Poorest areas of England ‘will suffer under new NHS spending formula’

Plan will see funding rise by 14 per cent for some and drop by a quarter for others

The poorest parts of England will have their health funding cut while affluent areas will benefit under a proposed new NHS spending formula, experts have warned.

Click image above to enlarge graphic

New plans for allocating resources across England’s clinical commissioning groups (CCGs), under consideration by NHS England, would see a measure that takes deprivation into account dropped in favour of a greater emphasis on the age of the population.

But in a letter to the British Medical Journal, academics from Durham University said that, with life expectancies already higher in wealthy areas, the new formula measure could “undermine the principle of equal opportunity of access for equal need” and entrench the North-South health divide.

Using the proposed new formula to map spending across England, they found the more affluent and healthy South-east would benefit the most, while poorer, less healthy areas in the North would lose out substantially.

In one CCG, South Eastern Hamp-shire, where the healthy life expectancy for women is 68, NHS funding would increase by £164 per person under the new formula – a 14 per cent increase. By contrast, in Sunderland, where a woman’s healthy life expectancy is 58, NHS funding per person would decrease by £146 – a decline of 11 per cent.

Poorer parts of London would also lose out, they warned, with Camden receiving £273 less per head – a cut of more than a quarter on current spending.

“Although these changes are not on the scale that a purely ‘age only’ allocation formula would produce, they are still sufficient to undermine the principle of ‘equal opportunity of access for equal need,’” write Professor Clare Bambra and Dr Alison Copeland, from Durham’s Wolfson Research Institute for Health and Wellbeing.

Figures released by Public Health England earlier this year highlighted what the Health Secretary, Jeremy Hunt, called “shocking” variations across England in the number of people dying prematurely, with poorer areas, predominately in the North, performing much worse than affluent and mostly southern areas.

Hampshire was the 10th best-performing region in England for numbers of premature deaths from the four main killers: cancer, heart disease and stroke, lung disease and liver disease, with 215 premature deaths per 100,000 members of the population. Sunderland, meanwhile, came in the bottom 20 worst-performing regions with 337 early deaths per 100,000 people.

While older people usually need far more health services, concentrating health spending in areas where there are more elderly people can exacerbate existing inequalities – because it is these areas where, by definition, life expectancy will already be higher.

NHS England is currently reviewing the way it allocates funding following advice from the independent Advisory Council of Resource Allocation. The NHS allocates funding of more than £63bn to England’s 211 CCGs.

A spokesman for NHS England, said: “The funding allocations review group has been exploring and considering the best approach to ensuring that any future funding allocation proposals ensure equal access to health services across the country and address health inequalities. It is only right that as part of this process we continue to examine the risks and benefits of a range of potential options.

“CCGs’ commissioning responsibilities are only one part of the full range of NHS services commissioned, so it is vital to understand their allocations in the context of primary care, specialised services and social care, and ensure that money is targeted to the areas in which it will have the biggest impact in improving patient outcomes.”

NHS England is reviewing its funding allocation (Getty) NHS England is reviewing its funding allocation (Getty)  

Explainer: Funding formula

The NHS’s stated intention in allocating health funding in different parts of the country is to “provide equal opportunity of access for equal need”. The first element of the funding formula  is the size of local populations, with more money being allocated the more people there are. Spending per head is then adjusted or weighted depending on different needs.

The more elderly the population, the more the need, because older people are more likely to require more hospital appointments, drugs, health visitors and other interventions. The costs of delivering healthcare in any given area are also taken into account. So in London, land and building costs will be higher than they are in Leeds, and staff costs may also be higher.

Currently, the spending formula also includes a deprivation measure: the “health inequality weighting”. It is this final measure that may be removed from the new formula – placing a greater emphasis on age-related allocation, which, experts say, risks exacerbating existing inequalities by focusing resources in areas where life expectancies are already high.

Charlie Cooper

Life and Style
ebookNow available in paperback
ebookA delicious collection of 50 meaty main courses
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: International Marketing Manager

    Negotiable: Recruitment Genius: An International Marketing Manager is required...

