## Wednesday, 17 August 2016

### National lottery

Yesterday, many British newspapers have covered the news of the new Dementia Atlas, released by the Department of Health.

As far as I can see, the atlas uses data from a variety of sources (including the Quality Outcomes Framework, QOF, scheme, which collects information from general practices around the country, providing incentives to the doctors to record data on key indicators).

So far so good $-$ nothing wrong with that. In fact, cool representation with maps highlighting geographical variation across England and providing rates for several summary statistics, eg prevalence of dementia, level of diagnosis, etc. As usual, though, the media couldn't resist jumping on the news and making a meal of it, mostly by presenting it with grand headlines, which in many cases missed the point, or bluntly mis-represented reality, I think.

For example, beloved Daily Mail and The Telegraph yell about "Post-code lottery in care". Now, it may well be that the data reveal massive inequality in the access to care and diagnosis across the country, which is a very good thing to expose in order to tackle it and then remove it or at least limit it $-$ that's in the spirit of the NHS. But, although I think the website should have made a much better job at explaining the numbers reported, it appears that the information presented in the maps is about the raw rates! It's not quite clear then whether the background characteristics of each area (defined in terms of Clinical Commissioning Group, CCG) do play a role in explaining away some of the differences in the actual rates for each of the measures reported in the table.

So may well be that we're playing Peter Griffin's lottery with people's health. Or there may be much more than that. But some media just don't care about which is which...