Select Committee on Health Written Evidence

3.  NHS RESOURCES AND ACTIVITY

3.1  General

  3.1.1  Could the Department update tables 3.1.1 showing gross expenditure on HCHS by service sector and age group for the latest year for which data are available? [3.1.1]

  ANSWER

  1.  The data requested is given in Table 3.1.1(a).

  2.  The latest year for which disaggregated data are available is 2003-04 since the allocation of programme-age related activity data is reliant on patient level data from the Hospital Episode Statistics (HES).

  3.  Table 3.1.1(b) shows the proportion of HCHS expenditure by programme of care.

Table 3.1.1(b)

PROPORTION OF HCHS EXPENDITURE BY PROGRAMME OF CARE

Programme of Care	Proportion of expenditure
Acute services	56%
Mental health	13%
Services intended primarily for the elderly	6%
Other services	16%
Learning disability	4%
Maternity	3%

  Notes:

1.  Total in above table does not sum to 100% due to rounding.

  4.  Table 3.1.1(c) shows the proportion of HCHS expenditure by age group.

Table 3.1.1(c)

PROPORTION OF HCHS EXPENDITURE BY AGE GROUP

Age band	Proportion of expenditure
All births	4%
Age 0-4	6%
Age 5-15	4%
Age 16-44	24%
Age 45-64	18%
Age 65-74	15%
Age 75-84	18%
Age 85+	10%

  Notes:

1.  Total in above table does not sum to 100% due to rounding.

  5.  Services aimed specifically, or mainly, at the elderly account for 6% of total HCHS expenditure. However, those aged 65 and over accounted for 43% of total expenditure despite being only 16% of the population. This is mainly due to high levels of spend in other sectors, with 56% of acute expenditure, and significant proportions of expenditure on services for mentally ill people being used by this age group.

Table 3.1.1(a)

HCHS EXPENDITURE BY SECTOR AND AGE GROUP, 2003-04

									£ million
Service sector	All births	Age 0-4	Age 5-15	Age 16-44	Age 45-64	Age 65-74	Age 75-84	Age 85+	TOTAL
Acute	0	1,596	726	4,400	4,202	4,048	4,268	2,271	21,510
Geriatrics(1)	0	11	26	157	219	398	850	685	2,346
Mental Health	0	3	61	2,086	1,139	635	785	379	5,088
Other	90	130	64	518	435	390	439	246	2,312
Other Community	136	551	418	1,122	469	213	291	176	3,376
Learning Disability	0	51	144	827	453	119	29	4	1,627
Maternity(2)	1,327	0	0	0	0	0	0	0	1,327
HQ Admin(3)	23	35	22	137	104	87	100	56	564
TOTAL	1,577	2,376	1,461	9,245	7,021	5,890	6,763	3,818	38,151

  Notes:

1.  Expenditure on those under 65 occurs in the elderly sector due to the allocation of general community patient care (which includes district nursing) and chiropody to this sector. Both of these initially provided services aimed at the elderly although their role has now become more widespread across different age groups.

2.  In calculating expenditure by age it has been assumed that all expenditure in Maternity is spent on the baby. No allocation from the total has been allocated to the costs incurred by the mother (eg hotel costs, complications, etc).

3.  HQ administration has been allocated according to the expenditure already known within the relevant age groups.

  3.1.2  Could the Department update tables 3.1.2, showing gross expenditure on Family Health Services? [3.1.2]

  ANSWER

  1.  The information requested showing gross expenditure on FHS in 2002-03 to 2004-05 is contained in Table 3.1.2.

Table 3.1.2

FAMILY HEALTH SERVICES GROSS EXPENDITURE 2002-03 to 2004-05

			£ million
	2002-03	2003-04	2004-05(5)
Drugs Total (1)	6,345	6,948	7,376
GMS Non-Discretionary	2,068	1,903	N/A(8)
GMS Discretionary	840	781	N/A(8)
Total GMS of which:	2,908	2,684	N/A(8)
PMS (discretionary)(2)	1,152	1,939	N/A(8)
GDS(4)	1,709	1,767	1,670
PDS (discretionary)(2) (3)	41	48	220
Dispensing Costs(6)	918	959	953
GOS	304	322	337
Total Other FHS	4,124	5,035	3,180
Total FHS(7)	13,377	14,667	10,556

