Next year a huge chunk of money for health improvement services will be taken from local NHS bodies (PCTs – primary care trusts) and given to local government (councils) instead.
As a result, as David Buck explains, the Department of Health has had to quickly find out – for the first time – how much money is being spent on public health, so that it knows how much it needs to reallocate – and the result is particularly useful if you’re interested in previous spending or how it might change under the new system.
“Once it has determined the overall sum, it then has to make the tricky decision about how much to give each local authority – whether to stick with the historical pattern, or to allocate it on some other basis. How it decides on local allocations and how fast it moves to implement the changes in allocations will have big consequences for local authority public health services.”
The money is significant - about “£2.2 billion from the overall public health spend of £5.2 billion”, and this will be capped nationally for the first time.
The variation revealed by the data equally interesting:
“[S]pending in London ranges from £19 per head in Bexley (£4.4 million in total) to £117 per head (£27.8 million in total) in Tower Hamlets. The average spend across England is £40 per head but in England, as in London, there is huge variation – Kent’s population is over twice the size of County Durham’s yet NHS spending on public health in Kent is lower. This is because each primary care trust has made its own decisions on how to allocate its NHS funding between public health and other priorities. Those decisions may be based on rigorous analysis of local needs, on purely historical grounds or on higher local priorities being given to treatment rather than prevention. Since the Department has not been in the business of telling the local NHS how much it should spend on public health or of collecting statistics, until now this variation has been invisible, unlike variation in access to high-profile routine NHS services, such as operations or drugs.”
There are two implications here: firstly, that there are newsworthy historical patterns to report (note in the visualisation above how much more the City of London spends per head than almost anywhere else, despite having low levels of deprivation), and secondly, that we can expect both winners and losers under the new system – both of which will also be newsworthy (current outliers are again the ones to watch here, as they are more likely to be affected).
The Advisory Council on Resource Allocation (ACRA) will play a key role in this, as they will help the DoH “decide which local authority gets what from the overall pot.” You can find details of ACRA, its reports and members on this DoH page.
Anyone covering this field would be advised to set up a Google Alert for any mention of the body.
We’ve republished the data here. If you can do anything with it, or write anything based on the data, let us know.. Accompanying report embedded below: