Data summary

February 2026 – Following the most recent Scottish Atlas of Healthcare Variation publication in May 2025, the Scottish Government undertook a survey and evaluation to gather views of healthcare professionals on the usability and impact of the Atlas and to ascertain whether the Atlas is viewed as an effective tool to help identify and tackle unwarranted variation. The evaluation highlighted lower than anticipated levels of engagement with and utilisation of the Atlas. Following consideration of the evaluation recommendations, the Chief Medical Officer has decided that further investment in the Atlas should pause. As a result, there are no plans to undertake any further updates or revisions to the Atlas at this time and PHS will focus on alternative ways of supporting work on this topic.

About this release

The Scottish Atlas of Healthcare Variation aims to highlight geographical variation in the provision of health services and associated health outcomes.

This release by Public Health Scotland (PHS) presents an update to the Atlas to include deprivation data (using Scottish Index of Multiple Deprivation quintiles) for hips and knee replacements, and cataract procedures for financial years 2019/20 to 2023/24.

Publication summary

View the publication summary:

Main points

Cataract surgery (aged 65+ years) 2023/24

  • In 2023/24, the rate that cataract procedures were performed in people aged 65 years and over in Scotland was 3,634.9 per 100,000 population, an increase in the rate of 3,384.7 per 100,000 population in 2022/23.
  • There was a 2.5-fold variation in the directly age-sex standardised rate of cataract procedures in people aged 65 years across the NHS Boards of Residence in Scotland, ranging from 1,904.6 to 4,725.1 per 100,000 population.

Elective primary hip replacement 2023/24

  • The highest number of elective primary hip replacements performed in Scotland in recent years was 7,686 in 2023/24.
  • Across NHS Boards there was a 2.2-fold variation in the directly age-sex standardised rate of elective hip replacement procedures in Scotland, ranging from 96.6 to 208.3 per 100,000 population. The corresponding figure for Scotland was 133.0 per 100,000 population.

Elective primary knee replacement 2023/24

  • In 2023/24 there were 7,125 procedures carried out and there was a 2.6-fold variation in the directly age-sex standardised rate of elective knee replacement procedures across the NHS Boards of Residence in Scotland, ranging from 95.4 to 244.9 per 100,000 population. The corresponding figure for Scotland was 122.9 per 100,000 population.

Background

The Scottish Atlas of Healthcare Variation is an important tool to help identify unwarranted variation, realising Realistic Medicine and support reducing harm and waste within the health service. It is designed to facilitate discussion and raise questions about why differences exist with a view to improving equity of access and providing better value care for local populations.

Last updated: 03 February 2026