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Primary Care Trust Revenue Allocations/NHS Operating Framework

Volume 485: debated on Monday 8 December 2008

The national health service has benefited from successive generous spending settlements, as investment in the NHS has trebled since 1997. This investment has funded the record increases in staff, hospitals and medical advances we have seen in recent years.

We have also seen strong financial management across the NHS over the last few years, which has turned a deficit into a healthy surplus. The NHS has exceeded its Gershon efficiency targets, delivering £7.88 billion savings over the last four years. We expect the NHS to continue to deliver at this level, and to bring forward further proposals to drive additional efficiencies throughout their operations. We can be confident, therefore, that in the tighter economic climate ahead, the NHS is on a firm financial footing and will be well equipped to meet the efficiency challenges of the coming years.

I am pleased to announce today the next round of revenue allocations to primary care trusts (PCTs) for 2009-10 and 2010-11. PCTs will receive an average increase of 5.5 per cent. in both years, a total increase in funding of £8.6 billion, bringing the total allocations to PCTs over two years to £164 billion.

This means that by 2010-11 PCTs will receive, on average, £1,612 per person. The comparable figure in 1996-97 was £426 per head. We are putting a greater proportion of the resources available into local communities and closer to patients, with more than 80 per cent. of the NHS revenue budget allocated directly to PCTs.

I will be writing this week to every hon. Member in England detailing their relevant PCT’s allocations for the two years. I also have included with this statement a table of the 2009-10 and 2010-11 PCT revenue allocations.

The allocations that I am announcing today are based on a new, more technically robust formula that has been recommended by the independent Advisory Committee on Resource Allocation (ACRA). This improves on the previous formula by:

targeting funds at the places with the worse health outcomes;

assessing need according to age and other factors together for the first time; and

a new market forces factor (MFF) which reduces unhelpful variation.

It includes a health inequalities formula that continues to target resources to the places with the biggest health problems.

I have placed in the Library ACRA’s report and recommendations on the funding formula to make it fairer.

Alongside these revenue allocations, David Nicholson, the NHS chief executive, is publishing this week the NHS operating framework for 2009-10, which sets out the priorities for next year.

This year’s operating framework sets out how we will support the health service to deliver the vision in Lord Darzi’s “High Quality Care for All” to put quality at the heart of everything the NHS does.

To ensure that we continue to empower and support the local NHS, we need to plot a stable and consistent path. Therefore, the five key priorities for the NHS are consistent with last year:

improving standards of cleanliness and tackling healthcare associated infections;

improving access to care through the achievement of the 18-week referral to treatment pledge and improving access to GP services, including at evenings and at weekends;

improving the health of adults and children and reducing health inequalities, by focusing on improving care for cancer and stroke, and paying particular attention to children’s health, particularly in the most deprived areas of the country;

improving patient experience, staff satisfaction and engagement; and

preparing to respond in a state of emergency, such as an outbreak of pandemic influenza.

Alongside the national priorities, PCTs will set their own local priorities built on evidence about local needs. They will need to work in step with local government through local area agreements that focus on improving health and well-being as well as better healthcare.

To deliver that agenda of improving services for patients in this challenging economic climate, we need to redouble our efforts to improve efficiency in the public sector and to get best value for taxpayers’ money.

In this context, high quality care is not a luxury but a necessity. Prioritising the most effective treatments, reducing errors and waste and keeping people healthy and independent for as long as possible are all things that contribute not only to the quality of care, but also to a more efficient and productive health service. High quality and value for money are not competing alternatives; they are one and the same thing.

We will accelerate our commitment to implement the vision of quality as the organising principle for the NHS set out in “High Quality Care for All”. As Lord Darzi said in his interim report last year: “Effective care matters of course because patients should get the best outcomes. The evidence also shows that the most effective treatment is very often the most efficient treatment”.

For example, through the great efforts of the NHS to tackle healthcare associated infections in recent years, we estimate the NHS has already saved over £75 million in reduced bed days and drug costs, while improving outcomes for patients. These savings will rise as we continue to drive down infection rates. Better care equals better value

Recent efforts have underlined the potential for further efficiency gains. As the NHS develops its plans in 2009, it will build on the work of the cross-Government operational efficiency programme and Department of Health’s own public value programme.

Already we have estimated there are substantial savings that can be delivered through driving up the quality of care, reducing waste and better commissioning and procurement, including, through better use of shared business services, improvements in the way the NHS estate is used, driving up quality through the world class commissioning programme, and changes to the tariff.

