Statement
My right honourable friend the Secretary of State for Health (Alan Johnson) has made the following Written Ministerial Statement.
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 that we have seen in recent years.
We have also seen strong financial management across the NHS over the past 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 its 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 honourable Member in England detailing their relevant PCT’s allocations for the two years. I have also 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 worst 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 that 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’s:
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 that 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 the Department of Health’s own public value programme.
Already we have estimated that substantial savings 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 in which 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.
PCT name 2009-10 allocation £000s 2010-11 allocation £000s Two-year increase £000s Two-year increase % 2010-11 closing DFT % 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 Scilly 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%