About this release

This release by Public Health Scotland (PHS) presents geographical variation for 6 procedure maps and equivalent same day surgery maps. Information is reported at NHS board and local authority level for financial years 2017/18 to 2021/22.

Publication summary

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Main points

Cataract surgery (aged 65+ years) 2021/22

• Across NHS Boards there was a 2.2-fold variation in the rate of cataract procedures performed in people aged 65 years and over, ranging from 2,451 to 5,478.8 per 100,000 population, adjusted for age and sex. The corresponding figure for Scotland, as a whole, was 3,122.6.
• The highest number of cataracts procedures recorded in the past few years was 40,999 in 2019/20, falling to 32,983 in 2021/22 due to pausing operations during the COVID-19 pandemic.

Cholecystectomy 2021/22

• Cholecystectomy procedure rates varied by 3.2 fold, ranging from 60.8 to 192.4 per 100,000 population across NHS Boards. The corresponding figure for Scotland, as a whole, was 104.7.
• There was a decrease in the number of patients having a cholecystectomy from 8,256 in 2018/19 to 4,386 in 2020/21, due to the COVID-19 pandemic. In 2021/22 there were 5,813 procedures.

Elective primary hip replacement 2021/22

• There was a 4.1-fold variation in the rate of elective primary hip replacement procedures across the NHS Boards, ranging from 70.2 to 289.6 per 100,000 population. The corresponding figure for Scotland, as a whole, was 85.9.
• The highest number of elective primary hip replacement procedures in Scotland recorded in the past few years was 7,395 in 2018/19. The number of procedures fell to 2,779 in 2020/21 due to the COVID-19 pandemic. In 2021/22 there were 4,786 procedures.

Elective primary knee replacement 2021/22

• Elective primary knee replacement procedures varied by 7.8-fold, ranging from 31.3 to 244.6 per 100,000 population across the NHS Boards. The corresponding figure for Scotland, as a whole, was 59.9.
• The highest number of elective primary knee replacement procedures in Scotland recorded in the past few years was 7,531 in 2018/19. The number of procedures fell to 1,928 in 2020/21 due to the COVID-19 pandemic. In 2021/22 there were 3,328 procedures.

Hernia 2021/22

• Across NHS Boards there was a 3.9-fold variation in the rate of hernia procedures performed, ranging from 74.5 to 291.9 per 100,000 population, adjusted for age and sex. The corresponding figure for Scotland, as a whole, was 108.5.
• Overall incidence of hernia surgery was reduced from 10,848 in 2018/19 to 3,794 in 2020/21 due to the COVID-19 pandemic. In 2021/22 there were 5,770 procedures.

Colonoscopy 2020

• There was a 2.4-fold variation in the rate of colonoscopy procedures across NHS Boards, ranging from 447.5 to 1,062.7 per 100,000 population. The corresponding figure for Scotland, as a whole was, 704.2.
• The highest number of colonoscopy procedures in Scotland recorded in the past few years was 72,098 in 2019. Due to the COVID-19 pandemic, the number of procedures fell to 38,698 in 2020.

Background

The Scottish Atlas of Healthcare Variation aims to highlight geographical variation in the provision of health services and associated health outcomes. It is designed to facilitate discussion and raise questions about why differences exist and promote quality improvement through this conversation.

The Scottish Atlas of Healthcare Variation is an important tool to contribute to eliminating unwarranted variation, realising Realistic Medicine and support reducing harm and waste within the health service. The tool is designed to highlight variation and no judgement on the performance or inferences on quality of care of one geographical area against another should be concluded.