Memorandum from NHS East Midlands (EM2-16)
1.1. NHS East Midlands is the guardian of
the NHS in our region, holding to account local commissioners.
Our role is to translate and communicate national policy, set
direction and support and develop all NHS Trust bodies (Primary
Care Trusts and NHS Trusts providing acute, mental health and
ambulance services).
1.2. We ensure that local health systems
operate effectively and efficiently for all of our communities.
This includes making certain that national standards and priorities
are met so that the population of the East Midlands is cared for
in high quality, safe environments and that services are continuously
improved and developed. An absolute priority for us is improving
health and reducing inequalities.
1.3. The East Midlands has nine Primary
Care Trusts (PCTs). They are the leaders of the local health communities
and are responsible for commissioning health and healthcare services
for their local population. These organisations hold their community's
share of the regional NHS budget. They serve a range of rural,
inner city and urban populations.
1.4. NHS East Midlands was formally established
on 1 July 2006, replacing the former Leicestershire, Northamptonshire
and Rutland Strategic Health Authority and Trent Strategic Health
Authority.
1.5. NHS East Midlands is ultimately responsible
to the Secretary of State for Health.
2.1. Following the Committee's "call
for evidence" in July 2009, NHS East Midlands provided a
submission to the Inquiry through an agreed process with the Government
Office for the East Midlands.
2.2. The NHS East Midlands contribution
sat as part of the Government Office's memorandum (EM02-01), however
we would like to reiterate the evidence provided earlier with
some additional supplementary information.
3.1. Department for Health regional revenue
funding allocations to NHS were—£6.4 billion in
2009-10 and £6.7 billion in 2010-11. It represents
approximately 8% of the national (England) share of revenue allocations
totals of £80 billion in 2009-10 and £84 billion
in 2010-11.
3.2. NHS revenue allocations are made primarily
to Primary Care Trusts as they are the commissioning organisations.
Hospitals and Mental Health Trusts generate their income from
being commissioned (primarily by the Primary Care Trusts) to provide
health and social care services.
3.3. Under the pre-2009-10 funding
formula all Primary Care Trusts in the East Midlands were "under
target"—where actual funding was less than the assessed
funding needs.
3.4. All 9 Primary Care Trusts in the
region remain "under target" at present with 8 PCTs
in the worst 20 for distance from target. This has led to
claims that the region's health organisations are being under-funded
and that the region is not receiving its "fair share".
3.5. The new (2009-10) funding formula recognises
the higher needs of Primary Care Trusts in the East Midlands and,
as a consequence, East Midlands Primary Care Trusts benefit directly
from higher levels of growth funding.
3.6. The average growth in allocations for
Primary Care Trusts in the East Midlands is 12.3% over the two
years, 2009-10 and 2010-11, compared with the England average
of 11.3%.
3.7. All but one of the region's Primary
Care Trusts (Derby City PCT) is in the top two deciles for growth
over the two years 2009-10 and 2010-11. Bassetlaw PCT received
the highest growth of any PCT for 2009-10 and 2010-11—17.1%
over the two years.
3.8. Funding is allocated nationally by
the Department for Health using a new (for 2009-10) weighted capitation
formula overseen by the Advisory Committee on Revenue Allocation—an
independent committee that advises Ministers on possible changes
to the formula prior to each round of revenue allocations. Funding
is allocated to Primary Care Trusts on the basis of the relative
needs of their populations. The weighted capitation formula is
used to determine Primary Care Trusts ' target shares of resources
to enable them to commission similar levels of healthcare for
populations with similar healthcare need. The formula is made
up of several components—population, age, need, market forces
and health inequalities.
4.1. The table below provides a detailed
breakdown of revenue allocations to East Midlands Primary Care
Trusts in 2009-10 and 2010-11.
| Primary Care Trust
| 2009-10 allocation £000s | 2010-11 allocation £000s
| % 0f
national budget | Two year increase £000s
| Two year increase % | 2010-11 closing
DFT %[44]
|
Bassetlaw PCT | 167,978
| 182,407 | 0.2160% | 26,671
| 17.10% | -6.20% |
| Derbyshire County PCT | 1,048,875
| 1,107,225 | 1.3114% | 118,065
| 11.90% | -6.20% |
| Lincolnshire Teaching PCT | 1,060,265
| 1,127,697 | 1.3356% | 136,737
| 13.80% | -6.20% |
| Nottingham City PCT | 487,694
| 514,727 | 0.6096% | 53,945
| 11.70% | -6.20% |
| Nottinghamshire County Teaching PCT |
943,520 | 997,415 | 1.1813%
| 105,012 | 11.80% | -6.20%
|
| Leicester City PCT | 488,731 |
515,611 | 0.6107% | 58,787
| 12.90% | -6.10% |
| Derby City PCT | 405,847 |
428,169 | 0.5071% | 43,479
| 11.30% | -5.80% |
| Leicestershire County and Rutland PCT |
830,158 | 879,975 | 1.0422%
| 93,096 | 11.80% | -5.60%
|
| Northamptonshire Teaching PCT | 927,249
| 983,436 | 1.1648% | 104,527
| 11.90% | -1.40% |
14 January 2009
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44
DFT-Distance from Target: the percentage difference between actual
funding and assessed funding needs. Back
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