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

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

ES Rentals

    Independent Dating
    and  

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

    iJobs Job Widget
    iJobs General

    SThree: Trainee Recruitment Consultant - Dublin

    £13676.46 - £16411.61 per annum + OTE: SThree: SThree Trainee Recruitment Cons...

    Ashdown Group: Marketing or Business Graduate Opportunity - Norwich - £22,000

    £18000 - £22000 per annum + training: Ashdown Group: Business and Marketing Gr...

    SThree: Trainee Recruitment Consultant

    £20000 - £25000 per annum + Commission: SThree: Are you great at building rela...

    Ashdown Group: Database Analyst - Birmingham - £22,000 plus benefits

    £20000 - £22000 per annum + excellent benefits: Ashdown Group: Application Sup...

    Day In a Page

    Fishing for votes with Nigel Farage: The Ukip leader shows how he can work an audience as he casts his line to the disaffected of Grimsby

    Fishing is on Nigel Farage's mind

    Ukip leader casts a line to the disaffected
    Who is bombing whom in the Middle East? It's amazing they don't all hit each other

    Who is bombing whom in the Middle East?

    Robert Fisk untangles the countries and factions
    China's influence on fashion: At the top of the game both creatively and commercially

    China's influence on fashion

    At the top of the game both creatively and commercially
    Lord O’Donnell: Former cabinet secretary on the election and life away from the levers of power

    The man known as GOD has a reputation for getting the job done

    Lord O'Donnell's three principles of rule
    Rainbow shades: It's all bright on the night

    Rainbow shades

    It's all bright on the night
    'It was first time I had ever tasted chocolate. I kept a piece, and when Amsterdam was liberated, I gave it to the first Allied soldier I saw'

    Bread from heaven

    Dutch survivors thank RAF for World War II drop that saved millions
    Britain will be 'run for the wealthy and powerful' if Tories retain power - Labour

    How 'the Axe' helped Labour

    UK will be 'run for the wealthy and powerful' if Tories retain power
    Rare and exclusive video shows the horrific price paid by activists for challenging the rule of jihadist extremists in Syria

    The price to be paid for challenging the rule of extremists

    A revolution now 'consuming its own children'
    Welcome to the world of Megagames

    Welcome to the world of Megagames

    300 players take part in Watch the Skies! board game in London
    'Nymphomaniac' actress reveals what it was really like to star in one of the most explicit films ever

    Charlotte Gainsbourg on 'Nymphomaniac'

    Starring in one of the most explicit films ever
    Robert Fisk in Abu Dhabi: The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers

    Robert Fisk in Abu Dhabi

    The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers
    Vince Cable interview: Charging fees for employment tribunals was 'a very bad move'

    Vince Cable exclusive interview

    Charging fees for employment tribunals was 'a very bad move'
    Iwan Rheon interview: Game of Thrones star returns to his Welsh roots to record debut album

    Iwan Rheon is returning to his Welsh roots

    Rheon is best known for his role as the Bastard of Bolton. It's gruelling playing a sadistic torturer, he tells Craig McLean, but it hasn't stopped him recording an album of Welsh psychedelia
    Morne Hardenberg interview: Cameraman for BBC's upcoming show Shark on filming the ocean's most dangerous predator

    It's time for my close-up

    Meet the man who films great whites for a living
    Increasing numbers of homeless people in America keep their mobile phones on the streets

    Homeless people keep mobile phones

    A homeless person with a smartphone is a common sight in the US. And that's creating a network where the 'hobo' community can share information - and fight stigma - like never before