  Notes:

1.  Drugs data source: Prescription Pricing Authority, England. Figures include amounts paid to pharmacy and appliance contractors by the PPA and amounts authorised for dispensing doctors and personal administration in England, for financial years April to March. The data do not cover costs for drugs prescribed in hospital but dispensed in the community or private prescriptions.

2.  Personal Medical Services (PMS) and Personal Dental Services (PDS) schemes are Primary Care Act pilots designed to test locally-managed approaches to the delivery of primary care. PDS and PMS expenditure figures exclude any related capital investment by NHS trusts.

3.  PDS expenditure figures are also gross of patient charge income.

4.  The gross GDS costs include the cost of refunds to patients who incorrectly paid income charges.

5.  Figures for 2004-05 are provisional or forecast outturn figures as audited accounts data are still to be received.

6.  Growth in dispensing costs is affected by the inclusion of an increasing element (around £30 million in 2003-04) in PMS discretionary expenditure.

7.  All figures are resource figures.

8.  Following new GP contract status from 1 April 2004, G/PMS practice based data is not comparable with former GP only 2003-04 GMS figures.

  3.1.3  Could the Department update tables 3.1.3, integrating expenditure on HCHS and FHS? Could this integrated information also be provided by Strategic Health Authority area? [3.1.3]

  ANSWER

  1.  The information requested is contained in Table 3.1.3.

  2.  It is not possible to produce the HCHS programme budget figures at strategic health authority area level.

Table 3.1.3

HCFHS PROGRAMME BUDGET EXPENDITURE 2003-04 PRICES (Real Terms)

					£ million
	1999-2000	2000-01	2001-02	2002-03	2003-04
Acute IP	—	—	—	—	—
Acute IP (Pats using a bed) including DC	11,498	12,187	13,215	14,164	15,061
Acute OP	—	—	—	—	—
Acute OP without Day Cases	4,519	4,731	5,103	5,685	6,449
Obstetric IP	885	922	800	879	918
Obstetric OP	174	185	161	188	216
Geriatric IP	1,343	1,428	1,397	1,290	1,223
Units for YD	—	—	—	—	—
Geriatric & YD OP	59	62	65	70	74
Learning Disability IP	943	970	960	868	854
Learning Disability OP	23	22	25	44	84
Mental Health IP	2,257	2,513	2,601	2,767	2,857
Mental Health OP	408	448	521	674	882
Non Psychiatric DP (general and acute)	127	138	102	88	94
Learning Disability Day Pats )	68	68	53	60	49
Mental Illness DP	362	369	339	354	316
Other Hospital	1,116	1,712	1,661	1,608	1,137
TOTAL HOSPITAL	23,781	25,755	27,003	28,738	30,214
Chiropody	121	130	168	238	232
Family Planning	77	84	105	139	129
Immunisation and surveillance	359	384	256	224	224
Screening	74	80	94	135	149
Professional advice and support	373	380	174	113	138
General Patient Care	1,149	1,124	830	764	722
Community MI Nursing	740	845	862	937	1,033
Community MH Nursing	534	561	515	541	640
Community Maternity	230	209	301	167	193
Health Promotion	91	95	44	89	107
Community Dental	107	117	75	188	169
Services to GP's	437	536	695	1,025	1,019
Other CHS	606	700	691	1,248	1,441
TOTAL COMMUNITY	4,900	5,246	4,810	5,808	6,197
Ambulances	779	882	991	959	1,176
HQ Administration	863	870	1,171	599	564
Joint Finance	186	99	58	0	0
TOTAL HCHS	30,509	32,851	34,033	36,104	38,151
Total GMS of which:	3,719	3,761	3,347	2,908	2,684
Non-Discretionary	2,732	2,737	2,435	2,068	1,903
Discretionary	987	1,025	912	864	781
Total Other FHS of which:	8,269	8,585	9,579	10,469	11,983
Drugs	5,409	5,637	5,916	6,345	6,948
PMS (discretionary) (1)			635	1,152	1,939
GDS	1,646	1,696	1,734	1,709	1,767
PDS (discretionary) (1)			38	41	48
Dispensing Costs	900	933	933	919	959
GOS	313	319	321	304	322
Total HCFHS	42,496	45,197	46,959	49,481	52,818

