Public Expenditure on Health and Personal Social Services 2008 - Health Committee Contents


3.  System Reform

3.1.1  What has NHS expenditure on the purchase of healthcare from non-NHS bodies been in each year since 1997-98? Could the Department provide a detailed breakdown of these data where available? What efforts are being made to ensure this information is available from Foundation Trusts?(Q16)

Answer

  1.  Table 16a shows the overall spending on healthcare provided by non-NHS bodies. Figures are from annual financial returns and for 2006-07 and 2007-08 from audited PCT summarisation schedules and should be reliable.

  2.  The figures show the total purchase of healthcare from non-NHS bodies and so include nursing care spend (for non-NHS staff). The data in the table include expenditure on services provided by all non-NHS bodies, including local authorities and other statutory bodies, as well as independent healthcare providers. The figures cannot be broken down between acute and non-acute.

  3.  From 2006-07, new analysis is available showing how non-NHS spend by PCTs, which accounts for 95% of the total, is spread across different types of provider (see Table 16b).

  4.  The responsibilities of NHS foundation trusts (NHS FTs) to provide information externally are set out in the NHS Act 2006. Under s48, the Terms of Authorisation for NHS FTs:

    —  must require the trust to disclose such information as the SofS specifies to Monitor; and

    —  may require the trust to disclose other information to Monitor.

  5.  NHS FTs have independent status in the NHS and are free from SofS's powers of direction. The earned autonomy enjoyed by foundation status is a fundamental part of health reform and it is important that this is properly protected. The Department has worked with Monitor and others to ensure that only information determined as necessary is collected from the NHS FT sector eg to support policy development, standard setting, funding decisions for the NHS etc. All data returns from NHS FTs are set out in schedule 6 of each Authorisation in accordance with the legislation and principles set out in guidance.

  6.  NHS FTs are not required to complete information data requests that do not fit with mandatory requirements. In this specific case, these data will be included as part of each NHS foundation trust's annual accounts, which they must present before Parliament each year. Monitor is also obliged to prepare a report each year that presents an overall summary of the accounts of NHS foundation trusts and lay this before Parliament, which is published on the Monitor website. These show that between 2004-05 and 2006-07 the non-NHS spend by NHS foundation trusts was £15 million, £20 million and £48 million respectively. Figures for 2007-08 are not yet available.

Table 16a

EXPENDITURE BY NHS BODIES ON THE PURCHASE OF HEALTHCARE FROM NON-NHS BODIES

£ thousands
YearHealth authorities/ Primary careNHS trusts Total expenditure
strategic health authorities trusts


1997-98
985,746 n/a122,4361,108,182
1998-991,108,471n/a 121,9541,230,425
1999-20001,166,412n/a 134,7841,301,196
2000-011,328,20833,774 187,1901,549,172
2001-021,136,793409,936 246,2381,792,967
2002-0327,2341,873,925 338,1722,239,331
2003-043,3292,903,763 408,8013,315,893
2004-0503,353,036 312,9883,666,024
2005-0604,096,300 319,2314,415,531
2006-0704,700,373 297,4404,997,813
2007-0805,718,197 295,0796,013,276


Source:

Financial Planning and Allocations, DH.

Annual Financial Returns of Health Authorities, 1997-98 to 2001-02.

Annual Financial Returns of Strategic Health Authorities, 2002-03 to 2007-08.

Annual Financial Returns of NHS Trusts, 1997-98 to 2005-06.

Audited NHS Trust summarisation schedules 2006-07 and 2007-08.

Annual Financial Returns Primary Care Trusts, 2000-01 to 2005-06.

Audited PCT summarisation schedules 2006-07 and 2007-08.

Footnote:

1.  2004-05, 2005-06, 2006-07 and 2007-08 NHS trusts data does not include NHS foundation trusts.


Table 16b

EXPENDITURE BY PCTs ON THE PURCHASE OF HEALTHCARE FROM NON-NHS BODIES, 2006-07 AND 2007-08

£ million
Spend with2006-07 2007-08


ISTCs
200 314
Other private sector providers1,992 2,602
Voluntary sector366 421
Local authorities1,487 1,936
Other655445
Total spend by PCTs4,700 5,718


Source:

Financial Planning and Allocations, DH.

(Audited PCT summarisation schedules 2006-07 and 2007-08).

Footnote:

1.  Figures for 2006-07 have been restated following further validation.





 
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Prepared 8 December 2008