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

Jacqueline Bisset has claimed that young women today are obsessed with being 'hot', rather than 'charming', 'romantic' or 'beautiful'
New Zealand fly-half Aaron Cruden pictured in The Zookeeper's Son on a late-night drinking session
Liam Payne has attacked the media for reporting his tweet of support to Willie Robertson and the subsequent backlash from fans
peopleBut One Direction star insists he is not homophobic
Arts and Entertainment
A bit rich: Maggie Smith in Downton Abbey
tvSeries 5 opening episode attracts lowest ratings since drama began
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Arts and Entertainment
Ben Affleck stars as prime suspect Nick Dunne in the film adaptation of Gone Girl
filmBen Affleck and Rosamund Pike excel in David Fincher's film, says Geoffrey Macnab
Arts and Entertainment
Lena Dunham
booksLena Dunham's memoirs - written at the age of 28 - are honest to the point of making you squirm
Life and Style
fashionThe supermodel on her career, motherhood and Cara Delevingne
Life and Style
A new app has been launched that enables people to have a cuddle from a stranger
techNew app offers 'PG alternative' to dating services like Tinder
Greg Dyke insists he will not resign as Football Association chairman after receiving a watch worth more than £16,000 but has called for an end to the culture of gifts being given to football officials
Arts and Entertainment
Jake Quickenden sings his heart out in his second audition
tvX Factor: How did the Jakes - and Charlie Martinez - fare?
premier league
Frank Lampard and his non-celebration
premier leagueManchester City vs Chelsea match report from the Etihad Stadium
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

    Web Application Support Manager

    £60000 Per Annum: Clearwater People Solutions Ltd: Our client based in Reigate...

    ** Cover Supervisor Ugently Required In Sefton Area **

    £60 - £65 per day: Randstad Education Liverpool: Job opportunity for Secondary...

    Music Teacher

    £85 - £125 per day: Randstad Education Chester: Job Opportunity for Secondary ...

    Maths Teacher

    £85 - £125 per day: Randstad Education Chester: Job Opportunity for Secondary ...

    Day In a Page

    A roller-coaster tale from the 'voice of a generation'

    Not That Kind of Girl:

    A roller-coaster tale from 'voice of a generation' Lena Dunham
    London is not bedlam or a cradle of vice. In fact it, as much as anywhere, deserves independence

    London is not bedlam or a cradle of vice

    In fact it, as much as anywhere, deserves independence
    Vivienne Westwood 'didn’t want' relationship with Malcolm McLaren

    Vivienne Westwood 'didn’t want' relationship with McLaren

    Designer 'felt pressured' into going out with Sex Pistols manager
    Jourdan Dunn: Model mother

    Model mother

    Jordan Dunn became one of the best-paid models in the world
    Apple still coolest brand – despite U2 PR disaster

    Apple still the coolest brand

    Despite PR disaster of free U2 album
    Scottish referendum: The Yes vote was the love that dared speak its name, but it was not to be

    Despite the result, this is the end of the status quo

    Boyd Tonkin on the fall-out from the Scottish referendum
    Manolo Blahnik: The high priest of heels talks flats, Englishness, and why he loves Mary Beard

    Manolo Blahnik: Flats, Englishness, and Mary Beard

    The shoe designer who has been dubbed 'the patron saint of the stiletto'
    The Beatles biographer reveals exclusive original manuscripts of some of the best pop songs ever written

    Scrambled eggs and LSD

    Behind The Beatles' lyrics - thanks to Hunter Davis's original manuscript copies
    'Normcore' fashion: Blending in is the new standing out in latest catwalk non-trend

    'Normcore': Blending in is the new standing out

    Just when fashion was in grave danger of running out of trends, it only went and invented the non-trend. Rebecca Gonsalves investigates
    Dance’s new leading ladies fight back: How female vocalists are now writing their own hits

    New leading ladies of dance fight back

    How female vocalists are now writing their own hits
    Mystery of the Ground Zero wedding photo

    A shot in the dark

    Mystery of the wedding photo from Ground Zero
    His life, the universe and everything

    His life, the universe and everything

    New biography sheds light on comic genius of Douglas Adams
    Save us from small screen superheroes

    Save us from small screen superheroes

    Shows like Agents of S.H.I.E.L.D are little more than marketing tools
    Reach for the skies

    Reach for the skies

    From pools to football pitches, rooftop living is looking up
    These are the 12 best hotel spas in the UK

    12 best hotel spas in the UK

    Some hotels go all out on facilities; others stand out for the sheer quality of treatments