  Notes

  1.  Personal Medical Services (PMS) and Personal Dental Services (PDS) schemes are Primary Care Act pilots designed to test locally-managed approaches to the delivery of primary care. PDS and PMS expenditure figures exclude any related capital investment by NHS trusts; PDS expenditure figures are also gross of patient charge income.

2.  FHS figures are on a cash basis for the years 1998-99 to 2001-02, whereas from 2002-03 is a resource basis.

  3.1.4  Could the Department give an account of the funding streams for the General Medical Services budget and provide a trend analysis? [3.1.4]

  ANSWER

  1.  The two funding streams that make up the GMS budget are the discretionary—(cash-limited) and non-discretionary (non cash-limited) budgets. Table 3.1.4 gives a trend analysis.

  2.  GMS GPs as a whole receive an average level of pay per GP plus reimbursement of all expenses. Some of these expenses are reimbursed directly in whole or part. Of these direct reimbursements, some eg a proportion of staff, premises and IT costs are met from discretionary spending; pay and remaining expenses are delivered through non-discretionary spend. Actual expenditure each year may deliver more or less than the profession's entitlement to pay or expenses. This outcome can only be finalised when a firm estimate of GMS expenses is available some two to three years after year-end. Over or underpayments are then normally corrected in subsequent years.

  3.  PCT, discretionary expenditure on reimbursing GMS GPs' practice staff, premises and IM & T expenses is protected by "GMS expenditure floors" which where introduced in 1998-99 and requires each PCT to deliver year-on-year increases in GMS discretionary spend which are at least in line with GDP.

  4.  All elements of a PMS Pilot's allocation are funded by transfers of money from the national GMS non-discretionary budget and a PCT's unified budget.

  5.  Please note that GMS Discretionary and Non-Discretionary data lines are taken from the latest Departmental report. All spend up to 2001-02 is cash based. Due to changes in Government accounting regulations, spend from 2002-03 and including 2003-04 onwards will be on a resource (I & E) basis.

Table 3.1.4

TREND ANALYSIS OF FUNDING STREAMS OF THE GMS BUDGET

£m	1996-97	1997-98	1998-99	1999-2000	2000-01	2001-02	2002-03	2003-04
GMS Non-Discretionary	2,073	2,198	2,243	2,451	2,510	2,288	2,068	1,903
GMS Discretionary	800	835	878	897	940	857	840	781
PMS	N/A	N/A	37	84	174	569	1,152	1,939
Total GMS Including PMS spend)	2,873	3,033	3,158	3,432	3,624	3,714	4,060	4,623
Percentage change total year-on-year		5.57%	4.12%	8.68%	5.59%	2.48%	9.32%	13.87%

  Source: GMS discretionary and non-discretionary financial returns from the former 90 Family Health Service Authorities (up to 1995-96)

  Notes:

1.  Up to 2000-01 data is from the 95 England health authorities. For 2001-02 PCTs were introduced but were only reporting on GMS discretionary expenditure.

2.  2002-03 spend is based on combined 28 SHA Qtr 1-2 and Qtr 3-4 303 PCT spend. Owing to PCTs not having non-discretionary banking rights until September 2003. 2003-04 spend is based on 304 audited PCT returns.

