Mapping choice in the NHS: Analysis of routine data

New policies in the National Health Service in England seek to extend the choice of provider of care for patients on waiting lists for elective surgery. We try to identify where in the country there are likely to be most constraints on choice for patients waiting over 6 months for elective care. The available supply and demand for hsoptial care, based on a 60 minute travel time from individual location, is estimated using routinely collected information. We show that for most of the population there is already a significant potential choice of hospital. The number of available and unoccupied beds within 60 minutes travel time is lowest in the Scottish Borders, North Yorkshire, and parts of East Anglia, Lincolnshire, Devon and Cornwall. Adding in private facilities does not alter this pattern. Putting together demand with this supply, the number waiting over 6 months per bed within 60 minutes travel time is highest in the South East (except London), parts of the South West (Cornwall, Bristol), East Anglia and the Welsh Borders. We conlcude that people in the South East outside London, East Anglia, and parts of the South West are likely to have to travel further to exercise meaningful choice.