Mapping choice in the NHS: cross sectional study of routinely collected data.
OBJECTIVE
To identify where in England there are likely to be most constraints on choice of hospital for patients waiting longer than six months for elective care.


METHODS
Cross sectional study using routinely collected data.


METHODS
Population of England and NHS trusts and private sector hospitals in England.


METHODS
All residents in England.


METHODS
Availability of beds (available and unoccupied hospital beds), demand (number of people waiting longer than six months), and access (travel time to facilities) to hospital care in England.


RESULTS
Most people in England already have an extensive potential choice of hospital. The number of available and unoccupied beds within 60 minutes' travel time was lowest in the Scottish borders, North Yorkshire, and parts of East Anglia, Lincolnshire, Devon, and Cornwall. This pattern was not altered by adding in private facilities. Putting demand with this supply, the number of people in a geographical area waiting longer than six months per bed within 60 minutes' travel time was highest in the south east (except London), parts of the south west (Cornwall, Bristol), East Anglia, and the Welsh border.


CONCLUSIONS
People in the south east (outside London), East Anglia, and parts of the south west are likely to have to travel further to exercise meaningful choice of hospital for elective care.
Damiani
Mike
M
Policy Directorate, King's Fund, London W1G 0AN.
Propper
Carol
C
Dixon
Jennifer
J
D001509:Bed Occupancy / Q000145:classification*; D002391:Catchment Area, Health / Q000706:statistics & numerical data*; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D004739:England; D005843:Geography; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D008377:Maps as Topic; D012111:Residence Characteristics; D013222:State Medicine / Q000592:standards / Q000706:statistics & numerical data; D013997:Time Factors; D014850:Waiting Lists