3.  PMS Pilots funding covers wave 1-5B funding

4.  PMS spend includes both local transfers from the Unified budget discretionary amounts and GMS non-discretionary transfers.

5.  Discretionary and non-discretionary GMS figures reflect the growth over the period in GP and practice staff numbers, and the rise in pay and expenses.

6.  All figures up to 2001-02 are based on cash only spend. Due to changes in accounting regulations figures for 2002-03 and 2003-04 are resource based.

3.2  Inflation

  3.2.1  Could the Department give an explanation as to the level of funding set aside for inflation in 2005-06? In particular, can it give the average pay awards to each (subjective) staff group and the inflation assumptions for non pay including capital charges? [3.2.1]

  ANSWER

  1.  NHS funding will rise by £6.7 billion in 2005-06 equivalent to 6.9% real terms growth. This funding will help the NHS to meet healthcare pressures reflected in Local Delivery Plans. However, it is for health economies, including strategic health authorities in partnership with NHS trusts, primary care trusts and local authorities to determine how best to use their funds to meet national and local priorities for improving health and modernising services; to provide greater choice and better access for patients. The significant additional resources available will aid them in this process.

  2.  In 2005-06, for the majority of NHS trusts, the scope of Payment by Results (PbR) includes only elective care. The national price tariff underpinning the system is adjusted annually for unavoidable cost pressures. The uplift is based on the same assumptions that underpin the revenue allocations to PCTs. The uplift includes:

—  the expected impact on pay, including Agenda for Change and the consultant contract;

—  increases in the cost of drugs and other technology, including increases arising from NICE appraisal and guidelines;

—  price inflation for goods and services; and

—  an overall 1.7% efficiency gain assumption.

  3.  For 2005-06 the total uplift for the national tariff is 5.3%. The components of this are shown in Table 3.2.1(a).

Pay

  4.  Table 3.2.1(b) shows the settlements awarded to those staff whose pay arrangements are determined by the Review Bodies.

Table 3.2.1(b)

REVIEW BODY PAY SETTLEMENTS 2005

Group	Settlement
Nursing and Midwifery	3.225%
Allied Health Professionals	3.225%
Consultants on the new contract	3.225%
Consultants on the old contract	3.000%
Juniors	3.000%
NCCGs	3.225%
FHS doctors	3.225%

Prices

  5.  The GDP deflator is used as a proxy for underlying non-pay inflation in the NHS. This needs to be adjusted for assumptions about the level of procurement and other efficiency savings that the NHS is expected to make.

Capital Charges

  6.  At national level, the cost of capital charges paid by the NHS is a circular flow of funds. The total of the capital charges estimates made by NHS trusts forms part of the total cash resources available through PCT allocations.

  7.  Indices for land, buildings and equipment are produced for the Department each year by the Valuation Office, in order that the NHS may calculate capital charges in advance of the financial year.

  8.  The aggregate index used to uplift capital charges from 2003-04 to 2004-05 levels was 4.8%.

Table 3.2.1(a)

NHS TARIFF UPLIFT 2005-06

2005-06 (over 2004-05 baseline)
	£m	%
Baseline	46,162
Increase in pay and prices
Pay Awards	956	2.1
Pay Drift	202	0.4
Pensions indexation	154	0.3
Non-pay inflation (prices)	257	0.6
Clinical Negligence Costs	58	0.1
Secondary care drugs (price)	199	0.4
Capital Charges	56	0.1
PFI	49	0.1
Gross pay and price increase	1,931	4.2
Efficiency @ 1.7%	-785	-1.7
Net pay and price increase	1,146	2.5
Reform and quality
Junior Doctors Contract	0	0.0
Consultant Contract	200	0.4
Agenda for Change	460	1.0
Working time directive	0	0.0
Estimates Cost of NICE appraisals	96	0.2
Estimates Cost of NICE guidelines	231	0.5
Investment in new capital	184	0.4
Total reform and quality	1,172	2.5
Technical adjustments
Capital charges revaluation	134	0.3
Total technical adjustments	134	0.3
	Overall	5.3

