Scottish Atlas of Variation Surgical Procedures dashboard: Survey insights on the latest Atlas maps

Findings

User uptake and awareness of the Scottish Atlas of Healthcare Variation

• Around two thirds of all respondents (66%) had not used the Atlas.^[2] The remaining respondents had used it occasionally (19%) or a very small number of times (15%). Usage varied by group: 79% of dentistry respondents had not used the Atlas, compared to 43% of those working in hips, knees, and cataracts.
• Unwarranted Variation Training on TURAS is an e-learning module that explains what unwarranted variation is and its impact on care and health systems. Just 7% of respondents overall had completed the unwarranted variation training on TURAS. When broken down by group, 18% of Hips, Knees, and Cataracts professionals had completed the training, whilst none of the dentistry respondents had.
• All respondents were asked what developments they think could optimise the effective use of the Atlas. Respondents most frequently suggested ‘increased awareness and communication about the purpose and benefits of the Atlas’ (54%), ‘regular updates to ensure the data remains current and relevant’ (47%), ‘improved clarity of the data presented in the Atlas’ (37%) and ‘enhanced training and support for interpreting and applying the data’ (36%).
• Respondents who had not used the Atlas were asked what would encourage them to do so. Many highlighted a lack of awareness and limited understanding of the Atlas and its purpose:

“To know more about it and why/how it can help me do my job better and deliver better care.”

“Knowing what you can use it for and where to find it. We haven't heard anything about it as far as I know/recollect.”

• Respondents who had infrequently used the Atlas were asked what would encourage them to use it more often. Several suggested more up-to-date data and prompts when the data had been updated or may require action:

“Up-to-date data.”

“Prompts that the info [information] has been updated.”

• Some respondents felt the data presented in the Atlas was too generic and lacked sufficient detail. They suggested it would be more relevant to their practice if it included additional information on procedures, specific conditions and waiting times.

“The high-level atlas data is too generic to make much of it, other than that we are an outlier or not.”

• Several suggested that providing clearer information, educational resources and contextual explanations of variation would support greater engagement.

“Simply identifying evidence of variation is insufficient without analysis of why there are variations. The reasons for the variations are far more useful than the knowledge of what the variation is from one locale to another.”

• Respondents were asked what additional support would help them interpret the data. From a list of six options, the most commonly selected was ‘case studies or examples to illustrate data use’ (60%), followed by ‘additional training sessions on data interpretation’ (44%), ‘tools to visualise and analyse the data’ (42%) and ‘improved narrative and guidance accompanying the data’ (36%).

Confidence and impact among Atlas users

The insights in this section are based on feedback from respondents who had used the Atlas (n=21).

• Most respondents were confident overall in using the Atlas, with over half (57%) feeling somewhat confident, and around one in three feeling either confident (29%) or very confident (5%). One in ten (10%) reported not feeling confident.
• The large majority of respondents agreed (67%) or strongly agreed (14%) that the data is presented clearly.
• Around six in ten respondents agreed (52%) or strongly agreed (10%) that the explanations of the data are sufficiently detailed.
• Nearly half of respondents either agreed (38%) or strongly agreed (10%) that there is sufficient data at a local level, while one in three (33%) disagreed and 5% strongly disagreed.
• Nearly three quarters either agreed (43%) or strongly agreed (29%) that the Atlas would benefit from illustrative examples or case studies.
• Around seven in ten (71%) felt that the Atlas is a somewhat useful tool to drive improvement in access to care for the populations they serve.
• Just under a third of respondents (29%) had used the Atlas to begin addressing unwarranted variation in access to care within their area. Over half (53%) had not used the Atlas to do so and 18% reported they had not used it and do not have plans to do so.
• Around two thirds of respondents found presenting the Atlas data through a deprivation lens either somewhat helpful (38%) or very helpful (29%).
• The majority of respondents (71%) reported that the Atlas data occasionally prompted discussions within their team or Health Board about variation in access to care, while nearly one third were either unaware of any discussions (24%) or unsure (5%).