    Recruitment Genius: Project Coordinator - Leading Training Business

    £23000 - £27000 per annum: Recruitment Genius: As a small-but-growing entrepre...

    Recruitment Genius: Warehouse Person - Part-time

    £8500 per annum: Recruitment Genius: An opportunity has arisen for a Warehouse...

    Recruitment Genius: Supply Chain Assistant

    Negotiable: Recruitment Genius: A Supply Chain Assistant is required to join a...

    Day In a Page

    John Palmer: 'Goldfinger' of British crime was murdered, say police

    Murder of the Brink’s-MAT mastermind

    'Goldfinger' of British crime's life ended in a blaze of bullets, say police
    Forget little green men - aliens will look like humans, says Cambridge University evolution expert

    Forget little green men

    Leading evolutionary biologist says aliens will look like humans
    The Real Stories of Migrant Britain: An Algerian scientist adjusts to life working in a kebab shop

    The Real Stories of Migrant Britain

    An Algerian scientist struggles to adjust to her new life working in a Scottish kebab shop
    Bodyworlds museum: Dr Gunther von Hagens has battled legal threats, Parkinson's disease, and the threat of bankruptcy

    Dying dream of Doctor Death

    Dr Gunther von Hagens has battled legal threats, Parkinson's disease, and the threat of bankruptcy
    UK heatwave: Temperature reaches 39.8 degrees on Central Line - the sweatiest place in London

    39.8 degrees recorded on Tube

    There's hot (London) and too damn hot (the Underground). Simon Usborne braved the Central line to discover what its passengers suffer
    Kitchens go hi-tech: From robot chefs to recipe-shopping apps, computerised cooking is coming

    Computerised cooking is coming

    From apps that automatically make shopping lists from your recipe books to smart ovens and robot chefs, Kevin Maney rounds up innovations to make your mouth water
    Jessie Cave interview: The Harry Potter star has published a feminist collection of cartoons

    Jessie Cave's feminist cartoons

    The Harry Potter star tells Alice Jones how a one-night stand changed her life
    Football Beyond Borders: Even the most distruptive pupils score at homework club

    Education: Football Beyond Borders

    Add football to an after-school homework club, and even the naughtiest boys can score
    10 best barbecue books

    Fire up the barbie: 10 best barbecue books

    We've got Bibles to get you grilling and smoking like a true south American pro
    Wimbledon 2015: Nick Bollettieri - Junk balls and chop and slice are only way 5ft 1in Kurumi Nara can live with Petra Kvitova’s power

    Nick Bollettieri's Wimbledon Files

    Junk balls and chop and slice are only way 5ft 1in Kurumi Nara can live with Petra Kvitova’s power
    Ron Dennis exclusive: ‘This is one of the best McLaren teams ever – we are going to do it’

    ‘This is one of the best McLaren teams ever – we are going to do it’

    Ron Dennis shrugs off a poor start to the season in an exclusive interview, and says the glory days will come back
    Seifeddine Rezgui: What motivated a shy student to kill 38 holidaymakers in Tunisia?

    Making of a killer

    What motivated a shy student to kill 38 holidaymakers in Tunisia?
    UK Heatwave: Temperatures on the tube are going to exceed the legal limit for transporting cattle

    Just when you thought your commute couldn't get any worse...

    Heatwave will see temperatures on the Tube exceed legal limit for transporting cattle
    Exclusive - The Real Stories of Migrant Britain: Swapping Bucharest for London

    The Real Stories of Migrant Britain

    Meet the man who swapped Romania for the UK in a bid to provide for his family, only to discover that the home he left behind wasn't quite what it seemed
    Cheaper energy on the way, but it's not all sunshine and rainbows

    Cheaper energy on the way, but it's not all sunshine and rainbows

    Solar power will help bring down electricity prices over the next five years, according to a new report. But it’s cheap imports of ‘dirty power’ that will lower them the most