  3.2.2  Could the Department please update the information provided in response to last year's questionnaire in relation to the components of the health specific inflation indices for revenue spending on HCHS and Family Health Services respectively, together with capital spending on HCHS? The tables for the HCHS should show separate inflation indices for Review Body staff and non-Review Body staff pay, and whatever other breakdowns of staff are available. [3.2.2]

  ANSWER

HCHS pay and prices inflation

Prices

  1.  Increases in the cost of goods and services within the Hospital and Community Health Service (ie the non-pay components) of inflation are measured by the Health Service Cost Index (HSCI). The HSCI weights together price increases for a broad range of items used by the health service—for example, drugs, medical equipment, fuel, telephone charges—using weights derived from expenditure on these various goods and services reported in financial returns.

  Pay

Table 3.2.2(a)

INFLATION FOR SPECIFIC ITEMS OF HCHS REVENUE EXPENDITURE

	2002-03	2003-04	2004-05
	%	%	%
Total staff pay	5.0	7.3	(2) 5.9
Review Body staff	5.1	8.3	(2) 5.8
Non-Review Body staff	4.8	4.1	(2) 6.2
Prices	(1) 1.0	(1) 1.5	1.0
HCHS Total	(1) 3.5	(1) 5.2	(2) 4.1

  Notes

  1.  Prices and total HCHS inflation for 2002-03 and 2003-04 have been updated following a validation exercise.

2.  Pay inflation for 2004-05 have been estimated by considering pay pressures in 2004-05 (eg paybill increase and pay reform) from the baseline year of 2003-04. These figures will be updated when actual paybill figures become available.

FHS Inflation

  2.  The components of the Family Health Service (FHS) inflation index are set out in Table 3.2.2(b). For General Medical and Personal Medical Services (GMS/PMS) and General Dental and Personal Dental Services (GDS/PDS), service specific inflation is calculated as the increase year on year in the average cost per practitioner. For both services, the changes in unit costs include volume and quality effects (eg increase in practice staff numbers or the provision of a changing range of services) as well as pure price effects. For the Pharmaceutical Service (PhS) and General Ophthalmic Service (GOS), service inflation is assumed equal to movements in the GDP deflator.

  3.  Due to the increasing significance of Personal Medical and Dental Services as elements of primary care, the medical and dental indices have been recalculated to combine GMS and PMS expenditure, and GDS and PDS expenditure. This, together with some retrospective revisions to the GDP deflator, will have altered some of the inflation factors compared to previous versions of the index. The reforms undertaken in the GMS, and planned in the GDS, including the growth in PMS and PDS services and the transition from non discretionary services to local commissioning by PCTs, mean the present structure of the FHS inflation index may need to be reviewed.

Table 3.2.2(b)

COMPONENTS OF THE FHS INFLATION INDEX

	2001-02	2002-03	2003-04
	%	%	%
GMS/PMS	1.0	5.2	(1) 9.7
GDS/PDS	2.8	4.0	1.8
PhS	2.5	3.2	2.6
GOS	2.5	3.2	2.6
FHS Total	2.1	3.9	4.6

  Notes

  1.  The comparatively high GMS/PMS inflation figure for 2003-04 is due to a significant increase in expenditure on PMS between 2002-03 and 2003-04.

  4.  For 2003-04 to 2005-06, an uplift for unavoidable cost pressure on the Payment by Results national tariff has also been calculated. The tariff includes such areas as pay, prices and capital charges. For 2004-05 the national tariff has been calculated to be 8.7%.

  5.  The uplift includes:

—  the expected impact from pay and workforce reform through Agenda for Change and the consultant contract;

—  increases in the cost of drugs and other technology, including increases arising from NICE appraisals and guidance;

—  price inflation for goods and services; and

—  an overall 1.7% efficiency gain assumption.