Over the course of the next year, the NHS will plan, bottom-up and in detail, how these productivity opportunities will be realised in 2010-11 and in future years. We want the NHS to bring forward the best package of measures appropriate to each locality.

Of course, a renewed drive for efficiency will be challenging, but even after making an allowance for improved efficiency, with 5.5 per cent. allocations in both of the next two years and prudent drawdown of £800 million of the NHS surplus over the same period, we are confident that the NHS can still secure the continuous improvement in care that patients, public and staff rightly demand.

2009-10 and 2010-11 PCT Revenue Allocations

2009-10

Allocation

2010-11

Allocation

Two-year

Increase

Two-year

Increase

2010-11

Closing DFT

£000s

£000s

£000s

%

%

Ashton, Leigh and Wigan PCT

511,831

539,982

54,834

11.3%

-4.5%

Barking and Dagenham PCT

301,080

316,599

30,789

10.8%

1.3%

Barnet PCT

528,745

555,931

53,442

10.6%

6.7%

Barnsley PCT

409,151

437,291

57,837

15.2%

-6.2%

Bassetlaw PCT

167,978

182,407

26,671

17.1%

-6.2%

Bath and North East Somerset PCT

255,385

268,516

25,812

10.6%

4.4%

Bedfordshire PCT

551,987

585,386

62,176

11.9%

-3.5%

Berkshire East PCT

532,623

560,009

53,833

10.6%

3.7%

Berkshire West PCT

597,061

627,760

60,346

10.6%

5.1%

Bexley Care Trust

321,350

337,896

32,552

10.7%

1.4%

Birmingham East and North PCT

674,108

711,184

72,219

11.3%

-2.5%

Blackburn with Darwen PCT

258,536

272,755

27,698

11.3%

-2.4%

Blackpool PCT

263,731

278,236

28,254

11.3%

-3.6%

Bolton PCT

439,803

463,992

47,117

11.3%

-2.6%

Bournemouth and Poole Teaching PCT

509,384

535,575

51,485

10.6%

3.6%

Bradford and Airedale Teaching PCT

810,920

856,745

88,101

11.5%

-1.2%

Brent Teaching PCT

501,538

527,325

50,692

10.6%

7.7%

Brighton and Hove City PCT

438,902

461,469

44,361

10.6%

7.7%

Bristol PCT

660,306

695,459

68,412

10.9%

0.4%

Bromley PCT

466,265

490,239

47,126

10.6%

8.6%

Buckinghamshire PCT

652,120

685,650

65,911

10.6%

2.1%

Bury PCT

282,130

297,647

30,225

11.3%

-3.1%

Calderdale PCT

308,563

325,895

33,418

11.4%

-1.4%

Cambridgeshire PCT

777,313

827,498

90,708

12.3%

-2.1%

Camden PCT

453,989

477,331

45,886

10.6%

12.4%

Central and Eastern Cheshire PCT

645,100

679,543

67,099

11.0%

0.4%

Central Lancashire PCT

688,006

725,915

73,777

11.3%

-2.2%

City and Hackney Teaching PCT

472,222

496,502

47,729

10.6%

6.6%

Cornwall and Isles of Stilly PCT

808,369

856,214

94,181

12.4%

-6.2%

County Durham PCT

886,825

935,601

95,008

11.3%

-5.4%

Coventry Teaching PCT

529,616

558,745

56,739

11.3%

-0.3%

Croydon PCT

526,752

553,836

53,240

10.6%

5.1%

Cumbria Teaching PCT

783,807

826,917

83,971

11.3%

-2.0%

Darlington PCT

166,081

174,705

16,913

10.7%

0.9%

Derby City PCT

405,847

428,169

43,479

11.3%

-5.8%

Derbyshire County PCT

1,048,875

1,107,225

118,065

11.9%

-6.2%

Devon PCT

1,088,020

1,152,427

121,128

11.7%

-1.0%

Doncaster PCT

502,312

529,939

53,814

11.3%

-5.5%

Dorset PCT

580,964

613,261

62,584

11.4%

-0.6%

Dudley PCT

461,918

487,324

49,487

11.3%

-3.9%

Ealing PCT

545,775

573,837

55,163

10.6%

8.0%

East and North Hertfordshire PCT

759,311

803,338

83,612

11.6%

