ABSTRACT
This chapter argues that the term 'variation' is used as a homogenous concept, creating confusion between what is good and acceptable variation in healthcare and that which is unacceptable and unwarranted variation. It explores the research and evidence base behind variation in healthcare, its causes, effects and management strategies. The chapter reflects on the learning from the application of theories and models to a case study examining patterns in the request for laboratory blood tests by primary care practitioners situated in a small locality in a clinical commissioning group (CCG) in England, UK. It illustrates the complexity involved when seeking to improve outcomes and deliver better value through the understanding of variation and its various forms. Organisational decisions are, therefore, historically conditioned. Path dependency's origins, its impact and how it can be understood are, therefore, important. It is important to understand the path dependencies created by healthcare policy which influence variation.