  3.2.3  Could the Department please update the information provided in response to last year's questionnaire in relation to the increases in expenditure on the NHS in cash terms, real terms (GDP deflator) and real terms (NHS deflator)? [3.2.3]

  ANSWER

  1.  The information requested is given in Table 3.2.3.

  2.  Between 1993-94 and 2003-04, the latest year for which NHS specific indices are available, net NHS expenditure has increased by:

—  109.4% in cash terms;

—  59.6% in real terms adjusted by the GDP deflator; and

—  42.0% after accounting for NHS specific inflation.

  3.  Between 2003-04 and 2007-08, net NHS resources increase by:

—  60.6% in cash terms; and

—  41.8% in real terms adjusted by the GDP deflator.

Table 3.2.3

CHANGE IN NET NHS EXPENDITURE 1993-94 TO 2007-08

		Net NHS expenditure(3)	Percentage Change	Real terms change(1)	Change after adjusting for NHS specific inflation(2)
		£m	%	%	%
Cash
1993-94	Outturn	28,942	—	—	—
1994-95	Outturn	30,590	5.7	4.1	3.0
1995-96	Outturn	31,985	4.6	1.7	0.8
1996-97	Outturn	32,997	3.2	-0.4	0.3
1997-98	Outturn	34,664	5.1	2.0	2.9
1998-99	Outturn	36,608	5.6	2.9	1.6
1999-2000	Outturn	39,881	8.9	6.8	4.1
Stage 1 Resource Basis
1999-2000	Outturn	40,201	—	—	—
2000-01	Outturn	43,932	9.3	7.9	5.0
2001-02	Outturn	49,021	11.6	8.9	6.5
2002-03	Outturn	53,850	9.9	6.5	6.1
Stage 2 Resource Basis
2002-03	Estimated outturn	55,724	—	—	—
2003-04(4)	Plan	63,001	13.1	10.2	8.0
2004-05	Plan	69,710	10.6	8.4
2005-06	Plan	76,388	9.6	6.9
2006-07	Plan	84,324	10.4	7.5
2007-08	Plan	92,643	9.9	7.0

  Notes

  1.  Change after adjusting for the GDP deflator (30 June 2005).

2.  NHS specific inflation index is available of the period up to 2003-04.

3.  NHS Expenditure Figures for the period 1999-2000 to 2007-08 are consitent with Table 2.2.1.

4.  NHS expenditure figures for 2002-03 to 2007-08 have been adjusted for classification changes by HMT. As a result, growth in NHS expenditure in 2003-04 is distorted. Once these are adjusted for, real terms growth in NHS expenditure in 2003-04 is 7.3%.

  3.2.4  Could the Department please update the information provided in response to last year's questionnaire in relation to the construction of the NHS inflation index from main sub-indices of pay and other factor costs since 1992, and comment on the assumptions underlying this construct? Would the Department provide the weights used for each sub-index, for each year? [3.2.4]

  ANSWER

  1.  The NHS inflation is constructed using 5 sub-indices. These are listed below and shown in Table 3.2.4(a).

—  HCHS pay index: This measures the change in average pay-bill per head of those employed within the HCHS;

—  HCHS price inflation: This measures the change in the price of goods and services supplied to the HCHS, it is measured by the Health Service Cost Index;

—  HCHS Capital Inflation Index: This reflects the changes in prices experienced in HCHS capital projects and is calculated using a mixture of the construction price index and the GDP deflator;

—  FHS Index: This is produced using different assumptions for each of the main groups. For general medical services and general dental services, inflation is calculated as the increase in the average cost per practitioner. For both services, the change in unit costs includes volume and quality effects as well as pure price effects. For pharmaceutical services and general ophthalmic services, service inflation is assumed equal to movements in the GDP deflator;

—  The "other" Index: This comprises of the revenue and capital expenditure on Central Health Miscellaneous Services (CHMS) and Departmental Administration (including the Medicines Control Agency and NHS Estates). The GDP deflator is used in the absence of service specific deflators.

