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The NHS postcode lottery: fact or fiction?

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18th May 2015

The idea that National Health Service (NHS) care varies by region is not a new one. Indeed, over the past few years, politicians have been forced to deny claims that patients in some regions are exposed to worse care than others. The British Health Report 2015, commissioned by personal injury and medical negligence solicitors, Your Legal Friend, investigated whether medical professionals and the public believe there is a healthcare postcode lottery.

Whilst only 18% of medical professionals questioned thought the standard of care is affected by region, a worrying 50% said they believe it actually varies within regions and sometimes even within hospitals. So for many medical professionals, the main issue is one of variability in the standard of care wherever that care is delivered.

In contrast, between 60% and 70% of the general public believe there is a postcode lottery for NHS treatment.  This perception also influences their confidence in the NHS’s ability to provide ground-breaking treatment, with almost a third (32%) of the public agreeing that the NHS can provide these treatments – but it depends on where you live.

Take a look at our infographic highlighting the British Health Report’s findings.

 An infographic about the NHS postcode lottery

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Which types of care fare better or worse?

The British Health Report asked the views of both the public and healthcare professionals on three specific areas of the NHS: surgery, medical treatment and after care.


Overall, three quarters of medical professionals said they believe that a postcode lottery either absolutely (27%) or somewhat (47%) exists for NHS care. This view was driven by those in the know, with 41% of consultants and 37% of surgeons reporting that they were sure a lottery exists.

Although slightly more positive, the public seemed to share the view that the speed and quality of care for surgery depends on where you live. When questioned, 35% of the public believed that a disparity in care somewhat exists, whilst 32% felt that it absolutely did.  

Medical treatment

A similar story exists for medical treatment. This time, just under three quarters (73%) of medical professionals said they believe a postcode lottery either absolutely (24%) or somewhat (49%) exists for medical treatment in the NHS.  Again, this view was most keenly felt by surgeons, with 85% of this group reporting that a lottery either absolutely (38%) or somewhat (47%) exists.

Likewise, 67% of the public said they believed standards of care varied depending on where you live, with 27% believing that standards absolutely varied and 40% believing that they varied somewhat. 

After care

Finally, 74% of medical professionals felt that access to after care was either absolutely (32%) or somewhat (42%) dictated by postcode.

Again, the public were slightly more positive than healthcare professionals, with 68% believing that a postcode lottery for after care either definitely (28%) or somewhat (35%) exists.

Around one quarter of the public said they simply didn’t know whether a postcode lottery existed for surgery (25%), medical treatment (24%) or after care (28%), possibly because they hadn’t had direct experience of using these services. By comparison, around 17% of medical professionals admitted to not knowing whether a postcode lottery existed for the various areas of healthcare.

Is the postcode lottery a myth?

The British Health Report 2015 found that, while the postcode lottery is a popular concept with the media and one that is either reinforced by or reflected in public opinion, for healthcare professionals the main issue appears to be variability in standards of care across the NHS, not only within a geographic area but also within the same hospital.