Vascular Services Research

Socio-economic project

Further details of the original research programme can be found by following this link to the NIHR Vascular Research Programme.  The details below describe the newly instigated research funded by a NIHR Programme Development Grant

Vascular services

Vascular services provide specialist surgical treatment and care for patients with a range of conditions which affect blood vessels, principally conditions which affect arteries in the neck (carotid arteries), the main artery in the abdomen (aorta), and arteries and veins in the legs. We recently completed an NIHR Programme Grant entitled “The Design, Development, Commissioning and Evaluation of Patient Focused Vascular Services”. The work was undertaken to inform the redesign of vascular services in England. 

This project

This project is a further analysis of hospital admissions data we obtained from NHS Digital for the Programme Grant. The anonymised data provide details on vascular hospital admissions in England from April 2006 to March 2018. Data were manipulated into a format suitable for our analyses. A Clinical Consensus Group, comprising clinicians involved in the management of vascular disease, provided advice on the process of classifying admissions data into clinically useful categories.

Project aims

This project aims to add value by investigating how social and economic circumstances, geography and ethnicity influence the use of vascular services and how long patients survive after surgery. Investigating these variations was not an aim of the main programme grant but our findings indicate that further analysis is important. For example, one of the findings is that there is a trend towards centralisation of services for major and emergency work (following recommendations indicating that patients operated on in a smaller number of larger centres have better survival rates), but also a tendency for centralisation of minor procedures and investigations. Centralisation may however make it more difficult for people living in economically disadvantaged areas to access services. 

Data analysis

We will carry out statistical analyses to address a range of questions regarding associations between social and economic circumstances, geography and ethnicity, and vascular surgery rates and survival following surgery.

Patient and public involvement 

Patient representatives will be involved as members of the Project Management Group. In addition, a non-disease specific, public advisory panel at Sheffield Teaching Hospitals NHS Foundation Trust will be engaged in the research.

Anticipated benefits

Identification of inequalities in vascular health care will provide information and insights that could inform the delivery of vascular services in England. An example of a potential insight is that older people living in economically disadvantaged areas might be less likely to be referred for specialist surgery, resulting in higher death rates in these areas. The results ought to be relevant to government policy makers when the government starts to develop its “levelling up” policy agenda in relation to health and social care in order to reduce health inequalities.