  2.  The weights attached to each of the elements for each of the years are shown in Table 3.2.4(b).

  3.  The weights attached to each of the elements are similar in magnitude to last year, however, they have changed considerably since 2001-02. This is due to an increase in the number of PCTs from 164 to 304. PCTs have progressively taken over the commissioning of healthcare from health authorities but also the provision of some services from NHS trusts. The revenue expenditure for the provider function cannot be accurately eliminated from the total revenue expenditure hence year on year increases in total revenue expenditure are not comparable.

  4.  Change in weights (specifically FHS and HCHS) from 2003-04 is due to a shift in responsibility of healthcare to PCTs.

Table 3.2.4(a)

NHS INFLATION SUB-INDICES

Year	HCHS	HCHS	HCHS	FHS	Other	NHS
	Pay	Prices	Capital			total
1992-93	100.0	100.0	100.0	100.0	100.0	100.0
1993-94	104.2	101.4	104.4	100.6	102.5	102.7
1994-95	107.7	102.3	112.9	102.9	103.8	105.4
1995-96	112.5	105.6	118.0	105.5	106.8	109.3
1996-97	116.2	107.2	119.7	109.0	110.2	112.4
1997-98	119.1	107.6	124.7	112.2	113.6	114.8
1998-99	124.9	110.3	128.5	115.6	116.7	119.3
1999-2000	133.5	111.6	132.1	120.3	119.5	124.8
2000-01	142.7	111.2	139.7	123.6	122.2	129.9
2001-02	154.5	111.3	148.8	126.2	125.3	136.1
2002-03	162.3	112.8	155.4	130.1	129.5	140.8
2003-04	174.2	113.9	149.3	136.1	133.2	147.5

Table 3.2.4(b)

NHS INFLATION WEIGHTS

Year	HCHS	HCHS	HCHS	FHS	Other	NHS
	Pay	Prices	Capital			total
1992-93	49%	21%	6%	21%	3%	100%
1993-94	49%	21%	5%	22%	3%	100%
1994-95	49%	21%	6%	22%	3%	100%
1995-96	49%	21%	5%	22%	3%	100%
1996-97	50%	21%	4%	23%	2%	100%
1997-98	47%	25%	3%	23%	2%	100%
1998-99	47%	25%	3%	22%	2%	100%
1999-2000	46%	24%	3%	24%	2%	100%
2000-01	46%	22%	4%	26%	2%	100%
2001-02	47%	21%	4%	26%	2%	100%
2002-03	48%	32%	4%	14%	2%	100%
2003-04	45%	30%	4%	18%	2%	100%

3.3  Hospital and Community Health Services Allocations and Distance from Targets

  3.3.1  Could the Department please update the information provided in table 3.3.1 in response to last year's questionnaire on expenditure covering HCHS and FHS for each SHA area together with estimates of distances from target needs based expenditure? [ 3.3.1]

  ANSWER

  1.  The information requested is provided in Table 3.3.1.

  2.  Table 3.3.1 has been updated to show the 2006-07 and 2007-08 revenue allocations to PCTs and distances from target at SHA level. The 2003-06 and 2006-08 revenue allocations cover hospital and community health services (HCHS), prescribing (the drugs bill), general medical services discretionary (general practice infrastructure) and HIV/AIDS. As a result of implementing the new GMS contract, the 2006-07 and 2007-08 revenue allocations also cover primary medical services.

  3.  The 2006-07 and 2007-08 revenue allocations represent £135 billion investment in the NHS, £64 billion to primary care trusts (PCTs) in 2006-07 and £70 billion in 2007-08. Over the two years covered by this allocation PCTs will receive an average increase of 19.5%.

---

---

Prepared 5 May 2006