-0.6%

East Lancashire Teaching PCT

629,300

663,912

67,419

11.3%

-0.2%

East Riding of Yorkshire PCT

432,198

458,519

49,720

12.2%

-6.2%

East Sussex Downs and Weald PCT

513,310

539,702

51,881

10.6%

2.4%

Eastern and Coastal Kent PCT

1,151,643

1,216,563

124,958

11.4%

-0.8%

Enfield PCT

436,718

459,173

44,140

10.6%

2.1%

Gateshead PCT

357,224

376,601

38,000

11.2%

0.1%

Gloucestershire PCT

825,908

868,490

83,597

10.7%

1.3%

Great Yarmouth and Waveney PCT

361,014

381,535

39,341

11.5%

-2.9%

Greenwich Teaching PCT

424,160

445,968

42,871

10.6%

4.0%

Halton and St. Helens PCT

537,116

566,657

57,543

11.3%

-4.5%

Hammersmith and Fulham PCT

326,448

343,232

32,995

10.6%

16.2%

Hampshire PCT

1,709,698

1,799,471

175,170

10.8%

0.7%

Haringey Teaching PCT

424,321

446,139

42,887

10.6%

2.1%

Harrow PCT

313,370

329,483

31,673

10.6%

7.4%

Hartlepool PCT

163,405

172,392

17,506

11.3%

-4.3%

Hastings and Rother PCT

303,746

319,363

30,700

10.6%

2.1%

Havering PCT

376,447

396,316

39,278

11.0%

0.5%

Heart of Birmingham Teaching PCT

523,451

550,366

52,906

10.6%

10.2%

Herefordshire PCT

256,778

272,050

28,658

11.8%

-3.1%

Heywood, Middleton and Rochdale PCT

358,484

378,201

38,405

11.3%

0.0%

Hillingdon PCT

379,496

399,009

38,357

10.6%

6.4%

Hounslow PCT

362,964

381,627

36,686

10.6%

5.1%

Hull Teaching PCT

455,982

481,061

48,959

11.3%

-6.0%

Isle of Wight NHS PCT

232,671

245,882

25,341

11.5%

-1.2%

Islington PCT

412,126

433,316

41,655

10.6%

11.7%

Kensington and Chelsea PCT

337,424

354,773

34,104

10.6%

20.4%

Kingston PCT

249,459

262,286

25,213

10.6%

13.5%

Kirklees PCT

598,931

631,872

64,165

11.3%

-1.8%

Knowsley PCT

303,843

320,554

32,552

11.3%

-0.1%

Lambeth PCT

580,017

609,840

58,624

10.6%

14.8%

Leeds PCT

1,169,992

1,235,149

126,152

11.4%

-1.7%

Leicester City PCT

488,731

515,611

58,787

12.9%

-6.1%

Leicestershire County and Rutland PCT

830,158

879,975

93,096

11.8%

-5.6%

Lewisham PCT

484,939

509,873

49,014

10.6%

12.0%

Lincolnshire Teaching PCT

1,060,265

1,127,697

136,737

13.8%

-6.2%

Liverpool PCT

906,876

953,504

91,817

10.7%

1.7%

Luton PCT

282,841

298,802

30,707

11.5%

-2.4%

Manchester PCT

925,276

979,818

102,780

11.7%

-3.5%

Medway PCT

391,582

412,814

41,635

11.2%

0.2%

Mid Essex PCT

461,830

488,887

51,133

11.7%

-3.5%

Middlesbrough PCT

257,714

271,888

27,610

11.3%

-0.6%

Milton Keynes PCT

315,520

338,522

39,450

13.2%

-3.2%

Newcastle PCT

466,097

490,062

47,110

10.6%

2.8%

Newham PCT

510,371

536,897

51,869

10.7%

0.9%

Norfolk PCT

1,069,968

1,133,968

119,781

11.8%

-5.1%

North East Essex PCT

489,796

520,205

55,943

12.0%

-5.3%

North East Lincolnshire Care Trust Plus

259,146

273,399

27,763

11.3%

-1.9%

North Lancashire Teaching PCT

520,037

549,674

56,748

11.5%

-3.7%

North Lincolnshire PCT

238,152

252,197

28,256

12.6%

-6.2%

North Somerset PCT

287,957

306,265

33,320

12.2%

-5.2%

North Staffordshire PCT

316,252

333,646

33,881

11.3%

-2.9%

North Tyneside PCT

345,791

364,810

37,046

11.3%

-1.2%

North Yorkshire and York PCT

1,076,587

1,139,019

118,557

11.6%

-2.4%

Northamptonshire Teaching PCT

927,249

983,436

104,527

11.9%

-1.4%

Northumberland Care Trust

