Background: Vascular services' delivery has been criticised, and re-organis
ation based on a 600,000 population model suggested. We assessed the feasib
ility of this model in three geographically disparate English regions.
Methods: Surgical arterial activity by Trust was analysed using 1994/95 dat
a from Hospital Episode Statistics. A postal survey of acute Trusts was use
d to assess vascular facilities and personnel. Distances between hospitals
and enumeration districts were mapped using a Geographical Information Syst
em.
Main outcome measures: Number (proportion) of Trusts performing over 100 ar
terial procedures a year. Number (proportion) of Trusts with a vascular on-
call rota. Proportion of population likely to live more than 40 km away (eq
uivalent to 1 h blue-light ambulance travel time) from a vascular unit unde
r the proposed model.
Results: Twelve of the 32 Trusts (38%) performed over 100 arterial procedur
es annually; 23 Trusts completed the survey. Of these, five (22%) had a vas
cular on-call rota. Under the 600,000 model, in East Anglia a further 16.5%
of the population would live > 40 km from a vascular unit. In Wessex, a fu
rther 0.4% of the population would live > 40 km from a vascular unit, Impac
t on access in North West Thames was negligible.
Conclusions: A 600,000 population model could be feasible in urbanised regi
ons, but not in geographically remote ones.