title: A strategy for vascular services--testing the 600,000 population model.
abstract: BACKGROUND
  Vascular services' delivery has been criticised, and re-organisation based on a 600,000 population model suggested. We assessed the feasibility of this model in three geographically disparate English regions.
  
  
  METHODS
  Surgical arterial activity by Trust was analyzed using 1994/95 data from Hospital Episode Statistics. A postal survey of acute Trusts was used to assess vascular facilities and personnel. Distances between hospitals and enumeration districts were mapped using a Geographical Information System.
  
  
  METHODS
  Number (proportion) of Trusts performing over 100 arterial procedures a year. Number (proportion) of Trusts with a vascular on-call rota. Proportion of population likely to live more than 40 km away (equivalent to 1 h blue-light ambulance travel time) from a vascular unit under the proposed model.
  
  
  RESULTS
  Twelve of the 32 Trusts (38%) performed over 100 arterial procedures annually; 23 Trusts completed the survey. Of these, five (22%) had a vascular on-call rota. Under the 600,000 model, in East Anglia a further 16.5% of the population would live > 40 km from a vascular unit. In Wessex, a further 0.4% of the population would live > 40 km from a vascular unit. Impact on access in North West Thames was negligible.
  
  
  CONCLUSIONS
  A 600,000 population model could be feasible in urbanized regions, but not in geographically remote ones.
authors.affiliation: Department of Public Health, Kensington & Chelsea and Westminster Health Authority, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Arora
authors.forename: J
authors.initials: J
authors.lastname: Wolfe
authors.forename: R
authors.initials: R
authors.lastname: Maheswaran
authors.forename: A
authors.initials: A
authors.lastname: Grossinho
authors.forename: S
authors.initials: S
authors.lastname: Darke
authors.forename: J
authors.initials: J
authors.lastname: Colin
authors.forename: S
authors.initials: S
authors.lastname: Hargreaves
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D004739:England; D005240:Feasibility Studies; D006297:Health Services Accessibility; D006801:Humans; D017146:Models, Organizational; D011156:Population Density; D014656:Vascular Surgical Procedures / Q000458:organization & administration*; D000078329:Workforce