498,897

526,337

53,448

11.3%

-3.2%

Nottingham City PCT

487,694

514,727

53,945

11.7%

-6.2%

Nottinghamshire County Teaching PCT

943,520

997,415

105,012

11.8%

-6.2%

Oldham PCT

379,096

399,946

40,614

11.3%

-1.4%

Oxfordshire PCT

830,948

873,673

83,986

10.6%

3.2%

Peterborough PCT

244,676

257,356

24,830

10.7%

1.0%

Plymouth Teaching PCT

393,303

416,482

43,682

11.7%

-5.9%

Portsmouth City Teaching PCT

311,043

328,095

33,267

11.3%

0.0%

Redbridge PCT

365,515

385,618

39,159

11.3%

-1.1%

Redcar and Cleveland PCT

233,544

246,388

25,020

11.3%

-1.6%

Richmond and Twickenham PCT

267,442

281,193

27,031

10.6%

23.4%

Rotherham PCT

409,554

432,140

45,922

11.9%

-6.2%

Salford PCT

425,994

449,125

45,339

11.2%

0.1%

Sandwell PCT

523,488

552,279

56,083

11.3%

-5.4%

Sefton PCT

479,220

503,861

48,463

10.6%

1.9%

Sheffield PCT

885,052

931,076

90,381

10.8%

0.9%

Shropshire County PCT

412,573

436,629

45,564

11.7%

-3.8%

Solihull Care Trust

294,018

310,080

31,371

11.3%

0.1%

Somerset PCT

751,518

796,505

84,166

11.8%

-2.6%

South Birmingham PCT

587,304

619,168

62,482

11.2%

0.1%

South East Essex PCT

500,226

527,738

53,591

11.3%

-2.2%

South Gloucestershire PCT

323,108

339,722

32,657

10.6%

2.2%

South Staffordshire PCT

826,224

873,709

104,752

13.6%

-6.2%

South Tyneside PCT

279,272

294,039

29,326

11.1%

0.5%

South West Essex PCT

602,217

635,283

64,461

11.3%

0.0%

Southampton City PCT

368,298

388,555

39,457

11.3%

-1.9%

Southwark PCT

492,748

518,084

49,803

10.6%

5.7%

Stockport PCT

431,751

453,950

43,638

10.6%

3.4%

Stockton-on-Tees Teaching PCT

287,728

303,980

31,252

11.5%

-6.0%

Stoke-on-Trent PCT

451,376

476,202

53,205

12.6%

-5.5%

Suffolk PCT

820,056

869,582

92,277

11.9%

-4.0%

Sunderland Teaching PCT

510,293

537,800

54,110

11.2%

0.2%

Surrey PCT

1,565,807

1,646,316

158,260

10.6%

11.6%

Sutton and Merton PCT

583,188

613,174

58,944

10.6%

9.7%

Swindon PCT

277,524

294,545

31,489

12.0%

-1.3%

Tameside and Glossop PCT

383,015

404,080

41,033

11.3%

-1.5%

Telford and Wrekin PCT

237,482

251,590

26,636

11.8%

-6.2%

Torbay Care Trust

236,008

249,424

25,720

11.5%

-3.4%

Tower Hamlets PCT

447,591

470,605

45,239

10.6%

3.4%

Trafford PCT

340,332

357,831

34,398

10.6%

7.7%

Wakefield District PCT

564,093

595,118

66,463

12.6%

-6.2%

Walsall Teaching PCT

425,164

448,548

45,549

11.3%

-2.2%

Waltham Forest PCT

395,510

415,846

39,977

10.6%

2.2%

Wandsworth PCT

488,965

514,106

49,421

10.6%

14.4%

Warrington PCT

290,606

306,628

31,172

11.3%

-1.4%

Warwickshire PCT

739,819

781,747

80,496

11.5%

-1.4%

West Essex PCT

390,481

410,562

39,470

10.6%

1.6%

West Hertfordshire PCT

773,604

813,380

78,190

10.6%

5.3%

West Kent PCT

926,518

977,459

98,922

11.3%

0.0%

West Sussex PCT

1,172,602

1,232,894

118,518

10.6%

3.7%

Western Cheshire PCT

375,103

394,678

38,320

10.8%

0.8%

Westminster PCT

447,789

470,813

45,259

10.6%

20.8%

Wiltshire PCT

610,462

642,526

62,527

10.8%

0.6%

Wirral PCT

565,696

594,782

57,176

10.6%

2.3%

Wolverhampton City PCT

408,545

431,015

43,769

11.3%

-2.6%

Worcestershire PCT

771,728

815,248

83,752

11.4%

-2.6%

England

80,030,703

84,432,392

8,573,905

11.3%

0.0%