, compared to fewer than 60 per cent in Australia. Cervical screening rates are also high, although have recently deteriorated in the UK.

The authors of the research acknowledge that data limitations can make meaningful comparisons difficult and caution against rankings or league tables focused on data at a single point in time, highlighting the value in longitudinal studies such as this one. The report also notes that national level data will often mask considerable variations within countries and the level of performance on care quality indicators can also be due to factors not within the control of healthcare systems, such as lifestyle choices and population health.

Commenting on the report, Nuffield Trust Chief Executive Nigel Edwards said: "Interpreting international data on healthcare systems is notoriously tricky, and any comparisons should be handled with care. However, it is clear from this analysis that the UK can and should do better. Our poor performance on cancer survival compared with other leading countries is well-known and continues to be a concern. It is also worrying that a UK citizen appears to have a significantly lower chance of surviving a heart attack than a Scandinavian one.

"In spite of some positive findings in other studies, such as last year’s report from the Commonwealth Fund, it is still the case that on some important indicators there is significant room for improvement. We enter the new parliament with a mountain to climb in reducing preventable hospital admissions and improving survival from common killer diseases, all at a time of continuing austerity affecting public services."