Vascular services provide specialist surgical treatment and care for patients with a range of conditions which affect blood vessels, principally conditions which affect
arteries in the neck (carotid arteries)
the main artery in the abdomen (aorta)
arteries and veins in the legs.
We recently completed an NIHR Programme Grant entitled “The Design, Development, Commissioning and Evaluation of Patient Focused Vascular Services”. The work was undertaken to inform the redesign of vascular services in England.
Purpose of this research
This project will carry out further analysis of hospital admissions data we obtained from NHS Digital for the Programme Grant.
The anonymised data provide details on vascular hospital admissions in England from April 2006 to March 2018. Data were manipulated into a format suitable for our analyses.
A Clinical Consensus Group, comprising clinicians involved in the management of vascular disease, provided advice on the process of classifying admissions data into clinically useful categories.
Aims of the project
This project aims to add value by investigating how social and economic circumstances, geography and ethnicity influence the use of vascular services and how long patients survive after surgery.
Investigating these variations was not an aim of the main programme grant but our findings indicate that further analysis is important to carry out.
For example, one of the findings is that there is a trend towards centralisation of services for major and emergency work. This is following recommendations indicating that patients operated on in a smaller number of larger centres have better survival rates. There is also a tendency for centralisation of minor procedures and investigations.
Centralisation may however make it more difficult for people living in economically disadvantaged areas to access services.
We will carry out statistical analyses to address a range of questions regarding associations between social and economic circumstances, geography and ethnicity, and vascular surgery rates and survival following surgery.
The data analysis is based upon hospital episode statistics supplied by NHS Digital. For details of the privacy arrangements relating to these data see our Privacy Notice (PDF, 228KB).
Patient and public involvement and engagement
Patient representatives will be involved as members of the Project Management Group.
In addition, a non-disease specific, public advisory panel at Sheffield Teaching Hospitals NHS Foundation Trust will be engaged in the research.
Identification of inequalities in vascular health care will provide information and insights that could inform the delivery of vascular services in England.
An example of a potential insight is that older people living in economically disadvantaged areas might be less likely to be referred for specialist surgery, resulting in higher death rates in these areas.
The results ought to be relevant to government policy makers when the government starts to develop its “levelling up” policy agenda in relation to health and social care in order to reduce health inequalities.
The project has resulted in several peer reviewed publications relating to the various treatments provided by vascular services and the way in which the disease, treatments, and outcomes relate to socioeconomic, ethnic and geographic factors.
For further details see the publications section of this website.